bluuebunny/crossref_metadata_2025 huggingface dataset:
Nonlinear electrocardiographic imaging using polynomial approximation networks
Authors: Rajagopal Abhejit , Radzicki Vincent , Lee Hua , Chandrasekaran Shivkumar
Published: October 2018

Electrocardiography is a valuable tool to aid in medical understanding and treatment of heart-related ailments, specifically atrial fibrillation (AF) and other irregular cardiac behavior. Although signs of AF will manifest in conventional electrocardiogram (ECG) recordings, interpretation and localization of AF sources require significant clinical expertise. In this vein, electrocardiographic imaging has emerged as an important medical imaging modality that provides reconstructions of the heart's electrical activity from non-invasive multi-lead body-surface ECG and anatomical x-ray computed tomography images. In this paper, we present a nonlinear inversion model for computing this mapping to improve upon the reconstruction performance of current methods. While contemporary techniques typically determine an inverse solution by discretizing and inverting an underdetermined linear system of partial differential equations governing the relationship between voltage potentials of the heart and torso, the presented technique re-casts this problem as a task in function approximation and provides a direct parameterization of the inverse operator using a polynomial neural network. That is, the outlined nonlinear inversion technique is a generalization of contemporary reconstruction techniques which allows geometrical and material parameterizations of the forward-model to be optimized using real experimental data collected from patients suffering from AF, as to better represent the inverse operator with respect to reconstruction metrics applicable to electrophysiology. The accuracy of our model is evaluated against a dataset of real-patient recordings to demonstrate its validity, and mathematical analysis is provided to support the polynomial expansion used in our inversion model.
Tracer-Encapsulated Solid Pellet (TESPEL) injection system for Wendelstein 7-X
Authors: Bussiahn R. , Tamura N. , McCarthy K. J. , Burhenn R. , Hayashi H. , Laube R. , Klinger T. ,   LHD Experiment Group,   W7-X Team
Published: October 2018

Impurity confinement in fusion plasmas is mainly determined by transport mechanisms in the core region. For the Wendelstein 7-X stellarator, its island divertor is expected to screen effectively external impurity sources in the scrape-off layer at higher densities. However, the unique feature of Tracer-Encapsulated Solid Pellet (TESPEL) injection, releasing impurities at a well-localized radial position directly in the core plasma, enables investigating such transport mechanisms. This paper reports on the detailed design of a completely new TESPEL injection system, which has been designed by the National Institute for Fusion Science, Toki, Japan, and is currently being installed at Max-Planck-Institut für Plasmaphysik, Greifswald, Germany, for the Wendelstein 7-X. This injector consists of a storage and injection unit, attached to a system of guiding tubes which run through 3 successive differential pumping stages. A light-gate system and an optical observation system are used to determine the location of the deposited tracers. Laboratory tests carried out by shooting TESPELs onto a sample foil showed good performance after careful realignment of the guiding tubes.
Ab initio response functions for Cherenkov-based neutron detectors
Authors: Schlossberg D. J. , Moore A. S. , Beeman B. V. , Eckart M. J. , Grim G. P. , Hartouni E. P. , Hatarik R. , Rubery M. S. , Sayre D. B. , Waltz C.
Published: October 2018

Neutron time-of-flight diagnostics at the NIF were recently outfitted with Cherenkov detectors. A fused silica radiator delivers sub-nanosecond response time and is optically coupled to a microchannel plate photomultiplier tube with gain from ∼1 to 104. Capitalizing on fast time response and gamma-ray sensitivity, these systems can provide better than 30 ps precision for measuring first moments of neutron distributions. Generation of ab initio instrument response functions (IRFs) is critical to meet the <1% uncertainty needed. A combination of Monte Carlo modeling, benchtop characterization, and in situ comparison is employed. Close agreement is shown between the modeled IRFs and in situ measurements using the NIF’s short-pulse advanced radiographic capability beams. First and second moments of neutron spectra calculated using ab initio IRFs agree well with established scintillator measurements. Next-step designs offer increased sensitivity and time-response.
Prediction of limit cycle amplitudes in thermoacoustic engines by means of impedance measurements
Authors: Zorgnotti V. , Penelet G. , Poignand G. , Garrett S. L.
Published: October 2018

This paper deals with the prediction of the frequency and the amplitude of self-sustained oscillations generated in thermoacoustic prime movers, which are compared to measurements. A specially designed, high amplitude, acoustic impedance sensor was developed to perform measurements of the input impedance of a thermoacoustic core, as a function of the heating power supplied to the device, of the frequency, and of the amplitude of acoustic forcing. Those measurements can then be used to predict the spontaneous generation of acoustic oscillations and their saturation up to a steady-state. Those predictions were successful for various acoustic loads connected to the thermoacoustic core. Moreover, the measurements of acoustic impedance as a function of the amplitude of acoustic oscillations are compared to a model based on the linear thermoacoustic theory, and this comparison provides insights into the processes controlling the saturation of acoustic oscillations. The experimental procedure described in this paper can also have practical value, since it provides an empirical way, in principle, to optimize the coupling between the thermoacoustic core and the load so that the potential efficiency of thermoacoustic energy conversion is maximized.
2D WSe2/MoS2 van der Waals heterojunction photodiode for visible-near infrared broadband detection
Authors: Lee Hyo Sun , Ahn Jongtae , Shim Wooyoung , Im Seongil , Hwang Do Kyung
Published: October 2018

Two dimensional (2D) layered van der Waals (vdW) atomic crystals are an important class of emerging materials due to their unique physical properties. In particular, the nature of dangling–bond–free surfaces in 2D vdW materials enables the formation of heterojunctions without the constraint of atomic lattice match. Here, we report on a 2D WSe2/MoS2 multilayer van der Waals heterojunction PN diode and its application for visible-near infrared broadband detection. The WSe2/MoS2 PN diode shows excellent performance with an ideality factor of 1.5 and a high rectification (ON/OFF) ratio of over 106. This PN diode exhibits spectral photo-responses from the ultraviolet (405 nm) region to the near infrared (808 nm) region with obvious photovoltaic behaviors (very clear open circuit voltage and short circuit current). In addition to the static behavior, photocurrent switching behaviors are clearly observed under periodic illuminations at up to 1 KHz. The device shows a linear response within the optical power density range of 10−5 W cm−2 to 1 W cm−2 and a linear dynamic range is estimated to be 123 dB.
Efficient learning and crossbar operations with atomically-thin 2-D material compound synapses
Authors: Sanchez Esqueda Ivan , Zhao Huan , Wang Han
Published: October 2018

Accurate and efficient synaptic weight programming and vector-matrix multiplication are demonstrated using compound synapses constructed with ultralow power binary memristive devices having oxidized atomically thin two-dimensional hexagonal boron nitride (BNOx) filament formation layers. Experimental data of the resistive-switching current-voltage characteristics of BNOx memristors are used to formulate variation-aware models that enable statistically analyzing the trade-off between efficiency and accuracy as a function of the synaptic resolution (i.e., levels of synaptic weight programming). Results are compared with commonly reported oxide-based memristors indicating orders of magnitude (i.e., ∼105) improvements in power efficiency and ∼2-5× improvements in accuracy.
Control of the solidification structure of hypermonotectic Cu-40 wt.%Pb alloy melt by pulse currents
Authors: Sun Xiaosi , Hao Weixin , Ma Teng , Geng Guihong
Published: October 2018

In this study, pulse currents with different peak densities were applied on hypermonotectic Cu-40 wt.% Pb alloy during the cooling process. The microstructures of the alloy before and after the application of pulse currents were compared to explore the influences of pulse currents on solidification microstructures of the alloy. The comparison results indicated that pulse currents could decrease the activity of clusters inside the alloy melt, enhance the solvent effect, and reduce the volume fraction of the second phase, thus inhibiting liquid phase separation and achieving the control of the solidification structure of the alloy.
Study of spin-orbit torque induced magnetization switching in synthetic antiferromagnet with ultrathin Ta spacer layer
Authors: Kong W. J. , Wan C. H. , Tao B. S. , Fang C. , Huang L. , Guo C. Y. , Irfan M. , Han X. F.
Published: October 2018

Spin manipulation in magnetic materials based on spin-orbit torque gives rise to promising families of magnetic memory and logic devices. In the synthetic antiferromagnetic structure of CoFeB/Ta/CoFeB where both CoFeB layers exhibit perpendicular anisotropy, we study the magnetization switching process based on the mechanism of spin-orbit torque and interlayer exchange coupling mediated by a Ta layer. The magnetization switching trigged by in-plane current is achieved. Though the heavy metal Ta layer is ultrathin, the critical current density is 8 × 106–1 × 107 A/cm2 with a bias field of 5–10 mT. Meanwhile, the current induced anti-damping-like field and field-like field are determined by the harmonic lock-in technique. Harmonic results suggest that the generation efficiency of the field-like field is ∼1.24 times that of the anti-damping-like field. The effective spin Hall angle of a Ta layer is derived to be around −0.158. Finally, we examine the magnetic properties of CoFeB layers as a function of temperature which indicates that the magnetic properties of bottom and top CoFeB layers have a close correlation with the interface quality and growth order.
Significantly enhanced breakdown field for core-shell structured poly(vinylidene fluoride-hexafluoropropylene)/TiO2 nanocomposites for ultra-high energy density capacitor applications
Authors: Wang Chenchen , Zhang Jinxi , Gong Shaobo , Ren Kailiang
Published: October 2018

Organic/inorganic nanocomposite materials have been extensively studied for high energy density capacitor applications due to their relatively large dielectric constant. However, most of these nanocomposite materials suffer from a very low breakdown field. In this investigation, poly(methyl methacrylate) (PMMA) grafted titanium dioxide (TiO2) (TiO2-g-PMMA) was synthesized through a seeded emulsion polymerization method. Then, the hybrid nanoparticles were incorporated into a poly(vinylidene fluoride-hexafluoropropylene) (PVDF-HFP) film using solution casting to form a PVDF-HFP/TiO2-g-PMMA nanocomposite. After the characterization, it was revealed that the TiO2 nanoparticles were perfectly coated with the PMMA layer. Furthermore, the dielectric measurement results showed that the permittivity nanocomposite was enhanced by 13.9% as compared with the pristine PVDF-HFP film. The polarization loop data of the nanocomposite indicated that the highest breakdown field and energy density of the PVDF-HFP film with 1 vol. % TiO2-g-PMMA reached 560 MV/m and 14.2 J/cm3, respectively. The breakdown field of the nanocomposite with grafting is doubled as compared with the nanocomposite without grafting. Furthermore, as compared with the pristine PVDF-HFP at the same electric field, the energy density of the PVDF-HFP/TiO2-g-PMMA nanocomposite (1 vol. %) is increased by 14.4% (from 12.4 to 14.2 J/cm3). The nanocomposite film also showed an improved charge-discharge energy efficiency of 47% under 500 MV/m electric field, which was much higher than the pristine PVDF-based polymer. The PVDF-HFP/TiO2-g-PMMA nanocomposite shows a great promise for future high energy density capacitor applications.
Capital planning for operating theatres based on projecting future theatre requirements
Authors: Sheehan Jennifer A. , Tyler Peter , Jayasinha Hirani , Meleady Kathleen T. , Jones Neill
Published: October 2018

During 2006, NSW and ACT Health Departments jointly engaged KPMG to develop an Operating Theatre Requirements’ Projection Model and an accompanying planning guideline. A research scan was carried out to identify drivers of surgical demand, theatre capacity and theatre performance, as well as locating existing approaches to modelling operating theatre requirements for planning purposes. The project delivered a Microsoft Excel-based model for projecting future operating theatre requirements, together with an accompanying guideline for use of the model and interpretation of its outputs. It provides a valuable addition to the suite of tools available to Health staff for service and capital planning. The model operates with several limitations, largely due to being data dependent, and the state and completeness of available theatre activity data. However, the operational flexibility built into the model allows users to compensate for these limitations, on a case by case basis, when the user has access to suitable, local data. The design flexibility of the model means that updating the model as improved data become available is not difficult; resulting in revisions being able to be made quickly, and disseminated to users rapidly.

What is known about the topic?
In New South Wales there has been no documented, consistent, robust planning methodology to guide the estimated future requirements for operating and procedural suites, nor recommendations available to determine the number of operating theatres that provide optimal efficiency.

What does this paper add?
Opportunities to design and build new operating suites rarely arise. There is a great deal of uncertainty about future surgical models of care and recent history shows that technology and development of new procedures and approaches have greatly changed the nature of the theatres and rooms required for many interventions. This paper describes the process of developing a planning methodology to estimate the future operating suite capacity required to meet forecast future surgical demand across New South Wales for both metropolitan and rural Area Health Services.

What are the implications for practitioners?
Although now used only in the New South Wales public sector, the methodology can easily be applied to planning requirements for operating theatres in the private sector.
Two hundred days of nurse practitioner prescribing and role development: a case study report from a hospital-based acute pain management team
Authors: Schoenwald Anthony V.
Published: October 2018

Purpose. This report evaluates a beginning Nurse Practitioner (NP) role in Acute Pain Management. Healthcare setting. The role was implemented within an anaesthesiology-based pain service. The NP author developed this pain service in 2002 and was endorsed as an NP 6 years later. The NP reviews all clients undergoing major surgery or trauma and provides pain management to women for caesarean section. Prior to this role, there were significant delays for some patients requiring prompt analgesia. This was because of the decreased availability of anaesthetists to fully participate in the pain service due to the demand for complex anaesthesiology practice. Method of data collection. Data were conveniently collected by the NP on prescription and service provision over 200 working days. Main findings. Therapeutic activity reflected contemporary pain management practice and espouse the NP as a safe and effective clinician. The role has improved patient access to pain management through the prompt use of non-pharmacological interventions, drugs used to treat analgesic side effects, opioids and non-opioid analgesics. Principal conclusions. These initial positive outcomes are consistent with NP role development described elsewhere in Australia and overseas across a variety of healthcare settings. To sustain this role, robust continuing education and clinical support is required. What is known about the topic? There is little published information on the development of the Nurse Practitioner (NP) role in acute pain services in Australia or overseas. The acute pain role is a new development in Australia and so previous descriptions of NP practice have focussed on other specialty areas such as Emergency or Mental Health. What does this paper add? This report demonstrates positive and safe client outcomes as a result of a NP role in acute pain management. More importantly, it may contribute to accumulating evidence that NPs are safe prescribers of opioids and other analgesics in acute settings. What are the implications for practitioners? Novice NPs and Candidates practising in this specialty need to use this information as support for their own role development and implementation in other acute pain services in Australia.
Portal drained-viscera heat production and net flux of volatile fatty acids in Iberian pigs fed acorn
Authors: Lachica M. , González-Valero L. , Rodríguez-López J. M. , Lara L. , Fernández-Fígares I.
Published: October 2018

The aim of the present study was to determine the portal-drained viscera (PDV) heat production (HP) and net PDV flux of volatile fatty acids (VFA: acetic, propionic and butyric acids) in Iberian pigs (34-kg bodyweight) fed with acorn from evergreen oak, and to ascertain whether there is an effect of acorn feeding over time. In addition, potential contribution of both parameters to the energy budget of the animal was calculated. The following two sampling periods were conducted with six gilts: after 1 day (I) and after 1 week (II) of acorn feeding. Postprandial PDV HP was 29% greater (P < 0.01) in Sampling period II than in Sampling period I, but net PDV flux of VFA was only slightly greater (5%, P > 0.1). Potential proportional contribution of VFA to the whole HP was almost identical in both sampling periods (0.057, on average), representing 0.109 (on average) of the metabolisable energy requirements for maintenance. Pigs adapted for 1 week to an acorn diet had increased PDV HP without an increase in the net PDV flux of VFA, indicating that, apparently, nutrients other than VFA were responsible for the increased PDV HP.
Bacterial endophyte in Macropidia fuliginosa: its localisation and eradication from in vitro cultured basal-stem callus
Authors: Miyazaki Junji , Tan Beng H. , Errington Stephen G. , Kuo John J. S.
Published: October 2018

Endophytic contamination reduces efficiency in micropropagation and causes plant-culture losses. Micropropagation of black kangaroo paw (Macropidia fuliginosa (Hook.) Druce) contributes both to the needs of the Western Australia’s nursery industry and towards conservation of this unique Australian wildflower, because the seeds are difficult to germinate. Plant preservative mixture (PPM), a proprietary mixture of two broad-spectrum isothiazolone biocides, has recently been used as a prophylactic anti-bacterial agent in plant-tissue culture. Its efficacy for eradicating endogenous bacterial contaminants in M. fuliginosa was demonstrated. Plantlets of M. fuliginosa were artificially infected with Sinorhizobium meliloti, a non-sporing bacterium isolated from rhizome tissues of red kangaroo paw (Anigozanthos rufus). Histological studies using light and electron microscopy revealed the presence of bacterial cells in intercellular spaces within the leaf mesophyll and in the lumen of xylem vessels after infection. Bacterial cells were also found in intercellular spaces of callus, the latter induced from the stem base of infected shoots with 0.05 mg L–1 thidiazuron. The eradication protocol involved infiltration of infected axillary buds and basal-stem calli with 5 mL L–1 PPM under vacuum. Quantitation by high-performance liquid chromatography (HPLC) revealed that callus tissue absorbed significantly more PPM than did axillary buds. Indexation of plantlets raised from PPM-treated tissues indicated successful eradication of the endophyte from basal-stem calli, and from shoots regenerated from them.
Syntheses and Substituent Effects on the Properties of Unsymmetrical Photochromic Diarylethenes Bearing a Benzothiophene Unit
Authors: Pu Shouzhi , Li Min , Liu Gang , Le Zhanggao
Published: October 2018

Photochromic unsymmetrical diarylethenes 1a–5a that bear different electron-donating or electron-withdrawing substitutes have been synthesized, and the structures of 2a–5a determined by single-crystal X-ray diffraction analysis. Substituent effects on their optoelectronic properties, including photochromism, fluorescence, and electrochemical properties are investigated in detail. The strong electron-donating substituents have effective contributions to the absorption maxima of the closed-ring isomers and the molar coefficients, whereas the electron-withdrawing substituents can shift significantly the absorption maxima of the diarylethenes to a longer wavelength and increase their cyclization quantum yield. Diarylethenes 2, 3, and 4 show good photochromism both in solution and in the single crystalline phase. However, diarylethenes 5 shows no photochromism in the crystalline phase. Diarylethenes 1, 2, and 3 exhibit good fluorescent switching upon alternating irradiation with UV and visible light, and their fluorescent conversions in the photostationary state are all larger than 80% in hexane. In addition, cyclic voltammogram tests show that different electron-donating and electron-withdrawing substituents have a remarkable effect on the electrochemical behaviours of these diarylethenes.
Structural Studies on α-Pyrone Cycloadducts. Manifestation of the Early Stages of CO2 Extrusion by retro Hetero-Diels - Alder Reaction
Authors: Roth-Barton Jesse , Goh Yit Wooi , Karnezis Asimo , White Jonathan M.
Published: October 2018

Structures of the α-pyrone (pyran-2-one) cycloadducts 4–8 show deviations of some bond distances from their normal values, consistent with manifestation of the early stages of the retro hetero-Diels–Alder decarboxylation reaction in the ground state structures. Thus the bridgehead C–O(CO) and C–CO(O) bonds are lengthened and the bridging C–O bond is shortened. The degree of lengthening of the C–O(CO) and C–CO(O) bonds is similar, whereas in the calculated transition state structure there is significant asymmetry in the extent of C–CO(O) and C–O(CO) bond breaking.
Benefits of oxygation of subsurface drip-irrigation water for cotton in a Vertosol
Authors: Pendergast L. , Bhattarai S. P. , Midmore D. J.
Published: October 2018

Australian cotton (Gossypium hirsutum L.) is predominantly grown on heavy clay soils (Vertosols). Cotton grown on Vertosols often experiences episodes of low oxygen concentration in the root-zone, particularly after irrigation events. In subsurface drip-irrigation (SDI), cotton receives frequent irrigation and sustained wetting fronts are developed in the rhizosphere. This can lead to poor soil diffusion of oxygen, causing temporal and spatial hypoxia. As cotton is sensitive to waterlogging, exposure to this condition can result in a significant yield penalty. Use of aerated water for drip irrigation (‘oxygation’) can ameliorate hypoxia in the wetting front and, therefore, overcome the negative effects of poor soil aeration. The efficacy of oxygation, delivered via SDI to broadacre cotton, was evaluated over seven seasons (2005–06 to 2012–13). Oxygation of irrigation water by Mazzei air-injector produced significantly (P < 0.001) higher yields (200.3 v. 182.7 g m–2) and water-use efficiencies. Averaged over seven years, the yield and gross production water-use index of oxygated cotton exceeded that of the control by 10% and 7%, respectively. The improvements in yields and water-use efficiency in response to oxygation could be ascribed to greater root development and increased light interception by the crop canopies, contributing to enhanced crop physiological performance by ameliorating exposure to hypoxia. Oxygation of SDI contributed to improvements in both yields and water-use efficiency, which may contribute to greater economic feasibility of SDI for broadacre cotton production in Vertosols.
1Sl(1B) Chromosome substitution in Chinese Spring wheat promotes starch granule development and starch biosynthesis
Authors: Cao Min , Chen Guanxing , Wang Chang , Zhen Shoumin , Li Xiaohui , Zhang Wenying , Zeller F. J. , Hsam S. L. K. , Hu Yingkao , Yan Yueming
Published: October 2018

The common wheat variety Chinese Spring (CS) chromosome substitution line CS-1Sl(1B) was used in this study, in which the 1B chromosome in CS (Triticum aestivum L., 2n = 6x = 42, AABBDD) was substituted by the 1Sl from Aegilops longissima (2n = 2x = 14, SlSl). The results showed that the substitution of 1B in CS by 1Sl chromosome could significantly increase amylopectin and total starch contents. The dynamic changes in starch granules during grain development in CS and CS-1Sl(1B) demonstrated that the substitution line possessed higher amount of A-type starch granules and greater diameter of both A- and B-granules. qRT-PCR revealed that some key genes involved in starch biosynthesis, such as starch synthases (SSI, SSII and SSIII), starch branching enzymes (SBE IIa and SBE IIb) and granule-bound starch synthase (GBSS I), displayed higher transcript levels of mRNA expressions during grain development in CS-1Sl(1B). Our results indicate that the substituted 1Sl chromosome carries important genes that influence starch granule development and starch biosynthesis, which may be used as potential gene resources for improvement of wheat starch quality.
Broadleaf weed control in irrigated pasture containing Trifolium repens
Authors: Davy Josh S. , Karle Betsy M. , Kyser Guy B. , DiTomaso Joseph M. , Rinella Mathew J.
Published: October 2018

Increasing lease and purchase costs for irrigated pasture are encouraging producers to use herbicides to control broadleaf weeds and maximise forage production on their current land base, as opposed to seeking out additional pastureland. There are two challenges to using herbicides to control broadleaf weeds in irrigated pasture. One challenge is that producers often encounter weed species for which herbicide information is limited or non-existent. Another challenge is that broadleaf herbicides tend to damage desirable legumes. We evaluated the efficacy of several broadleaf herbicide options for Symphyotrichum divaricatum, a species not previously the subject of research in irrigated pasture. Additionally, we monitored herbicide impacts on desirable legumes, principally Trifolium repens. We also evaluated control of Convolvulus arvensis and Plantago lanceolata, subjects of considerable herbicide research. Our goal was to identify herbicide options that controlled all three weeds while causing the least damage to legumes. Several rates and combinations of dicamba, diflufenzopyr, triclopyr, MCPA, and 2,4-D provided statistically indistinguishable control of C. arvensis and P. lanceolata, with point estimates suggesting 66–88% control in 2011 and 43–86% control in 2012. 2,4-D + triclopyr appeared to provide the best control of P. lanceolata and C. arvensis, with point estimates for high rates indicating nearly 100% control in both years. However, this combination was particularly damaging to legumes. Based on these findings, we recommend 2,4-D + triclopyr where desirable legumes are absent. Where desirable legumes are present, we recommend 2,4-D alone. Whereas 2,4-D alone appeared not to perform as well as 2,4-D + triclopyr at controlling S. divaricatum in 2012, it was less damaging to desirable legumes.
The impact on health outcome measures of switching to generic medicines consequent to reference pricing: the case of olanzapine in New Zealand
Authors: Lessing Charon , Ashton Toni , Davis Peter
Published: October 2018

INTRODUCTION: New Zealand's Pharmaceutical Management Agency (PHARMAC) manages the list of medicines available for prescribing with government subsidy, within a fixed annual medicines budget. PHARMAC achieves this through a mix of pricing strategies including reference pricing. In 2011, PHARMAC applied generic reference pricing to olanzapine tablets. AIM: This study sought to evaluate change in outcome measures of patients switching from originator to generic olanzapine consequent to the introduction of the policy. METHODS: A retrospective study using national health data collections was conducted. Outcome measures included medicines indicators (change in dosage, concomitant therapy and treatment cessation), health care service indicators (use of emergency departments, hospitals and specialist services), surveillance reports of adverse events, and mortality. RESULTS: Subsequent to the removal of funding for originator brand olanzapine tablets, 99.7% of patients meeting the inclusion criteria switched to using generic olanzapine. Limited case reports of suspected therapeutic loss were received in the study time period. No increase in use of additional oral or injectable antipsychotic medication was observed after switching, nor any increase in other unique, non-antipsychotic prescription items. However, a high incidence of multiple switching between available brands was found. No net impact of switching brands on health service utilisation or mortality was found. DISCUSSION: The study shows that a switch can be made safely from originator olanzapine to a generic brand, and suggests that switching to generics should generally be viewed more positively. Generic reference pricing achieves considerable savings and, as a pricing policy, could be applied more widely. KEYWORDS: Antipsychotic agents; drug costs; drugs, generic; olanzapine
Midlife safer sex challenges for heterosexual New Zealand women re-partnering or in casual relationships
Authors: Morison Trish , Cook Catherine
Published: October 2018

INTRODUCTION: The rate of sexually transmitted infections (STIs) amongst midlife and older heterosexual women in New Zealand is rising. Popular culture celebrates a heightened sexuality for this population group. However, depictions of sexually savvy 'cougars' are at odds with reality for many women. International literature highlights that these women are often ill-equipped to negotiate safer sex and condom use, instead focusing on pleasing men and attributing their silence to spontaneity. The study aimed to explore barriers to safer heterosexual sex as perceived by midlife and older New Zealand women who are re-partnering or in casual relationships. METHODS: This qualitative study utilised Interpretive Phenomenology Analysis, supported by the theory of gender and power, to examine the gender-normative assumptions and behaviours in women's accounts of unprotected sex. Eight single women aged 40–69 participated in individual, in-depth interviews. This exploration included eliciting women's accounts of potential information resources, such as clinical consultations. FINDINGS: Analysis indicated that these women held misconceptions about STI transmission but had not sought educational material, nor discussed their sexual health with health professionals. Results highlighted women's ambivalence about prioritising safer sex, preferring to comply with partners' wishes, particularly when under the influence of alcohol. Women described valuing their own pleasure and their distaste for condom use, but data emphasised that women predominantly aligned their choices with men's preferences. CONCLUSION: This study highlights that the women were both ill-informed and vulnerable with regards to sexual health. General practitioners are well placed to provide education and sexual health advice. KEYWORDS: Condoms; heterosexual; middle aged; sexual behaviour; sexual health; women
Dunedin's free clinic: an exploration of its model of care using case study methodology
Authors: Loh Lik , Jaye Chrystal , Dovey Susan , Lloyd Hywel , Rowe Joanne
Published: October 2018

INTRODUCTION: Models of care are important therapeutic modalities for achieving the goals of health care teams, but they are seldom explicitly stated or investigated. AIM: To describe the model of care at Dunedin's free clinic, and assess whether this model catered to the particular needs of enrolled patients. METHODS: A mixed methods study was conducted using case study methodology to construct the clinic's model of care from multiple data sources, and to create a profile of patients' needs. A nested case study of patients with diabetes examined patients' social vulnerability characteristics. The pattern matching analytic technique was used to assess the degree of alignment between the model of care and patients' needs. RESULTS: Patients were not only high users of both primary and secondary health care, but also of justice and social welfare sector services. The care of patients with diabetes was complicated by coexisting social vulnerability and medical comorbidities. Surveyed patients placed high value on interpersonal dimensions of care, the Christian ethos of the clinic, and the wider range of services available. DISCUSSION: This study suggests a degree of 'fit' between the clinic's model of care and the needs of enrolled patients. A model of care that caters to the needs of patients with complex needs is important for securing their engagement in health services. KEYWORDS: Health services research; health status disparities; primary health care; qualitative research; vulnerable populations
Health promotion funding, workforce recruitment and turnover in New Zealand
Authors: Lovell Sarah , Egan Richard , Robertson Lindsay , Hicks Karen
Published: October 2018

INTRODUCTION: Almost a decade on from the New Zealand Primary Health Care Strategy and amidst concerns about funding of health promotion, we undertook a nationwide survey of health promotion providers. AIM: To identify trends in recruitment and turnover in New Zealand's health promotion workforce. METHODS: Surveys were sent to 160 organisations identified as having a health focus and employing one or more health promoter. Respondents, primarily health promotion managers, were asked to report budget, retention and hiring data for 1 July 2009 through 1 July 2010. RESULTS: Responses were received from 53% of organisations. Among respondents, government funding for health promotion declined by 6.3% in the year ended July 2010 and health promoter positions decreased by 7.5% (equalling 36.6 full-time equivalent positions). Among staff who left their roles, 79% also left the field of health promotion. Forty-two organisations (52%) reported employing health promoters on time-limited contracts of three years or less; this employment arrangement was particularly common in public health units (80%) and primary health organisations (57%). Among new hires, 46% (n=55) were identified as Maori. DISCUSSION: Low retention of health promoters may reflect the common use of limited-term employment contracts, which allow employers to alter staffing levels as funding changes. More than half the surveyed primary health organisations reported using fixed-term employment contracts. This may compromise health promotion understanding, culture and institutional memory in these organisations. New Zealand's commitment to addressing ethnic inequalities in health outcomes was evident in the high proportion of Maori who made up new hires. KEYWORDS: Employment; health policy; health promotion; public health; workforce
Viewpoint: Poverty, medicines and health care: It's the little things?
Authors: Norris Pauline , McIntosh Brendon , Tordoff June , Te Karu Leanne , Yen Chang Shih
Published: October 2018

Small patient charges and policies and events that may seem minor to health care professionals can have a big impact on the wellbeing of people living in poverty. Despite good intentions, policies can have unintended consequences for those who are struggling to access health care.
Dental scales could occur in all scaled subfamilies of Entomobryidae (Collembola): new definition of Entomobryinae with description of a new genus and three new species
Authors: Zhang Feng , Pan Zhixiang , Wu Jun , Ding Yinhuan , Yu Daoyuan , Wang Beixin
Published: October 2018

Body scales are fundamental in the classification of Entomobryidae at all taxonomical levels. Traditionally, scales on dens were considered to be absent in Entomobryinae, but present in other scaled subfamilies; however, this opinion was strongly challenged by recent morphological advances in tergal specialised chaetae (S-chaetae). A new genus, Lepidodens, is strikingly similar to the scaled Entomobryinae genus Willowsia in having pointed scales with relatively long ribs and 2, 2|1, 2, 2, 8, 3 tergal S-chaetae, but differs from it in having dental scales and a unique position of S-microchaetae on the first abdominal segment. Multilocus phylogeny and topology tests also support this view, the new genus clustering with Entomobryinae rather than Seirinae. Three new species, L. nigrofasciatus, L. similis and L. hainanicus, are described from South China. This study clearly undermines the traditional separation of Entomobryinae and Seirinae/Lepidocyrtinae, and demonstrates that dental scales could occur in all entomobryid subfamilies containing scaled taxa. In this new phylogenetic hypothesis, Entomobryinae has the greatest diversity in scale morphology and distribution among scaled collembolan groups, indicating multiple independent origins of scales.
Cyphastrea (Cnidaria : Scleractinia : Merulinidae) in the Red Sea: phylogeny and a new reef coral species
Authors: Arrigoni Roberto , Berumen Michael L. , Huang Danwei , Terraneo Tullia I. , Benzoni Francesca
Published: October 2018

The scleractinian coral Cyphastrea is a common and widespread genus throughout the coral reefs of the Indo-Pacific. Little is known about the phylogenetic relationships within this taxon and species identification is based mainly on traditional skeletal characters, such as the number of septa, septa cycles, growth form and corallite dimensions. Here we present the first focussed reconstruction of phylogenetic relationships among Cyphastrea species, analysing 57 colonies from the Red Sea, where five morphospecies live in sympatry. Analyses based on three loci (nuclear histone H3, 28S rDNA and a mitochondrial intergenic region) reveal the existence of three well-supported molecular lineages. None of the five previously defined morphospecies are monophyletic and they cluster into two clades, suggesting the need of a systematic revision in Cyphastrea. The third lineage is described as C. magna Benzoni & Arrigoni, sp. nov., a new reef coral species collected from the northern and central Red Sea. Cyphastrea magna Benzoni & Arrigoni, sp. nov. is characterised by the largest corallite diameter among known Cyphastrea species, a wide trabecular columella >1/4 of calice width, and 12 equal primary septa. This study suggests that morphology-based taxonomy in Cyphastrea may not identify monophyletic units and strengthens the application of genetics in coral systematics.
Survival of fish passing downstream at a small hydropower facility
Authors: Amaral Stephen V. , Coleman Benjamin S. , Rackovan Jenna L. , Withers Kelly , Mater Benjamin
Published: October 2018

Hydropower dams can negatively affect upstream and downstream migratory fish populations in many ways, such as blocking access to upstream habitats and causing injuries or mortality during downstream passage. For downstream passage at projects in the USA, federal regulators and agencies responsible for oversight of hydropower facilities typically require assessment studies and mitigation to address negative effects, with a primary goal of minimising fish impingement and turbine entrainment and mortality. So as to assess the effects of downstream passage of fish populations at a unique, small hydro project on the Mississippi River, impingement and entrainment rates, Oberymeyer gate passage, spillway gate passage, turbine survival, and total downstream passage survival were estimated. It was determined that 85% of fish passing downstream at the project would be small enough to pass through the bar spacing of the trash racks and 15% would be physically excluded. When 55% of river flow enters the turbine intake channel, the total project survival rates were estimated to be 77.3% with an Obermeyer gate bypass rate of 10 and 96.6% with a gate bypass rate of 90%. Therefore, any effects on local fish populations resulting from the operation of the project are expected to be negligible and inconsequential on the basis of expected survival rates for the range and probability of river flows occurring at the project.
High chlamydia and gonorrhoea repeat positivity in remote Aboriginal communities 2009–2011: longitudinal analysis of testing for re-infection at 3 months suggests the need for more frequent screening
Authors: Garton Linda , Dyda Amalie , Guy Rebecca , Silver Bronwyn , McGregor Skye , Hengel Belinda , Rumbold Alice , Taylor-Thomson Debbie , Knox Janet , Maher Lisa , Kaldor John , Ward James , on behalf of the STRIVE Investigators
Published: October 2018

Background Extremely high rates of diagnosis of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) have been recorded in remote communities across northern and central Australia. Re-testing at 3 months, after treatment administered, of CT or NG is recommended to detect repeat infections and prevent morbidity and ongoing transmission. Methods: Baseline CT and NG laboratory data (2009–2010) from 65 remote health services participating in a cluster randomised trial was used to calculate the proportion of individuals re-tested after an initial CT or NG diagnosis at <2 months (not recommended), 2–4 months (recommended) and 5–12 months and the proportion with repeat positivity on re-test. To assess if there were difference in re-testing and repeat positivity by age group and sex, t-tests were used. Results: There was a total of 2054 people diagnosed with CT and/or NG in the study period; 14.9% were re-tested at 2–4 months, 26.9% at 5–12 months, a total of 41.8% overall. Re-testing was higher in females than in males in both the 2–4-month (16.9% v. 11.5%, P < 0.01) and 5–12-month (28.9% v. 23.5%, P = 0.01) periods. Women aged 25–29 years had a significantly higher level of re-testing 5–12 months post-diagnosis than females aged 16–19 years (39.8% v. 25.4%, P < 0.01). There was a total of 858 people re-tested at 2–12 months and repeat positivity was 26.7%. There was higher repeat NG positivity than repeat CT positivity (28.8% v. 18.1%, P < 0.01). Conclusions: Just under half the individuals diagnosed with CT or NG were re-tested at 2–12 months post-diagnosis; however, only 15% were re-tested in the recommended time period of 2–4 months. The higher NG repeat positivity compared with CT is important, as repeat NG infections have been associated with higher risk of pelvic inflammatory disease-related hospitalisation. Findings have implications for clinical practice in remote community settings and will inform ongoing sexual health quality improvement programs in remote community clinics.
HIV testing self-efficacy is associated with higher HIV testing frequency and perceived likelihood to self-test among gay and bisexual men
Authors: Jamil Muhammad S. , Guy Rebecca J. , Bavinton Benjamin R. , Fairley Christopher K. , Grulich Andrew E. , Holt Martin , Smith Kirsty S. , Chen Marcus , McNulty Anna M. , Conway Damian P. , Keen Phillip , Bradley Jack , Russell Darren , Kaldor John M. , Prestage Garrett , on behalf of the FORTH Investigator Group
Published: October 2018

Background Regular testing of individuals at higher-risk of HIV is central to current prevention strategies. The aim of the present study was to examine the extent to which confidence in one’s perceived ability to undertake various aspects of HIV testing and self-testing (self-efficacy) affected HIV testing outcomes. We assessed factors, including self-efficacy, associated with HIV testing frequency and the likelihood to self-test among gay and bisexual men (GBM). Methods: Participants were HIV-negative GBM at an increased risk of HIV (more than five partners or condomless anal intercourse in the previous 3 months) enrolled in a randomised controlled trial of HIV self-testing. The baseline questionnaire captured data regarding sociodemographic characteristics, HIV and/or sexually transmissible infection testing history, sexual behaviour, beliefs and attitudes towards HIV and eight items capturing confidence in HIV testing ability that were combined as a single broad measure of HIV testing self-efficacy (α = 0.81). Factors associated with three or more HIV tests in the past year and the likelihood of self-testing in the future were determined using logistic regression. Results: Of 354 GBM, 34% reported three or more HIV tests in the past year, and 64% reported being ‘very likely’ to self-test. Factors independently associated with three or more HIV tests in the past year were: higher self-efficacy (adjusted odds ratio (aOR) 1.08 per unit increase; 95% confidence interval (CI) 1.02–1.14; P = 0.004); >10 male partners in the past 6 months (aOR 1.79; 95% CI 1.05–3.04; P = 0.031) and higher optimism regarding the effects of HIV treatments on HIV transmission (aOR 1.14; 95% CI 1.00–1.29; P = 0.044). Only higher self-efficacy was independently associated with reporting a greater likelihood to self-test in the future (aOR 1.10; 95% CI 1.05–1.15; P < 0.001). Conclusions: Improving self-efficacy by enhancing GBM’s knowledge and experience may lead to higher testing frequency. The self-efficacy measure used in the present study could be useful in identifying GBM likely to face difficulties with HIV testing and self-testing.
Molecular profiling of nonalcoholic fatty liver disease-associated hepatocellular carcinoma using SB transposon mutagenesis
Authors: Kodama Takahiro , Yi Jing , Newberg Justin Y. , Tien Jean C. , Wu Hao , Finegold Milton J. , Kodama Michiko , Wei Zhubo , Tamura Takeshi , Takehara Tetsuo , Johnson Randy L. , Jenkins Nancy A. , Copeland Neal G.
Published: October 2018

Significance

Nonalcoholic fatty liver disease (NAFLD) is the fastest rising cause of hepatocellular carcinoma (HCC) in Western countries; however, the molecular mechanisms driving NAFLD-HCC remain elusive. Using Sleeping Beauty transposon mutagenesis in two mouse models of NAFLD-HCC, we identified hundreds of NAFLD-HCC candidate cancer genes that were enriched in pathways often associated with NAFLD and HCC. We also showed that Sav1, which functions in the Hippo signaling pathway and was the most frequently mutated gene identified by SB in both screens, prevents progression of steatohepatitis and subsequent HCC development in coordination with PI3K signaling via suppression of Yap, a downstream effector of the Hippo pathway. Our forward genetic screens have thus identified pathways and genes driving the development of NAFLD-HCC.
Sequential sampling strategy for extreme event statistics in nonlinear dynamical systems
Authors: Mohamad Mustafa A. , Sapsis Themistoklis P.
Published: October 2018

Significance

Understanding the statistics of extreme events in dynamical systems of high complexity is of vital importance for reliability assessment and design. We formulate a method to pick samples optimally so that we have rapid convergence of the full statistics of a quantity of interest, including the tails that describe extreme events. This is important for large-scale problems in science and engineering, where we desire to predict the statistics of relevant quantities but can only afford a limited number of simulations or experiments due to their very expensive cost. We demonstrate our approach in a hydromechanical system with millions of degrees of freedom, where only 10–20 carefully selected samples can lead to accurate approximation of the extreme event statistics.