bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Uncertain Map Features on Risk Beliefs and Perceived Ambiguity for Maps of Modeled Cancer Risk from Air Pollution
Authors: Severtson Dolores J. , Myers Jeffrey D.
Published: September 2012

Maps are often used to convey information generated by models, for example, modeled cancer risk from air pollution. The concrete nature of images, such as maps, may convey more certainty than warranted for modeled information. Three map features were selected to communicate the uncertainty of modeled cancer risk: (i) map contours appeared in or out of focus, (ii) one or three colors were used, and (iii) a verbal‐relative or numeric risk expression was used in the legend. Study aims were to assess how these features influenced risk beliefs and the ambiguity of risk beliefs at four assigned map locations that varied by risk level. We applied an integrated conceptual framework to conduct this full factorial experiment with 32 maps that varied by the three dichotomous features and four risk levels; 826 university students participated. Data was analyzed using structural equation modeling. Unfocused contours and the verbal‐relative risk expression generated more ambiguity than their counterparts. Focused contours generated stronger risk beliefs for higher risk levels and weaker beliefs for lower risk levels. Number of colors had minimal influence. The magnitude of risk level, conveyed using incrementally darker shading, had a substantial dose‐response influence on the strength of risk beliefs. Personal characteristics of prior beliefs and numeracy also had substantial influences. Bottom‐up and top‐down information processing suggest why iconic visual features of incremental shading and contour focus had the strongest visual influences on risk beliefs and ambiguity. Variations in contour focus and risk expression show promise for fostering appropriate levels of ambiguity.
How to Model a Negligible Probability Under the WTO Sanitary and Phytosanitary Agreement?
Authors: Powell Mark R.
Published: September 2012

Since the 1997 EC – Hormones decision, World Trade Organization (WTO) Dispute Settlement Panels have wrestled with the question of what constitutes a negligible risk under the Sanitary and Phytosanitary Agreement. More recently, the 2010 WTO Australia – Apples Panel focused considerable attention on the appropriate quantitative model for a negligible probability in a risk assessment. The 2006 Australian Import Risk Analysis for Apples from New Zealand translated narrative probability statements into quantitative ranges. The uncertainty about a “negligible” probability was characterized as a uniform distribution with a minimum value of zero and a maximum value of 10−6. The Australia – Apples Panel found that the use of this distribution would tend to overestimate the likelihood of “negligible” events and indicated that a triangular distribution with a most probable value of zero and a maximum value of 10−6 would correct the bias. The Panel observed that the midpoint of the uniform distribution is 5 × 10−7 but did not consider that the triangular distribution has an expected value of 3.3 × 10−7. Therefore, if this triangular distribution is the appropriate correction, the magnitude of the bias found by the Panel appears modest. The Panel's detailed critique of the Australian risk assessment, and the conclusions of the WTO Appellate Body about the materiality of flaws found by the Panel, may have important implications for the standard of review for risk assessments under the WTO SPS Agreement.
Cooperation, Conflict, or Disengagement? Coparenting Styles and Father Involvement in Fragile Families
Authors: Waller Maureen R.
Published: September 2012

This paper draws on information from the Fragile Families Study (N = 2,695) to examine how different coparenting styles emerge and are related to fathers' involvement with young children in a representative sample of unmarried parents. The results show that the quantity and quality of paternal involvement is significantly higher when unmarried parents establish a cooperative as opposed to a disengaged or conflicted coparenting style. Cooperative coparenting is less likely, however, when unmarried parents have separated after the birth or were never together as a couple, when fathers are unemployed or have other risk factors, when the child has a more difficult temperament, and when parents have fewer children together. This analysis also helps clarify previously equivocal findings concerning the relationship between coparenting conflict and paternal involvement. Regression results show that paternal involvement is not significantly different among parents with cooperative and mixed coparenting styles, indicating that when unmarried parents can work together and support each other's parenting efforts, even if they argue frequently while doing so, fathers remain more involved. At the same time, conflicted coparenting leads to a larger decrease in father involvement than disengaged coparenting. In the context of poorer‐quality coparenting relationships, it was conflict that mattered for fathering, not just parents' inability to cooperate. Implications of these findings for parenting education programs are discussed.
Introduction to the Special Section
Authors: McHale James , Waller Maureen R.
Published: September 2012

Podcast.
Evolution of CT Imaging Features of Carotid Atherosclerotic Plaques in a 1‐Year Prospective Cohort Study
Authors: Adraktas Dionesia D. , Tong Elizabeth , Furtado Andre D. , Cheng Su‐Chun , Wintermark Max
Published: September 2012

PURPOSE

The purpose of this study was to identify imaging markers and clinical risk factors that significantly predict the evolution of computed tomography (CT) imaging features of carotid artery atherosclerotic disease over a 1‐year period.

METHODS

Our prospective study involved 120 consecutive patients undergoing emergent CT evaluation for symptoms of acute stroke. These patients were asked to consent to a follow‐up CT exam in 1 year. To evaluate for atherosclerotic plaque, both at baseline and on follow‐up, we employed a comprehensive computed tomography angiography (CTA) protocol that captured the carotid, vertebral, aortic, and coronary arteries. To further evaluate carotid artery plaque components, we used an automated classifier computer algorithm that distinguishes among the histological components of the carotid artery wall (lipids, calcium, fibrous tissue) based on appropriate thresholds of CT density. Baseline values of carotid imaging features and clinical variables were assessed for their ability to significantly predict changes in these imaging features over 1 year.

RESULTS

Of these 120 consecutive patients, 17 received both a baseline and a follow‐up CTA exam. Wall volume increased more when the largest lipid cluster was located close to the lumen (coefficient −7.61, −13.83 to −1.40, P = .016). The volume of lipid increased with age (coefficient .36, .21 to .50, P = .000), in smokers (coefficient 8.89, 6.82 to 10.95, P = .000) and when fewer lipid clusters were present at baseline (coefficient −0.11, −0.17 to −.04, P = .001). The volume of calcium increased with greater volume of lipid at baseline (coefficient .35, .02 to .68, P = .035) and in patients on statins (coefficient 4.79, 1.73 to 7.86, P = .002).

CONCLUSIONS

There are a number of imaging markers and risk factors that significantly predict the evolution of CT imaging features of carotid artery atherosclerotic disease over a 1‐year period.
A Pictorial Essay of Brain Perfusion‐CT: Not Every Abnormality Is a Stroke!
Authors: Keedy Alexander , Soares Bruno , Wintermark Max
Published: September 2012

Perfusion‐CT (PCT) of the brain is a rapidly evolving imaging technique used to assess blood supply to the brain parenchyma. PCT is readily available at most imaging centers, resulting in steadily increasing use of this imaging technique. Though PCT was initially introduced and still most widely used to evaluate patients with acute ischemic stroke, a wide variety of other pathologic processes demonstrate abnormal perfusion maps. Therefore, it is important for the radiologist to recognize altered perfusion patterns observed in diseases other than typical ischemic stroke. The goal of this article is to show the perfusion maps and review the perfusion patterns observed in some subtypes of atypical stroke and in neurological entities other than stroke, so that they are recognized and not confused with the PCT patterns observed in patients with typical ischemic stroke.
Low‐paid workers in urban China
Authors: DENG Quheng , LI Shi
Published: September 2012

Using CHIP and RUMCI data for 1995, 2002, 2007 and 2008, this article estimates the extent of low pay among local and rural‐migrant workers in urban China. Based on a threshold of two‐thirds of median hourly wages, it finds that a high overall proportion of urban employees are low‐paid. While incidence remained relatively stable among locals between 1995 and 2008, it declined for migrants from 2002 to 2007, though the latter were still much more likely to be in low‐paid jobs. After investigating the determinants and welfare implications of low pay, the authors conclude with an argument for subsidized training, stricter minimum wage enforcement and firm‐level wage bargaining.
Minimum wage violation in South Africa
Authors: BHORAT Haroon , KANBUR Ravi , MAYET Natasha
Published: September 2012

This article aims to provide a more solid, quantified basis for policy debate over minimum wage levels and their enforcement in South Africa – and in other developing countries. Matching data from the 2007 Labour Force Survey to the occupational and locational specifications of gazetted minimum wages, the authors present estimates of minimum wage violation in South Africa. They find that 44 per cent of covered workers get paid wages below the statutory minimum, with an average shortfall of 35 per cent of the minimum wage. Around these averages, violation is most prevalent in the security, forestry and farming sectors.
Indicadores clasificatorios de normativas laborales: el caso del salario mínimo demuestra su ineficacia
Authors: LEE Sangheon
Published: September 2012

El interés creciente por los efectos de la reglamentación laboral en el rendimiento del mercado de trabajo ha suscitado intentos de análisis cuantitativos para comparaciones entre países. Sin negar la contribución de este enfoque a la investigación empírica, el autor analiza críticamente los indicadores clasificatorios de los regímenes normativos, en concreto el componente relativo al salario mínimo del influyente indicador de normas del trabajo del Banco Mundial, y descubre problemas importantes: sesgo teórico y errores de medición, ignorancia de las características institucionales y negación de los aspectos no determinables en la reglamentación, tras lo cual advierte del peligro de utilizar estos indicadores para fundamentar decisiones políticas.
Shiga toxin‐encoding genes (stx genes) in human faecal samples
Authors: Urdahl Anne Margrete , Solheim Heidi Tetlie , Vold Line , Hasseltvedt Viggo , Wasteson Yngvild
Published: September 2012

The aim of the two studies reported here was to investigate the distribution of stx genes in human faecal samples from volunteers and in faecal samples submitted to a regional microbiology hospital laboratory, and to isolate and characterize STEC from stx‐positive samples. In total, faecal samples from 13.9% of 165 volunteers and 36.1% of 416 swabs from the regional microbiology hospital laboratory were positive for stx genes after screening by PCR. Isolation of STEC and of E. coli O157 from stx‐positive faecal samples was performed by a filter‐hybridization protocol and by automated immunomagnetic separation, respectively, and isolates were further characterized by serotyping, virulence typing by PCR and toxin production by the Vero cell assay. STEC were isolated from two samples only, an O146:H21 isolate from one of the volunteers and an O157:H7 isolate from a human case of diarrhoea. To conclude; the results show that it is not unusual to detect stx genes in faecal samples from humans in Norway, both from asymptomatic people and from people with gastrointestinal illness. This finding emphasizes the importance of correct diagnostic criteria for interpretation of the finding of an occasional stx‐positive sample or an STEC isolate when searching for an aetiological agent of human cases of diarrhoea.
Rabelais’s Serious Joke. The Épisode torcheculatif and the High/Low Equation
Authors: Paine Skye
Published: September 2012

In the thirteenth chapter of Gargantua (1534), François Rabelais outlines how the young Gargantua showed his extraordinary intelligence by inventing the perfect way to wipe one’s bottom. Gargantua tested 54 bumwipes from hats to cats, and ended with the perfect means: a well‐plumed goose. This chapter has seemed almost too vulgar to be approached by critics and scholars. François Rigolot is among the few to treat this chapter in exclusivity, yet his reading remains imprecise. How are we ever going to honor the author’s instructions to “weigh carefully” the interior of what we read if we concede that the exterior is too vulgar?  In this paper, I argue that this is a chapter on the consumption and production of writing itself: the intellectual production of the human being (epitomized by writing) is equalized with the production of his body (epitomized by defecating). To arrive at this conclusion, one must solve the central riddle of this chapter: Why was the goose chosen? This simple (yet neglected) question brings us to a more complete comprehension of one of Rabelais’s favorite themes: the mixing of the spiritual and the corporeal.
Coexpression of Escherichia coli RNase III in silkworm cells improves the efficiency of RNA interference induced by long hairpin dsRNAs
Authors: Lee Jae Man , Kojin Yoshito , Tatsuke Tsuneyuki , Mon Hiroaki , Miyagawa Yoshitaka , Kusakabe Takahiro
Published: September 2012

Abstract  Long hairpin dsRNA transcribed from chromosomal DNA can induce RNA interference in Bombyx mori cells, although its gene silencing efficiency is lower than that of exogenously introduced double‐stranded RNAs (dsRNAs). To solve this problem, we monitored the nuclear cytoplasmic translocation of the transcribed hairpin dsRNA and analyzed the processing efficiency into mature small interfering RNA (siRNA). Northern blot analysis revealed that the transcribed hairpin dsRNAs were spliced and transported into the cytoplasm, but were not effectively diced into siRNAs. Interestingly, RNAi with hairpin dsRNAs from genome‐integrated IR transgene was stimulated by the coexpression of Escherichia coli RNase III, although this exogenous enzyme seemed to bring about nonspecific cleavage of cellular mRNA.
Field Treatment of MTBE‐Contaminated Groundwater Using Ozone/UV Oxidation
Authors: Patterson Craig L. , Cadena Fernando , Sinha Rajib , Ngo‐Kidd Dzung Kim , Ghassemi Abbas , Radha Krishnan E.
Published: September 2012

Methyl‐tertiary butyl ether (MTBE) is often found in groundwater as a result of gasoline spills and leaking underground storage tanks. An extrapolation of occurrence data in 2008 estimated at least one detection of MTBE in approximately 165 small and large public water systems serving 896,000 people nationally (United States Environmental Protection Agency [U.S. EPA] 2008). The objective of this collaborative field study was to evaluate a small groundwater treatment system to determine the effectiveness of ultraviolet (UV)/ozone treatment in removing MTBE from contaminated drinking water wells. A pilot‐scale advanced oxidation process (AOP) system was tested to evaluate the oxidation efficiency of MTBE and intermediates under field conditions. This system used ozone as an oxidizer in the presence of UV light at hydraulic retention times varying from 1 to 3 min. MTBE removal efficiencies approaching 97% were possible with this system, even with low retention times. The intermediate t‐butyl alcohol (TBA) was removed to a lesser extent (71%) under the same test conditions. The main intermediate formed in the oxidation process of the contaminated groundwater in these studies was acetone. The concentrations of the other anticipated intermediates t‐butyl formate (TBF), isopropyl alcohol (IPA), methyl acetate (MAc), and possible co‐occurring aromatics (BTEX) in the effluent were negligible.
Harmonisation of micronutrient‐based dietary standards globally: Challenges and future developments
Authors: GIBSON Rosalind S.
Published: September 2012

Aim:  The terminology and frame work for setting nutrient‐based dietary standards (NBDS) varies across countries leading to discrepancies in health, food policies and trade. Hence, harmonising approaches for NBDS warrants investigation.

Methods:  A working group reviewed the terminology used to define NBDS and upper levels, statistical approaches for their use for individuals and populations, criteria to establish requirements, extrapolate and interpolate missing data, bioavailability issues and the potential impact of inter‐individual variations other than life‐stage and gender on nutrient requirements.

Results:  The group proposed the term—nutrient intake values (NIVs)—that include the average nutrient requirement (ANR) and upper nutrient level. An individual nutrient level (INLx) based on the ANR was also proposed, the x representing the percentile for an acceptable risk for inadequacy for an individual. To assess nutrient adequacy and plan diets for groups, use of the ANR cut‐point or probability approach was recommended. In the future, NIVs may be set that take into account inter‐individual differences in lifestyle, environment, health, genotype and epigenetics.

Conclusions:  Use of the proposed terminology and framework for NIVs has global potential for evaluating nutrient intakes and diets for individuals and populations and for use in several aspects of food and nutrition policy.
‘The eyes see what the mind knows.’ Adult‐onset Still's disease, a case series and review in a south Asian population
Authors: Ishaq Muhammad , Nazir Lubna , Riaz Amir , Alam Syed M. , Shaikh Muhammad I.
Published: September 2012

Aim

Adult‐onset Still's disease (AOSD) is a rare disease. Very few cases have been reported from the South‐Asian region so the aim of this study is to assess the clinical and laboratory aspects of 15 patients with AOSD in a tertiary referral hospital in Karachi.

Methods

Retrospective data was collected from all patients diagnosed using Yamaguchi criteria for AOSD between January 2004 and December 2010 at Jinnah Medical College Hospital, Karachi.

Results

Data of 15 patients with AOSD were analyzed. Their ages ranged from 17 to 55 years, the male‐to‐female ratio being 6 : 1. The most common clinical features were fever and articular symptoms (100%), sore throat (60%), rash (53.3%), weight loss (93.3%), lymphadenopathy (40%) and elevated erythrocyte sedimentation rate (86.7%). All patients had leukocytosis with counts > 20 000/mm 3 were seen in 40%. Elevated liver enzymes were present in 80% of the case series and hyperferritinemia in 100% with a mean of 3962 ng/mL (range 555–13 865). Ambiguity in presentation and lack of serologic markers make diagnosis of AOSD difficult as 40% of patients were receiving empirical anti‐tuberculous therapy prior to final diagnosis.

Conclusion

It is necessary for physicians to have a high index of suspicion for AOSD in patients with high‐grade fever, arthralgia and leukocytosis.
Testing Phase‐Specific Self‐Efficacy Beliefs in the Context of Dietary Behaviour Change
Authors: Ochsner Sibylle , Scholz Urte , Hornung Rainer
Published: September 2012

Background: Self‐efficacy is an important predictor of health behaviour change. Within the health action process approach (HAPA; Schwarzer, 2008), motivational and volitional self‐efficacy can be distinguished. Motivational self‐efficacy is assumed to serve as predictor of intention formation whereas volitional self‐efficacy should be relevant for behaviour change. This study examined these assumptions in a sample with overweight and obese individuals. Moreover, we tested whether behavioural intentions moderate the association between volitional self‐efficacy and behaviour. Methods: Overall, 373 overweight and obese individuals completed a baseline and six months later a follow‐up questionnaire on HAPA variables and dietary behaviour. Results: A factor analysis confirmed the phase‐specific separation of self‐efficacy. Motivational self‐efficacy emerged as predictor for behavioural intentions over and above other HAPA variables after six months, whereas volitional self‐efficacy did not. Volitional self‐efficacy interacted with intention in the prediction of behaviour, indicating that volitional self‐efficacy is only beneficial for individuals with high levels of intentions. Conclusions: The results provide evidence for the phase‐specific distinction of self‐efficacy in the context of dietary change in an overweight or obese sample. Thus, differentiating between motivational and volitional self‐efficacy beliefs should be considered when developing future interventions of dietary change.
Perioperative iron administration as an alternative to blood transfusion in major surgery
Authors: GARCÍA‐ERCE JOSÉ ANTONIO , CANTANHEDE GABRIEL , CUENCA JORGE , HERRERA ANTONIO
Published: September 2012

In the surgical setting, anemia is a common feature and an independent risk factor for blood transfusion, inpatient complications, delayed hospital discharge and poorer functional recovery. Despite adverse side effects and the increasing costs to health systems, allogeneic blood transfusion is the standard of care for anemia. Within this context, NATA (Network for the Advancement of Transfusion Alternatives) guidelines advocate steps towards prevention, diagnosis of anemia and stimulation of erythropoiesis in surgical patients. These include iron – p.o. and i.v. formulations – and recombinant human erythropoietin (rHuEPO) as viable alternatives pre‐, peri‐ and/or postoperatively. The combination of these methods with restrictive transfusion triggers, tranexamic acid and blood salvage techniques may reduce perioperative transfusion rates. The main objective of this article is to briefly review the use of iron in surgical patients, with special focus on orthopedic surgery. From the analyzed information, it can be concluded that, despite the lack of large randomized controlled trials, results indicate that because of the low incidence of serious side effects and the rapid increase of hemoglobin levels, i.v. iron emerges as a safe and effective drug for treating and preventing perioperative anemia. In addition, i.v. iron administration reduces rHuEPO dose requirements. The use of new i.v. iron formulations will allow the administration of large doses in a single session, thus facilitating a more widespread use of this therapeutic option.
A simple method for dealing with large state spaces
Authors: Schapaugh Adam W. , Tyre Andrew J.
Published: September 2012

Most sequential decision‐making problems in conservation can be viewed conceptually and modelled as a Markov decision process. The goal in this context is to construct apolicythat associates each state of the system with a particular action. This policy should offer optimal performance in the sense of maximizing or minimizing a specified conservation objective

Dynamic programming algorithms rely on explicit enumeration to derive the optimal policy. This is problematic from a computational perspective as the size of the state space grows exponentially with the number of state variables.

We present a state aggregation method where the idea is to capture the most important aspects of the original Markov decision process, find an optimal policy over this reduced space and use this as an approximate solution to the original problem.

Applying the aggregation method to a species reintroduction problem, we demonstrate how we were able to reduce the number of states by 75% and reduce the size of the transition matrices by almost 94% (324 vs. 5184), and the abstract action matched the optimal action more than 86% of the time.

We conclude that the aggregation method is not a panacea for the curse of dimensionality, but it does advance our ability to construct approximately optimal policies in systems with large state spaces.
Conduction Slowing Contributes to Spontaneous Ventricular Arrhythmias in Intrinsically Active Murine RyR2‐P2328S Hearts
Authors: ZHANG YANMIN , WU JINGJING , JEEVARATNAM KAMALAN , KING JAMES H. , GUZADHUR LAILA , REN XIAOLEI , GRACE ANDREW A. , LEI MING , HUANG CHRISTOPHER L.‐H. , FRASER JAMES A.
Published: September 2012

Conduction Changes in RyR2‐P2328S Hearts. Introduction: The familial condition catecholaminergic polymorphic ventricular tachycardia (CPVT) is characterized by episodic bidirectional ventricular tachycardia (BVT), polymorphic ventricular tachycardia (PVT), and ventricular fibrillation following adrenergic challenge. It is associated with mutations involving the cardiac ryanodine receptor (RyR2).

Methods and Results:
We explored for a slowing of myocardial conduction that could potentially result in a substrate for the spontaneous arrhythmogenesis that was observed following introduction of isoproterenol and caffeine in intrinsically beating murine RyR2‐P2328S hearts. Such pharmacological challenge increased the number of arrhythmic episodes in electrocardiographic recordings from intact anesthetized mice, with the greatest effects in the homozygote RyR2S/S. Arrhythmias took the form of bigeminy, BVT, monomorphic ventricular tachycardia, and PVT, as found in human CPVT. Ventricular epicardial conduction velocities (CVs) measured using multielectrode array recordings and maximum action potential upstroke rates, (dV/dt)max, measured using intracellular microelectrodes were indistinguishable in untreated wild‐type (WT) and RyR2S/S. Pharmacological challenge of RyR2S/S, but not WT hearts, then reduced CV and (dV/dt)max and also revealed a strongly arrhythmic phenotype. There was no evidence of gross structural or fibrotic changes in either RyR2+/S or RyR2S/S hearts on light microscopy.

Conclusions:
We associate altered ventricular myocardial CV potentially resulting in arrhythmogenic substrate with arrhythmic properties associated with genetic RyR2 alterations for the first time. (J Cardiovasc Electrophysiol, Vol. 24, pp. 210‐218, February 2013)
Xenotransplantation literature update, July–August 2012
Authors: Schneider Mårten K. J. , Seebach Jörg D.
Published: September 2012

Schneider MKJ, Seebach JD. Xenotransplantation literature update, July to August 2012. Xenotransplantation 2012; 19: 323–325. © 2012 John Wiley & Sons A/S.
Identification and Analysis of the First 2009 Pandemic H1N1 Influenza Virus from U.S. Feral Swine
Authors: Clavijo A. , Nikooienejad A. , Esfahani M. S. , Metz R. P. , Schwartz S. , Atashpaz‐Gargari E. , Deliberto T. J. , Lutman M. W. , Pedersen K. , Bazan L. R. , Koster L. G. , Jenkins‐Moore M. , Swenson S. L. , Zhang M. , Beckham T. , Johnson C. D. , Bounpheng M.
Published: September 2012

The first case of pandemic H1N1 influenza (pH1N1) virus in feral swine in the United States was identified in Texas through the United States Department of Agriculture (USDA) Wildlife Services’ surveillance program. Two samples were identified as pandemic influenza by reverse transcriptase quantitative PCR (RT‐qPCR). Full‐genome Sanger sequencing of all eight influenza segments was performed. In addition, Illumina deep sequencing of the original diagnostic samples and their respective virus isolation cultures were performed to assess the feasibility of using an unbiased whole‐genome linear target amplification method and multiple sample sequencing in a single Illumina GAIIx lane. Identical sequences were obtained using both techniques. Phylogenetic analysis indicated that all gene segments belonged to the pH1N1 (2009) lineage. In conclusion, we have identified the first pH1N1 isolate in feral swine in the United States and have demonstrated the use of an easy unbiased linear amplification method for deep sequencing of multiple samples.
Design of Planar, Shape-Changing Rigid-Body Mechanisms for Morphing Aircraft Wings
Authors: Zhao Kai , Schmiedeler James P. , Murray Andrew P.
Published: September 2012

This paper presents a procedure to synthesize planar rigid-body mechanisms, containing both prismatic and revolute joints, capable of approximating a shape change defined by a set of morphing curves in different positions. The existing mechanization process is extended specifically to enable the design of morphing aircraft wings. A portion of the closed-curve morphing chain that has minimal displacement is identified as the structural ground after the segmentation process. Because of the revolute joints placed at the endpoints of the ground section, the moving links of the fixed-end morphing chain need to be repositioned relative to each of the desired wing shapes so as to minimize the error in approximating them. With the introduction of prismatic joints, a building-block approach is employed to mechanize the fixed-end morphing chain. The blocks are located in an assembly position to generate a single degree-of-freedom (DOF) mechanism. Because of the additional constraints associated with prismatic joints compared to revolute joints, the size of the solution space is reduced, so random searches of the design space to find solution mechanisms are ineffective. A multi-objective genetic algorithm is employed instead to find a group of viable designs that tradeoff minimizing matching error with maximizing mechanical advantage. The procedure is demonstrated with a synthesis example of a 1-DOF mechanism approximating eight closed-curve wing profiles.
Design of a Family of Ultra-Precision Linear Motion Mechanisms
Authors: Hongzhe Zhao , Shusheng Bi , Jingjun Yu , Jun Guo
Published: September 2012

The parasitic motion of a parallel four-bar mechanism (PFBM) is undesirable for designers. In this paper, the rigid joints in PFBM are replaced with their flexural counterparts, and the center shift of rotational flexural pivots can be made full use of in order to compensate for this parasitic motion. First, three schemes are proposed to design a family of ultraprecision linear-motion mechanisms. Therefore, the generalized cross-spring pivots are utilized as joints, and six configurations are obtained. Then, for parasitic motion of these configurations, the compensation condition is presented, and the design space of geometric parameters is given. Moreover, the characteristic evaluation of these configurations is implemented, and an approach to improve their performances is further proposed. In addition, a model is developed to parametrically predict the parasitic motion and primary motion. Finally, the analytic model is verified by finite element analysis (FEA), so these linear-motion mechanisms can be employed in precision engineering.
Monte Carlo simulation of photon buildup factors for shielding materials in diagnostic x‐ray facilities
Authors: Kharrati Hedi , Agrebi Amel , Karoui Mohamed Karim
Published: September 2012

Purpose:

A simulation of buildup factors for ordinary concrete, steel, lead, plate glass, lead glass, and gypsum wallboard in broad beam geometry for photons energies from 10 keV to 150 keV at 5 keV intervals is presented.

Methods:

Monte CarloN‐particle radiation transport computer code has been used to determine the buildup factors for the studied shielding materials.

Results:

An example concretizing the use of the obtained buildup factors data in computing the broad beam transmission for tube potentials at 70, 100, 120, and 140 kVp is given. The half value layer, the tenth value layer, and the equilibrium tenth value layer are calculated from the broad beam transmission for these tube potentials.

Conclusions:

The obtained values compared with those calculated from the published data show the ability of these data to predict shielding transmission curves. Therefore, the buildup factors data can be combined with primary, scatter, and leakage x‐ray spectra to provide a computationally based solution to broad beam transmission for barriers in shielding x‐ray facilities.
Acquired methaemoglobinaemia related to phenazopyridine ingestion
Authors: Shahani Lokesh , Sattovia Stacy
Published: September 2012

Methaemoglobin is an altered state of haemoglobin in which the ferrous ions of haeme are oxidised to the ferric state. This results in increased affinity to the bound oxygen and decreasing its availability to tissues. Most cases of methaemoglobinaemia are acquired, resulting from an increased methaemoglobin formation by various exogenous agents. The authors report an elderly patient presenting to the emergency department with a 1-month history of shortness of breath. Around the same time she had started using over-the-counter (OTC) phenazopyridine tablets for urinary symptoms. The patient was hypoxic and cyanotic; however, lacked evidence of hypoxaemia on the arterial blood gas. The presence of abnormal haemoglobin was suspected and confirmed by elevated levels of methaemoglobin. Phenazopyridine was proposed to be the likely aetiology of the methaemoglobinaemia, which the patient was not aware of. This case highlights the importance of always inquiring the OTC drug use especially in geriatric population.
OP10 Effects of socio Economic Position in Childhood and Adulthood on Cardiometabolic Risk Factors: The Jerusalem Perinatal Family Follow-Up Study
Authors: Manor O , Savitsky B , Hochner H , Meiner V , Siscovick DS , Friedlander Y
Published: September 2012

Background

Studies indicate that Socio Economic Position (SEP) might be an important predictor of cardiometabolic disease mortality and morbidity; yet the importance of timing of the effect of SEP on cardiometabolic risk factors has not been fully established. Our aim was to assess the independent effect of SEP in both childhood and adulthood on cardiometabolic risk factors in young adults and to examine potential interactive effects of SEP at both time points on these risk factors.

Methods

This is a prospective follow-up of 1132 individuals, born in Jerusalem between the years 1974–76, to young adulthood with bio-medical data at mean age 32. Outcomes include Body Mass Index (BMI), Waist to Hip Ratio (WHR), blood pressure, waist circumference (WC), pelvis circumference, body fat percentage, fasting levels of Triglyceride (TG), HDL-C, LDL-C, glucose, insulin, and lifestyle characteristics, including smoking and physical activity. SEP in childhood was based on father’s occupation (scale 1–6) and in adulthood, on subject’s occupation (scale 1–5). Additional analyses used maternal and subject’s years of education. GLM and logistic regression models were used with mutual adjustment for SEP at both time points and further adjustment for gender, ethnic origin and fasting duration. Log transformation was used for TG and insulin levels.

Results

Independently of current SEP, lower childhood SEP was significantly associated with higher logTG (β=0.013, p=0.042), higher LDL (β=1.979, p=0.023), higher body fat percentage (β=0.476, p=0.025) and higher odds of physical inactivity (OR=1.13, p=0.043). Independently of childhood SEP, lower adulthood SEP was significantly associated with lower HDL level (β=–0.934, p=0.026), higher WHR (β=0.006, p=0.002), and higher odds of smoking (OR=1.31, p=0.001) and physical inactivity (OR=1.34, p<0.0001). Significant interactions were found between SEP in both time points and LDL, WHR and WC (p for interactions=0.01, 0.024 and 0.055 respectively). The detrimental effect of lower SEP in adulthood on LDL level was strongest among subjects with high SEP in childhood (β=4.54, p<0.0001), compared with those having lower SEP in childhood. Similar trends were observed for WHR and WC (β=0.011, p<0.0001 and β=1.754, p=0.004 for associations of adulthood SEP with WHR and WC respectively, among subjects with high childhood SEP). Analyses, based on education as a measure of SEP, yielded similar interactive patterns.

Conclusion

Adverse SEP at both childhood and adulthood has an independent influence on physiological and behavioral risk factors. The interaction between SEP in childhood and adulthood in their effect on cardiometabolic risk factors points to the important role played by social mobility in affecting adult poorer health.
OP17 Do Low Levels of Psychological Distress Predict Mortality? Evidence from an Individual Participant Meta-Analysis of ten Prospective Cohort Studies
Authors: Russ TC , Stamatakis E , Hamer M , Starr JM , Kivimaki M , Batty GD
Published: September 2012

Background

A series of studies have linked psychological distress (depression and anxiety) with cause-specific mortality, but the risk of lower, sub-clinically symptomatic, levels of distress – hitherto of little interest to specialist mental health practitioners – has not been quantified.

Methods

We conducted an individual participant meta-analysis of ten large prospective cohort studies from the Health Survey for England. Baseline psychological distress was measured using the 12-item General Health Questionnaire, and mortality from death certification. The analytical sample comprised 68,222 individuals from general population samples of adults aged 35 and over, free of cardiovascular disease and cancer and living in private households in England at study baseline. The main outcome measures were death from all causes (n=8,365), cardiovascular disease (n=3,382), all cancers (n=2,552), and external causes (n=386). Mean (standard deviation) follow-up was 8.2 (3.5) years.

Results

There was a positive, dose-response association between psychological distress across the full range of severity and mortality risk (age- and sex-adjusted hazard ratio for General Health Questionnaire scores of 1–3 compared to zero: 1.20, 95% CI 1.13 to 1.27; scores 4–6: 1.43 1.31 to 1.56; and scores 7–12: 1.94, 1.66 to 2.26; p for trend <0.001). This association remained after adjustment for somatic co-morbidity plus behavioural and socioeconomic factors. A similar association was found for death from cardiovascular disease, cancer, and external causes.

Conclusion

Psychological distress is associated with increased risk of mortality from several major causes in a dose-response pattern. Even at lower levels of distress the mortality risk was elevated.
OP24 Assessing the Cost-Effectiveness of Alternative Care Pathways: A Case Study Evaluating Early Transfer to Neuroscience Centres for Critically ill Patients with Acute Traumatic Brain Injury
Authors: Grieve R , Harrison D , Sadique MZ , Gomes M , Menon D , Rowan K
Published: September 2012

Background

Acute traumatic brain injury (TBI) is a major cause of death, disability and cost. For critically-ill adult TBI patients who present outside a neuroscience centre, and do not require neurosurgery, there is little evidence on whether early transfer to a neuroscience centre is worthwhile. NICE guidelines list the issue as a key research topic. We aimed to assess the relative cost-effectiveness of ‘early transfer’ (within 18 hours of hospital presentation) versus ‘no or late transfer’ (after 24 hours) for these patients.

Methods

The Risk Adjustment In Neurocritical care (RAIN) Study validated risk prediction models following TBI. The RAIN Study recruited admissions following acute TBI to 67 adult critical care units during 2009–11. Detailed information was collected on baseline prognostic factors, the time of transfer to neuroscience centres, and mortality. Resource use data were recorded for six months, and combined with unit costs to report total hospital and community health service costs. At the six month follow-up, data were collected on health-related quality of life (HRQoL), by the EQ–5D–3L. The lifetime cost-effectiveness analysis extrapolated from six month endpoints, informed by the literature. We report lifetime incremental cost per QALY of ‘early’ versus ‘no or late transfer’, overall and for subgroups (age <=70, vs >70; mild/moderate, vs severe TBI; major extracranial injury, vs none). To adjust for baseline differences we used the previously validated risk prediction models in regression analyses. In sensitivity analyses we considered alternative approaches for extrapolating from the six month endpoints and undertaking risk adjustment.

Results

There were 584 patients in the ‘early’ and 263 in the ‘no or late transfer’ group. After risk adjustment, early transfer was associated, at six months, with lower mortality (odds ratio 0.52, 95% CI 0.34 to 0.80), higher HRQoL for survivors (mean gain 0.13, 0.032 to 0.225), but positive incremental costs (£15,000, £11,123 to £18,880). The lifetime cost per QALY for ‘early transfer’ was £11,000. For patients older than 70, ‘early transfer’ was associated with higher mortality, and was unlikely to be cost-effective (probability 0.15 at £20,000 per QALY). For other subgroups, the corresponding probabilities that ‘early transfer’ is cost-effective were between 0.7 and 1.

Conclusion

For critically-ill patients with acute TBI aged 70 or less, early transfer to a neuroscience centre appears cost-effective. While this finding is robust to alternative methodological assumptions and choice of risk prediction model, further research is required to investigate the potential impact of unobserved confounding.
OP33 Exposure-Based Assessment of Modal Travel Risk in England Using Routine Health Data
Authors: Mindell JS , Leslie D , Wardlaw M
Published: September 2012

Background

Cycling can make large contributions to population health but perceived road danger is a strong disincentive to cycling. Research on cycling safety is distorted by not making like-for-like comparisons. We examined age- and sex-specific deaths and injuries in England by travel mode, considering both the ICD external codes included in official travel risk data and those excluded but required for accurate comparative assessment, to provide more precise comparisons of travel risks by mode.

Methods

ICD–10 external codes were grouped by type of incident for pedestrians, cyclists, and car/van drivers; the fourth digit was used to exclude non-transport casualties. Numbers of hospital admissions, from Hospital Episodes Statistics data, and deaths in England 2007–2009 were obtained for these ICD codes, by age-group and sex. Aggregated per capita distance travelled by age-group, sex and mode in England from National Travel Survey for each year 2007–2009, weighted to be nationally-representative, was multiplied by the estimated mid-year population. Time spent travelling was estimated using mean trip speeds by mode. We calculated fatal injury and hospital admission rates by distance travelled and by time spent travelling by age-group, sex, and travel mode. 95% confidence intervals for Poisson parameters were calculated using the formulae for weighted sums.

Results

Fatalities per million hours’ use (f/mhu) varied little (0.15–0.45f/mhu by mode for men, 0.09–0.31f/mhu for women). Risks were similar for men aged 21–49 years for all three modes and for female pedestrians and drivers aged 21–69 years. The group most at risk for each mode were: male drivers aged 17–20 years (1.3f/mhu, 95% CI 1.2, 1.4); male cyclists aged 70 years or older (2.2 f/mhu, 1.6, 3.0) and female pedestrians aged 70 years or older (0.95 f/mhu, 0.86, 1.1). In general, fatality rates were substantially higher amongst males than females, except for drivers aged 60 years or older. Risks per hour for male drivers under 30 years were similar or higher than for male cyclists; for 17–20 year olds the risk was higher for drivers (33/Bn km, 95% CI 30, 36; 1.3f/mhu, 1.2, 1.4) than cyclists (20/Bn km, 10, 37; 0.24f/mhu, 0.12, 0.45) using distance or time.

Conclusion

This is the first study in the UK to provide travel casualty rates by distance travelled and per hour, by mode, by age-group and sex, based on nationally-representative data, to enable unbiased intermodal comparisons for population sub-groups. Males aged 17–20 years old face higher risks as drivers than as cyclists, and do not achieve better safety as drivers until over 30 years. Not making like-for-like comparisons sustains the misleading stereotype that cycling is relatively hazardous.
OP35 The Health Impacts of Free Bus Travel for Young People in London
Authors: Edwards P , Steinbach R , Wilkinson P , Petticrew M , Goodman A , Jones A , Roberts H , Kelly C , Nellthorp J , Green J
Published: September 2012

Background

Interventions in transport systems have potentially far-reaching impacts on public health, but can be challenging to evaluate. In 2005, young people in London gained access to free bus travel; an intervention that has a number of potential risks and benefits to health. As transport access is linked to well-being, we might expect the policy to benefit the health of young people by reducing transport exclusion. However, health effects might also include: young people doing less walking, thus reducing levels of physical activity, but also reducing exposure to pedestrian injury risk; or being more exposed to assault as they travel further.

Methods

We utilized change-on-change analyses comparing pre (2001–2004) and post (2006–2009) changes in outcomes in ‘younger people’ (intervention group, 12–17 years) to ‘adults’ (control group, 25–59 years) in London, UK. Main outcome measures included changes in travel patterns (trips made by main travel mode and distances travelled), road traffic injuries and hospital admissions for assault.

Results

Post-intervention, the total number of journeys to school or work made by younger people increased relative to adults (change-on-change ratio 1.19: 95% CI 1.13–1.25), and the proportion of short trips (<1km) by bus doubled (1.97: 1.07–3.84). There was some evidence that younger people made fewer trips where walking was the main mode of travel (0.76: 0.70–0.85), but no evidence for a change in overall distances walked by younger people post-intervention. Against background declines in road traffic injury, the decrease in road injury to young people was larger relative to adults (0.84; 0.82–0.87), however pedestrian injuries declined similarly in both groups. Rates of hospitalisation due to assaults increased in younger people relative to adults (1.20: 1.13–1.27).

Conclusion

A change in the distribution of travel modes used by younger people (relative to adults who had not received free bus travel) was observed post-intervention. Younger people made fewer trips where walking was their main mode of travel, but there was little overall difference in distances walked, suggesting that the policy may have generated journeys but made little overall impact on prevalence of active transport. Observed changes in road traffic injuries reflect the relative risks of changing travel modes. The intervention has been associated with a small relative increase in assaults to younger people. A change-on-change analysis has enabled us to use this ‘natural experiment’ to quantify some important health outcomes of a transport policy in the absence of evidence from a randomised trial.