bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Hydraulic Heat Engine Based on Ferrofluid Displacer With Applications in Solar Power Generation
Authors: Saadat Mohsen , Mirzakhanloo Mehdi , Gagnon Pieter , Alam Mohammad-Reza
Published: November 2017

Conventional closed cycle heat engines — such as Stirling engines — have many advantages, such as high theoretical efficiency and the ability to produce useful work out of any heat source. However, they suffer from low power density due to poor heat transfer capability between the working gas and its surrounding walls. In this work, we proposed a new architecture where the solid displacer of a Stirling engine is replaced with a ferrofluid liquid displacer. In this approach, the relative displacer location with respects to the engine chamber is controlled (and stabilized) through a strong magnetic field generated by a permanent magnet. The liquid nature of the displacer allows the hot and cold chambers of the engine to be filled with porous material, improving the heat transfer by an order of magnitude. Additionally, this engine architecture mitigates sealing issues, can operate at higher pressures, and has naturally lubricating surfaces. A relatively simple configuration of this idea is modeled in this work. Exploratory dynamic simulations of this unoptimized architecture show a thermal efficiency of 21% and a power density of approximately 700W/lit.
Human Intention Estimation With Tactile Sensors in Human-Robot Collaboration
Authors: Wang Yiwei , Sheng Yixuan , Wang Ji , Zhang Wenlong
Published: November 2017

In this paper, machine learning methods are proposed for human intention estimation based on the change of force distribution on the interaction surface during human-robot collaboration (HRC). The force distribution under different human intentions are examined when the human and robot are jointly carrying the same piece of object. A pair of Robotiq tactile sensors is applied to monitor the change of force distribution on the interaction surface. Three machine learning algorithms are tested on recognition of human intentions based on the force distribution patterns on the contact surface of grippers for the manipulator. The K-nearest Neighbor model is selected to build a real-time framework, which includes human intention estimation and cooperative motion planning for the robot manipulator. A real-time experiment is conducted to validate the method, which suggests the human intention estimation approach can help enhance the efficiency of HRC.
Estimation of Remaining Useful Life of an Intake Air Filter in an Automotive Engine
Authors: Jammoussi Hassene , Landolsi Fakhreddine , Makki Imad
Published: November 2017

The intake air filter monitor is a diagnostics/prognostics feature that aims to determine the condition of the intake air filter in the internal combustion engine. This feature is required to indicate the need for maintenance whenever the filter is clogged to the point where the engine performance may be impacted. The prognostics of the air filter helps in saving on operational costs, maintaining the optimal fuel economy, and planning for service/maintenance before failure.

In this paper, one diagnostics/prognostics method is reviewed and a generic statistics based process is proposed to convert the percent life remaining of the air filter into time and distance indicators. The estimated indicators are determined based on the vehicle driving statistics together with the degradation rate of the filter. These indicators provide more meaningful real time information to the driver or fleet owner than a percentage of the remaining life. The proposed method was validated based on driving data of a production vehicle obtained from Ford big data drive (BDD), combined with simulated degradation profile of the air filter.
Safe Navigation With the Collision Avoidance of a Brownian Motion Obstacle
Authors: Munishkin Alexey A. , Milutinović Dejan , Casbeer David W.
Published: November 2017

This paper develops a control that combines deterministic and stochastic optimal control solutions to the problem of safe navigation around a spherical obstacle in order to reach a way-point location. The solution for navigation towards the way-point is based on the deterministic minimum time optimal control. Since the intent of the obstacle is unknown to the navigating vehicle, the vehicle anticipates this uncertainty and uses a stochastic optimal control for navigation around the obstacle. The two navigation solutions are combined based on their value functions. Results are illustrated by numerical simulations.
On the State Estimation of an Agonistic-Antagonistic Muscle System
Authors: Nguyen Thang , Warner Holly , Mohammadi Hanieh , Simon Dan , Richter Hanz
Published: November 2017

In this paper, an agonistic-antagonistic muscle system is presented. This dual muscle system is based on the Hill muscle model. The problem of estimating the state variables and activation signals of the dual muscle system is addressed. A proposed estimation scheme which combines a super-twisting observer and an input estimator is given to provide a solution to the problem. A backstepping control method is used to track a reference trajectory. Numerical results are conducted to show that the relative error for state estimation is about 1% and that for the unknown inputs is about 3% when the measurements of the length of a muscle and its nonlinear spring force are affected by noise profiles whose normalized amplitude is 0.005.
A Tracked Double-Bodied Vehicle for Use in Outdoor Environments
Authors: Benson Michael , Clayton Garrett M.
Published: November 2017

This paper presents an unmanned ground vehicle for use in outdoor environments. The vehicle features a two-bodied design in which the two bodies can rotate relative to each other about a fixed axis. The vehicle uses tracked locomotion for performance in rugged environments and a linear actuator for control of the bodys’ relative orientation. A spring-damper is used to mitigate vibrations due to surface conditions that would add noise to the sensors. A nonlinear model for the vehicle is introduced, and linearized. Design considerations of the suspension system are discussed, including the reduction of vibrations and the maximization of contact forces. Finally, the vehicle dynamics are simulated for the linear and nonlinear models, and the effectiveness and computation time of the two are compared.
Maneuverability and Heading Control of a Quadruped Robot Utilizing Tail Dynamics
Authors: Saab Wael , Ben-Tzvi Pinhas
Published: November 2017

This paper presents modeling and analysis of a quadruped robot that utilizes tail dynamics to control its heading angle. The tail is envisioned to assist locomotion as a means separate from its legs to generate forces and moments to improve performance in terms maneuverability. Tail motion is analyzed for both low and high-speed tail actuation to derive sufficient conditions to maintain equilibrium and formulate maneuverability relations that result in rotation and translation of the robotic system. Sensitivity analysis is presented to select optimal tail mass and length ratios to maximize the change of the heading angle. A heading controller is then proposed and simulated to achieve a desired heading angle utilizing tail dynamics. Results of this research will assist in the design, modeling, and analysis of robotic systems sharing similar topologies to the proposed model, such as mobile robots with wheeled, tracked, multi-legged, or articulated-body based locomotion with swinging extremities such as tails, torsos, and limbs.
Designing Robust Ultrafiltration Rate Profiles Based on Identifying Fluid Volume Model Parameters During Hemodialysis
Authors: Abohtyra Rammah M. , Hollot C. V. , Horowitz J. , Germain M. G. , Chait Y.
Published: November 2017

Chronic dialysis is a necessary treatment for end-stage kidney disease (ESKD) patients in order to increase life span, with hemodialysis (HD) being the dominant modality. Despite significant advances in HD technology, only half of ESKD patients treated with this modality survive more than 3 years. Fluid management remains one of the most challenging aspects of HD care, with serious implications for morbidity and mortality. Ultrafiltration has been associated with intradialytic hypotension, also associated with adverse outcomes. Therefore, removing a specified fluid volume to achieve an adequate balance without negative outcomes remains a critical challenge to improving patient outcomes. Therefore, it has been suggested that in addition to blood pressure information, routine HD treatments should include blood volume monitoring. Sensors integrated in dialysis machines are able to track the concentration of various blood components, such as hematocrit, with high accuracy and resolution and to derive a relative blood volume (RBV) changes.

In this paper, we propose a novel algorithm to design an optimal, robust ultrafiltration rate profile based on identifying the parameters of a fluid volume model of an individual patient during HD and RBV sensor. Our design achieves, if exists, an optimal ultrafiltration profile for the identified nominal model under maximum ultrafiltration and hematocrit constraints, and guarantees that these constraints are satisfied over a pre-defined set of parameter uncertainty. We demonstrate the performance of our algorithm through a combination of clinical data and simulations.
Distributed Estimation and Tracking Using Time-Difference-of-Arrival (TDOA) Measurements
Authors: Ennasr Osama N. , Tan Xiaobo
Published: November 2017

Localization and tracking of a moving target arises in many different contexts and is an important problem in the field of wireless sensor networks. One class of localization schemes exploits the time-difference-of-arrival (TDOA) of a signal emitted by the target and detected by multiple sensors. Much of the existing work on TDOA-based target localization and tracking adopts a centralized approach, where all measurements are sent to a reference agent which produces an estimate of the target’s location. In this work, we propose a fully distributed approach to target localization and tracking by a group of mobile robots. Specifically, we utilize a Networked Extended Kalman Filter (NEKF) to estimate the target’s location in a distributed manner. The target location estimates by individual robots, which are shown to converge to the true value, are then fed into a distributed control law that maintains a specified formation of the robots around the target, which optimizes the estimation accuracy. In order to reduce the energy expenditure of the robots, we further propose a movement control strategy based on the Cramer-Rao bound to balance the trade-off between estimation performance and the total distance traveled by the robots. A numerical example involving robots with unicycle dynamics is provided to illustrate the performance of the proposed approach.
Adaptive Control Design for Nonlinear Systems via Successive Approximations
Authors: Babaei Naser , Salamci Metin U. , Karakurt Ahmet Hakan
Published: November 2017

The paper presents an approach to the Model Reference Adaptive Control (MRAC) design for nonlinear dynamical systems. A nonlinear reference system is considered such that its response is designed to be stable via Successive Approximation Approach (SAA). Having designed the stable reference model through the SAA, MRAC is then formulated for nonlinear plant dynamics with a new adaptation rule to guarantee the convergence of the nonlinear plant response to that of the response of the nonlinear reference model. The proposed design methodology is illustrated with examples for different case studies.
Evaluation Metrics of Upper Extremities for People With Neurological Disorders: An Energy Based Approach
Authors: Ilia Theodosis , Louca Loucas S.
Published: November 2017

Various neurological disorders, like Parkinson’s disease, Multiple Sclerosis, Huntington’s disease and Stroke, affect millions of people worldwide. Tremor that is a result of these disorders affects the performance of many Activities of Daily Living such as dressing, bathing, self-care, and writing, which reduces the functional independence and self-rated quality of life. Standardized rating scales have been developed, however, these scales display some degree of variability due to their subjective/qualitative approach. Therefore, the accurate and objective measure of a patient’s condition is crucial. Due to the lack of objectivity and accuracy from conventional procedures, there is a need to develop an objective evaluation system. In this work, a horizontal movement test is implemented in a Virtual Environment with the use of a Haptic Interface. The proposed test consists of a simple reaching task (more tasks are under development) for defining quantitative metrics. Wrist motion is accurately measured using the haptic interface and analyzed to calculate evaluation metrics based on the joint energy and spatial deviation from the ideal path. To improve the sensitivity of the metrics, a harmonic disturbance force is applied by the haptic interface to the user. The disturbance frequency is varied from 1 to 7 Hz and the duration of the movement is constraint to be constant. Fourteen healthy adults performed the experiments with 10 to 21 repetitions for each movement conditions. The results show that all users spend higher energy to complete the test at frequencies around 2.5 Hz. The statistical analysis indicates that energy is a reliable evaluation metric, with low variance, that can be used to quantify upper extremities.
Non-Model-Based Delamination Detection of Composite Plates Using Measured Mode Shapes
Authors: Xu Y. F. , Chen Da-Ming , Zhu W. D.
Published: November 2017

Delamination is one type of damage that frequently occurs in laminated composite structures, and identification of such damage has been a major research topic in the past few decades. This paper proposes an accurate non-model-based method for delamination identification of laminated composite plates. A weighted mode shape damage index is formulated using squared weighted difference between a measured mode shape of a composite plate with delamination and one from a polynomial that fits the measured mode shape of the composite plate with a proper order. Weighted mode shape damage indices associated with at least two measured mode shapes of the same mode are synthesized to formulate a synthetic mode shape damage index to exclude some false positive identification results due to measurement noise and error. An auxiliary mode shape damage index is proposed to further assist delamination identification, by which some false negative identification results can be excluded and edges of a delamination area can be accurately and completely identified. Numerical examples are presented to investigate effectiveness of the proposed method, and it is shown that edges of a delamination area in composite plates can be accurately and completely identified when measured mode shapes are contaminated by measurement noise and error.
A Data Model for Turbulence Analysis Downstream of an Ocean Current Turbine Rotor for Hydrokinetic Power Generation
Authors: Shang Yuchen , Xiros Nikolaos I. , VanZwieten James H. , Sultan Cornel
Published: November 2017

Neural networks are derived to be used as closed-form representations of mean hydrokinetic turbine performance variables. These representations can be used to obtain estimates of turbine performance when the ambient turbulence characteristics, namely in-flow velocity and turbulence intensity, are given. The neural networks were developed using a detailed hydrodynamic code, which simulates performance of a rigidly mounted hydrokinetic turbine where only rotor rotation is allowed (1-DOF). By varying the in-flow velocity (U) of the water current between 0.4m/s and 2.6m/s with a step of 0.2m/s, as well as Turbulence Intensity (TI) between 5% and 20% with a step of 2.5%, a set of variables including the output shaft power, shaft torque, force on a single blade and drag force were obtained for each case. The obtained data sets were used to train appropriately sized, feed-forward (i.e. without recirculation) neural networks. Four neural networks obtained, one for each output variable of the hydrodynamic code. Each neural net constitutes a closed-form, explicit mathematical relationship (equation) generating estimates for the corresponding dependent variable it has been trained to approximate, when presented with specific values for the independent (input) variables current velocity, U, and turbulence intensity, TI. Four output (dependent) variables of interest of the hydrodynamic code are considered: shaft power, shaft torque, force on a single blade and drag. The dependent variables are actually time-averaged steady-state values derived from each hydrodynamic code run. The results of the neural networks are validated using the background theory, as well as the data generated by the hydrodynamic code. Error of less than 1% has been achieved between the neural net output and the hydrodynamics code data values suggesting that the neural networks and the equations are usable in place of the hydrodynamic code for estimating time-averaged loadings and power production.
Non-Linear Sliding Mode Control of a Tilting-Rotor Quadcopter
Authors: Sridhar Siddharth , Kumar Rumit , Radmanesh Mohammadreza , Kumar Manish
Published: November 2017

A non-linear control of a tilt-rotor quadcopter using sliding mode technique is presented in this paper. The tilt-rotor quadcopters are a novel class of quadcopters with a servo motor installed on each arm that enables the quadcopter’s rotors to tilt to a particular angle. Using these additional tilt angles, this type of a quadcopter can be used to achieve desired trajectories with faster maneuvering and can handle external disturbances better than a conventional quadcopter. In this paper, sliding mode control technique is utilized for the pitch, roll and yaw motions for the quadcopter while an independent PD controller provides the tilt angles to the servo motors. The dynamic model of the tilt-rotor quadcopter is presented, based on which sliding surfaces were designed to minimize the tracking errors. Using the control inputs derived from these sliding surfaces, the state variables converge to their desired values in finite-time. Further, the non-linear sliding surface coefficients are obtained by stability analysis. Numerical simulation results demonstrate the performance and robustness against disturbances of this proposed sliding mode control technique.
On the Modeling and Analysis of an Energy Harvester Moving Vibration Absorber for Power Lines
Authors: Barry Oumar , Bukhari Mohammad
Published: November 2017

Wind-induced vibration of power lines has been a major challenge for design engineers for decades. Hitherto, there is no effective devices that can suppress these vibrations throughout a wide range of resonant frequencies. This paper presents a promising vibration suppression technique using an energy harvester moving vibration absorber (EHMVA), which can simultaneously harvest energy and suppress the vibrations. The vibration-based energy harvesting can be achieved using an electromagnetic transducer, which replaces the viscous damping element of conventional absorbers. This harvested energy can then be utilized to power small sensors and electronic devices required for EHMVA to adapt to wind characteristics and move to an optimum location, thus leading to potentially superior vibration control. The coupled dynamics between a single conductor and EHMVA is presented and numerical examples are carried out to investigate the performance of the proposed absorber. The findings are very promising and open a horizon of future opportunities to optimize the design of EHMVAs for superior performance.
Identification of Hydrodynamic Coefficients of a Robotic Fish Using Improved Extended Kalman Filter
Authors: Dang Fengying , Zhang Feitian
Published: November 2017

Bio-inspired robotic fish have received an increasingly rapid development in recent years due to their advanced performances, such as high energy efficiency and high maneuverability. An accurate dynamic model is essential to the design and control of such robots. Hydrodynamic co-efficients play an important role in modeling the robot, which are usually obtained from theoretical calculation or water tunnel experiments. This paper proposes a novel method for hydrodynamic coefficients identification using an improved Kalman filter with angular velocity and distributed pressure measurements, which are typically available from the robot’s on-board sensors. Simulation based on a Joukowski airfoil shaped robotic fish demonstrates the proposed method.
Vulnerabilities of Cyber-Physical Linear Control Systems to Sophisticated Attacks
Authors: Radisavljevic-Gajic Verica , Park Seri , Chasaki Danai
Published: November 2017

The purpose of this paper is to examine fundamentals of linear control systems and consider vulnerability of the main cyber physical control system features and concepts under malicious attacks, first of all, stability, controllability, and observability, design of feedback loops, design and placement of sensors and controllers. The detailed study is limited to the most important vulnerability issues in time-invariant, unconstrained, deterministic, linear physical systems. Several interesting and motivations examples are provided. We outline also some basic vulnerability studies for time-invariant nonlinear systems.
Distributed ℋ∞ Frequency Control for Inverter Connected Microgrids
Authors: Chu Cheong Matthew K. , Qian Haiya , Conger Julia , Chen Dongmei , Du Pengwei
Published: November 2017

Microgrids are small-scale power networks where distributed generation and inverter interfaced power sources are common. These networks are faced with more significant control challenges; a smaller system can less effectively dampen and distribute power disturbances or fluctuations, and the system frequency is less robust without synchronous generators to provide rotational inertia. In this paper we will develop optimal control algorithms to control the voltage and frequency in an islanded inverter-based microgrid. The voltages and frequency of this system are controlled using decentralized ℋ∞ control. The decentralized controllers operate using only local data, making the control methodolgy scalable. In addition, the studied controllers can be tuned to achieve the desired transient behavior. For voltage and frequency control of microgrids, transient performance is still an area of weakness. The proposed control scheme extends optimal control to the field of microgrid control and can improve the state of microgrid technology.
Identification of Nonlinear Friction Properties in the Conditions of Self-Excited Vibrations
Authors: Piatkowski Tomasz , Wolski Miroslaw , Osowski Przemyslaw
Published: November 2017

The paper presents method of the friction coefficient characteristics determination for kinematic pairs in the self-excited vibration conditions occurring in the Froude pendulum. Friction coefficients were calculated by measuring the vibration amplitude of the pendulum. Measurement of this amplitude for kinetic friction coefficient is carried out in the conditions of sliding friction and a static one — when the conditions of stickslip phenomena exist. The proposed method was verified using the LuGre friction model.
Reliability of individual differences in degraded speech perception
Authors: Carbonell Kathy M.
Published: November 2017

Listeners' speech perception abilities vary extensively in challenging listening conditions. There is little evidence as to whether this variability is a result of true, stable individual differences or just variability arising from measurement error. This study examines listeners’ word recognition abilities across multiple sessions and a variety of degraded speech tasks (noise-vocoded, time-compressed, and speech in babble noise). Participants transcribed isolated single syllable words presented in all three degradation types and repeated these tasks (with different words) on a separate day. Correlations of transcription accuracy demonstrate that individual differences in performance are reliable across sessions. In addition, performance on all three degradation types was correlated. These results suggest that differences in performance on degraded speech perception tasks for normal hearing listeners are robust and that there are underlying factors that promote the ability to understand degraded speech regardless of the specific manner of degradation. Uncovering these general performance factors may provide insight into the salient performance variance observed in listeners with hearing impairment.
Noise interference with echo delay discrimination in bat biosonar
Authors: Simmons J. A.
Published: November 2017

Echolocating big brown bats (Eptesicus fuscus) were trained in a two-choice task to discriminate differences in the delay of electronic echoes at 1.7 ms delay (30 cm simulated range). Difference thresholds (∼45 μs) were comparable to previously published results. At selected above-threshold differences (116 and 232 μs delay), performance was measured in the presence of wideband random noise at increasing amplitudes in 10-dB steps to determine the noise level that prevented discrimination. Performance eventually failed, but the bats increased the amplitude and duration of their broadcasts to compensate for increasing noise, which allowed performance to persist at noise levels about 25 dB higher than without compensation. In the 232-μs delay discrimination condition, echo signal-to-noise ratio (2E/N0) was 8–10 dB at the noise level that depressed performance to chance. Predicted echo-delay accuracy using big brown bat signals follows the Cramér-Rao bound for signal-to-noise ratios above 15 dB, but worsens below 15 dB due to side-peak ambiguity. At 2E/N0 = 7–10 dB, predicted Cramér-Rao delay accuracy would be about 1 μs; considering side-peak ambiguity it would be about 200–300 μs. The bats' 232 μs performance reflects the intrusion of side-peak ambiguity into delay accuracy at low signal-to-noise ratios.
Generation of specific inhibitors of SUMO-1– and SUMO-2/3–mediated protein-protein interactions using Affimer (Adhiron) technology
Authors: Hughes David J. , Tiede Christian , Penswick Natalie , Tang Anna Ah-San , Trinh Chi H. , Mandal Upasana , Zajac Katarzyna Z. , Gaule Thembaninskosi , Howell Gareth , Edwards Thomas A. , Duan Jianxin , Feyfant Eric , McPherson Michael J. , Tomlinson Darren C. , Whitehouse Adrian
Published: November 2017

Artificial binding proteins are tools for exploring cellular processes dependent on SUMOylation.
MAFB enhances oncogenic Notch signaling in T cell acute lymphoblastic leukemia
Authors: Pajcini Kostandin V. , Xu Lanwei , Shao Lijian , Petrovic Jelena , Palasiewicz Karol , Ohtani Yumi , Bailis Will , Lee Curtis , Wertheim Gerald B. , Mani Rajeswaran , Muthusamy Natarajan , Li Yunlei , Meijerink Jules P. P. , Blacklow Stephen C. , Faryabi Robert B. , Cherry Sara , Pear Warren S.
Published: November 2017

The transcription factor MAFB epigenetically facilitates Notch1-induced T cell leukemia.
Fifteen-minute consultation: A child with a suspected drug allergy
Authors: Wu Peishan , Longbottom Katherine , Hague Rosemary , Vance Gillian
Published: November 2017

Adverse drug reactions are common in children, but true drug allergy is rare. It can be difficult to determine whether signs such as skin rashes are caused by the underlying illness or medications prescribed. Accurate diagnosis is important for patient safety and optimal treatment. We review the presentation of drug allergy and discuss current management options for children.
Prospective daily diary study reporting of any and all symptoms in healthy adults in Pakistan: prevalence and response
Authors: Anwar Mudassir , Green James A , Norris Pauline , Bukhari Nadeem Irfan
Published: November 2017

Objectives

Prevalence of symptoms in everyday life and how people respond to these symptoms is little studied outside Western culture and developed countries. We sought to use modified diary methods to explore the prevalence of and responses to symptoms in Pakistan.

Design

Prospective daily survey of symptoms and response.

Setting

8 cities across four provinces in Pakistan.

Participants

Stratified intercept in each city to recruit 153 participants of which 151 completed.

Primary and secondary outcome measures

Each day for 30 days, participants were prompted by text message (short message service (SMS)) to complete a symptom diary. On days where symptoms were experienced, participants also reported how they responded. Prevalence was adjusted to population age and gender distributions.

Results

92% of participants experienced symptoms (adjusted prevalence 94%, 95% CI 91% to 97%), with musculoskeletal pain (83%, adj. 84%, 95% CI 84% to 90%) and respiratory symptoms (75%, adj. 77%, 95% CI 71% to 84%) the most prevalent types of symptoms. Self-medication and use of home remedies and traditional medicines were the most common responses. Seeking professional help or using conventional medicine were less common, and self-medication responses included the use of antibiotics without prescription. The range of home remedies and traditional medicines was very diverse.

Conclusions

While symptom experience in Pakistan was similar to Western countries, home remedies were much more frequently used to respond to symptoms. Understanding how people respond and manage their experience of symptoms outside formal healthcare is important for designing effective policy and interventions, and this needs to be understood within the broader context including the cultural and economic setting, the health system and other structural determinants of health.
The costs of functional gastrointestinal disorders and related signs and symptoms in infants: a systematic literature review and cost calculation for England
Authors: Mahon James , Lifschitz Carlos , Ludwig Thomas , Thapar Nikhil , Glanville Julie , Miqdady Mohamad , Saps Miguel , Quak Seng Hock , Lenoir Wijnkoop Irene , Edwards Mary , Wood Hannah , Szajewska Hania
Published: November 2017

Objectives

To estimate the cost of functional gastrointestinal disorders (FGIDs) and related signs and symptoms in infants to the third party payer and to parents.

Study design

To estimate the cost of illness (COI) of infant FGIDs, a two-stage process was applied: a systematic literature review and a COI calculation. As no pertinent papers were found in the systematic literature review, a ‘de novo’ analysis was performed. For the latter, the potential costs for the third party payer (the National Health Service (NHS) in England) and for parents/carers for the treatment of FGIDs in infants were calculated, by using publicly available data. In constructing the calculation, estimates and assumptions (where necessary) were chosen to provide a lower bound (minimum) of the potential overall cost. In doing so, the interpretation of the calculation is that the true COI can be no lower than that estimated.

Results

Our calculation estimated that the total costs of treating FGIDs in infants in England were at least £72.3 million per year in 2014/2015 of which £49.1 million was NHS expenditure on prescriptions, community care and hospital treatment. Parents incurred £23.2 million in costs through purchase of over the counter remedies.

Conclusions

The total cost presented here is likely to be a significant underestimate as only lower bound estimates were used where applicable, and for example, costs of alternative therapies, inpatient treatments or diagnostic tests, and time off work by parents could not be adequately estimated and were omitted from the calculation. The number and kind of prescribed products and products sold over the counter to treat FGIDs suggest that there are gaps between treatment guidelines, which emphasise parental reassurance and nutritional advice, and their implementation.
Cross-sectional study evaluating data quality of the National Cancer Registration and Analysis Service (NCRAS) prostate cancer registry data using the Cluster randomised trial of PSA testing for Prostate cancer (CAP)
Authors: Merriel Samuel William David , Turner Emma L , Walsh Eleanor , Young Grace J , Metcalfe Chris , Hounsome Luke , Tudge Isobel , Donovan Jenny , Hamdy Freddie , Neal David , Martin Richard M
Published: November 2017

Objectives

To compare the completeness and agreement of prostate cancer data recorded by the National Cancer Registration and Analysis Service (NCRAS) with research-level data specifically abstracted from medical records from the Cluster randomised triAl of prostate specific antigen (PSA) testing for Prostate cancer (CAP) trial.

Design

Cross-sectional comparison study.

Participants

We included 1356 men from the CAP trial cohort who were linked to the NCRAS registry.

Primary and secondary outcome measures

Completeness of prostate cancer data in NCRAS and CAP and agreement for tumour, node, metastases (TNM) stage (T1/T2; T3; T4/N1/M1) and Gleason grade (4–6; 7; 8–10), measured by differences in proportions and Cohen’s kappa statistic. Data were also stratified by year and pre-2010 versus post-2010, when NCRAS reporting standards changed.

Results

Compared with CAP, completeness was lower in NCRAS for Gleason grade (41.2% vs 76.7%, difference 35.5, 95% CI 32.1 to 39.0) and TNM stage (29.9% vs 67.6%, difference 37.6, 95% CI 34.1 to 41.1). NCRAS completeness for Gleason grade (pre-2010 vs post-2010 31.69% vs 64%; difference 32.31, 95% CI 26.76 to 37.87) and TNM stage (19.31% vs 55.50%; difference 36.19, 95% CI 30.72 to 41.67) improved over time. Agreement for Gleason grade was high (Cohen’s kappa, κ=0.90, 95% CI 0.88 to 0.93), but lower for TNM stage (κ=0.41, 95% CI 0.37 to 0.51) overall. There was a trend towards improved agreement on Gleason grade, but not TNM stage, when comparing pre-2010 and post-2010 data.

Conclusion

NCRAS case identification was very high; however, data on prostate cancer grade was less complete than CAP, and agreement for TNM stage was modest. Although the completeness of NCRAS data has improved since 2010, the higher completeness rate in CAP demonstrates that gains could potentially be achieved in routine registry data. This study’s findings highlight a need for improved recording of stage and grade data in the source medical records.
Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance
Authors: Zulyniak Michael A , de Souza Russell J , Shaikh Mateen , Desai Dipika , Lefebvre Diana L , Gupta Milan , Wilson Julie , Wahi Gita , Subbarao Padmaja , Becker Allan B , Mandhane Piush , Turvey Stuart E , Beyene Joseph , Atkinson Stephanie , Morrison Katherine M , McDonald Sarah , Teo Koon K , Sears Malcolm R , Anand Sonia S
Published: November 2017

Objective

Birth weight is an indicator of newborn health and a strong predictor of health outcomes in later life. Significant variation in diet during pregnancy between ethnic groups in high-income countries provides an ideal opportunity to investigate the influence of maternal diet on birth weight.

Setting

Four multiethnic birth cohorts based in Canada (the NutriGen Alliance).

Participants

3997 full-term mother–infant pairs of diverse ethnic groups who had principal component analysis-derived diet pattern scores—plant-based, Western and health-conscious—and birth weight data.

Results

No associations were identified between the Western and health-conscious diet patterns and birth weight; however, the plant-based dietary pattern was inversely associated with birth weight (β=−67.6 g per 1-unit increase; P<0.001), and an interaction with non-white ethnicity and birth weight was observed. Ethnically stratified analyses demonstrated that among white Europeans, maternal consumption of a plant-based diet associated with lower birth weight (β=−65.9 g per 1-unit increase; P<0.001), increased risk of small-for-gestational age (SGA; OR=1.46; 95% CI 1.08 to 1.54;P=0.005) and reduced risk of large-for-gestational age (LGA; OR=0.71; 95% CI 0.53 to 0.95;P=0.02). Among South Asians, maternal consumption of a plant-based diet associated with a higher birth weight (β=+40.5 g per 1-unit increase; P=0.01), partially explained by cooked vegetable consumption.

Conclusions

Maternal consumption of a plant-based diet during pregnancy is associated with birth weight. Among white Europeans, a plant-based diet is associated with lower birth weight, reduced odds of an infant born LGA and increased odds of SGA, whereas among South Asians living in Canada, a plant-based diet is associated with increased birth weight.
Long-term prognosis of young breast cancer patients (≤40 years) who did not receive adjuvant systemic treatment: protocol for the PARADIGM initiative cohort study
Authors: Dackus Gwen MHE , ter Hoeve Natalie D , Opdam Mark , Vreuls Willem , Varga Zsuzsanna , Koop Esther , Willems Stefan M , Van Deurzen Carolien HM , Groen Emilie J , Cordoba Alicia , Bart Jos , Mooyaart Antien L , van den Tweel Jan G , Zolota Vicky , Wesseling Jelle , Sapino Anna , Chmielik Ewa , Ryska Ales , Amant Frederic , Broeks Annegien , Kerkhoven Ron , Stathonikos Nikolas , Veta Mitko , Voogd Adri , Jozwiak Katarzyna , Hauptmann Michael , Hoogstraat Marlous , Schmidt Marjanka K , Sonke Gabe , van der Wall Elsken , Siesling Sabine , van Diest Paul J , Linn Sabine C
Published: November 2017

Introduction

Currently used tools for breast cancer prognostication and prediction may not adequately reflect a young patient’s prognosis or likely treatment benefit because they were not adequately validated in young patients. Since breast cancers diagnosed at a young age are considered prognostically unfavourable, many treatment guidelines recommend adjuvant systemic treatment for all young patients. Patients cured by locoregional treatment alone are, therefore, overtreated. Lack of prognosticators for young breast cancer patients represents an unmet medical need and has led to the initiation of the PAtients with bReAst cancer DIaGnosed preMenopausally (PARADIGM) initiative. Our aim is to reduce overtreatment of women diagnosed with breast cancer aged≤40 years.

Methods and analysis

All young, adjuvant systemic treatment naive breast cancer patients, who had no prior malignancy and were diagnosed between 1989 and 2000, were identified using the population based Netherlands Cancer Registry (n=3525). Archival tumour tissues were retrieved through linkage with the Dutch nationwide pathology registry. Tissue slides will be digitalised and placed on an online image database platform for clinicopathological revision by an international team of breast pathologists. Immunohistochemical subtype will be assessed using tissue microarrays. Tumour RNA will be isolated and subjected to next-generation sequencing. Differences in gene expression found between patients with a favourable and those with a less favourable prognosis will be used to establish a prognostic classifier, using the triple negative patients as proof of principle.

Ethics and dissemination

Observational data from the Netherlands Cancer Registry and left over archival patient material are used. Therefore, the Dutch law on Research Involving Human Subjects Act (WMO) is not applicable. The PARADIGM study received a ‘non-WMO’ declaration from the Medical Ethics Committee of the Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, waiving individual patient consent. All data and material used are stored in a coded way. Study results will be presented at international (breast cancer) conferences and published in peer-reviewed, open-access journals.
MONITOR-IC study, a mixed methods prospective multicentre controlled cohort study assessing 5-year outcomes of ICU survivors and related healthcare costs: a study protocol
Authors: Geense Wytske , Zegers Marieke , Vermeulen Hester , van den Boogaard Mark , van der Hoeven Johannes
Published: November 2017

Introduction

Due to advances in critical care medicine, more patients survive their critical illness. However, intensive care unit (ICU) survivors often experience long-term physical, cognitive and mental problems, summarised as post-intensive care syndrome (PICS), impacting their health-related quality of life (HRQoL). In what frequency PICS occurs, and to what extent this influences ICU survivors’ HRQoL, is mostly unknown. The aims of this study are therefore to study the: (1) 5-year patient outcomes, (2) predictors for PICS, (3) ratio between HRQoL of ICU survivors and healthcare-related costs, and (4) care and support needs.

Methods

The MONITOR-IC study is a multicentre prospective controlled cohort study, carried out in ICUs in four Dutch hospitals. Patients will be included between July 2016 and July 2021 and followed for 5 years. We estimated to include 12000 ICU patients. Outcomes are the HRQoL, physical, cognitive and mental symptoms, ICU survivors’ care and support needs, healthcare use and related costs. A control cohort of otherwise seriously ill patients will be assembled to compare long-term patient-reported outcomes. We will use a mixed methods design, including questionnaires, medical data from patient records, cost data from health insurance companies and interviews with patients and family members.

Ethics and dissemination

Insights from this study will be used to inform ICU patients and their family members about long-term consequences of ICU care, and to develop prediction and screening instruments to detect patients at risk for PICS. Subsequently, tailored interventions can be developed and implemented to prevent and mitigate long-term consequences. Additionally, insights into the ratio between HRQoL of ICU patients and related healthcare costs during 5 years after ICU admission can be used to discuss the added value of ICU care from a community perspective. The study has been approved by the research ethics committee of the Radboud University Medical Center (2016-2724).

Clinical trial registration

NCT03246334
Impact of improved insulation and heating on mortality risk of older cohort members with prior cardiovascular or respiratory hospitalisations
Authors: Preval Nicholas , Keall Michael , Telfar-Barnard Lucy , Grimes Arthur , Howden-Chapman Philippa
Published: November 2017

Objectives

We carried out an evaluation of a large-scale New Zealand retrofit programme using administrative data that provided the statistical power to assess the effect of insulation and/or heating retrofits on cardiovascular and respiratory-related mortality in people aged 65 and over with prior respiratory or circulatory hospitalisations.

Design

Quasi-experimental cohort study based on administrative data.

Setting

New Zealand.

Participants

From a larger study cohort of over 900 000 people, we selected two subcohorts: 3287 people who were aged 65 and over and had experienced pretreatment period cardiovascular-related hospitalisation (ICD-10 chapter 9), and 1561 people aged 65 and over who had experienced pretreatment respiratory-related hospitalisation (ICD-10 chapter 10).

Interventions

Treatment group individuals lived in a home that received insulation and/or heating retrofits under the Warm Up New Zealand: Heat Smart programme. Control group individuals lived in a home that was matched to a treatment home based on physical characteristics and location.

Primary and secondary outcome measures

HR for all-cause mortality for treatment with insulation, heating, or insulation and heating relative to control group.

Results

People with pretreatment circulatory hospitalisation who occupied a household that received only insulation had an HR for all-cause mortality of 0.673 (95% CI 0.535 to 0.847) (p<0.001) relative to control group members. Individuals with a pretreatment respiratory hospitalisation who occupied a household that received only an insulation retrofit had an HR for all-cause mortality of 0.830 (95% CI 0.655 to 1.051) (p=0.122) relative to control group members. There was no evidence of an additional benefit from receiving heating.

Conclusions

We interpret the hazard rate observed for cardiovascular subcohort individuals who received insulation as evidence of a protective effect, reducing the risk of mortality for vulnerable older adults. There is suggestive evidence of a protective effect of insulation for the respiratory subcohort.
Healthcare providers’ gestational weight gain counselling practises and the influence of knowledge and attitudes: a cross-sectional mixed methods study
Authors: Morris Jill , Nikolopoulos Hara , Berry Tanya , Jain Venu , Vallis Michael , Piccinini-Vallis Helena , Bell Rhonda C
Published: November 2017

Objective

To understand current gestational weight gain (GWG) counselling practices of healthcare providers, and the relationships between practices, knowledge and attitudes.

Design

Concurrent mixed methods with data integration: cross-sectional survey and semistructured interviews.

Participants

Prenatal healthcare providers in Canada: general practitioners, obstetricians, midwives, nurse practitioners and registered nurses in primary care settings.

Results

Typically, GWG information was provided early in pregnancy, but not discussed again unless there was a concern. Few routinely provided women with individualised GWG advice (21%), rate of GWG (16%) or discussed the risks of inappropriate GWG to mother and baby (20% and 19%). More routinely discussed physical activity (46%) and food requirements (28%); midwives did these two activities more frequently than all other disciplines (P<0.001). Midwives interviewed noted a focus on overall wellness instead of weight, and had longer appointment times which allowed them to provide more in-depth counselling. Regression results identified that the higher priority level that healthcare providers place on GWG, the more likely they were to report providing GWG advice and discussing risks of GWG outside recommendations (β=0.71, P<0.001) and discussing physical activity and food requirements (β=0.341, P<0.001). Interview data linked the priority level of GWG to length of appointments, financial compensation methods for healthcare providers and the midwifery versus medical model of care.

Conclusions

Interventions for healthcare providers to enhance GWG counselling practices should consider the range of factors that influence the priority level healthcare providers place on GWG counselling.