bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of type I Boston keratoprosthesis implantation on vision-related quality of life
Authors: Ang Marcus , Man Ryan , Fenwick Eva , Lamoureux Ecosse , Wilkins Mark
Published: September 2017

Aim

To determine the impact of type I Boston keratoprosthesis (KPro) implantation on vision-related quality of life (VRQoL).

Methods

Prospective study in 33 patients (mean age 56±12 years, 67% male) with bilateral corneal blindness, who underwent a KPro implantation at a single tertiary eye hospital (June 2011–July 2015). VRQoL was evaluated using the Impact of Vision Impairment Questionnaire (IVI) at baseline and at 3–6 months postsurgery, after stabilisation of best-corrected visual acuity (BCVA). Rasch analysis was used to transform the IVI responses into interval-level measures comprising the ‘reading’, ‘mobility’ and ‘emotional’ subscales with effect sizes calculated for pre-post VRQoL scores.

Results

Mean preoperative BCVA was counting-fingers at 2 feet in the operated eye (20/240 fellow eye). Preoperative VRQoL scores: −2.27, –2.91 and −3.06 logits for the reading, mobility and emotional subscales, respectively. Device retention rate was 90% over the follow-up period (mean 26±12 months). We observed large gains for reading and mobility of 1.92 logits (effect size 0.88), and 2.64 logits (effect size 0.89) respectively, with a moderate gain in the emotional subscale of 2.11 logits (effect size 0.59). These improvements did not vary significantly with BCVA on multivariate analysis (all p>0.05).

Conclusion

We observed a differential short-term improvement to VRQoL after KPro implantation with a significant impact on emotional well-being, which may not be fully explained by visual improvement alone. Further studies are required to confirm if these improvements in VRQoL are sustained in the long-term and are generalisable to other populations.
Inter-relationship between visual symptoms, activity limitation and psychological functioning in patients with diabetic retinopathy
Authors: Fenwick Eva K , Cheng Grand H-L , Man Ryan E K , Khadka Jyoti , Rees Gwyn , Wong Tien Y , Pesudovs Konrad , Lamoureux Ecosse Luc
Published: September 2017

Aims

We explored the direct and indirect impact of restrictions in daily living activities on the relationship between perceived visual symptoms associated with diabetic retinopathy (DR) and psychological functioning.

Methods

In this prospective, cross-sectional study, 514 tertiary patients with DR (mean age±SD, 60.4±12.6 years; 64% male) answered questions related to nine domains of DR-specific quality of life. These were classified into the following predictor, mediating and outcome variables: visual symptoms (predictor variable); activity limitation, driving, lighting, social restriction, inconvenience, mobility (mediating variables); and emotional distress and concerns (outcome variables). Direct and indirect relationships between study variables were assessed using path analysis, using interval-level person measures derived from Rasch analyses of the study questionnaires.

Results

We found no direct effect of DR-related visual symptoms on emotional distress or concerns. Rather, the association between visual symptoms and emotional distress was mediated (all p<0.05) by mobility (indirect effect=0.07), inconvenience (indirect effect=0.28), activity limitation (indirect effect=0.13) and social restriction (indirect effect=0.11). Similarly, the relationship between DR-related visual symptoms and concerns was mediated by inconvenience (indirect effect=0.36) and social restriction (indirect effect=0.11). Lighting and driving did not have a mediating role.

Conclusions

The link between vision and psychological functioning outcomes such as emotional distress and concern is complex in patients with DR and mediated by limitations in daily living activities and social factors. Interventions to enhance daily functioning and social interaction may be effective in reducing emotional distress associated with DR-related vision impairment.
Trend analysis of mortality rates and causes of death in children under 5 years old in Beijing, China from 1992 to 2015 and forecast of mortality into the future: an entire population-based epidemiological study
Authors: Cao Han , Wang Jing , Li Yichen , Li Dongyang , Guo Jin , Hu Yifei , Meng Kai , He Dian , Liu Bin , Liu Zheng , Qi Han , Zhang Ling
Published: September 2017

Objectives

To analyse trends in mortality and causes of death among children aged under 5 years in Beijing, China between 1992 and 2015 and to forecast under-5 mortality rates (U5MRs) for the period 2016–2020.

Methods

An entire population-based epidemiological study was conducted. Data collection was based on the Child Death Reporting Card of the Beijing Under-5 Mortality Rate Surveillance Network. Trends in mortality and leading causes of death were analysed using the χ2test and SPSS 19.0 software. An autoregressive integrated moving average (ARIMA) model was fitted to forecast U5MRs between 2016 and 2020 using the EViews 8.0 software.

Results

Mortality in neonates, infants and children aged under 5 years decreased by 84.06%, 80.04% and 80.17% from 1992 to 2015, respectively. However, the U5MR increased by 7.20% from 2013 to 2015. Birth asphyxia, congenital heart disease, preterm/low birth weight and other congenital abnormalities comprised the top five causes of death. The greatest, most rapid reduction was that of pneumonia by 92.26%, with an annual average rate of reduction of 10.53%. The distribution of causes of death differed among children of different ages. Accidental asphyxia and sepsis were among the top five causes of death in children aged 28 days to 1 year and accident was among the top five causes in children aged 1–4 years. The U5MRs in Beijing are projected to be 2.88‰, 2.87‰, 2.90‰, 2.97‰ and 3.09‰ for the period 2016–2020, based on the predictive model.

Conclusion

Beijing has made considerable progress in reducing U5MRs from 1992 to 2015. However, U5MRs could show a slight upward trend from 2016 to 2020. Future considerations for child healthcare include the management of birth asphyxia, congenital heart disease, preterm/low birth weight and other congenital abnormalities. Specific preventative measures should be implemented for children of various age groups.
Comparison of anthropometric indices for predicting the risk of metabolic syndrome and its components in Chinese adults: a prospective, longitudinal study
Authors: Wang Haoyu , Liu Aihua , Zhao Tong , Gong Xun , Pang Tianxiao , Zhou Yingying , Xiao Yue , Yan Yumeng , Fan Chenling , Teng Weiping , Lai Yaxin , Shan Zhongyan
Published: September 2017

Objectives

Our study aimed to distinguish the ability of anthropometric indices to assess the risk of metabolic syndrome (MetS).

Design

Prospective cohort study.

Setting

Shenyang, China.

Participants

A total of 379 residents aged between 40 and 65 were enrolled. 253 of them were free of MetS and had been followed up for 4.5 years.

Methods

At baseline, all the participants underwent a thorough medical examination. A variety of anthropometric parameters were measured and calculated, including waist circumference (WC), body mass index (BMI), a body shape index (ABSI), abdominal volume index (AVI), body adiposity index, body roundness index, conicity index, waist-to-hip ratio and visceral adiposity index (VAI). After 4.5 year follow-up, we re-examined whether participants were suffering from MetS. A receiver operating characteristic (ROC) curve was applied to examine the potential of the above indices to identify the status and risk of MetS.

Outcomes

Occurrence of MetS.

Results

At baseline, 33.2% participants suffered from MetS. All of the anthropometric indices showed clinical significance, and VAI was superior to the other indices as it was found to have the largest area under the ROC curve. After a 4.5 year follow-up, 37.8% of men and 23.9% of women developed MetS. ROC curve analysis suggested that baseline BMI was the strongest predictor of MetS for men (0.77 (0.68–0.85)), and AVI was the strongest for women (0.72 (0.64–0.79)). However, no significant difference was observed between WC and both indices. In contrast, the baseline ABSI did not predict MetS in both genders.

Conclusions

The present study indicated that these different indices derived from anthropometric parameters have different discriminatory abilities for MetS. Although WC did not have the largest area under the ROC curve for diagnosing and predicting MetS, it may remain a better index of MetS status and risk because of its simplicity and wide use.
A cross-sectional study in a tertiary care hospital in China: noise or silence in the operating room
Authors: Wang Xiaoxiao , Zeng Lin , Li Gang , Xu Mao , Wei Bin , Li Yan , Li Nan , Tao Liyuan , Zhang Hua , Guo Xiangyang , Zhao Yiming
Published: September 2017

Objectives

This study aims to provide a comprehensive description of noise levels in operating rooms (ORs) in a tertiary care hospital in China. Additionally, the study aims to examine the deviation in noise levels from international and internal standards as well as the differences in noise levels by category of surgery and day of the week.

Methods

We monitored noise levels in 23 ORs in a tertiary care hospital in China between August 2015 and March 2016. Dosimeters were used to determine noise levels. The noise data collected in the dosimeter were downloaded to an IBM computer for subsequent analysis. One-way analysis of variance and Student’s t-test were used to examine the differences in noise levels.

Results

The noise level in the ORs ranged between 59.2 and 72.3 dB(A), with 100% of the measurements exceeding the recommended hospital noise standards. There was substantial similarity in noise levels from Monday to Friday (F=1.404, p=0.234), with a range between 63.7 and 64.5 dB(A). The difference in noise levels by category of surgery was significant (F=3.381, p<0.001). The results of the post hoc analysis suggested that ophthalmic surgery had significantly higher noise levels than otolaryngological surgery or general surgery.

Conclusions

Ophthalmic surgery had significantly higher noise levels than otolaryngological or general surgeries. High noise levels were identified in all evaluated ORs during weekdays, and these levels consistently exceeded the currently accepted standards. These findings warrant further investigation to determine the harmful effects of noise on both patients and staff in ORs.￼￼
Development of core outcome sets for effectiveness trials of interventions to prevent and/or treat delirium (Del-COrS): study protocol
Authors: Rose Louise , Agar Meera , Burry Lisa D , Campbell Noll , Clarke Mike , Lee Jacques , Siddiqi Najma , Page Valerie J
Published: September 2017

Introduction

Delirium is a common, serious and potentially preventable condition with devastating impact on the quality of life prompting a proliferation of interventional trials. Core outcome sets aim to standardise outcome reporting by identifying outcomes perceived fundamental for measurement in trials of a specific interest area. Our aim is to develop international consensus on two core outcome sets for trials of interventions to prevent and/or treat delirium, irrespective of study population. We aim to identify additional core outcomes specific to the critically ill, acutely hospitalised patients, palliative care and older adults.

Methods and analysis

We will conduct a systematic review of published and ongoing delirium trials (1980 onwards) and one-on-one interviews of patients who have experienced delirium and family members. These data will inform Delphi round 1 of a two-stage consensus process. In round 2, we will provide participants their own response, summarised group responses and those of patient/family participants for rescoring. We will randomise participants to receive feedback as proportion scoring the outcome as critical or as group mean responses. We will hold a consensus meeting using nominal group technique to finalise outcomes for inclusion. We will repeat the Delphi process and consensus meeting to select measures for each core outcome. We will recruit 240 Delphi participants giving us 80% power to detect a 1.0–1.5 point (9-point scale) difference by feedback method between rounds. We will analyse differences for subsequent scores, magnitude of opinion change, items retained and level of agreement.

Ethics and dissemination

We are obtaining research ethics approvals according to local governance. Participation will be voluntary and data deidentified. Support from three international delirium organisations will be instrumental in dissemination and core outcome set uptake. We will disseminate through peer-reviewed open access publications and present at conferences selected to reach a wide range of knowledge users.
Assessing the extent of drug interactions among patients with multimorbidity in primary and secondary care in the West Midlands (UK): a study protocol for the Mixed Methods Multimorbidity Study (MiMMS)
Authors: Backman Ruth , Weber Philip , Turner Alice M , Lee Mark , Litchfield Ian
Published: September 2017

Introduction

The numbers of patients with three or more chronic conditions (multimorbidity) are increasing, and will rise to 2.9 million by 2018 in the UK alone. Currently in the UK, conditions are mainly managed using over 250 sets of single-condition guidance, which has the potential to generate conflicting recommendations for lifestyle and concurrent medication for individual patients with more than one condition. To address some of these issues, we are developing a new computer-based tool to help manage these patients more effectively. For this tool to be applicable and relevant to current practice, we must first better understand how existing patients with multimorbidity are being managed, particularly relating to concerns over prescribing and potential polypharmacy.

Methods and analysis

Up to four secondary care centres, two community pharmacies and between four and eight primary care centres in the West Midlands will be recruited. Interviewees will be purposively sampled from these sites, up to a maximum of 30. In this mixed methods study, we will perform a dual framework analysis on the qualitative data; the first analysis will use the Theoretical Domains Framework to assess barriers and enablers for healthcare professionals around the management of multimorbid patients; the second analysis will use Normalisation Process Theory to understand how interventions are currently being successfully implemented in both settings. We will also extract quantitative anonymised patient data from primary care to determine the extent of polypharmacy currently present for patients with multimorbidity in the West Midlands.

Discussion

We aim to combine these data so that we can build a useful, fully implementable tool which addresses the barriers most amenable to change within both primary and secondary care contexts.

Ethics and dissemination

Favourable ethical approval has been granted by The University of Birmingham Research Ethics Committee (ERN_16–0074) on 17 May 2016. Our work will be disseminated through peer-reviewed literature, trade journals and conferences. We will also use the dedicated web page hosted by the University to serve as a central point of contact and as a repository of our findings. We aim to produce a minimum of three articles from this work to contribute to the international scientific literature.

Protocol registration number

NIHR Clinical Research Network Portfolio Registration CPMS ID 30613.
Does improving sleep lead to better mental health? A protocol for a meta-analytic review of randomised controlled trials
Authors: Scott Alexander J , Webb Thomas L , Rowse Georgina
Published: September 2017

Introduction

Sleep and mental health go hand-in-hand, with many, if not all, mental health problems being associated with problems sleeping. Although sleep has been traditionally conceptualised as a secondary consequence of mental health problems, contemporary views prescribe a more influential, causal role of sleep in the formation and maintenance of mental health problems. One way to evaluate this assertion is to examine the extent to which interventions that improve sleep also improve mental health.

Method and analysis

Randomised controlled trials (RCTs) describing the effects of interventions designed to improve sleep on mental health will be identified via a systematic search of four bibliographic databases (in addition to a search for unpublished literature). Hedges’gand associated 95% CIs will be computed from means and SDs where possible. Following this, meta-analysis will be used to synthesise the effect sizes from the primary studies and investigate the impact of variables that could potentially moderate the effects. The Jadad scale for reporting RCTs will be used to assess study quality and publication bias will be assessed via visual inspection of a funnel plot and Egger’s test alongside Orwin’s fail-safen. Finally, mediation analysis will be used to investigate the extent to which changes in outcomes relating to mental health can be attributed to changes in sleep quality.

Ethics and dissemination

This study requires no ethical approval. The findings will be submitted for publication in a peer-reviewed journal and promoted to relevant stakeholders.

PROSPERO registration number

CRD42017055450.
Disability acquisition and mental health: effect modification by demographic and socioeconomic characteristics using data from an Australian longitudinal study
Authors: Aitken Zoe , Simpson Julie Anne , Bentley Rebecca , Kavanagh Anne Marie
Published: September 2017

Objectives

There is evidence of a causal relationship between disability acquisition and poor mental health, but the substantial heterogeneity in the magnitude of the effect is poorly understood and may be aetiologically informative. This study aimed to identify demographic and socioeconomic factors that modify the effect of disability acquisition on mental health.

Design and setting

The Household, Income and Labour Dynamics in Australia Survey is a nationally representative longitudinal survey of Australian households that has been conducted annually since 2001. Four waves of data were included in this analysis, from 2011 to 2014.

Participants

Individuals who acquired a disability (n=387) were compared with those who remained disability-free in all four waves (n=7936).

Primary outcome measure

Mental health was measured using the mental health subscale of the Short Form 36 (SF-36) general health questionnaire, which measures symptoms of depression, anxiety and psychological well-being.

Methods

Linear regression models were fitted to estimate the effect of disability acquisition on mental health, testing for effect modification by key demographic and socioeconomic characteristics. To maximise causal inference, we used a propensity score approach with inverse probability of treatment weighting to control for confounding and multiple imputation using chained equations to assess the impact of missing data.

Results

On average, disability acquisition was associated with a 5-point decline in mental health score (estimated mean difference: −5.1, 95% CI −7.2 to –3.0). There was strong evidence that income and relationship status modified the effect, with more detrimental effects in the lowest (−12.5, 95% CI −18.5 to –6.5) compared with highest income quintile (−1.1, 95% CI –4.9 to 2.7) and for people not in a relationship (−8.8, 95% CI −12.9 to –4.8) compared with those who were (−3.7, 95% CI −6.1 to –1.4).

Conclusions

Our results suggest that the detrimental effect of disability acquisition on mental health is substantially greater for socioeconomic disadvantaged individuals.
Interdisciplinary model of care (RADICALS) for early detection and management of chronic obstructive pulmonary disease (COPD) in Australian primary care: study protocol for a cluster randomised controlled trial
Authors: Liang Jenifer , Abramson Michael J , Zwar Nicholas , Russell Grant , Holland Anne E , Bonevski Billie , Mahal Ajay , Hecke Benjamin van , Phillips Kirsten , Eustace Paula , Paul Eldho , Petrie Kate , Wilson Sally , George Johnson
Published: September 2017

Introduction

Up to half of all smokers develop clinically significant chronic obstructive pulmonary disease (COPD). Gaps exist in the implementation and uptake of evidence-based guidelines for managing COPD in primary care. We describe the methodology of a cluster randomised controlled trial (cRCT) evaluating the efficacy and cost-effectiveness of an interdisciplinary model of care aimed at reducing the burden of smoking and COPD in Australian primary care settings.

Methods and analysis

A cRCT is being undertaken to evaluate an interdisciplinary model of care (RADICALS — Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers). General practice clinics across Melbourne, Australia, are identified and randomised to the intervention group (RADICALS) or usual care. Patients who are current or ex-smokers, of at least 10 pack years, including those with an existing diagnosis of COPD, are being recruited to identify 280 participants with a spirometry-confirmed diagnosis of COPD. Handheld lung function devices are being used to facilitate case-finding. RADICALS includes individualised smoking cessation support, home-based pulmonary rehabilitation and home medicines review. Patients at control group sites receive usual care and Quitline referral, as appropriate. Follow-ups occur at 6 and 12 months from baseline to assess changes in quality of life, abstinence rates, health resource utilisation, symptom severity and lung function. The primary outcome is change in St George’s Respiratory Questionnaire score of patients with COPD at 6 months from baseline.

Ethics and dissemination

This project has been approved by the Monash University Human Research Ethics Committee and La Trobe University Human Ethics Committee (CF14/1018 – 2014000433). Results of the study will be disseminated in peer-reviewed journals and research conferences. If the intervention is successful, the RADICALS programme could potentially be integrated into general practices across Australia and sustained over time.

Trial registration number

ACTRN12614001155684; Pre-results.
Diagnostic validity of early-onset obsessive-compulsive disorder in the Danish Psychiatric Central Register: findings from a cohort sample
Authors: Nissen Judith , Powell Shelagh , Koch Susanne V , Crowley James J , Matthiesen Manuel , Grice Dorothy E , Thomsen Per H , Parner E
Published: September 2017

Objectives

Employing national registers for research purposes depends on a high diagnostic validity. The aim of the present study was to examine the diagnostic validity of recorded diagnoses of early-onset obsessive-compulsive disorder (OCD) in the Danish Psychiatric Central Register (DPCR).

Design

Review of patient journals selected randomly through the DPCR.

Method

One hundred cases of OCD were randomly selected from DPCR. Using a predefined coding scheme based on the Children’s Yale Brown Obsessive Compulsive Scale (CYBOCS), experienced research nurse or child and adolescent psychiatrists assessed each journal to determine the presence/absence of OCD diagnostic criteria. The detailed assessments were reviewed by two senior child and adolescent psychiatrists to determine if diagnostic criteria were met.

Primary outcome measurements

Positive predictive value (PPV) was used as the primary outcome measurement.

Results

A total of 3462 children/adolescents received an OCD diagnosis as the main diagnosis between 1 January 1995 and 31 December 2015. The average age at diagnosis was 13.21±2.89 years. The most frequent registered OCD subcode was the combined diagnosis DF42.2. Of the 100 cases we examined, 35 had at least one registered comorbidity. For OCD, the PPV was good (PPV 0.85). Excluding journals with insufficient information, the PPV was 0.96. For the subcode F42.2 the PPV was 0.77. The inter-rater reliability was 0.94. The presence of the CYBOCS in the journal significantly increased the PPV for the OCD diagnosis altogether and for the subcode DF42.2.

Conclusion

The validity and reliability of International Classification of Disease 10th revision codes for OCD in the DPCR is generally high. The subcodes for predominant obsessions/predominant compulsions are less certain and should be used with caution. The results apply for both children and adolescents and for both older and more recent cases. Altogether, the study suggests that there is a high validity of the OCD diagnosis in the Danish National Registers.
Impact of oral self-care on incident functional disability in elderly Japanese: the Ohsaki Cohort 2006 study
Authors: Bando Shino , Tomata Yasutake , Aida Jun , Sugiyama Kemmyo , Sugawara Yumi , Tsuji Ichiro
Published: September 2017

Objectives

To assess whether oral self-care (tooth brushing, regular dental visits and use of dentures) affects incident functional disability in elderly individuals with tooth loss.

Design

A 5.7-year prospective cohort study.

Setting

Ohsaki City, Japan.

Participants

12 370 community-dwelling individuals aged 65 years and older.

Primary outcome measures

Incident functional disability (new long-term care insurance certification).

Results

The 5.7-year incidence rate of disability was 18.8%. In comparison with participants who had ≥20 teeth, the HRs (95% CIs) for incident functional disability among participants who had 10–19 and 0–9 teeth were 1.15 (1.01–1.30) and 1.20 (1.07–1.34), respectively (p trend<0.05). However, the corresponding values for those who brushed their teeth ≥2 times per day were not significantly higher in the ‘10–19 teeth’ and ‘0–9 teeth’ groups (HRs (95% CI) 1.05 (0.91–1.21) for participants with 10–19 teeth, and 1.09 (0.96–1.23) for participants with 0–9 teeth), although HRs for those who brushed their teeth <2 times per day were significantly higher (HRs (95% CI) 1.32 (1.12–1.55) for participants with 10–19 teeth, and 1.33 (1.17–1.51) for participants with 0–9 teeth). Such a negating association was not observed for other forms of oral self-care.

Conclusions

Tooth brushing may partially negate the increased risk of incident functional disability associated with having fewer remaining teeth.
British Thoracic Society quality standards for home oxygen use in adults
Authors: Suntharalingam Jay , Wilkinson Tom , Annandale Joseph , Davey Claire , Fielding Rhea , Freeman Daryl , Gibbons Michael , Hardinge Maxine , Hippolyte Sabrine , Knowles Vikki , Lee Cassandra , MacNee William , Pollington Jacqueline , Vora Vandana , Watts Trefor , Wijesinghe Meme
Published: September 2017

Introduction

The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for home oxygen provision in the UK, together with measurable markers of good practice. Quality statements are based on the British Thoracic Society (BTS) Guideline for Home Oxygen Use in Adults.

Methods

Development of BTS Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards.

Results

10 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for home oxygen use, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare.

Discussion

BTS Quality Standards for home oxygen use in adults form a key part of the range of supporting materials that the society produces to assist in the dissemination and implementation of a guideline’s recommendations.
Development of diagnostic criteria and a prognostic score for hepatitis B virus-related acute-on-chronic liver failure
Authors: Wu Tianzhou , Li Jiang , Shao Li , Xin Jiaojiao , Jiang Longyan , Zhou Qian , Shi Dongyan , Jiang Jing , Sun Suwan , Jin Linfeng , Ye Ping , Yang Lingling , Lu Yinyun , Li Tan , Huang Jianrong , Xu Xiaowei , Chen Jiajia , Hao Shaorui , Chen Yuemei , Xin Shaojie , Gao Zhiliang , Duan Zhongping , Han Tao , Wang Yuming , Gan Jianhe , Feng Tingting , Pan Chen , Chen Yongping , Li Hai , Huang Yan , Xie Qing , Lin Shumei , Li Lanjuan , Li Jun
Published: September 2017

Objective

The definition of acute-on-chronic liver failure (ACLF) based on cirrhosis, irrespective of aetiology, remains controversial. This study aimed to clarify the clinicopathological characteristics of patients with hepatitis B virus-related ACLF (HBV-ACLF) in a prospective study and develop new diagnostic criteria and a prognostic score for such patients.

Design

The clinical data from 1322 hospitalised patients with acute decompensation of cirrhosis or severe liver injury due to chronic hepatitis B (CHB) at 13 liver centres in China were used to develop new diagnostic and prognostic criteria.

Results

Of the patients assessed using the Chronic Liver Failure Consortium criteria with the exception of cirrhosis, 391 patients with ACLF were identified: 92 with non-cirrhotic HBV-ACLF, 271 with cirrhotic HBV-ACLF and 28 with ACLF with cirrhosis caused by non-HBV aetiologies (non-HBV-ACLF). The short-term (28/90 days) mortality of the patients with HBV-ACLF were significantly higher than those of the patients with non-HBV-ACLF. Total bilirubin (TB) ≥12 mg/dL and an international normalised ratio (INR) ≥1.5 was proposed as an additional diagnostic indicator of HBV-ACLF, and 19.3% of patients with an HBV aetiology were additionally diagnosed with ACLF. The new prognostic score (0.741×INR+0.523×HBV-SOFA+0.026×age+0.003×TB) for short-term mortality was superior to five other scores based on both discovery and external validation studies.

Conclusions

Regardless of the presence of cirrhosis, patients with CHB, TB ≥12 mg/dL and INR ≥1.5 should be diagnosed with ACLF. The new criteria diagnosed nearly 20% more patients with an HBV aetiology with ACLF, thus increasing their opportunity to receive timely intensive management.
Vital exhaustion and sudden cardiac death in the Atherosclerosis Risk in Communities Study
Authors: Bogle Brittany M , Sotoodehnia Nona , Kucharska-Newton Anna M , Rosamond Wayne D
Published: September 2017

Objective

Vital exhaustion (VE), a construct defined as lack of energy, increased fatigue and irritability, and feelings of demoralisation, has been associated with cardiovascular events. We sought to examine the relation between VE and sudden cardiac death (SCD) in the Atherosclerosis Risk in Communities (ARIC) Study.

Methods

The ARIC Study is a predominately biracial cohort of men and women, aged 45–64 at baseline, initiated in 1987 through random sampling in four US communities. VE was measured using the Maastricht questionnaire between 1990 and 1992 among 13 923 individuals. Cox proportional hazards models were used to examine the hazard of out-of-hospital SCD across tertiles of VE scores.

Results

Through 2012, 457 SCD cases, defined as a sudden pulseless condition presumed due to a ventricular tachyarrhythmia in a previously stable individual, were identified in ARIC by physician record review. Adjusting for age, sex and race/centre, participants in the highest VE tertile had an increased risk of SCD (HR 1.48, 95% CI 1.17 to 1.87), but these findings did not remain significant after adjustment for established cardiovascular disease risk factors (HR 0.94, 95% CI 0.73 to 1.20).

Conclusions

Among participants of the ARIC study, VE was not associated with an increased risk for SCD after adjustment for cardiovascular risk factors.
MRI, CT and histopathological findings in a cat with hypovitaminosis A
Authors: Espadas Irene , Ricci Emanuele , McConnell Fraser , Sanchez‐Masian Daniel
Published: September 2017

An adult, male, domestic longhair cat was evaluated for chronic progressive visual impairment and lethargy. Neurological abnormalities localised to the cerebellum/central vestibular system, and optic chiasm/retinas and/or optic nerves were present on clinical examination. MRI and CT studies showed diffuse hyperostosis with thickening of the calvarium and tentorium cerebelli causing compression and distortion of the brain. Biochemical testing showed low plasma retinol levels at 0.1 μmol/l (0.86–2.2). Postmortem examination showed reduction in volume of the frontal lobes secondary to diffuse skull hyperostosis. Microscopically, there were mild white matter spongiosis affecting the corona radiata and optic nerves and multiple small plaque‐like thickening of the meninges. This is the first case report to provide a comprehensive clinical, diagnostic imaging and pathological details of hypovitaminosis A in a cat.
Spores and vegetative cells of phenotypically and genetically diverse Bacillus cereus sensu lato are common bacteria in fresh water of northeastern Poland
Authors: Bartoszewicz Marek , Czyżewska Urszula
Published: September 2017

Gram-positive rods Bacillus cereus sensu lato (sl) are common in natural habitats and food products. It is believed that they are restricted to spores; however, their ecology in aquatic habitats is still poorly investigated. Thus, the aim of the study was to assess the rain-dependent fluctuations in the concentration of B. cereus sl vegetative cells and spores, with evaluation of their phylogenetic and population structure in relation to the toxicity and psychrotolerance. We proved that vegetative cells of B. cereus sl are widely distributed in fresh water of rivers and lakes, being as common as spores. Moreover, heavy rain has a huge impact on their concentration in undisturbed environments. The diversity of B. cereus sl reflects the multiple sources of bacteria and the differences between their distinct environments. Next, their diverse genetic structure and phenotypes better fit their ecological properties than their taxonomic affiliation.
Predicting new drug indications from network analysis
Authors: Mohd Ali Yousoff Effendy , Kwa Kiam Heong , Ratnavelu Kurunathan
Published: September 2017

This work adapts centrality measures commonly used in social network analysis to identify drugs with better positions in drug-side effect network and drug-indication network for the purpose of drug repositioning. Our basic hypothesis is that drugs having similar phenotypic profiles such as side effects may also share similar therapeutic properties based on related mechanism of action and vice versa. The networks were constructed from Side Effect Resource (SIDER) 4.1 which contains 1430 unique drugs with side effects and 1437 unique drugs with indications. Within the giant components of these networks, drugs were ranked based on their centrality scores whereby 18 prominent drugs from the drug-side effect network and 15 prominent drugs from the drug-indication network were identified. Indications and side effects of prominent drugs were deduced from the profiles of their neighbors in the networks and compared to existing clinical studies while an optimum threshold of similarity among drugs was sought for. The threshold can then be utilized for predicting indications and side effects of all drugs. Similarities of drugs were measured by the extent to which they share phenotypic profiles and neighbors. To improve the likelihood of accurate predictions, only profiles such as side effects of common or very common frequencies were considered. In summary, our work is an attempt to offer an alternative approach to drug repositioning using centrality measures commonly used for analyzing social networks.
Acoustic response of multi-stopband local resonance plate
Authors: Sun Yonggan , Li Sheng , Jiao Ziquan
Published: September 2017

This paper primarily investigates the effect of damping ratios on the acoustic response of a multi-stopband local resonance plate consisting of two-dimensional periodic arrays of tuned mass-spring combinations attached to a thin homogeneous plate. A Floquet–Bloch approach is employed to demonstrate the stopbands for an infinite plate. In addition, the acoustic radiation behavior and average sound radiation pressure level of finite plates are computed. A continuous and much wider stopband with good vibro-acoustic behavior can be obtained when care is taken in the design of the damping ratios of local resonance plates.
Software Quality and Community Structure in Java Software Networks
Authors: Concas Giulio , Marchesi Michele , Monni Cristina , Orrù Matteo , Tonelli Roberto
Published: September 2017

We present a study of 600 Java software networks with the aim of characterizing the relationship among their defectiveness and community metrics. We analyze the community structure of such networks, defined as their topological division into subnetworks of densely connected nodes. A high density of connections represents a higher level of cooperation between classes, so a well-defined division in communities could indicate that the software system has been designed in a modular fashion and all its functionalities are well separated. We show how the community structure can be an indicator of well-written, high quality code by retrieving the communities of the analyzed systems and by ranking their division in communities through the built-in metric called modularity. We found that the software systems with highest modularity possess the majority of bugs, and tested whether this result is related to some confounding effect. We found two power laws relating the maximum defect density with two different metrics: the number of detected communities inside a software network and the clustering coefficient. We finally found a linear correlation between clustering coefficient and number of communities. Our results can be used to make predictive hypotheses about software defectiveness of future releases of the analyzed systems.
Style analysis with particle filtering and generalized simulated annealing
Authors: Fukui Takaya , Sato Seisho , Takahashi Akihiko
Published: September 2017

This paper proposes a new approach to style analysis of mutual funds in a general state space framework with particle filtering and generalized simulated annealing (GSA). Specifically, we regard the exposure of each style index as a latent state variable in a state space model and employ a Monte Carlo filter as a particle filtering method, where GSA is effectively applied to estimating unknown parameters.

An empirical analysis using data of three Japanese equity mutual funds with six standard style indexes confirms the validity of our method. Moreover, we create fund-specific style indexes to further improve estimation in the analysis.
Empathy in Virtual Agents and Robots
Authors: Paiva Ana , Leite Iolanda , Boukricha Hana , Wachsmuth Ipke
Published: September 2017

This article surveys the area of computational empathy, analysing different ways by which artificial agents can simulate and trigger empathy in their interactions with humans. Empathic agents can be seen as agents that have the capacity to place themselves into the position of a user’s or another agent’s emotional situation and respond appropriately. We also survey artificial agents that, by their design and behaviour, can lead users to respond emotionally as if they were experiencing the agent’s situation. In the course of this survey, we present the research conducted to date on empathic agents in light of the principles and mechanisms of empathy found in humans. We end by discussing some of the main challenges that this exciting area will be facing in the future.
Detecting Users’ Cognitive Load by Galvanic Skin Response with Affective Interference
Authors: Nourbakhsh Nargess , Chen Fang , Wang Yang , Calvo Rafael A.
Published: September 2017

Experiencing high cognitive load during complex and demanding tasks results in performance reduction, stress, and errors. However, these could be prevented by a system capable of constantly monitoring users’ cognitive load fluctuations and adjusting its interactions accordingly. Physiological data and behaviors have been found to be suitable measures of cognitive load and are now available in many consumer devices. An advantage of these measures over subjective and performance-based methods is that they are captured in real time and implicitly while the user interacts with the system, which makes them suitable for real-world applications. On the other hand, emotion interference can change physiological responses and make accurate cognitive load measurement more challenging. In this work, we have studied six galvanic skin response (GSR) features in detection of four cognitive load levels with the interference of emotions. The data was derived from two arithmetic experiments and emotions were induced by displaying pleasant and unpleasant pictures in the background. Two types of classifiers were applied to detect cognitive load levels. Results from both studies indicate that the features explored can detect four and two cognitive load levels with high accuracy even under emotional changes. More specifically, rise duration and accumulative GSR are the common best features in all situations, having the highest accuracy especially in the presence of emotions.
Effects of Speed, Cyclicity, and Dimensionality on Distancing, Time, and Preference in Human-Aerial Vehicle Interactions
Authors: Duncan Brittany A. , Murphy Robin R.
Published: September 2017

This article will present a simulation-based approach to testing multiple variables in the behavior of a small Unmanned Aerial Vehicle (sUAV), inspired by insect and animal motions, to understand how these variables impact time of interaction, preference for interaction, and distancing in Human-Robot Interaction (HRI). Previous work has focused on communicating directionality of flight, intentionality of the robot, and perception of motion in sUAVs, while interactions involving direct distancing from these vehicles have been limited to a single study (likely due to safety concerns). This study takes place in a Cave Automatic Virtual Environment (CAVE) to maintain a sense of scale and immersion with the users, while also allowing for safe interaction. Additionally, the two-alternative forced-choice method is employed as a unique methodology to the study of collocated HRI in order to both study the impact of these variables on preference and allow participants to choose whether or not to interact with a specific robot. This article will be of interest to end-users of sUAV technologies to encourage appropriate distancing based on their application, practitioners in HRI to understand the use of this new methodology, and human-aerial vehicle researchers to understand the perception of these vehicles by 64 naive users. Results suggest that low speed (by 0.27m,
p
< 0.02) and high cyclicity (by 0.28m,
p
< 0.01) expressions can be used to increase distancing; that low speed (by 4.4s,
p
< 0.01) and three-dimensional (by 2.6s,
p
< 0.01) expressions can be used to decrease time of interaction; and low speed (by 10.4%,
p
< 0.01) expressions are less preferred for passability in human-aerial vehicle interactions.
Hyper-Learning Algorithms for Online Evolution of Robot Controllers
Authors: Silva Fernando , Correia Luís , Christensen Anders Lyhne
Published: September 2017

A long-standing goal in artificial intelligence and robotics is synthesising agents that can effectively learn and adapt throughout their lifetime. One open-ended approach to behaviour learning in autonomous robots is
online evolution
, which is part of the evolutionary robotics field of research. In online evolution approaches, an evolutionary algorithm is executed on the robots during task execution, which enables continuous optimisation and adaptation of behaviour. Despite the potential for automatic behaviour learning, online evolution has not been widely adopted because it often requires several hours or days to synthesise solutions to a given task. In this respect, research in the field has failed to develop a prevalent algorithm able to effectively synthesise solutions to a large number of different tasks in a timely manner. Rather than focusing on a single algorithm, we argue for more general
mechanisms
that can combine the benefits of different algorithms to increase the performance of online evolution of robot controllers. We conduct a comprehensive assessment of a novel approach called
online hyper-evolution
(OHE). Robots executing OHE use the different sources of feedback information traditionally associated with controller evaluation to find effective evolutionary algorithms during task execution. First, we study two approaches: OHE-fitness, which uses the fitness score of controllers as the criterion to select promising algorithms over time, and OHE-diversity, which relies on the behavioural diversity of controllers for algorithm selection. We then propose a novel class of techniques called OHE-hybrid, which combine diversity and fitness to search for suitable algorithms. In addition to their effectiveness at selecting suitable algorithms, the different OHE approaches are evaluated for their ability to
construct
algorithms by controlling which algorithmic components should be employed for controller generation (e.g., mutation, crossover, among others), an unprecedented approach in evolutionary robotics. Results show that OHE (i) facilitates the evolution of controllers with high performance, (ii) can increase effectiveness at different stages of evolution by combining the benefits of multiple algorithms over time, and (iii) can be effectively applied to construct new algorithms during task execution. Overall, our study shows that OHE is a powerful new paradigm that allows robots to improve their learning process as they operate in the task environment.
Fast Proxy Re-Encryption for Publish/Subscribe Systems
Authors: Polyakov Yuriy , Rohloff Kurt , Sahu Gyana , Vaikuntanathan Vinod
Published: September 2017

We develop two IND-CPA-secure multihop unidirectional Proxy Re-Encryption (PRE) schemes by applying the Ring-LWE (RLWE) key switching approach from the homomorphic encryption literature. Unidirectional PRE is ideal for secure publish-subscribe operations where a publisher encrypts information using a public key without knowing upfront who the subscriber will be and what private key will be used for decryption. The proposed PRE schemes provide a multihop capability, meaning that when PRE-encrypted information is published onto a PRE-enabled server, the server can either delegate access to specific clients or enable other servers the right to delegate access. Our first scheme (which we call NTRU-ABD-PRE) is based on a variant of the NTRU-RLWE homomorphic encryption scheme. Our second and main PRE scheme (which we call BV-PRE) is built on top of the Brakerski-Vaikuntanathan (BV) homomorphic encryption scheme and relies solely on the RLWE assumption.

We present an open-source C++ implementation of both schemes and discuss several algorithmic and software optimizations. We examine parameter selection tradeoffs in the context of security, runtime/latency, throughput, ciphertext expansion, memory usage, and multihop capabilities. Our experimental analysis demonstrates that BV-PRE outperforms NTRU-ABD-PRE in both single-hop and multihop settings. The BV-PRE scheme has a lower time and space complexity than existing IND-CPA-secure lattice-based PRE schemes and requires small concrete parameters, making the scheme computationally efficient for use on low-resource embedded systems while still providing 100 bits of security. We present practical recommendations for applying the PRE schemes to several use cases of ad hoc information sharing for publish-subscribe operations.