bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient-centred rehabilitation for non-communicable disease in a low-resource setting: study protocol for a feasibility and proof-of-concept randomised clinical trial
Authors: Heine Martin , Fell Brittany Leigh , Robinson Ashleigh , Abbas Mumtaz , Derman Wayne , Hanekom Susan
Published: April 2019

Introduction

Non-communicable diseases (NCDs) are the leading cause of death globally. Even though NCD disproportionally affects low-to-middle income countries, these countries including South Africa, often have limited capacity for the prevention and control of NCDs. The standard evidence-based care for the long-term management of NCDs includes rehabilitation. However, evidence for the effectiveness of rehabilitation for NCDs originates predominantly from high-income countries. Despite the disproportionate disease burden in low-resourced settings, and due to the complex context and constraints in these settings, the delivery and study of evidence-based rehabilitation treatment in a low-resource setting is poorly understood. This study aims to test the design, methodology and feasibility of a minimalistic, patient-centred, rehabilitation programme for patients with NCD specifically designed for and conducted in a low-resource setting.

Methods and analysis

Stable patients with cancer, cardiovascular disease, chronic respiratory disease and/or diabetes mellitus will be recruited over the course of 1 year from a provincial day hospital located in an urban, low-resourced setting (Bishop Lavis, Cape Town, South Africa). A postponed information model will be adopted to allocate patients to a 6-week, group-based, individualised, patient-centred rehabilitation programme consisting of multimodal exercise, exercise education and health education; or usual care (ie, no care). Outcomes include feasibility measures, treatment fidelity, functional capacity (eg, 6 min walking test), physical activity level, health-related quality of life and a patient-perspective economic evaluation. Outcomes are assessed by a blinded assessor at baseline, postintervention and 8-week follow-up. Mixed-method analyses will be conducted to inform future research.

Ethics and dissemination

This study has been approved by the Health Research and Ethics Council, Stellenbosch University (M17/09/031). Information gathered in this research will be published in peer-reviewed journals, presented at national and international conferences, as well as local stakeholders.

Trial registration number

PACTR201807847711940; Pre-results.
General practitioners’ awareness of the recommendations for faecal immunochemical tests (FITs) for suspected lower gastrointestinal cancers: a national survey
Authors: Von Wagner Christian , Stoffel Sandro Tiziano , Freeman Madeline , Laszlo Helga E , Nicholson Brian D , Sheringham Jessica , Szinay Dorothy , Hirst Yasemin
Published: April 2019

Objectives

In July 2017, UK National Institute for Health and Care Excellence (NICE) published a diagnostic guidance (DG30) recommending the use of faecal immunochemical tests (FITs) for symptomatic patients who do not meet the urgent referral pathway for suspected colorectal cancer (CRC). We assessed general practitioners’ (GP) awareness of DG30 in primary care 6 months after its publication.

Design and setting

Cross-sectional online survey of GPs hosted by an English panel of Primary health care professionals.

Participants

In December 2017, 1024 GPs registered on an online panel (M3) based in England took part in an online survey.

Outcomes and variables

We investigated a number of factors including previous experience of using FIT and guaiac faecal occult blood tests (FOBTs), the number of urgent referrals for CRC that GPs have made in the last year and their sociodemographic and professional characteristics that could be associated with their self-reported awareness of the FIT diagnostic guidance.

Results

Of the 1024 GPs who completed the survey, 432 (42.2%) were aware of the current recommendation but only 102 (10%) had used it to guide their referrals. Awareness was lowest in North West England compared with London (30.5% vs 44.9%; adjusted OR: 0.55, 95% CI 0.33 to 0.92). Awareness of the FIT guidance was positively associated with test usage after the NICE update (adjusted OR: 13.00, 95% CI 6.87 to 24.61) and having specialist training (adjusted OR: 1.48, 95% CI 1.05 to 2.08). The number of urgent referrals, the previous use of FOBt, GPs’ age and gender, work experience and practice size (both in terms of the number of GPs or patients at the practice) were not associated with awareness.

Conclusions

Less than half of GPs in this survey recognised the current guidance on the use of FIT. Self-reported awareness was not systematically related to demographic of professional characteristics.
Epidemiological relationship betweenMycoplasma pneumoniaepneumonia and recurrent wheezing episode in children: an observational study at a single hospital in Korea
Authors: Rhim Jung Woo , Kang Hyun Mi , Yang Eun Ae , Lee Kyung Yil
Published: April 2019

Objective

This study was aimed to evaluate epidemiological and clinical relationship betweenMycoplasma pneumoniae(MP) infection and childhood recurrent wheezing episode (RWE).

Design

Retrospective case note review.

Setting

Paediatric department at a single Korean institution.

Participants

Consecutive admitted patients with MP pneumonia and RWE (0–15 years of age) between 2003 and 2014.

Methods

The retrospective medical records of patients with (MP) pneumonia (n=793 for epidemiological analysis and n=501 for clinical analysis) and those with RWE (n=384) from 2003 to 2014 were analysed. Diagnosis of MP pneumonia was made based on two-times titration of IgM antibody during hospitalisation. An RWE patient was defined as one with expiratory wheezing with at least one or more wheezing episodes based on medical records.

Results

During three MP pneumonia epidemics, there were no corresponding increases of patients with RWE in the epidemic years. In the 501 MP pneumonia patients, 52 (10.4%) had wheezing at presentation and 15 (3%) had RWE. The MP pneumonia patients with wheezing at presentation (n=52) were younger and were more likely to have an allergic disease history than those without wheezing (n=449). Among wheezing patients at presentation, 10 patients had previously RWE history. In a follow-up study, 13 patients (including 5 RWE) with initial wheezing and 25 patients (including 2 RWE) without wheezing had wheezy episodes after discharge. Among the total 501 patients, it was estimated that at least 31 MP pneumonia patients (6.2%) showed recurrent wheezing after initial MP infection.

Conclusions

A small part of children with MP pneumonia showed recurrent wheezing after MP pneumonia, and patients with RWE had a greater likelihood of experiencing wheezing when they had an initial MP infection. However, there were no increased admitted patients with RWE in MP pneumonia epidemic periods because of rarity of MP reinfection in children including patients with RWE or asthma.
Health system factors and caesarean sections in Kosovo: a cross-sectional study
Authors: Hoxha Ilir , Fejza Alban , Aliu Mrika , Jüni Peter , Goodman David C
Published: April 2019

Objective

To investigate the association of caesarean section rates with the health system characteristics in the public hospitals of Kosovo.

Design

Cross-sectional survey.

Setting

Five largest public hospitals in Kosovo.

Participants

859 women with low-risk deliveries who delivered from April to May 2015 in five public hospitals in Kosovo.

Outcome measures

The prespecified outcomes were the crude and adjusted OR of births delivered with caesarean section by health system characteristics such as delivery by the physician who provided antenatal care, health insurance status and other. Additional prespecified outcomes were caesarean section rates and crude ORs for delivery with caesarean in each public hospital.

Results

Women with personal monthly income had increased odds for caesarean (OR 1.55, 95% CI 1.06 to 2.27), as did women with private health insurance coverage (OR 3.44, 95% CI 1.20 to 9.85). Women instructed by a midwife on preparation for delivery had decreasing odds (OR 0.32, 95% CI 0.19 to 0.51) while women having preference for a caesarean had increasing odds for delivery with caesarean (OR 3.84, 95% CI 1.96 to 7.51). The odds for caesarean increased also in the case of delivery by a physician who provided antenatal care (OR 2.06, 95% CI 1.16 to 3.67) and delivery during office hours (OR 2.36, 95% CI 1.37 to 4.05), while delivery at the University Clinical Centre of Kosovo decreased the odds for caesarean (OR 0.46, 95% CI 0.24 to 0.90).

Conclusions

We found that several health system characteristics are associated with the increase of caesarean sections in a low-risk population of delivering women in public hospitals of Kosovo. These findings should be explored further and addressed via policy measures that would tackle provision of unnecessary caesareans. The study findings could assist Kosovo to develop corrective policies in addressing overuse of caesareans and may provide useful information for other middle-income countries.
Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: a protocol for a systematic review
Authors: Rinaldi Giulia , Hijazi Alexa , Haghparast-Bidgoli Hassan
Published: April 2019

Introduction

Type 2 diabetes mellitus (T2DM) remains one of the most common chronic diseases of adulthood which creates high degrees of morbidity and mortality worldwide. The incidence of T2DM continues to rise and recently, mHealth interventions have been increasingly used in the prevention, monitoring and management of T2DM. The aim of this study is to systematically review the published evidence on cost and cost-effectiveness of mHealth interventions for T2DM, as well as assess the quality of reporting of the evidence.

Methods and analysis

A comprehensive review of PubMed, EMBASE, Science Direct and Web of Science of articles published until January 2019 will be conducted. Included studies will be partial or full economic evaluations which provide cost or cost-effectiveness results for mHealth interventions targeting individuals diagnosed with, or at risk of, T2DM. The quality of reporting evidence will be assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results will be presented using a flowchart following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Graphical and tabulated representations of the results will be created for both descriptive and numerical results. The cost and cost-effectiveness values will be presented as reported by the original studies as well as converted into international dollars to allow comparability. As we are predicting heterogenous results, we will conduct a narrative and interpretive analysis of the data.

Ethics and dissemination

No formal approval or review of ethics is required for this systematic review as it will involve the collection and analysis of secondary data. This protocol follows the current PRISMA-P guidelines. The review will provide information on the cost and cost-effectiveness of mHealth interventions targeting T2DM. These results will be disseminated through publication and submission to conferences for presentations and posters.

PROSPERO registration number

CRD42019123476
Patient activation intervention to facilitate participation in recovery after total knee replacement (MIME): a cluster randomised cross-over trial
Authors: McDonall Jo , de Steiger Richard , Reynolds John , Redley Bernice , Livingston Patricia M , Hutchinson Anastasia F , Botti Mari
Published: April 2019

Background

Patient participation in care is a fundamental element of safe and high-quality healthcare with the potential to enhance health outcomes and improve patient satisfaction.

Objectives

To test the efficacy of a clinician-facilitated, bedside multimedia (MyStay) intervention designed to support patient participation in their recovery after total knee replacement surgery. The primary outcome was patients’ reported worst pain intensity on postoperative day 3. Secondary outcomes were patient activation, length of hospital stay, knee function and satisfaction with care.

Methods

Unmasked, cluster randomised, four-period cross-over trial with a simultaneous process evaluation within in a large private, not-for-profit, metropolitan teaching hospital. Statistical analyses used linear mixed models with random effects for wards, cohorts within wards and patients within cohorts and fixed effects for treatment and period.

Results

241 patients were recruited between March 2014 and June 2015. Patients were admitted to intervention (104) or control (137) clusters. Intervention group patients reported significantly lower mean pain intensity scores on postoperative day 3 (6.1 vs 7.1, 95% CI −1.94 to −0.08, p=0.04). The percentages of patients who reported severe pain (score ≥7) were 43.7% and 64.2% in the intervention and control groups, respectively (χ2 9.89, p=0.002; generalised linear mixed model Wald test, p=0.05). Intervention group patients on average stayed in hospital one less day (5.3 vs 6.3, 95% CI 0.05 to 1.94, p=0.04), reported higher activation (45.1% vs 27.1% at level 4 activation) (p=0.04) and higher overall satisfaction with care (9.3 vs 8.6, 95% CI 1.09 to 0.219, p=0.01), and were more likely to refer family or friends to the health service (9.3 vs 8.7, 95% CI 1.07 to 0.13, p=0.02).

Conclusion

The clinician-facilitated, MyStay bedside multimedia intervention enhanced patients’ activation and participation in their care after surgery; pain intensity and length of stay in hospital were reduced and patients were more satisfied with their care.

Trial registration

ACTRN12614000340639 (http://www.anzctr.org.au/default.aspx).
iValidate: a communication-based clinical intervention in life-limiting illness
Authors: Simpson Nicholas , Milnes Sharyn , Martin Peter , Phillips Anita , Silverman Jonathan , Keely Gerry , Forrester Mike , Dunning Trisha , Corke Charles , Orford Neil
Published: April 2019

Objectives

Report the implementation, user evaluation and key outcome measures of an educational intervention—the iValidate educational programme—designed to improve engagement in shared decision-making by health professionals caring for patients with life-limiting illness (LLI).

Design

Prospective, descriptive, cohort study.

Participants

Health professionals working in acute care settings caring for patients with an LLI.

Main outcomes measured

Participant evaluation of learning outcomes for communication skills and shared decision-making; demographic data of participants attending education workshops; and documentation of patients with LLI goals of management, including patient values and care decision based on area in acute care and seniority of doctor.

Results

The programme was well accepted by participants. Participant evaluations demonstrated self-reported improved confidence in the areas of patient identification, information gathering to ascertain patient values and shared decision-making. There was strong agreement with the course-enhanced knowledge of core communication skills and advanced skills such as discussing mismatched agendas.

Conclusions

We described the educational pedagogy, implementation and key outcome measures of the iValidate education programme, an intervention designed to improve person-centred care for patients with an LLI. A targeted education programme could produce cultural and institutional change for vulnerable populations within a healthcare institution. A concurrent research programme suggests effectiveness within the current service and the potential for transferability.
Fibrinolysis during liver transplantation: analysis by the Thrombodynamics method
Authors: Roullet Stéphanie , Labrouche Sylvie , Freyburger Geneviève
Published: April 2019

An issue in orthotopic liver transplantation (OLT) is the diagnosis of hyperfibrinolysis. The Thrombodynamics-4D assay (TD4D) is a videomicroscopy system allowing the dynamic analysis of fibrin clot. Fibrinolysis is highlighted by a change in clot intensity. The aim of this observational study was to evaluate the TD4D as a tool to diagnose fibrinolysis during OLT. Thirty consecutive patients were included. We studied a subset of 41 samples from 13 patients who demonstrated hyperfibrinolysis during OLT by global fibrinolytic capacity studied by the Lysis Timer (GFC/LT) and/or euglobulin clot lysis time (ECLT) and/or EXTEM maximum lysis (EXTEM ML) on ROTEM. Three samples exhibited fibrinolysis. They exhibited significantly shorter ECLT, higher lysis on EXTEM graphs, shorter GFC/LT clot lysis time and higher t-PA activity values. After adding urokinase, 13 samples exhibited fibrinolysis. In conclusion, TD4D allows the dynamic analysis of fibrin clot formation and lysis. It only recognises the most severe forms of hyperfibrinolysis during OLT.
Socioeconomic disparities in life expectancy gains among retired German men, 1997–2016
Authors: Wenau Georg , Grigoriev Pavel , Shkolnikov Vladimir
Published: April 2019

Background

Although estimates of socioeconomic mortality disparities in Germany exist, the trends in these disparities since the 1990s are still unknown. This study examines mortality trends across socioeconomic groups since the late 1990s among retired German men aged 65 and above.

Methods

Large administrative data sets were used to estimate mortality among retired German men, grouped according to their working-life biographies. The data covered the years 1997–2016 and included more than 84.1 million person-years and 4.3 million deaths. Individual pension entitlements served as a measure of lifetime income. Changes in total life expectancy at age 65 over time were decomposed into effects of group-specific mortality improvements and effects of compositional change.

Results

Over the two decades studied, male mortality declined in all income groups in both German regions. As mortality improved more rapidly among higher status groups, the social gradient in mortality widened. Since 1997, the distribution of pension entitlements of retired East German men has shifted substantially downwards. As a result, the impact of the most disadvantaged group on total mortality has increased and has partly attenuated the overall improvement.

Conclusion

Our results demonstrate that socioeconomic deprivation has substantial effects on levels of mortality in postreunification Germany. While East German retirees initially profited from the transition to the West German pension system, subsequent cohorts had to face challenges associated with the transition to the market economy. The results suggest that postreunification unemployment and status decline had delayed effects on old-age mortality in East Germany.
Time-dependence of NIHSS in predicting functional outcome of patients with acute ischemic stroke treated with intravenous thrombolysis
Authors: Wu Zimu , Zeng Minyan , Li Chao , Qiu Hongyan , Feng Haixia , Xu Xiaonan , Zhang Haoyang , Wu Jun
Published: April 2019

Objectives

The National Institute of Health Stroke Scale (NIHSS) is a predictor for the prognosis of acute ischaemic stroke (AIS) and its prediction is time-dependent. We examined the performance of NIHSS at different timepoints in predicting functional outcome of patients with thrombolysed AIS.

Methods

This prospective study included 269 patients with AIS treated with recombinant tissue plasminogen activator (rt-PA). Unfavourable functional outcome was defined as modified Rankin Scale score 4–6 at 3 months after rt-PA treatment. Receiver operating characteristic curves were used to examine the predictive power of NIHSS score at admission and 2 hours/24 hours/7 days/10 days after rt-PA treatment. Youden’s index was used to select the threshold of NIHSS score. Logistic regression was used to estimate the ORs of unfavourable functional outcome for patients with NIHSS score higher than the selected thresholds.

Results

The threshold of NIHSS score at admission was 12 (sensitivity: 0.51, specificity: 0.84) with an acceptable predictive power (area under curve [AUC] 0.74) for unfavourable functional outcome. The threshold changed to 5 at 24 hours after rt-PA treatment (sensitivity: 0.83, specificity: 0.65) and remained unchanged afterwards. The predictive power and sensitivity sequentially increased over time and peaked at 10 days after rt-PA treatment (AUC 0.92, sensitivity: 0.85, specificity: 0.80). NIHSS scores higher than the thresholds were associated with elevated risk of unfavourable functional outcome at all timepoints (all p<0.001).

Conclusions

NIHSS is time-dependent in predicting AIS prognosis with increasing predictive power over time. Since patients whose NIHSS score ≥ 12 are likely to have unfavourable functional outcome with rt-PA treatment only, mechanical thrombectomy should be largely taken into consideration for these patients.
Early complementopathy predicts the outcomes of patients with trauma
Authors: Li Yansong , Zhao Qingwei , Liu Bin , Dixon Alexander , Cancio Leopoldo , Dubick Michael , Dalle Lucca Jurandir
Published: April 2019

Background

Complementopathy (rapid complement activation and consumption after trauma) has been reported in trauma patients, but the underlying mechanism of these phenomena and their clinical significance remain unclear. This study aimed to determine the complement/complement pathway activation and identify the association of complement activation with clinical outcomes in trauma patients.

Methods

We studied 33 trauma patients with mean Injury Severity Score of 25, and 25 healthy volunteers. Sera were collected on patients’ arrival at the emergency department, as well as 1, 2, 3, 5, and 7 days after trauma, to measure the levels of terminal complement activation product soluble C5b-9 (sC5b-9) by ELISA. In addition, the functional complement activation pathway was evaluated using a commercial complement system screening kit.

Results

Serum concentrations of sC5b-9 (complement terminal pathway activity) were significantly increased in trauma patients throughout the entire observation period except on day 1. Complement terminal activities were significantly higher in 27 of 33 patients with systemic inflammatory response syndrome (SIRS) than non-SIRS patients on day 2, day 5, and day 7. Increased serum levels of sC5b-9 positively correlated with SIRS. Functional complement analysis revealed that the classical pathway was the predominant pathway responsible for complement activation. Burn patients tended to have a greater and prolonged classical pathway activation than non-burn patients, and burn injury and blunt injury were associated with higher blood levels of sC5b-9 than penetrating injury.

Discussion

Early complement activation through the classical pathway after trauma is observed and positively correlated with the development of SIRS. Thus, monitoring of the complement system might be beneficial in the care of critically injured patients.

Level of evidence

III.

Study type

Prognostic.
Amputation to treat osteomyelitis of the metatarsus in two partially domesticated springboks (Antidorcas marsupialis)
Authors: Poore Luke Alexander , Koeppel Katja , Steenkamp Gerhard
Published: April 2019

Two springboks were diagnosed with chronic osteomyelitis of the metatarsus of the left hindlimb. The springboks had both suffered open fractures of the metatarsus of the left hindlimb 12 weeks and one week prior to presentation. External coaptation had initially been used to give stability and encourage fracture healing. This had proved unsuccessful in both cases and an infection and osteomyelitis had developed at the fracture sites. Two amputations had been subsequently performed in case 1 but had failed to resolve infection of the skin and subcutaneous tissues. An osteomyelitis of the underlying metatarsus had developed. No treatment apart from external coaptation had been performed before referral in case 2. Surgical amputation of the metatarsus and tarsus was performed as salvage procedures in both cases. The springboks adjusted to the loss of the left tarsus and metatarsus with no orthopaedic disorders at re‐examinations 12 months after surgery.
Spontaneous pneumomediastinum in three adult horses
Authors: Smith Sarah , Marr Celia M
Published: April 2019

The report describes the diagnosis and management of spontaneous pneumomediastinum in three horses which were presented with acute‐onset increased respiratory effort. Pneumomediastinum was evident radiographically without evidence of internal or external trauma. Two horses had no obvious inciting cause and one horse had chronic interstitial pneumonia. All horses developed echocardiographic changes consistent with right heart dysfunction. Radiographic evidence of pneumomediastinum resolved in 14–21 days along with all other clinical abnormalities. Despite the severity of the initial clinical signs, all cases reported made a rapid and complete recovery, suggesting that, as in human beings, spontaneous pneumomediastinum in horses is a benign condition with a good prognosis.
Laryngopharyngeal mucosal fold causing upper airway obstruction in a dog
Authors: Penfold Miles John , van der Zee Johannes , Hartman Marthinus Jacobus
Published: April 2019

A 2.4‐kg, six‐year‐old, sterilised, male Pomeranian presented with dyspnoea that had begun two years prior and slowly progressed. Pharyngoscopy identified a redundant laryngopharyngeal mucosal fold that was being aspirated cranially into the laryngeal opening causing upper airway obstruction. A diode laser was used to resect the fold. Postoperative laryngeal oedema necessitated the use of a tracheostomy tube for just over two days. Otherwise, the dog made an uneventful recovery. To the authors’ knowledge, this is the first report of a redundant laryngopharyngeal mucosal fold resulting in upper airway obstruction in a dog.
Fluorescence-based techniques to assess the miscibility and physical stability of a drug–lipid complex
Authors: Huang Jiahao , Chen Peter X. , Wettig Shawn
Published: April 2019

The objective of this study was to evaluate the feasibility of using fluorescence-based techniques to assess the miscibility and physical stability of a drug–lipid complex pharmaceutical dosage form under a solvent-free condition. An indomethacin–phospholipid complex (IDM–DPC) was used as model complex for this study. The miscibility of indomethacin within the phospholipid was assessed by fluorescence spectroscopy, fluorescence microscopy, and infrared spectroscopy. The miscibility limit of the complex system was determined by fluorescence to be 20%–30% drug loading content, showing good correlation with infrared spectroscopy. The physical stability of the IDM–DPC stored at 40 °C was evaluated by fluorescence microscopy. Indomethacin formulated in the lipid complex with an indomethacin loading not more than 30% remained in an amorphous state within a period of 21 days, whereas the samples with a drug loading over 30% started to crystallize earlier with increasing drug content. IDM–DPC having higher miscibilities were found to be more resistant to recrystallization under heating, thus having better physical stability. Fluorescence-based techniques showed convenience and promise in characterizing drug–lipid miscibility and predicting storage stability under a solvent-free condition.
Minimum-energy distribution of point charges confined to a square
Authors: Oymak Hüseyin , Alkuwafi Abdulwahhab
Published: April 2019

The minimum-energy configurations of [Formula: see text] identical classical point charges confined within a square under the effect of a Coulombic [Formula: see text] potential have been determined by performing steepest-descent simulations. The energies of the final optimized configurations are given, along with their corresponding structural charge distributions. When all systems evolve in time to reach a minimum-energy configuration, local or global, they are all seen to be in quest of symmetry.
Lane Marking Detection Based on Segments with Upper and Lower Structure
Authors: Huang Junjie , Wang Zhiling , Liang Huawei , Lin Linglong , Yu Biao , Dong Fei , Xu Yan
Published: April 2019

An effective and accurate lane marking detection algorithm is a fundamental element of the intelligent vehicle system and the advanced driver assistant system, which can provide important information to ensure the vehicle runs in the lane or warn the driver in case of lane departure. However, in the complex urban environment, lane markings are always affected by illumination, shadow, rut, water, other vehicles, abandoned old lane markings and non-lane markings, etc. Meanwhile, the lane markings are weak caused by hard use over time. The dash and curve lane marking detection is also a challenge. In this paper, a new lane marking detection algorithm for urban traffic is proposed. In the low-level phase, an iterative adaptive threshold method is used for image segmentation, which is especially suitable for the blurred and weakened lane markings caused by low illumination or wear. In the middle-level phase, the algorithm clusters the candidate pixels into line segments, and the upper and lower structure is used to cluster the line segments into candidate lanes, which is more suitable for curve and dashed lane markings. In the high-level phase, we compute the highest scores to get the two optimal lane markings. The optimal strategy can exclude interference similar to lane markings. We test our algorithm on Future Challenge TSD-Lane dataset and KITTI UM dataset. The results show our algorithm can effectively detect lane markings under multiple disturbance, occlusions and sharp curves.
Unique Coverage with Rectangular Regions
Authors: Aschner Rom , Carmi Paz , Stein Yael
Published: April 2019

We study unique coverage problems with rectangle and half-strip regions, motivated by wireless networks in the context of coverage using directional antennae without interference. Given a set [Formula: see text] of points (clients) and a set [Formula: see text] of directional antennae in the plane, the goal is to assign a direction to each directional antenna in [Formula: see text], such that the number of clients in [Formula: see text] that are uniquely covered by the directional antennae is maximized. A client is covered uniquely if it is covered by exactly one antenna. We consider two types of rectangular regions representing half-strip directional antennae: unbounded half-strips and half-strips bounded by a range [Formula: see text] (i.e., [Formula: see text]-sided rectangular regions and rectangular regions). The directional antennae can be directed up or down. We present two polynomial time algorithms: an optimal solution for the problem with the [Formula: see text]-sided rectangular regions, and a constant factor approximation for the rectangular regions.
Helly-Type Theorems in Property Testing
Authors: Chakraborty Sourav , Pratap Rameshwar , Roy Sasanka , Saraf Shubhangi
Published: April 2019

Helly’s theorem is a fundamental result in discrete geometry, describing the ways in which convex sets intersect with each other. If [Formula: see text] is a set of [Formula: see text] points in [Formula: see text], we say that [Formula: see text] is [Formula: see text]-clusterable if it can be partitioned into [Formula: see text] clusters (subsets) such that each cluster can be contained in a translated copy of a geometric object [Formula: see text]. In this paper, as an application of Helly’s theorem, by taking a constant size sample from [Formula: see text], we present a testing algorithm for [Formula: see text]-clustering, i.e., to distinguish between the following two cases: when [Formula: see text] is [Formula: see text]-clusterable, and when it is [Formula: see text]-far from being [Formula: see text]-clusterable. A set [Formula: see text] is [Formula: see text]-far [Formula: see text] from being [Formula: see text]-clusterable if at least [Formula: see text] points need to be removed from [Formula: see text] in order to make it [Formula: see text]-clusterable. We solve this problem when [Formula: see text], and [Formula: see text] is a symmetric convex object. For [Formula: see text], we solve a weaker version of this problem. Finally, as an application of our testing result, in the case of clustering with outliers, we show that with high probability one can find the approximate clusters by querying only a constant size sample.
On Combinatorial Depth Measures
Authors: Durocher Stephane , Fraser Robert , Leblanc Alexandre , Morrison Jason , Skala Matthew
Published: April 2019

Given a set [Formula: see text] of points and a point [Formula: see text] in the plane, we define a function [Formula: see text] that provides a combinatorial characterization of the multiset of values [Formula: see text], where for each [Formula: see text], [Formula: see text] is the open half-plane determined by [Formula: see text] and [Formula: see text]. We introduce two new natural measures of depth, perihedral depth and eutomic depth, and we show how to express these and the well-known simplicial and Tukey depths concisely in terms of [Formula: see text]. The perihedral and eutomic depths of [Formula: see text] with respect to [Formula: see text] correspond respectively to the number of subsets of [Formula: see text] whose convex hull contains [Formula: see text], and the number of combinatorially distinct bisections of [Formula: see text] determined by a line through [Formula: see text]. We present algorithms to compute the depth of an arbitrary query point in [Formula: see text] time and medians (deepest points) with respect to these depth measures in [Formula: see text] and [Formula: see text] time respectively. For comparison, these results match or slightly improve on the corresponding best-known running times for simplicial depth, whose definition involves similar combinatorial complexity.
Characterization of groups with planar, toroidal or projective planar (proper) reduced power graphs
Authors: Anitha T. , Rajkumar R.
Published: April 2019

The reduced power graph [Formula: see text] of a group [Formula: see text] is the graph whose vertex set is the set of all elements of [Formula: see text], and two vertices [Formula: see text] and [Formula: see text] are adjacent in [Formula: see text] if and only if [Formula: see text] or [Formula: see text]. The proper reduced power graph [Formula: see text] is the subgraph of [Formula: see text] induced by the set of all nontrivial elements of [Formula: see text]. In this paper, we study the planarity, toroidality and projective planarity of (proper) reduced power graph of a group.
2-Local derivations of infinite-dimensional Lie algebras
Authors: Ayupov Shavkat , Yusupov Baxtiyor
Published: April 2019

In the present paper, we study 2-local derivations of infinite-dimensional Lie algebras over a field of characteristic zero. We prove that all 2-local derivations of the Witt algebra as well as of the positive Witt algebra and the classical one-sided Witt algebra are (global) derivations. We also give an example of an infinite-dimensional Lie algebra with a 2-local derivation which is not a derivation.
Multiscale transform-based secured joint efficient medical image compression-encryption using symmetric key cryptography and ebcot encoding technique
Authors: Raja S. P.
Published: April 2019

Due to the huge advancement in technology, digitizing the multimedia content like text, images and videos has become easier. Everyday huge amounts of multimedia content are shared through the social networks using internet. Sometimes this multimedia content can be hacked by the hackers. This will lead to the misuse of the data. On the other hand, the medical content needs high security and privacy. Motivated by this, joint secured medical image compression–encryption mechanisms are proposed in this paper using multiscale transforms and symmetric key encryption techniques. The multiscale transforms involved in this paper are wavelet transform, bandelet transform and curvelet transform. The encryption techniques involved in this paper are international data encryption algorithm (IDEA), Rivest Cipher (RC5) and Blowfish. The encoding technique used in this paper is embedded block coding with truncation (EBCOT). Experimental results are done for the proposed works and evaluated by using various parameters like Peak Signal-to-Noise Ratio (PSNR), Mean Square Error (MSE), Image Quality Index (IQI) and Structural Similarity Index (SSIM), Average Difference (AD), Normalized Cross-correlation (NK), Structural Content (SC), Maximum difference (MD), Laplacian Mean Squared Error (LMSE) and Normalized Absolute Error (NAE). It is justified that the proposed approaches in this paper yield good results.
Maps Generated by Entangled Momenta: Exploring Spin Entanglement in Relativity
Authors: Palge Veiko , Dunningham Jacob , Groote Stefan , Liivat Hannes
Published: April 2019

We study relativistic entanglement of a bipartite system consisting of massive spin-1/2 particles with momenta. The spin state is described by the maximally entangled Bell state and momenta are given by entangled Gaussian distributions. We conceptualize the dependency between spin and momentum in relativity along the lines of controlled operations in quantum information theory. This leads to a systematic study of maps generated by Wigner rotations on the spin degree of freedom of the total system in different boost scenarios. We use a visualization tool from quantum information theory in order to get better insight into how and why the entanglement changes in different boost geometries.
Some remarks on Yamabe solitons
Authors: Chakraborty Debabrata , Hui Shyamal Kumar , Mandal Yadab Chandra
Published: April 2019

The evolution of some geometric quantities on a compact Riemannian manifold [Formula: see text] whose metric is Yamabe soliton is discussed. Using these quantities, lower bound on the soliton constant is obtained. We discuss about commutator of soliton vector fields. Also, the condition of soliton vector field to be a geodesic vector field is obtained.
Unconventional Solar Energy: Singlet Fission
Authors: Michl Josef
Published: April 2019

Described simply, singlet fission is a process in which a singlet excited molecule transfers about half of its excitation energy to a neighbor molecule, both end up in their triplet state, and the two triplet excitations diffuse apart. The process is of interest for solar cells. Used in conjunction with ordinary solar cell material, a layer of singlet-fission material offers an opportunity to utilize higher energy photons more efficiently. The maximum theoretical efficiency is then close to 1/2 instead of the Shockley-Queisser value of 1/3 that applies to an ordinary single-junction cell. The problem that prevents an immediate production of singlet fission solar cells is the dearth of sufficiently stable efficient materials. The formulation of simple rules for the design of suitable compounds for the purpose is discussed.
Huangkui Lianchang Decoction Ameliorates DSS-Induced Ulcerative Colitis in Mice by Inhibiting the NF-kappaB Signaling Pathway
Authors: He Zongqi , Zhou Qing , Wen Ke , Wu Bensheng , Sun Xueliang , Wang Xiaopeng , Chen Yugen
Published: April 2019

Background.The nuclear factor kappa beta (NF-κB) signaling pathway plays an important role in ulcerative colitis (UC). Huangkui Lianchang decoction (HLD) is an effective traditional Chinese medicinal compound used in the treatment of UC. HLD has good effects in the clinic, but the mechanism by which HLD acts is unclear. This study aims to reveal the exact molecular mechanism of HLD in the treatment of UC.Methods. Mouse ulcerative colitis was induced by dextran sulfate sodium (DSS) and treated with HLD. Intestinal damage was assessed by disease activity index (DAI), colon macroscopic lesion scores, and histological scores. Interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-1βwere detected in colon tissue using ELISA. Myeloperoxidase (MPO) and superoxide dismutase (SOD) activities in the colonic mucosa were measured. The levels of IL-6, inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2) in the colon were determined by real-time quantitative polymerase chain reaction (qPCR). The expression of NF-κB, IκBα, and p-IκBαin the colon was measured by Western blot.Results. After treatment with HLD, the DAI scores, macroscopic lesion scores, and histological scores decreased, and the levels of inflammatory cytokines related to the NF-κB signaling pathway, such as IL-6, TNF-α, and IL-1β, as well as those of iNOS and COX-2, were reduced; at the same time, colonic pathological damage was alleviated, and the MPO and SOD activities decreased. Western blot confirmed that HLD can inhibit the NF-κB signaling pathway in DSS-induced ulcerative colitis.Conclusion. HLD can alleviate the inflammation caused by ulcerative colitis. In particular, high doses of HLD can significantly alleviate intestinal inflammation and have comparable efficacy to Mesalazine. We propose that the anti-inflammatory activity of HLD on DSS-induced colitis in mice may involve the inhibition of the NF-κB pathway.
A New Mathematical Method to Study the Singularity of 3‐RSR Multimode Mobile Parallel Mechanism
Authors: Zhang Chunyan , Wan Yu , Zhang Dan , Ma Qihua
Published: April 2019

In the process of parallel mechanism design, it is difficult to avoid the singularity, especially in the mobile parallel mechanism. Therefore, a new mathematical method to study the singularity of multimode mobile parallel mechanism is proposed. In this paper, the singularity of 3‐RSR parallel mechanism (PM) is analyzed by using reciprocal screw methods and linear geometry theory from two aspects of fixed mode and all‐attitude multiple motion modes. Specifically, the complete Jacobian matrix of the PM is obtained by using the screw theory, and the reciprocal screw of each branch is expressed with algebraic method and geometric drawing method. Furthermore, the singularity of the PM can be obtained by analyzing the reciprocal screw correlation and using the spatial linear geometry theory. Finally, we analyze the singular configuration of the PM under various modes, which provide theoretical guidance for the gait planning of the multimode mobile PM and will be useful for the selection of mechanism drive and time‐sharing control.
Neural Terminal Sliding‐Mode Control for Uncertain Systems with Building Structure Vibration
Authors: Wang Jianhui , Chen Wenli , Chen Zicong , Huang Yunchang , Huang Xing , Wu Wenqiang , He Biaotao , Zhang Chunliang
Published: April 2019

Building structures occasionally suffer from unpredictable earthquakes, which can cause severe damage and can threaten human lives. Thus, effective control methods are needed to protect against structural vibration in buildings, and rapid finite‐time convergence is a key performance indicator for vibration control systems. Rapid convergence can be ensured by applying a sliding‐mode control method. However, this method would result in chattering issue, which would weaken the feasibility of the physical implementation. To address this problem, a neural terminal sliding‐mode control method is proposed. The proposed method is combined with a terminal sliding‐mode and a hyperbolic tangent function to ensure that the considered system can be stabilized in finite‐time without chattering. Finally, the control effect of the proposed method is compared with that of LQR (linear quadratic regulator) control and switching function control. The simulation results showed that the proposed method can ensure rapid convergence while the chattering issue can be eliminated effectively. And the structural building vibration can be suppressed effectively too.
Intrapulmonary Autoantibodies to HSP72 Are Associated with Improved Outcomes in IPF
Authors: Mills Ross , Mathur Abhinav , Nicol Lisa M. , Walker Jeremy J. , Przybylski Alexander A. , Mackinnon Alison C. , Howie Sarah E. M. , Wallace William A. H. , Dransfield Ian , Hirani Nik
Published: April 2019

Rationale. Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic interstitial lung disease, with high mortality. Currently, the aetiology and the pathology of IPF are poorly understood, with both innate and adaptive responses previously being implicated in the disease pathogenesis. Heat shock proteins (Hsp) and antibodies to Hsp in patients with IPF have been suggested as therapeutic targets and prognostic biomarkers, respectively. We aimed to study the relationship between the expression of Hsp72 and anti-Hsp72 antibodies in the BAL fluid and serum Aw disease progression in patients with IPF.Methods. A novel indirect ELISA to measure anti-Hsp72 IgG was developed and together with commercially available ELISAs used to detect Hsp72 IgG, Hsp72 IgGAM, and Hsp72 antigen, in the serum and BALf of a cohort of IPF (n=107) and other interstitial lung disease (ILD) patients (n=66). Immunohistochemistry was used to detect Hsp72 in lung tissue. The cytokine expression from monocyte-derived macrophages was measured by ELISA.Results. Anti-Hsp72 IgG was detectable in the serum and BALf of IPF (n=107) and other ILDs (n=66). Total immunoglobulin concentrations in the BALf showed an excessive adaptive response in IPF compared to other ILDs and healthy controls (p=0.026). Immunohistochemistry detection of C4d and Hsp72 showed that these antibodies may be targeting high expressing Hsp72 type II alveolar epithelial cells. However, detection of anti-Hsp72 antibodies in the BALf revealed that increasing concentrations were associated with improved patient survival (adjusted HR 0.62, 95% CI 0.45-0.85;p=0.003).In vitroexperiments demonstrate that anti-Hsp72 complexes stimulate macrophages to secrete CXCL8 and CCL18.Conclusion. Our results indicate that intrapulmonary anti-Hsp72 antibodies are associated with improved outcomes in IPF. These may represent natural autoantibodies, and anti-Hsp72 IgM and IgA may provide a beneficial role in disease pathogenesis, though the mechanism of action for this has yet to be determined.
Dynamic Characteristics of Spur Gear Pair with Dynamic Center Distance and Backlash
Authors: Liu Jie , Liu She , Zhao Weiqiang , Zhang Lei
Published: April 2019

Effect of dynamic backlash and rotational speed is investigated on the six-degree-of-freedom model of the gear-bearing system with the time-varying meshing stiffness. The relationship between dynamic backlash and center distance can be defined clearly. The nonlinear differential equations of the model are solved by the Newmark-β method. The results show that system amplitude increases in the wake of increasing rotational speed. After reaching a certain rotational speed, the system jumps from periodic motion to chaos motion, and the effective amplitude is changed violently. Comparing the dynamic backlash with fixed backlash, the amplitude of the dynamic backlash is augmented and the frequency components are diversified. The vibration displacement is enlarged by the dynamic backlash and the chaotic behavior of the system becomes complex with increasing rotational speed. The numerical results provide a useful reference source for engineers to select rotational speed section for steady running.