bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrating AR services for the masses: geotagged POI transformation platform
Authors: Trojan Jakub
Published: August 2016

Purpose

The purpose of this paper is to propose the platform for effective transformation of points of interests (POIs) into augmented reality (AR), specifically into the three major software tools – Junaio, Layar and Wikitude. The objective is to facilitate the creation of POIs for common users of these programs and, thus, encourage the general public to participate in the formation of a new concept of applications using AR and location-based services.

Design/methodology/approach

The subject of this study was analysis of methods used for POI dynamisation under the context of location-based services. This paper suggests methodology based on database format transformation. It is focused on the creation of platform for automated geotagged POI transformation into AR.

Findings

The research results in prototype of online platform which is capable to automatically transform geotagged POI to three major AR applications. It discusses also the model implementation of this platform in Czech national tourist authority.

Research limitations/implications

The paper presents a proof-of-concept of dynamisation and transformation of an unspecified number of POIs stored in a simple table database and their transformation into the AR.

Practical implications

Services of AR are brought for the masses to effectively dynamise tourist information.

Social implications

Results could make the process of multimedialising data (POIs) more suitable for masses.

Originality/value

This paper presents a proof-of-concept of dynamisation and transformation of an unspecified number of POIs stored in a simple table database and their transfer into the three major AR applications.
Hip-hop based interventions as pedagogy/therapy in STEM
Authors: Emdin Christopher , Adjapong Edmund , Levy Ian
Published: August 2016

Purpose

This paper aims to argue that providing youth of color with opportunities to explore content while reflecting on and sharing mental health concerns is an under-focused dimension of teaching and learning that has the potential to positively impact these students’ academic achievement in science, technology, engineering and mathematics (STEM) disciplines

Design/methodology/approach

This paper used a qualitative study to interrogate a teaching/learning model through a hip-hop-based science program.

Findings

Because urban youth of color are traditionally most disengaged in STEM and also the ones who are the least likely to seek or be provided with mental health tools/services, it is suggested that there is a connection between their low academic achievement and the absence of opportunities for them to address emotions that impact their academic success. Furthermore, if these youths come from communities where mental health stressors are highly prevalent, and teaching is most restrictive, a model for teaching that considers practices that address both their academic and mental health needs becomes necessary.

Research limitations/implications

This work does not intend to devalue or undermine the role of school counselors or traditional teachers. It is believed that the role of the school counselor or social worker when youths identify themes that go beyond the scope of personal challenges is significant and that these professionals should be made available when engaging in this type of work. It is also believed that the educator who may not be privy to hip-hop can successfully engage in this type of activity with STEM students. Finally, the use of science as an exemplar for engaging in this work does not indicate that the other STEM disciplines cannot or should not explore this type of model.

Practical implications

The paper outlines a model that other educators/researchers may use and suggests ways that this brand of research may be implemented by scholars across the country.

Social implications

Through the implementation of the hip-hop-based science program as an intervention in science classrooms, students are provided the opportunity to bolster science content knowledge and knowledge of self. In addition, utilizing the hip-hop-based science program created an avenue for teachers to develop better understanding of students and their full socioemotional selves. This is especially necessary in STEM education where perceptions of students’ decisions to not engage in the disciplines are directly related to our collective unwillingness to present the subject matter in a way that goes beyond the glorification of its stoic and “old white” history.

Originality/value

This paper suggests a new dimension of STEM research through an exploration of hip-hop culture and youth emotions.
Enabling affordable omnidirectional subsurface extended image volumes via probing
Authors: van Leeuwen Tristan , Kumar Rajiv , Herrmann Felix J.
Published: August 2016

Image gathers as a function of subsurface offset are an important tool for the inference of rock properties and velocity analysis in areas of complex geology. Traditionally, these gathers are thought of as multidimensional correlations of the source and receiver wavefields. The bottleneck in computing these gathers lies in the fact that one needs to store, compute, and correlate these wavefields for all shots in order to obtain the desired image gathers. Therefore, the image gathers are typically only computed for a limited number of subsurface points and for a limited range of subsurface offsets, which may cause problems in complex geological areas with large geologic dips. We overcome increasing computational and storage costs of extended image volumes by introducing a formulation that avoids explicit storage and removes the customary and expensive loop over shots found in conventional extended imaging. As a result, we end up with a matrix–vector formulation from which different image gathers can be formed and with which amplitude‐versus‐angle and wave‐equation migration velocity analysis can be performed without requiring prior information on the geologic dips. Aside from demonstrating the formation of two‐way extended image gathers for different purposes and at greatly reduced costs, we also present a new approach to conduct automatic wave‐equation‐based migration‐velocity analysis. Instead of focusing in particular offset directions and preselected subsets of subsurface points, our method focuses every subsurface point for all subsurface offset directions using a randomized probing technique. As a consequence, we obtain good velocity models at low cost for complex models without the need to provide information on the geologic dips.
Development of reduced‐fat cheeses with the addition of Agave fructans
Authors: Palatnik Diana R , Aldrete Herrera Pamela , Rinaldoni Ana N , Ortiz Basurto Rosa I , Campderrós Mercedes E
Published: August 2016

Cheeses containing Agave fructans were compared with both full‐fat and reduced‐fat samples without fructans. Microstructure results showed that the cheeses obtained were very similar to the control samples (without fructans), even the full‐fat control sample, demonstrating the texturing role of the carbohydrates. Regarding the composition, a moisture content of 47.96 ± 1.45 and a good protein retention with a low‐fat content were found. Therefore, the cheese yield was not adversely affected, and no significant differences were observed in sensory aspects. Considering the health benefits of fructans and their abundance, this development could represent an innovation for dairy industry.
Lactobacilli isolated from the Armenian fermented milk product matsoun: Growth properties, antibacterial and proteolytic activity and their dependence on pH
Authors: Keryan Andranik , Bazukyan Inga , Trchounian Armen
Published: August 2016

Growth, antibacterial and proteolytic activities of two new lactobacilli strains isolated from matsoun (Armenian traditional dairy product) and their pH dependence were studied. The results demonstrated the antibacterial activity of lactobacilli against Gram‐positive and Gram‐negative test strains. This activity was stable when pH of cell culture medium was adjusted to the value of 6.5. At pH 8, the antibacterial activity of only one strain was stable. Both strains were able to hydrolyse casein in pH range of 5.5–8 with maximal activity at pH 5.5. Controlled pH conditions were suitable for biomass yield, while noncontrolled pH was better for expression of antibacterial activity.
Review article: Why is there still a debate regarding the safety and efficacy of intravenous thrombolysis in the management of presumed acute ischaemic stroke? A systematic review and meta‐analysis
Authors: Donaldson Lachlan , Fitzgerald Emily , Flower Oliver , Delaney Anthony
Published: August 2016

Objective

The objective of the present study is to independently and systematically assess the harms and benefits of intravenous thrombolysis for patients with presumed acute schaemic stroke.

Methods

We performed a systematic review and meta‐analysis of randomised clinical trials of intravenous thrombolysis compared with control in patients with presumed acute ischaemic stroke. The effectiveness of thrombolysis on functional outcome, symptomatic intracranial haemorrhage, early mortality and mortality at final follow up was assessed using a fixed‐effect meta‐analysis.

Results

A total of 26 studies that randomised 10 431 participants were included. The use of thrombolysis was associated with an increased odds of good functional outcome, estimated odds ratio (OR) 1.14 (95% confidence interval [CI] 1.04–1.25, P = 0.004), and also a significantly increased risk of symptomatic intracranial haemorrhage, estimated OR 4.28 (95% CI 3.34–5.48, P < 0.0005) and an increased risk of early mortality, estimated OR 1.51 (95% CI 1.27–1.78, P < 0.0005). There was no statistically significant evidence that the effect of recombinant tissue plasminogen activator (rt‐PA) was different from that of other thrombolytic agents. There was also an increase in mortality at final follow up associated with treatment with thrombolysis, estimated OR 1.17 (95% CI 1.06–1.30, P = 0.003), although this result was not consistent when limited to studies of rt‐PA, estimated OR 1.04 (95% CI 0.92–1.18, P = 0.49).

Conclusions

There is clear evidence of increased early mortality, increased rates of symptomatic intracranial haemorrhage and also of improved functional outcomes for patients with presumed acute ischaemic stroke treated with thrombolysis. The available data are unlikely to resolve the controversy regarding the use of intravenous thrombolysis in this population, and further randomised controlled trials are urgently required.
Nitrogen regulation of the xyl genes of Pseudomonas putida mt‐2 propagates into a significant effect of nitrate on m‐xylene mineralization in soil
Authors: Svenningsen Nanna B. , Nicolaisen Mette H. , Hansen Hans Christian B. , de Lorenzo Victor , Nybroe Ole
Published: August 2016

The nitrogen species available in the growth medium are key factors determining expression of xyl genes for biodegradation of aromatic compounds by Pseudomonas putida. Nitrogen compounds are frequently amended to promote degradation at polluted sites, but it remains unknown how regulation observed in the test tube is propagated into actual catabolism of, e.g. m‐xylene in soil, the natural habitat of this bacterium. To address this issue, we have developed a test‐tube‐to‐soil model system that exposes the end‐effects of remediation practices influencing gene expression of P. putida mt‐2. We found that NO3− compared with NH4+ had a stimulating effect on xyl gene expression in pure culture as well as in soil, and that this stimulation was translated into increased m‐xylene mineralization in soil. Furthermore, expression analysis of the nitrogen‐regulated genes amtB and gdhA allowed us to monitor nitrogen sensing status in both experimental systems. Hence, for nitrogen sources, regulatory patterns that emerge in soil reflect those observed in liquid cultures. The current study shows how distinct regulatory traits can lead to discrete environmental consequences; and it underpins that attempts to improve bioremediation by nitrogen amendment should integrate knowledge on their effects on growth and on catabolic gene regulation under natural conditions.
Improvement of Bacillus subtilis for poly‐γ‐glutamic acid production by genome shuffling
Authors: Zeng Wei , Chen Guiguang , Wu Hao , Wang Jun , Liu Yanliao , Guo Ye , Liang Zhiqun
Published: August 2016

Poly‐γ‐glutamic acid (γ‐PGA) is a promising microbial polymer with potential applications in industry, agriculture and medicine. The use of high γ‐PGA‐producing strains is an effective approach to improve productivity of γ‐PGA. In this study, we developed a mutant, F3‐178, from Bacillus subtilis GXA‐28 using genome shuffling. The morphological characteristics of F3‐178 and GXA‐28 were not identical. Compared with GXA‐28 (18.4 ± 0.8 g l−1), the yield of γ‐PGA was 1.9‐fold higher in F3‐178 (34.3 ± 1.2 g l−1). Results from batch fermentation in 3.7 l fermenter showed that F3‐178 was satisfactory for industrial production of γ‐PGA. Metabolic studies suggested that the higher γ‐PGA yield in F3‐178 could be attributed to increased intracellular flux and uptake of extracellular glutamate. Real‐time PCR indicated that mRNA level of pgsB in F3‐178 was 18.8‐fold higher than in GXA‐28, suggesting the higher yield might be related to the overexpression of genes involved in γ‐PGA production. This study demonstrated that genome shuffling can be used for rapid improvement of γ‐PGA strains, and the possible mechanism for the improved phenotype was also explored at the metabolic and transcriptional levels.
Latitudinal distribution of microbial communities in anaerobic biological stabilization ponds: effect of the mean annual temperature
Authors: Yuan Mengdong , Zhu Jing , Wang Cheng , Wu Mengxiong , Sun Faqian , Han Xingguo , He Yangyang , Wu Weixiang
Published: August 2016

Considering wide utilization and high methane fluxes from anaerobic biological stabilization ponds (ABSPs), understanding the methanogenesis in ABSPs is of fundamental importance. Here we investigated the variation and impact factors of methanogenesis in seven ABSPs that spanned from the north to the south of China. Results showed that methanogen abundance (7.7 × 109–8.7 × 1010 copies g−1 dry sediment) and methanogenic activities (2.2–21.2 μmol CH4 g−1 dry sediment h−1) were considerable for all sediments. Statistical analysis demonstrated that compared with other factors (ammonium, pH, COD and TOC), mean annual temperature (MAT) showed the lowest P value and thus was the most important influencing factor for the methanogenic process. Besides, with the increasing MAT, methanogenic activity was enhanced mainly due to the shift of the dominant methanogenic pathway from acetoclastic (49.8–70.7%) in low MAT areas to hydrogenotrophic (42.0–54.6%) in high MAT areas. This shift of methanogenic pathway was also paralleled with changes in composition of bacterial communities. These results suggested that future global warming may reshape the composition of methanogen communities and lead to an increasing methane emission from ABSPs. Therefore, further research is urgently needed to globally estimate methane emissions from ABSPs and re‐examine the role of ABSPs in wastewater treatment.
Clinical and economic outcomes among elderly myocardial infarction survivors in the United States
Authors: Yang Erru , Stokes Michael , Johansson Saga , Mellström Carl , Magnuson Elizabeth , Cohen David J. , Hunt Phillip
Published: August 2016

Objectives

Longitudinal data are limited regarding outcomes and costs beyond 1 year after acute myocardial infarction (MI) among elderly (≥65 years old) US patients. This study examined long‐term outcomes and healthcare costs among elderly MI survivors.

Methods

Retrospective analysis of 2002–2009 Medicare healthcare claims (5% random sample). Patients were ≥65 years old and survived ≥1 year without recurrent MI after MI hospitalization. Mortality, incidence of hospitalizations for stroke, major bleeding, MI, a composite endpoint (death, MI, or stroke), and nonpharmacy healthcare costs were determined.

Results

Eligible patients included 16 244 STEMI, 34 576 NSTEMI, and 3109 unspecified MI. NSTEMI and unspecified MI patients had significantly higher prevalence of comorbidities than STEMI patients, except for hypertension and dyslipidemia. MI incidence declined 36% over the follow‐up (3.82/100 person‐years [PY] to 2.45/100 PY). Mortality, stroke, and bleeding decreased until the third year of follow‐up and then increased. NSTEMI and unspecified MI patients had a significantly higher incidence of death, MI, the composite, and bleeding than STEMI patients throughout follow‐up. All‐cause inpatient costs during follow‐up were 2.6‐ and 1.9‐fold higher than baseline for STEMI and NSTEMI, respectively; cardiovascular‐related inpatient costs were 3.5‐ and 2.2‐fold higher, respectively.

Conclusions

Risks of mortality and cardiovascular events remain high in a Medicare population surviving >1 year after a MI. Continuing healthcare costs are doubled over pre‐MI levels up to 5 years after an MI. Secondary prevention measures beyond the acute post‐MI period may be indicated to reduce risk and cost in this chronic disease phase.
Research Progress in the Petroleum and Natural Gas Geological Theory of China
Authors: Yongsheng MA , Peirong ZHAO
Published: August 2016

The Chinese landmass, as a composite region, consists of multiple small continental blocks, such as Sino‐Korea, Yangtze, Tarim, etc., and orogenic belts. Because of its distinctive tectono‐sedimentary evolution, China's oil/gas‐bearing regions differ remarkably from that elsewhere in the world. For instance, in comparison to the Middle East oil/gas‐bearing regions which are characterized by Mesozoic‐Cenozoic marine oil/gas‐bearing beds, early oil and gas discoveries in China are distributed mainly in Mesozoic‐Cenozoic continental sedimentary basins. Generation of oil from terrestrial organic matter, or terrestrial oil generation, and the formation of large oil/gas fields in continental sedimentary basins were previously the major characteristics of petroleum geology of China. However, in the past 20 years, a series of major oil and gas discoveries from marine strata have been made. Marine oil/gas fields in China are mainly distributed in the Tarim, Sichuan, and Ordos basins, which are tectonically stable and covered with Mesozoic‐Cenozoic deposits. In these basins, hydrocarbon‐bearing strata are of old age and the oil/gas fields are commonly deeply‐buried. Cumulatively, 995 oil/gas fields have been found so far, making China the fourth largest oil‐producing country and the sixth largest gas‐producing country in the world. In terms of petroleum and natural gas geology, theories of hydrocarbon generation from continental strata, such as terrestrial oil generation and coal‐generated hydrocarbons, etc., have been established. Significant progress has been made in research on the sequence stratigraphy of continental strata, formation mechanisms of ultra‐deep clastic reservoirs, and hydrocarbon accumulation in the continental subtle reservoir. Regarding research on the marine petroleum geology of China, with respect to the major characteristics, such as deeply‐buried reservoirs, old strata, and multiple phases of transformation, important advances have been made, in areas such as the multiple‐elements of hydrocarbon supply, formation of reservoirs jointly controlled by deposition, tectonic activities, and diagenetic fluid‐rock reactions, and oil/gas reservoirs formed through superimposed multi‐stage hydrocarbon accumulation. As more and more unconventional hydrocarbon resources are discovered, unconventional oil and gas reservoirs are under study by Chinese petroleum geologists, who endeavor to come up with new discoveries on their formation mechanisms.
Shale Gas Formation and Occurrence in China: An Overview of the Current Status and Future Potential
Authors: Caineng ZOU , Zhi YANG , Songqi PAN , Yanyan CHEN , Senhu LIN , Jinliang HUANG , Songtao WU , Dazhong DONG , Shufang WANG , Feng LIANG , Shasha SUN , Yong HUANG , Dingwei WENG
Published: August 2016

Shale gas is one of the most promising unconventional resources both in China and abroad. It is known as a form of self‐contained source‐reservoir system with large and continuous dimensions. Through years of considerable exploration efforts, China has identified three large shale gas fields in the Fuling, Changning and Weiyuan areas of the Sichuan Basin, and has announced more than 540 billion m3 of proven shale gas reserves in marine shale systems. The geological theories for shale gas development have progressed rapidly in China as well. For example, the new depositional patterns have been introduced for deciphering the paleogeography and sedimentary systems of the Wufeng shale and Longmaxi shale in the Sichuan Basin. The shale gas storage mechanism has been widely accepted as differing from conventional natural gas in that it is adsorbed on organic matter or a mineral surface or occurs as free gas trapped in pores and fractures of the shale. Significant advances in the techniques of microstructural characterization have provided new insights on how gas molecules are stored in micro‐and nano‐scale porous shales. Furthermore, newly‐developed concepts and practices in the petroleum industry, such as hydraulic fracturing, microseismic monitoring and multiwell horizontal drilling, have made the production of this unevenly distributed but promising unconventional natural gas a reality. China has 10–36 trillion m3 of promising shale gas among the world's whole predicted technically recoverable reserves of 206.6 trillion m3. China is on the way to achieving its goal of an annual yield of 30–50 billion m3 by launching more trials within shale gas projects.
Groundwater System Division and Description of Asia
Authors: Fawang ZHANG , Qing YI , Yanpei CHENG , Chen YUE , Hua DONG
Published: August 2016

Based on landform, climate, river system, geological structure and hydrogeological structure and from the perspective of systematology, the groundwater system of Asia can be divided into 36 secondary groundwater systems under 11 primary ones by the intercontinental scale. This forms part of the work of the groundwater series map of Asia, which is compiled according to groundwater system division and evaluation of the total amount and types of aquifer, reflecting the large‐scale features of groundwater resources in Asia. Systematic profiling of groundwater in this way provides a scientific basis for groundwater exploitation planning and management in Asia, and avoiding disputes over groundwater resources and the environment among Asian countries.
A Simplified Numerical Approach for the Prediction of Rainfall‐Induced Retrogressive Landslides
Authors: Hungchou LIN , Yuzhen YU , Guangxin LI , Hua YANG , Jianbing PENG
Published: August 2016

Retrogressive landslides are common geological phenomena in mountainous areas and on onshore and offshore slopes. The impact of retrogressive landslides is different from that of other landslide types due to the phenomenon of retrogression. The hazards caused by retrogressive landslides may be increased because retrogressive landslides usually affect housing, facilities, and infrastructure located far from the original slopes. Additionally, substantial geomorphic evidence shows that the abundant supply of loose sediment in the source area of a debris flow is usually provided by retrogressive landslides that are triggered by the undercutting of water. Moreover, according to historic case studies, some large landslides are the evolution result of retrogressive landslides. Hence the ability to understand and predict the evolution of retrogressive landslides is crucial for the purpose of hazard mitigation. This paper discusses the phenomenon of a retrogressive landslide by using a model experiment and suggests a reasonably simplified numerical approach for the prediction of rainfall‐induced retrogressive landslides. The simplified numerical approach, which combines the finite element method for seepage analysis, the shear strength reduction finite element method, and the analysis criterion for the retrogression and accumulation effect, is presented and used to predict the characteristics of a retrogressive landslide. The results show that this numerical approach is capable of reasonably predicting the characteristics of retrogressive landslides under rainfall infiltration, particularly the magnitude of each landslide, the position of the slip surface, and the development processes of the retrogressive landslide. Therefore, this approach is expected to be a practical method for the mitigation of damage caused by rainfall‐induced retrogressive landslides.
Shared Decision Making to Improve the Emergency Care of Older Adults: A Research Agenda
Authors: Hogan Teresita M. , Richmond Natalie L. , Carpenter Christopher R. , Biese Kevin , Hwang Ula , Shah Manish N. , Escobedo Marcus , Berman Amy , Broder Joshua S. , Platts‐Mills Timothy F.
Published: August 2016

Older emergency department patients have high rates of serious illness and injury, are at high risk for side effects and adverse events from treatments and diagnostic tests, and in many cases, have nuanced goals of care in which pursuing the most aggressive approach is not desired. Although some forms of shared decision making (SDM) are commonly practiced by emergency physicians caring for older adults, broader use of SDM in this setting is limited by a lack of knowledge of the types of patients and conditions for which SDM is most helpful and the approaches and tools that can best facilitate this process. We describe a research agenda to generate new knowledge to optimize the use of SDM during the emergency care of older adults.
Detection of selection signatures of population‐specific genomic regions selected during domestication process in Jinhua pigs
Authors: Li Zhengcao , Chen Jiucheng , Wang Zhen , Pan Yuchun , Wang Qishan , Xu Ningying , Wang Zhengguang
Published: August 2016

Chinese pigs have been undergoing both natural and artificial selection for thousands of years. Jinhua pigs are of great importance, as they can be a valuable model for exploring the genetic mechanisms linked to meat quality and other traits such as disease resistance, reproduction and production. The purpose of this study was to identify distinctive footprints of selection between Jinhua pigs and other breeds utilizing genome‐wide SNP data. Genotyping by genome reducing and sequencing was implemented in order to perform cross‐population extended haplotype homozygosity to reveal strong signatures of selection for those economically important traits. This work was performed at a 2% genome level, which comprised 152 006 SNPs genotyped in a total of 517 individuals. Population‐specific footprints of selective sweeps were searched for in the genome of Jinhua pigs using six native breeds and three European breeds as reference groups. Several candidate genes associated with meat quality, health and reproduction, such as GH1, CRHR2, TRAF4 and CCK, were found to be overlapping with the significantly positive outliers. Additionally, the results revealed that some genomic regions associated with meat quality, immune response and reproduction in Jinhua pigs have evolved directionally under domestication and subsequent selections. The identified genes and biological pathways in Jinhua pigs showed different selection patterns in comparison with the Chinese and European breeds.
A prospective randomised study of a rigid video‐stylet vs. conventional lightwand intubation in cervical spine‐immobilised patients
Authors: Seo H. , Kim E. , Son J. D. , Ji S. , Min S. W. , Park H. P.
Published: August 2016

Compared with a lightwand which is used blind, Optiscope™, a rigid video‐stylet, can provide direct imaging of airway structures, potentially offering improved conditions in cervical spine‐immobilised patients. We randomly assigned 168 patients who required cervical immobilisation during tracheal intubation to use of the Optiscope or the lightwand. The initial intubation success rate (95% CI) was 90 (82–95)% with the Optiscope and 87 (78–93)% with the lightwand (p = 0.626). Median (IQR [range]) intubation time was longer (19 (12–41 [5–195] s vs. 15 (8–29 [3–117] s; p = 0.016), and there were fewer scooping movements (1 (1–2 [0–9]) vs. 2 (1–3 [0–14]); p = 0.002) when using the Optiscope compared with the lightwand. The incidence of postoperative airway complications was similar in the two groups. The devices were equivalent with respect to initial intubation success rate but the Optiscope yielded slightly longer intubating times.
Antibiotic resistance in early periprosthetic joint infection
Authors: Ravi Saiprasad , Zhu Mark , Luey Christopher , Young Simon W.
Published: August 2016

Background

Prophylactic antibiotics significantly reduce prosthetic joint infection (PJI) rates after hip and knee arthroplasty. However, rising antibiotic resistance has raised concerns over the adequacy of conventional prophylaxis. This study aimed to identify organisms causing PJIs in hip and knee arthroplasty secondary to perioperative contamination and their susceptibility to current prophylactic antibiotics.

Methods

We performed a retrospective audit of 4009 primary hip and knee arthroplasties (1852 hips and 2157 knees) at three tertiary referral hospitals. PJIs were identified according to the Infectious Diseases Society of America definition, and patients were followed‐up for 2 years. For patients with confirmed PJIs, causative bacteria and their antibiotic susceptibilities were identified.

Results

Thirty‐five PJI cases were identified (13 hips and 22 knees). The overall definite PJI rate was 0.87% (0.7% for hips, 1.0% for knees). Ninety‐six percent of patients with PJI received cefazolin prophylaxis. Culture information was available for 30 cases. The most common infecting organisms were coagulase‐negative staphylococci (CoNS), causing 35% of infections. Ninety‐two percent of CoNS strains were cefazolin‐resistant. Twenty‐five percent of patients were infected with Staphylococcus aureus, 9.1% of which were methicillin‐resistant. Overall, 53% of infecting organisms were cefazolin‐resistant.

Conclusions

The majority of bacteria causing early PJI are resistant to cefazolin. Whilst many organisms cultured were susceptible to vancomycin, there is currently insufficient evidence to justify its routine use as a prophylactic. However, when treating PJI in the early postoperative period, surgeons should be aware that most organisms will be methicillin‐resistant, and the choice of empirical antibiotic treatment should reflect this.
Colposcopy and additive diagnostic value of biopsies from colposcopy‐negative areas to detect cervical dysplasia
Authors: Baasland Ingrid , Hagen Bjørn , Vogt Christina , Valla Marit , Romundstad Pål R.
Published: August 2016

Introduction

We evaluated colposcopy in the routine diagnostic workup of women with abnormal cervical cytology, as well as the diagnostic value of endocervical curettage material and biopsies taken from colposcopy‐positive and colposcopy‐negative quadrants of the cervix.

Material and methods

This cross‐sectional study included 297 nonpregnant women with abnormal cervical cytology and no prior treatment for cervical dysplasia or cancer. All women underwent gynecological examination, colposcopy, endocervical curettage, and had cervical biopsies taken. Colposcopy was considered satisfactory if the squamocolumnar junction was fully visible, and biopsies were taken from all four quadrants of the cervix, regardless of colposcopy results.

Results

In all, 130 of the women in our study had satisfactory colposcopy results and were diagnosed with cervical intraepithelial neoplasia grade 2 or worse (CIN2+), 61% via a colposcopy‐positive biopsy and 39% via a colposcopy‐negative biopsy. Eighty‐seven of them had positive colposcopy results, but CIN2+ was histologically verified from colposcopy‐positive biopsies in 91% (n = 79) and from colposcopy‐negative biopsies in 9% (n = 8). The remaining 43 women with CIN2+ had negative colposcopy findings, so their diagnosis was verified in colposcopy‐negative biopsies. The sensitivity of colposcopy alone to detect CIN2+ was 61% (95% CI 52–69).

Conclusions

In the present study, colposcopy was not a stand‐alone diagnostic method. Colposcopy‐negative biopsies had a clear additive value, identifying a substantial proportion of women with both positive and negative colposcopy results with treatment‐worthy cervical dysplasia. Endocervical curettage material had little diagnostic value in this study.
Multidisciplinary care management has a positive effect on paediatric obesity and social and individual factors are associated with better outcomes
Authors: Carriere C. , Cabaussel C. , Bader C. , Barberger‐Gateau P. , Barat P. , Thibault H.
Published: August 2016

Aim

The RePPOP Aquitaine network, which was established in south‐west France to prevent and treat paediatric obesity, has developed a multidisciplinary approach based on multicomponent lifestyle interventions and family‐based actions. This study assessed the impact of its care management programme and investigated the factors associated with better outcomes.

Methods

The impact of the RePPOP care management programme was assessed by changes in the body mass index (BMI) Z score, between baseline and the end‐of‐care management. We focused on 982 overweight or obese children (59.9% girls) with a mean age of 10.64 years and a range of 2.4–17.9 years. A multivariate analysis examined the independent factors associated with better outcomes.

Results

At the end‐of‐care management programme, 75.5% of children had decreased their BMI Z score. Initial characteristics significantly associated with better outcomes were as follows: the age at baseline between five years and 15 years of age, playing sport at a club, being followed up by RePPOP for longer than 10 months, no parental obesity and no academic difficulties.

Conclusion

This study confirmed that multidisciplinary treatment had a significant positive effect on paediatric obesity and that social and individual factors affected the efficiency of the care management.
Prevention of progression to cirrhosis in hepatitis C with fibrosis: effectiveness and cost effectiveness of sequential therapy with new direct‐acting anti‐virals
Authors: Faria R. , Woods B. , Griffin S. , Palmer S. , Sculpher M. , Ryder S. D.
Published: August 2016

Background

The new direct‐acting anti‐virals (DAAs) for hepatitis C virus (HCV) infection offer higher cure rates, but at a much higher cost than the standard interferon‐based treatments.

Aim

To identify the cost‐effective treatment for patients with HCV infection with F3 liver fibrosis who are at high risk of progression to cirrhosis.

Methods

A decision‐analytic Markov model compared the health benefits and costs of all currently licensed treatments as single treatments and in sequential therapy of up to three lines. Costs were expressed in pound sterling from the perspective of the UK National Health Service. Health benefits were expressed in quality‐adjusted life years.

Results

Treatment before progression to cirrhosis always offers the most health benefits for the least costs. Sequential therapy with multiple treatment lines cures over 89% of patients across all HCV genotypes while ensuring a cost‐effective use of resources. Cost‐effective regimes for HCV genotype 1 patients include first‐line oral therapy with sofosbuvir–ledipasvir while peginterferon continues to have a role in other genotypes.

Conclusions

The cost‐effective treatment for HCV can be established using decision analytic modelling comparing single and sequential therapies. Sequential therapy with DAAs is effective and cost‐effective in HCV patients with F3 fibrosis. This information is of significant benefit to health care providers with budget limitations and provides a sound scientific basis for drug treatment choices.
An IL‐27/Stat3 axis induces expression of programmed cell death 1 ligands (PD‐L1/2) on infiltrating macrophages in lymphoma
Authors: Horlad Hasita , Ma Chaoya , Yano Hiromu , Pan Cheng , Ohnishi Koji , Fujiwara Yukio , Endo Shinya , Kikukawa Yoshitaka , Okuno Yutaka , Matsuoka Masao , Takeya Motohiro , Komohara Yoshihiro
Published: August 2016

Immune escape and tolerance in the tumor microenvironment are closely involved in tumor progression, and are caused by T‐cell exhaustion and mediated by the inhibitory signaling of immune checkpoint molecules including programmed death‐1 (PD‐1), cytotoxic T‐lymphocyte associated protein 4, and T‐cell immunoglobulin and mucin domaincontaining molecule‐3. In the present study, we investigated the expression of the PD‐1 ligand 1 (PD‐L1) in a lymphoma microenvironment using paraffin‐embedded tissue samples, and subsequently studied the detailed mechanism of upregulation of PD‐L1 on macrophages using cultured human macrophages and lymphoma cell lines. We found that macrophages in lymphoma tissues of almost all cases of adult T‐cell leukemia/lymphoma (ATLL), follicular lymphoma and diffuse large B‐cell lymphoma expressed PD‐L1. Cell culture studies showed that the conditioned medium of ATL‐T and SLVL cell lines induced increased expression of PD‐L1/2 on macrophages, and that this PD‐L1/2 overexpression was dependent on activation of signal transducer and activator of transcription 3 (Stat3). In vitro studies including cytokine array analysis showed that IL‐27 (heterodimer of p28 and EBI3) induced overexpression of PD‐L1/2 on macrophages via Stat3 activation. Because lymphoma cell lines produced IL‐27B (EBI3) but not IL‐27p28, it was proposed that the IL‐27p28 derived from macrophages and the IL‐27B (EBI3) derived from lymphoma cells formed an IL‐27 (heterodimer) that induced PD‐L1/2 overexpression. Although the significance of PD‐L1/2 expressions on macrophages in lymphoma progression has never been clarified, an IL‐27‐Stat3 axis might be a target for immunotherapy for lymphoma patients.
In Infants' Hands: Identification of Preverbal Infants at Risk for Primary Language Delay
Authors: Lüke Carina , Grimminger Angela , Rohlfing Katharina J. , Liszkowski Ulf , Ritterfeld Ute
Published: August 2016

Early identification of primary language delay is crucial to implement effective prevention programs. Available screening instruments are based on parents' reports and have only insufficient predictive validity. This study employed observational measures of preverbal infants' gestural communication to test its predictive validity for identifying later language delays. Pointing behavior of fifty‐nine 12‐month‐old infants was analyzed and related to their language skills 1 year later. Results confirm predictive validity of preverbal communication for language skills with the hand shape of pointing being superior compared to the underlying motives for pointing (imperative vs. declarative). Twelve‐month‐olds who pointed only with their open hand but never with their index finger were at risk for primary language delay at 2 years of age.
Subgroup differences in the associations between dog exposure during the first year of life and early life allergic outcomes
Authors: Wegienka G. , Havstad S. , Kim H. , Zoratti E. , Ownby D. , Woodcroft K. J. , Johnson C. C.
Published: August 2016

Background

The effect of dog exposure on the risk of children developing allergic disease remains controversial. Many analyses have not considered that associations may vary within population subgroups.

Objective

To examine whether associations between living with a dog in the first year of life and allergic outcomes vary within subgroups selected a priori (race, gender and delivery mode).

Methods

Black (n = 496) and White (n = 196) children enrolled in the WHEALS birth cohort study had a clinical examination at age 2 years to assess eczema and allergen‐specific IgE (sIgE) and perform skin prick testing (SPT). Whether the child lived with an indoor dog in the first year of life was assessed through interview, as was doctor diagnosis of asthma at ages 3–6 years.

Results

Living with a dog was associated with decreased odds of having ≥ 1 positive SPT (OR = 0.56, 95% CI: 0.34, 0.91) and having eczema (OR = 0.34, 95% CI: 0.20, 0.60). The association with SPT was stronger in those children born via caesarean section (c‐section) vs. vaginally (OR = 0.29, 95% CI: 0.12, 0.74 vs. OR = 0.76, 95% CI: 0.43, 1.37, respectively, interaction P = 0.087) and in those who were firstborn vs. not (OR = 0.27, 95% CI: 0.11, 0.67 vs. OR = 0.82, 95% CI: 0.45, 1.47, respectively, interaction P = 0.044). The association with eczema was stronger in children born vaginally compared with those born via caesarean section (OR = 0.17, 95% CI: 0.06, 0.43 vs. OR = 0.65, 95% CI: 0.31, 1.35, respectively, interaction P = 0.025) and was stronger in Black vs. White children (OR = 0.30, 95% CI: 0.15, 0.61 vs. OR = 0.78, 95% CI: 0.29, 2.11, respectively, interaction P = 0.12). Dog keeping was not significantly inversely associated with having ≥ 1 elevated sIgE and only approached statistical significance with asthma.

Conclusions and Clinical Relevance

Results likely vary between studies due to variability of specific exposure–outcome associations in subgroups defined by other factors as well as the relative distributions of those subgroups. Important allergic disorder associations will be missed without subgroup analyses.
Effects of maternal dietary egg intake during early lactation on human milk ovalbumin concentration: a randomized controlled trial
Authors: Metcalfe J. R. , Marsh J. A. , D'Vaz N. , Geddes D. T. , Lai C. T. , Prescott S. L. , Palmer D. J.
Published: August 2016

Background

There is limited understanding of how maternal diet affects breastmilk food allergen concentrations, and whether exposure to allergens through this route influences the development of infant oral tolerance or sensitization.

Objective

To investigate how maternal dietary egg ingestion during early lactation influences egg protein (ovalbumin) levels detected in human breastmilk.

Methods

In a randomized controlled trial, women were allocated to a dietary group for the first six weeks of lactation: high‐egg diet (> 4 eggs per week), low‐egg diet (one‐three eggs per week) or an egg‐free diet. Breastmilk samples were collected at 2, 4 and 6 weeks of lactation for the measurement of ovalbumin. The permeability of the mammary epithelium was assessed by measuring the breastmilk sodium : potassium ratio. Egg‐specific IgE and IgG4 were measured in infant plasma at 6 weeks, and prior to the introduction of egg in solids at 16 weeks.

Results

Average maternal egg ingestion was associated with breastmilk ovalbumin concentration. Specifically, for each additional egg ingested per week, there was an average 25% increase in ovalbumin concentration (95% CI: 5–48%, P = 0.01). Breastmilk ovalbumin concentrations were significantly higher in the ‘high‐egg’ group (> 4 eggs per week) compared with the ‘egg‐free’ group (P = 0.04). However, one‐third of women had no breastmilk ovalbumin detected. No detectable associations were found between mammary epithelium permeability and breastmilk ovalbumin concentrations. Infant plasma egg‐specific IgG4 levels were also positively associated with maternal egg ingestion, with an average 22% (95% CI: 3–45%) increase in infant egg‐specific IgG4 levels per additional egg consumed per week (P = 0.02).

Conclusions and Clinical Relevance

Increased maternal egg ingestion is associated with increased breastmilk ovalbumin, and markers of immune tolerance in infants. These results highlight the potential for maternal diet to benefit infant oral tolerance development during lactation.
Contrastive Constraints Guide Explanation‐Based Category Learning
Authors: Chin‐Parker Seth , Cantelon Julie
Published: August 2016

This paper provides evidence for a contrastive account of explanation that is motivated by pragmatic theories that recognize the contribution that context makes to the interpretation of a prompt for explanation. This study replicates the primary findings of previous work in explanation‐based category learning (Williams & Lombrozo, 2010), extending that work by illustrating the critical role of the context in this type of learning. Participants interacted with items from two categories either by describing the items or explaining their category membership. We manipulated the feature overlap between the categories and examined both the explanations generated and acquired knowledge of the categories. Explanations for membership in a given category were influenced by the unprompted contrast category, indicating an important role for contrastive processing in the generation of explanations. The influence of the contrast category was similarly seen in the transfer performance of the participants.
Exact and Heuristic Algorithms for Risk‐Aware Stochastic Physical Search
Authors: Brown Daniel S. , Hudack Jeffrey , Gemelli Nathaniel , Banerjee Bikramjit
Published: August 2016

We consider an intelligent agent seeking to obtain an item from one of several physical locations, where the cost to obtain the item at each location is stochastic. We study risk‐aware stochastic physical search (RA‐SPS), where both the cost to travel and the cost to obtain the item are taken from the same budget and where the objective is to maximize the probability of success while minimizing the required budget. This type of problem models many task‐planning scenarios, such as space exploration, shopping, or surveillance. In these types of scenarios, the actual cost of completing an objective at a location may only be revealed when an agent physically arrives at the location, and the agent may need to use a single resource to both search for and acquire the item of interest. We present exact and heuristic algorithms for solving RA‐SPS problems on complete metric graphs. We first formulate the problem as mixed integer linear programming problem. We then develop custom branch and bound algorithms that result in a dramatic reduction in computation time. Using these algorithms, we generate empirical insights into the hardness landscape of the RA‐SPS problem and compare the performance of several heuristics.
Metastatic pleural mesothelioma presenting in a breast fine needle aspiration specimen
Authors: Shield P. W. , Ribu D. L.
Published: August 2016

This is an unusual presentation of metastatic mesothelioma presenting as a breast lump and mimicking a primary tumour at that site.
An International Constitutional Court: Future Roles & Challenges
Authors: Nasrawin Laith K.
Published: August 2016

This article comprehensively examines the 1999 recommendation of the Tunisian government to create an International Constitutional Court that is designed to enhance the principles of democracy and human rights and to strengthen the constitutional doctrine which states that the people are the source of authority in a given country. This proposal, which was strongly advocated by former Tunisian President Mohamed Moncef Marzouki during his term in office, aims to underscore the importance of establishing an international judicial entity and analysing its bylaws with respect to its terms and conditions, formation, jurisdiction, and selection of judges. The article traces the trajectory of the movement, from the proposal stage to the latest developments in formally establishing the international judicial entity. Finally, the article identifies various possible difficulties and challenges that are likely to stand in the way of implementing the proposal.