bluuebunny/crossref_metadata_2025 huggingface dataset:
A scaling algorithm for optimizing arbitrary functions over vertices of polytopes
Authors: Chubanov Sergei
Published: June 2020

In this paper we present a scaling algorithm for minimizing arbitrary functions over vertices of polytopes in an oracle model of computation which includes an augmentation oracle. For the binary case, when the vertices are 0–1 vectors, we show that the oracle time is polynomial. Also, this algorithm allows us to generalize some concepts of combinatorial optimization concerning performance bounds of greedy algorithms and leads to new bounds for the complexity of the simplex method.
Diet-Induced Physiological Responses in the Liver of Atlantic Salmon (Salmo salar) Inferred Using Multiplex PCR Platforms
Authors: Caballero-Solares Albert , Xue Xi , Cleveland Beth M. , Foroutani Maryam Beheshti , Parrish Christopher C. , Taylor Richard G. , Rise Matthew L.
Published: June 2020

The simultaneous quantification of several transcripts via multiplex PCR can accelerate research in fish physiological responses to diet and enable the development of superior aquafeeds for farmed fish. We designed two multiplex PCR panels that included assays for 40 biomarker genes representing key aspects of fish physiology (growth, metabolism, oxidative stress, and inflammation) and 3 normalizer genes. We used both panels to assess the physiological effects of replacing fish meal and fish oil by terrestrial alternatives on Atlantic salmon smolts. In a 14-week trial, we tested three diets based on marine ingredients (MAR), animal by-products and vegetable oil (ABP), and plant protein and vegetable oil (VEG). Dietary treatments affected the expression of genes involved in hepatic glucose and lipid metabolism (e.g., srebp1, elovl2), cell redox status (e.g., txna, prdx1b), and inflammation (e.g., pgds, 5loxa). At the multivariate level, gene expression profiles were more divergent between fish fed the marine and terrestrial diets (MAR vs. ABP/VEG) than between the two terrestrial diets (ABP vs. VEG). Liver ARA was inversely related to glucose metabolism (gck)- and growth (igfbp-5b1, htra1b)-related biomarkers and hepatosomatic index. Liver DHA and EPA levels correlated negatively with elovl2, whereas ARA levels correlated positively with fadsd5. Lower hepatic EPA/ARA in ABP-fed fish correlated with the increased expression of biomarkers related to mitochondrial function (fabp3a), oxidative stress (txna, prdx1b), and inflammation (pgds, 5loxa). The analysis of hepatic biomarker gene expression via multiplex PCR revealed potential physiological impacts and nutrient-gene interactions in Atlantic salmon fed lower levels of marine-sourced nutrients.
CHIRPS: Explaining random forest classification
Authors: Hatwell Julian , Gaber Mohamed Medhat , Azad R. Muhammad Atif
Published: June 2020

Modern machine learning methods typically produce “black box” models that are opaque to interpretation. Yet, their demand has been increasing in theHuman-in-the-Loopprocesses, that is, those processes that require a human agent to verify, approve or reason about the automated decisions before they can be applied. To facilitate this interpretation, we proposeCollection of High Importance Random Path Snippets(CHIRPS); a novel algorithm for explaining random forest classificationper data instance. CHIRPS extracts a decision path from each tree in the forest that contributes to the majority classification, and then uses frequent pattern mining to identify the most commonly occurring split conditions. Then a simple, conjunctive form rule is constructed where the antecedent terms are derived from the attributes that had the most influence on the classification. This rule is returned alongside estimates of the rule’s precision and coverage on the training data along with counter-factual details. An experimental study involving nine data sets shows that classification rules returned by CHIRPS have a precision at least as high as the state of the art when evaluated on unseen data (0.91–0.99) and offer a much greater coverage (0.04–0.54). Furthermore, CHIRPS uniquely controls against under- and over-fitting solutions by maximising novel objective functions that are better suited to the local (per instance) explanation setting.
Progressive Pricing: The Ethical Case for Price Personalization
Authors: Coker Jerod , Izaret Jean-Manuel
Published: June 2020

Price discrimination is widely considered unethical/unfair by consumers, as has been borne out by decades of psychological research and mainstream press reporting. However, little academic work has been done to investigate the ethics of price discrimination. The work that has been done to date concludes that while price discrimination is not unethical, despite widespread lay perceptions, it is at best morally neutral. We argue price discrimination ismoreethical than unitary pricing, when done ‘progressively,’ meaning firms charge customers as a function of their willingness-to-pay. We introduce this specific kind of price discrimination as ‘Progressive Pricing’ and demonstrate it ethically outperforms a ‘Unitary Pricing’ scheme (where everyone pays the same price, regardless of their willingness-to-pay), at least within a broadly consequentialist framework. We do this by comparing a Unitary Pricing scheme to a Progressive one, analyzing them through the lenses of four different consequentialist ‘Social Welfare Functions’ (Utilitarian, Egalitarian, Prioritarian, and Leximin), which are used by welfare economists and philosophers to rank the distributions of different social outcomes, concluding that Progressive Pricing is preferred regardless of which Social Welfare Function(s) one finds most plausible.
Planning hinterland container transportation in congested deep-sea terminals
Authors: Zweers Bernard G. , Bhulai Sandjai , van der Mei Rob D.
Published: June 2020

The size of container ships and the number of containers being transshipped at container terminals have steadily increased over the years. Consequently, it is important to make efficient use of the hinterland capacity. A concept that is used to do this is synchromodal transportation, in which at the very last moment the mode of transportation for a container is decided. Unfortunately, some deep-sea terminals are rather congested and it is unknown by the time the transportation plan is made how many containers can be loaded to and unloaded from a barge. Motivated by this, we study an operational planning problem with uncertainty that is faced by an inland terminal in the port of Amsterdam as a two-stage stochastic problem with recourse. We solve this problem using sample average approximation (SAA) and a fast heuristic using constraints based on stochastic programming (SP). The SAA method gives near-optimal solutions for small instances. For larger instances, the SP-based method is shown to be a good alternative because it is much faster than the SAA method and produces solutions that are less than 1% from the SAA solutions.
A novel biosensor to monitor proline in pea root exudates and nodules under osmotic stress and recovery
Authors: Rubia María I. , Ramachandran Vinoy K. , Arrese-Igor Cesar , Larrainzar Estíbaliz , Poole Philip S.
Published: June 2020

Background and aims

Plant and bacteria are able to synthesise proline, which acts as a compound to counteract the negative effects of osmotic stresses. Most methodologies rely on the extraction of compounds using destructive methods. This work describes a new proline biosensor that allows the monitoring of proline levels in a non-invasive manner in root exudates and nodules of legume plants.

Methods

The proline biosensor was constructed by cloning the promoter region of pRL120553, a gene with high levels of induction in the presence of proline, in front of the lux cassette in Rhizobium leguminosarum bv. viciae.

Results

Free-living assays show that the proline biosensor is sensitive and specific for proline. Proline was detected in both root exudates and nodules of pea plants. The luminescence detected in bacteroids did not show variations during osmotic stress treatments, but significantly increased during recovery.

Conclusions

This biosensor is a useful tool for the in vivo monitoring of proline levels in root exudates and bacteroids of symbiotic root nodules, and it contributes to our understanding of the metabolic exchange occurring in nodules under abiotic stress conditions.
Mathematical formulations and improvements for the multi-depot open vehicle routing problem
Authors: Lalla-Ruiz Eduardo , Mes Martijn
Published: June 2020

The multi-depot open vehicle routing problem (MDOVRP) is a hard combinatorial optimization problem belonging to the vehicle routing problem family. It considers vehicles departing from different depots to deliver goods to customers without requiring to return to the depots once all customers have been served. The aim of this work is to provide a new two-index-based mathematical formulation for the MDOVRP as well as enhancements on alternative sub-tour elimination constraints. Through numerical experiments, using traditional benchmarks for the MDOVRP, we show that the proposed formulation outperforms existing ones. In addition, we provide insights with regards to problem instance defining parameters on the models performance.
Psychological and clinical characteristics of female patients with spontaneous coronary artery dissection
Authors: Smaardijk V. R. , Mommersteeg P. M. C. , Kop W. J. , Adlam D. , Maas A. H. E. M.
Published: June 2020

Aims

Spontaneous coronary artery dissection (SCAD) is increasingly recognised as a cause of myocardial infarction, but psychological characteristics of patients with SCAD have not yet been extensively investigated. We assessed the prevalence of a broad range of psychological and clinical factors, and their inter-relationships in patients with a history of SCAD. Furthermore, we investigated whether specific clusters of patients with SCAD can be identified.

Methods

Participants were recruited between March and May 2019 from a Dutch SCAD database and completed online questionnaires. Clinical information was verified by review of medical records. Participants were predominantly female (172/183; 94%). Analyses focused on the 172 female patients (mean age 52.0 ± 7.5 years, 37% postmenopausal).

Results

The most common comorbidities of SCAD were migraine (52%), fibromuscular dysplasia (FMD; 29%), chronic pain (29%), and tinnitus (28%). Six women (3%) had pregnancy-associated SCAD. Traditional cardiovascular risk factors were rare (<10%), except for hypertension (31%). Psychological assessment indicated high levels of perceived stress (PSS-10 ≥14; 50%), fatigue (FAS-10 ≥22; 56%), and a frequent history of burnout (25%). The prevalence of depression (9%) and anxiety (12%) was relatively low. Three clusters were identified: (A) FMD and chronic non-ischaemic conditions (tinnitus, chronic pain, and irritable bowel syndrome); (B) migraine; and (C) none of these conditions.

Conclusion

This study shows that perceived stress and fatigue are common in patients with SCAD, in addition to prevalent comorbid FMD, migraine, tinnitus, and non-ischaemic pain conditions. These factors may add to developing tailored rehabilitation programmes for patients with SCAD.
Changes in functional connectivity in people with HIV switching antiretroviral therapy
Authors: Toniolo Sofia , Cercignani Mara , Mora-Peris Borja , Underwood Jonathan , Alagaratnam Jasmini , Bozzali Marco , Boffito Marta , Nelson Mark , Winston Alan , Vera Jaime H.
Published: June 2020

We assessed changes in functional connectivity by fMRI (functional magnetic resonance imaging) and cognitive measures in otherwise neurologically asymptomatic people with HIV (PWH) switching combination antiretroviral therapy (cART). In a prospective study (baseline and follow-up after at least 4 months), virologically suppressed PWH switched non-nuclease reverse-transcriptase inhibitors (NNRTI; tenofovir-DF/emtricitabine with efavirenz to rilpivirine) and integrase-strand-transfer inhibitors (INSTI; tenofovir-DF/emtricitabine with raltegravir to dolutegravir). PWH were assessed by resting-state fMRI and stop-signal reaction time (SSRT) task fMRI as well as with a cognitive battery (CogState™) at baseline and follow-up. Switching from efavirenz to rilpivirine (n = 10) was associated with increased functional connectivity in the dorsal attention network (DAN) and a reduction in SSRTs (p = 0.025) that positively correlated with the time previously on efavirenz (mean = 4.8 years, p = 0.02). Switching from raltegravir to dolutegravir (n = 12) was associated with increased connectivity in the left DAN and bilateral sensory-motor and associative visual networks. In the NNRTI study, significant improvements in the cognitive domains of executive function, working memory and speed of visual processing were observed, whereas no significant changes in cognitive function were observed in the INSTI study. Changes in fMRI are evident in PWH without perceived neuropsychiatric complaints switching cART. fMRI may be a useful tool in assisting to elucidate the underlying pathogenic mechanisms of cART-related neuropsychiatric effects.
Risk and Protective Factors for Alcohol Use Disorders Across the Lifespan
Authors: Deeken Friederike , Banaschewski Tobias , Kluge Ulrike , Rapp Michael A.
Published: June 2020

Purpose of Review

Losing and regaining control over alcohol intake varies as a function of individual-level predictors across the lifespan. Specifically, the interplay of protective and risk factors for losing and regaining control, particularly in real-life settings, is thus far poorly understood. Individual differences in cognition, affect, emotion regulation, social factors, and personality traits, together with individual differences in brain structure and function, and biological markers of stress exposure may have different effects on alcohol consumption in different age groups. We will review current evidence for age-specific effects for losing and regaining control over alcohol intake and propose a framework for investigation across age groups.

Recent Findings

We find evidence for differences in relative impact of psychosocial predictors of alcohol consumption as a function of age that varies by gender. There is theoretical reason to assume that predictors vary in the time course of their taking effect: While e.g., early trauma and personality traits may be conceptualized as more distant antecedents of alcohol consumption, cognition, affect and emotion regulation can be conceptualized as co-correlates, where variation over periods of months may go along with changes in alcohol consumption. At the same time, craving, current stressors, and priming events may serve as short-term or immediate causes of alcohol consumption.

We propose a combination of longitudinal age cohorts to (i) identify individual-level differences (using latent growth curve models) and profiles (using latent growth mixture models) of the psychosocial and biological variables of interest that predict regaining or losing control, and ambulatory assessments every 2 days, in order to (ii) investigate effects of triggers and risk factors on current alcohol consumption. This approach will allow us to characterize age-related differences in the interplay between these factors in real-life settings.
Segmenting the manufacturing industries and measuring the performance: using interval-valued triangular fuzzy TOPSIS method
Authors: Prabhu M. , Abdullah Nabaz Nawzad , Ahmed Ramyar Rzgar , Nambirajan T. , Pandiyan Sanjeevi
Published: June 2020

In this globalized scenario, the overall performance of the manufacturing industries is the backbone of the development of the countries’ economies. In this research, the authors’ main objective of the study is to segment the manufacturing industries by using the triangular interval-valued fuzzy TOPSIS Method and find out the factors determining its performance. The researchers have collected the data from 350 manufacturing industries located in Puducherry, India. They applied a Simple Random sampling method by using a structured questionnaire from manufacturing industries. To analyze the data, the researchers used software packages like Excel, SPSS and LISREL 8.72. The researchers applied Confirmatory Factor Analysis, Triangular Interval-Valued Fuzzy TOPSIS Method, Chi square and Correspondent Analysis to conclude the result. Based on the factors loadings of the items, the contribution made by the items in respect of Performance may be ranked as Sales growth, Market share, Profit margin and Return on investment. With the help of Triangular Interval-Valued Fuzzy TOPSIS Method researchers segmented the manufacturing industries into three groups and by using the Chi square analysis the researchers found that the five demographics characteristics like Number of years in Business (Company), Scale of industry, Kind of manufacturing, Number of employees and location of the production plant of the respondents and these are significantly associated with segmenting the manufacturing industries and determine the performance of manufacturing industries.
Fuzzy Moderation and Moderated-Mediation Analysis
Authors: Yoon Jin Hee
Published: June 2020

In the causal relationship, a mediator variable is a variable that causes mediation in the dependent and the independent variables. If x is a predictor and y is a response variable, then w is a moderator variable that influences the causal relationship of x and y. A moderator variable is a variable that affects the strength of the relationship between a dependent and independent variable. When there are many complicated causal relations, a mediation analysis or a moderation analysis can be performed considering the existence of mediators or moderators. Moreover, when both mediators and moderators exist, a mediation–moderation analysis can be performed. The existence of these variables occurs in many fields, including social science, medical science, and natural science, etc. However, the values of such variables used are often observed as fuzzy numbers rather than as crisp numbers (real numbers). So in many cases, fuzzy analysis is required because observations are observed with ambiguous values, but in the meantime, only models that use crisp numbers rather than fuzzy numbers have been used. This paper proposes fuzzy moderation analysis and fuzzy moderated-mediation analysis as the first attempts of the moderation and moderated-mediation analysis using fuzzy data. The proposed models can also be used for science and engineering, medical data, but it can also be applied to the humanities fields, where a lot of ambiguous data are observed. For example, data from the humanities fields such as marketing, education or psychology, the data are observed based on a human’s mind. Nevertheless, they have been analyzed using crisp data so far. In this paper, we define several fuzzy moderation models and fuzzy mediation–moderation models considering various situations based on fuzzy least squares estimation (FLSE). In addition, the validity of the proposed model is shown in some examples; it compares the results with existing analysis using crisp data.
Investigations on the execution and evaluation of the Pummel test for polyvinyl butyral based interlayers
Authors: Schuster Miriam , Schneider Jens , Nguyen Tuong An
Published: June 2020

Laminated safety glass (LSG) is increasingly used as structural element in buildings. Of central importance for safety are the adhesion and the residual load-bearing capacity in the post fractured state. In literature a large number of tests to assess adhesion is mentioned. These include, e.g. peel tests, through-cracked-tensile/-bending tests, VW-pull tests and compressive shear tests. However, especially in industry, the Pummel test is widespread for determining the quality of adhesion in LSG with polyvinyl butyral based interlayers. This test method proves to be simple and quick to carry out: The laminate is stored at − 18 °C and then completely destroyed at room temperature with hammer blows. The adhesion level (0–10) is determined by visually comparing the adhering glass fragments with reference pictures or with the help of diagrams and tables which indicate the Pummel value as a function of the free film surface. Pummel value 0 is to be interpreted as no adhesion and Pummel value 10 as very high adhesion. Due to the lack of standardization, the execution and evaluation is very much dependent on the test institution and executive person. This paper shows different Pummel classifications that can currently be found on the market. Subsequently, approaches to the automatization and standardization of the execution and especially the evaluation of the Pummel test are shown. Three image evaluation methods in Matlab are presented, discussed and compared: (1) analysis of binary images, (2) statistical evaluation of the greyscale images and (3) texture analysis using co-occurrence matrices.
Validation of replacement questions for slowness and weakness to assess the Fried Phenotype: a cross-sectional study
Authors: Van der Elst Michael C. J. , Schoenmakers Birgitte , Op het Veld Linda P. M. , De Roeck Ellen E. , Van der Vorst Anne , Schols Jos M. G. A. , De Lepeleire Jan , Kempen Gertrudis I. J. M. ,   D-SCOPE Consortium
Published: June 2020

Purpose

When screening large populations, performance-based measures can be difficult to conduct because they are time consuming and costly, and require well-trained assessors. The aim of the present study is to validate a set of questions replacing the performance-based measures slowness and weakness as part of the Fried frailty phenotype (FRIED-P).

Methods

A cross-sectional study was conducted among community-dwelling older adults (≥ 60 years) in three Flemish municipalities. The Fried Phenotype (FRIED-P) was used to measure physical frailty. The two performance-based measures of the Fried Phenotype (slowness and weakness) were also measured by means of six substituting questions (FRIED-Q). These questions were validated through sensitivity, specificity, Cohen’s kappa value, observed agreement, correlation analysis, and the area under the curve (AUC, ROC curve).

Results

196 older adults participated. According to the FRIED-P, 19.5% of them were frail, 56.9% were pre-frail and 23.6% were non-frail. For slowness, the observed sensitivity was 47.0%, the specificity was 96.5% and the AUC was 0.717. For weakness, the sensitivity was 46.2%, the specificity was 83.7%, and the AUC was 0.649. The overall Spearman correlation between the FRIED-P and the FRIED-Q was r = 0.721 with an observed agreement of 76.6% (weighted linear kappa value = 0.663, quadratic kappa value = 0.738).

Conclusions

The concordance between the FRIED-P and FRIED-Q was substantial, characterized by a very high specificity, but a moderate sensitivity. This alternative operationalization of the Fried Phenotype—i.e., including six replacement questions instead of two performance-based tests—can be considered to apply as screening tool to screen physical frailty in large populations.
Factors associated with institutionalization among home-dwelling patients of Urgent Geriatric Outpatient Clinic: a 3-year follow-up study
Authors: Salminen Marika , Laine Jonna , Vahlberg Tero , Viikari Paula , Wuorela Maarit , Viitanen Matti , Viikari Laura
Published: June 2020

Purpose

To examine the effect of predictive factors on institutionalization among older patients.

Methods

The participants were older (aged 75 years or older) home-dwelling citizens evaluated at Urgent Geriatric Outpatient Clinic (UrGeriC) for the first time between the 1st of September 2013 and the 1st of September 2014 (n = 1300). They were followed up for institutionalization for 3 years. Death was used as a competing risk in Cox regression analyses.

Results

The mean age of the participants was 85.1 years (standard deviation [SD] 5.5, range 75–103 years), and 74% were female. The rates of institutionalization and mortality were 29.9% and 46.1%, respectively. The mean age for institutionalization was 86.1 (SD 5.6) years. According to multivariate Cox regression analyses, the use of home care (hazard ratio 2.43, 95% confidence interval 1.80–3.27, p < 0.001), dementia (2.38, 1.90–2.99, p < 0.001), higher age (≥ 95 vs. 75–84; 1.65, 1.03–2.62, p = 0.036), and falls during the previous 12 months (≥ 2 vs. no falls; 1.54, 1.10–2.16, p = 0.012) significantly predicted institutionalization during the 3-year follow-up.

Conclusion

Cognitive and/or functional impairment mainly predicted institutionalization among older patients of UrGeriC having health problems and acute difficulties in managing at home.
Opportunity and peril: how wolves use a dense network of forest roads
Authors: Bojarska Katarzyna , Sulich Joanna , Bachmann Sibyll , Okarma Henryk , Theuerkauf Jörn , Gula Roman
Published: June 2020

We investigated by snow tracking and GPS telemetry how wolvesCanis lupusused a dense (4 km/km2) network of forest roads for travel and scent marking. Forty-six percent of wolf trails but only 4.6% of telemetry locations were on forest roads. Wolves used forest roads to travel fast and far across their home ranges but spent relatively little time on roads, especially on those with high traffic levels and during the time of highest human activity. The probability of scent marking was higher on roads than off-road and increased with traffic intensity on roads and close to junctions. Our findings suggest that wolves take advantage of the forest road infrastructure, while minimising human encounters by spatio-temporal avoidance of all roads, even those with negligible traffic. The ongoing expansion and improvements of the forest road network might lead to elevated costs for wolves associated with avoidance of humans and roads.
Decisions and outcome for infants born near the limit of viability
Authors: Al Hazzani Fahad , Al Alaiyan Saleh , Bin Jabr Mohammed , Binmanee Abdulaziz , Shaltout Mahmoud , Al Motairy Yazeed Moqbil , Qashqary Abdulhameed Sami , Al Dughaither Abdullah Saleh
Published: June 2020

Background:

Initiation or withholding life support at birth on infants born prematurely near the limit of viability is not an easy decision, with wide variation in practice around the world. Our aim was to review the outcome of preterm infants born near the limit of viability at 23–25 weeks gestation in our institution, with regard to resuscitation decision, survival, and major outcome measures.

Methods:

We included all live newborn infants born prematurely at 23–25 weeks gestation at King Faisal Specialist Hospital and Research Centre from January 2006 to December 2015. We collected data on resuscitation decisions, survival, and major neonatal morbidities such as severe brain injury, severe retinopathy of prematurity, and bronchopulmonary dysplasia.

Results:

Between January 1, 2006 and December 31, 2015, 97 infants with a gestational age (GA) of 23–25 weeks gestation were admitted; 23, 42, and 32 infants were born at 23, 24, and 25 weeks gestation, respectively. At 23 weeks gestation, full support was initiated in 87% of patients and later on support was withheld in 17.4% of patients, finally 13% of patients survived to discharge. At 24 weeks, full support was initiated in 97.6% of patients, then withheld in 7.1% of patients, and ultimately 59.5% survived. At 25 weeks, full support was initiated in 93.8% of patients, then withheld in 15.6% of patients, and ultimately 62.5% survived. In terms of survival with and without the three major neonatal morbidities, at 23 weeks gestation, no infant survived without any morbidity as compared to 7.1% and 28.1% at 24 and 25 weeks, respectively. The incidence of survival with 1 major morbidity was 8.7%, 30.9%, and 34.4% at 23, 24, and 25 weeks, respectively, the incidence of survival with 2 major morbidities was 0%, 19%, and 0% at 23, 24, and 25 weeks, respectively, and the incidence of survival with 3 major morbidities was 4.3%, 2.4%, and 0% at 23, 24, and 25 weeks, respectively.

Conclusion:

In our patient cohort, survival and survival without major neonatal morbidity were very low at 23 weeks gestation, but it improved gradually as gestational age advanced.
Anal PAP, HPV tests and magnifying chromoendoscopy with biopsies in the diagnosis of anal intraephitelial neoplasia
Authors: Aguiar Carmen , García Laura , Boccardo María Belén , Vassel Macarena , Arriola Alejandra , Jaumandreu Sylvia , Rodríguez María Carmen , Alvarez Carmen , Heard Isabelle
Published: June 2020

Introduction Anal intraepithelial neoplasia (AIN) is the most likely precursor of squamous cells cancer which represents 90% of anal cancers. The use of biomolecular tests as a screening method has been extended by gynecology. Given the similarities that exist between the HPV disease in the lower genital tract and anorectal sectors, it is expected that HPV tests can provide information for the diagnosis, treatment and follow-up for AIN-affected patients.

Objectives Comparing the performance of anal cytology, PAP and HPV tests (Hybrid Capture and Papillocheck) against the histology of the diagnosis of low- and high-grade AIN in risk groups.

Material and methods A cross-sectional study was carried out to evaluate diagnostic methods for low- and high-grade AIN in 73 patients. Samples for anal PAP, Papillocheck and Hybrid Capture were taken from all patients who then, regardless of the results, underwent magnifying chromoendoscopy (MCE) along with biopsy. Diagnostic test performances and their 95% confidence intervals (CI: 95%) were calculated as well as the likelihood ratio for each test.

Results Of the 73 patients, 49 (67%) were women. The average age of the patients was 38 years. In 38 patients (52%), the histology was positive with 10 (14%) grade II AIN or higher. There were no statistically significant differences in sensitivity nor in specificity for low- and high-grade AINs between any of the tests.

Conclusion Anal PAP, the Hybrid Capture test (HC2, Qiagen) and PapilloCheck (Greiner Bio One) were highly sensitive but not specific for low- and high-grade AINs. Therefore, a biopsy should be conducted against a positive result of any of the tests to confirm AIN and the degree of dysplasia. The screening method selection depend on the availability but also costs of the test should be considered, since all the diagnostic tests have similar performance.
The Perception and Excessive Valuation of Small, Publicized Drinking Water Risks
Authors: Viscusi W. Kip , Huber Joel , Bell Jason
Published: June 2020

Low probability risks create challenges for individual decisions and potential pressures for government regulation. This article reports original survey evidence regarding the public’s perception and valuation of water-related risks from plastic bottles with bisphenol A, residues in drinking water of the herbicide atrazine, and trace amounts of prescription drugs in water. People who believe that they face high water-related risks generally believe that the risks apply and, given that belief, are willing to pay more to limit the risk. However, the expressed willingness to pay for risk reductions is inordinately high even among those who are unsure of whether they are even exposed to the risk, and therefore may not be reliable as values for the actual benefits.
‘We struggle and muddle.’ A qualitative study exploring community ABI therapists’ experiences of using, training in and implementing behaviour interventions
Authors: Carmichael Jai Jason , Hicks Amelia J. , Gould Kate Rachel , Feeney Timothy J. , Analytis Penelope , Ponsford Jennie Louise
Published: June 2020

Objectives:

Individuals with acquired brain injury (ABI) may present with challenging behaviours (CB) that place themselves and others at risk of harm and impact their community integration. It is crucial for community ABI therapists to successfully train in and implement behaviour interventions. The current study aimed to investigate community ABI therapists’ experiences of using, training in and implementing behaviour interventions. An additional aim was to determine these therapists’ understanding of Positive Behaviour Support (PBS), one approach to addressing CB with a focus on improving quality of life.

Methods:

Semi-structured interviews were conducted with 24 Australian community ABI therapists about their experiences of using, training in and implementing behaviour interventions and understanding of PBS. Inductive thematic analysis and content analysis were performed on interview transcripts.

Findings:

The thematic analysis resulted in the generation of six themes which described the difficulties participants faced in training in and delivering behaviour interventions and identified their training and implementation needs. The content analysis resulted in 10 categories that characterised participants’ understanding of PBS, which centred around the absence of consequences, a focus on antecedents, person-centred practice and encouraging prosocial alternatives to CB.

Conclusions:

The findings highlight a need and desire for more practical and interactive clinician training in behaviour interventions for individuals with ABI. Moreover, the findings suggest a limited understanding of PBS amongst community ABI therapists. Important considerations for the development of clinician training in ABI behaviour interventions and subsequent implementation into community practice are discussed.
Access to Focal Spasticity Care: A Cross Canada Survey of Physiatrists
Authors: Liang Kevin E. , Ngo Pham Vivian , Winston Paul
Published: June 2020

Successful management of focal spasticity requires access to botulinum toxin type A (BoNT-A) injections, physiotherapy, occupational therapy, and orthoses/bracing. To assess the quality of focal spasticity care across Canada, we sent a survey consisting of 22 questions to physiatrists involved in the management of outpatient spasticity. Thirty-four physiatrists from all 10 provinces responded to the survey. Wait time for BoNT-A treatment averaged 12.7 weeks from time of referral across Canada. More than 75% of patients faced barriers to obtaining physical therapy and orthoses. Access to best quality care for spasticity patients across Canada varies widely.
Central venous catheter bundle adherence: Kamishibai card (K-card) rounding for central-line–associated bloodstream infection (CLABSI) prevention
Authors: Ormsby Jennifer A. , Cronin Julie , Carpenter Jane , Graham Dionne A. , Potter-Bynoe Gail , Vaughan Ana M. , Weir Lindsay , Flaherty Kathleen A. , Chandonnet Celeste J. , Priebe Gregory P. , Sandora Thomas J.
Published: June 2020

Objective:

To institute facility-wide Kamishibai card (K-card) rounding for central venous catheter (CVC) maintenance bundle education and adherence and to evaluate its impact on bundle reliability and central-line–associated bloodstream infection (CLABSI) rates.

Design:

Quality improvement project.

Setting:

Inpatient units at a large, academic freestanding children’s hospital.

Participants:

Data for inpatients with a CVC in place for ≥1 day between November 1, 2017 and October 31, 2018 were included.

Intervention:

A K-card was developed based on 7 core elements in our CVC maintenance bundle. During monthly audits, auditors used the K-cards to ask bedside nurses standardized questions and to conduct medical record documentation reviews in real time. Adherence to every bundle element was required for the audit to be considered “adherent.” We recorded bundle reliability prospectively, and we compared reliability and CLABSI rates at baseline and 1 year after the intervention.

Results:

During the study period, 2,321 K-card audits were performed for 1,051 unique patients. Overall maintenance bundle reliability increased significantly from 43% at baseline to 78% at 12 months after implementation (P < .001). The hospital-wide CLABSI rate decreased from 1.35 during the 12-month baseline period to 1.17 during the 12-month intervention period, but the change was not statistically significant (incidence rate ratio [IRR], 0.87; 95% confidence interval [CI], 0.60–1.24; P = .41).

Conclusions:

Hospital-wide CVC K-card rounding facilitated standardized data collection, discussion of reliability, and real-time feedback to nurses. Maintenance bundle reliability increased after implementation, accompanied by a nonsignificant decrease in the CLABSI rate.
Influence on tail-biting in weaning pigs of crude fibre content and different crude fibre components in pigs' rations
Authors: Honeck A. , Ahlhorn J. , Burfeind O. , Gertz M. , grosse Beilage E. , Hasler M. , Tölle K. , Visscher C. , Krieter J.
Published: June 2020

The aim of the study was to analyse the influence on tail-biting in undocked pigs during the rearing period of crude fibre in piglets' rations. All pigs were fed the same pre-starter until weaning. The study comprised two trials with four experimental groups each. The first trial contained: a control group (CG1) with conventional feed (up to 40 g/kg crude fibre), two groups with an increased crude fibre content of up to 50 g/kg (G5) and 60 g/kg (G6), respectively, and one group with conventional feed and crude fibre provision ad libitum (AL). The second trial consisted of a control group (CG2) which received the same conventional feed as CG1 and three treatment groups with either soya hulls (SS), dried sugar beet pulp (DP) or oat fibre (OF) admixed to their ration, to achieve a crude fibre content of 60 g/kg in all three groups. The rearing week, the batch, the treatment group (only in trial one) and the interaction between batch and treatment group had a significant influence on tail-lesions (P < 0.05). The tail-biting process started in rearing week 3 (trial one) and 5 (trial two), respectively. Due to the low frequency of tail-biting during the present study, crude fibre seems to have no major influence on tail-biting during the rearing period. This unexpected result may be caused by the optimized conditions in which the piglets were kept and the intensive animal observation carried out by the employees. However, the batch effect was most influential.
Short-term results of upper airway stimulation in obstructive sleep apnoea patients: the Amsterdam experience
Authors: Vonk P E , Ravesloot M J L , van Maanen J P , de Vries N
Published: June 2020

Objectives

This paper aimed to: retrospectively analyse single-centre results in terms of surgical success, respiratory outcomes and adverse events after short-term follow up in obstructive sleep apnoea patients treated with upper airway stimulation; and evaluate the correlation between pre-operative drug-induced sleep endoscopy findings and surgical success.

Methods

A retrospective descriptive cohort study was conducted, including a consecutive series of obstructive sleep apnoea patients undergoing implantation of an upper airway stimulation system.

Results

Forty-four patients were included. The total median Apnoea–Hypopnea Index and oxygen desaturation index significantly decreased from 37.6 to 8.3 events per hour (p < 0.001) and from 37.1 to 15.9 events per hour (p < 0.001), respectively. The surgical success rate was 88.6 per cent, and did not significantly differ between patients with or without complete collapse at the retropalatal level (p = 0.784). The most common therapy-related adverse event reported was (temporary) stimulation-related discomfort.

Conclusion

Upper airway stimulation is an effective and safe treatment in obstructive sleep apnoea patients with continuous positive airway pressure intolerance or failure. There was no significant difference in surgical outcome between patients with tongue base collapse with or without complete anteroposterior collapse at the level of the palate.
Enter 9/11: Latin America and the Global War on Terror
Authors: Müller Markus-Michael
Published: June 2020

This article offers an analysis of the transnational discursive construction processes informing Latin American security governance in the aftermath of 9/11. It demonstrates that the Global War on Terror provided an opportunity for external and aligned local knowledge producers in the security establishments throughout the Americas to reframe Latin America's security problems through the promotion of a militarised security epistemology, and derived policies, centred on the region's ‘convergent threats’. In tracing the discursive repercussions of this epistemic reframing, the article shows that, by tapping into these discourses, military bureaucracies throughout the Americas were able to overcome their previous institutional marginalisation vis-à-vis civilian agencies. This development contributed to the renaissance of counter-insurgency and counter-terrorism discourses and policies in the region, allowing countries such as Colombia and Brazil to reposition themselves globally by exporting their military expertise for confronting post-9/11 threats beyond the region.
Prediction of depression cases, incidence, and chronicity in a large occupational cohort using machine learning techniques: an analysis of the ELSA-Brasil study
Authors: Librenza-Garcia Diego , Passos Ives Cavalcante , Feiten Jacson Gabriel , Lotufo Paulo A. , Goulart Alessandra C. , de Souza Santos Itamar , Viana Maria Carmen , Benseñor Isabela M. , Brunoni Andre Russowsky
Published: June 2020

Abstract

Background

Depression is highly prevalent and marked by a chronic and recurrent course. Despite being a major cause of disability worldwide, little is known regarding the determinants of its heterogeneous course. Machine learning techniques present an opportunity to develop tools to predict diagnosis and prognosis at an individual level.

Methods

We examined baseline (2008–2010) and follow-up (2012–2014) data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a large occupational cohort study. We implemented an elastic net regularization analysis with a 10-fold cross-validation procedure using socioeconomic and clinical factors as predictors to distinguish at follow-up: (1) depressed from non-depressed participants, (2) participants with incident depression from those who did not develop depression, and (3) participants with chronic (persistent or recurrent) depression from those without depression.

Results

We assessed 15 105 and 13 922 participants at waves 1 and 2, respectively. The elastic net regularization model distinguished outcome levels in the test dataset with an area under the curve of 0.79 (95% CI 0.76–0.82), 0.71 (95% CI 0.66–0.77), 0.90 (95% CI 0.86–0.95) for analyses 1, 2, and 3, respectively.

Conclusions

Diagnosis and prognosis related to depression can be predicted at an individual subject level by integrating low-cost variables, such as demographic and clinical data. Future studies should assess longer follow-up periods and combine biological predictors, such as genetics and blood biomarkers, to build more accurate tools to predict depression course.
Dimensions over categories: a meta-analysis of taxometric research
Authors: Haslam Nick , McGrath Melanie J. , Viechtbauer Wolfgang , Kuppens Peter
Published: June 2020

Taxometric procedures have been used extensively to investigate whether individual differences in personality and psychopathology are latently dimensional or categorical (‘taxonic’). We report the first meta-analysis of taxometric research, examining 317 findings drawn from 183 articles that employed an index of the comparative fit of observed data to dimensional and taxonic data simulations. Findings supporting dimensional models outnumbered those supporting taxonic models five to one. There were systematic differences among 17 construct domains in support for the two models, but psychopathology was no more likely to generate taxonic findings than normal variation (i.e. individual differences in personality, response styles, gender, and sexuality). No content domain showed aggregate support for the taxonic model. Six variables – alcohol use disorder, intermittent explosive disorder, problem gambling, autism, suicide risk, and pedophilia – emerged as the most plausible taxon candidates based on a preponderance of independently replicated findings. We also compared the 317 meta-analyzed findings to 185 additional taxometric findings from 96 articles that did not employ the comparative fit index. Studies that used the index were 4.88 times more likely to generate dimensional findings than those that did not after controlling for construct domain, implying that many taxonic findings obtained before the popularization of simulation-based techniques are spurious. The meta-analytic findings support the conclusion that the great majority of psychological differences between people are latently continuous, and that psychopathology is no exception.
District nurses’ use of a decision support and assessment tool to improve the quality and safety of medication use in older adults: a feasibility study
Authors: Lagerin Annica , Lundh Lena , Törnkvist Lena , Fastbom Johan
Published: June 2020

Aim:

To investigate whether district nurses (DNs) can identify factors related to the quality and safety of medication use among older patients via a clinical decision support system (CDSS) for medication and an instrument for assessing the safety of drug use [the Safe Medication Assessment tool (SMA)]. A secondary aim was to describe patients’ experiences of the assessment.

Background:

DNs in Stockholm County have the opportunity to establish special units at primary health care centers (PHCCs) for patients aged 75 years and older. The units conduct drug utilization reviews and create care plans for older adults.

Methods:

Nine DNs at 7 PHCCs in Stockholm County used the tools with 45 patients aged 75 years and older who used one or more drugs. Outcome measures were the number of drugs, potential drug-related problems, nursing interventions, and patient satisfaction. Prevalences of drug-related problems and nursing interventions were calculated. Eleven patients answered a telephone questionnaire on their experiences of the assessment.

Findings:

DNs identified factors indicative of drug-related problems, including polypharmacy (9.8 drugs per person), potential drug–drug interactions (prevalence 40%), potential adverse drug reactions (2.7 per person), and prescribers from more than two medical units (60%). DNs used several nursing interventions to improve the safety of medication use (e.g., patient education, initiating a pharmaceutical review). The patients thought it was meaningful to receive information about their drug use and important to identify potential drug-related problems. With the support of the CDSS and the SMA tool, the DNs could identify several factors related to inappropriate or unsafe medication and initiated a number of interventions to improve medication use. The patients were positive toward the assessments. Using these tools, the DNs may help promote safe medication use in older patients.
“I Am Already Annexed”: Ramon Reyes Lala and the Crafting of “Philippine” Advocacy for American Empire
Authors: Ventura Theresa
Published: June 2020

This article reconstructs the American career of the Manila-born author Ramon Reyes Lala. Lala became a naturalized United States citizen shortly before the War of 1898 garnered public interest in the history and geography of the Philippines. He capitalized on this interest by fashioning himself into an Oxford-educated nationalist exiled in the United States for his anti-Spanish activism, all the while hiding a South Asian background. Lala's spirited defense of American annexation and war earned him the political patronage of the Republican Party. Yet though Lala offered himself as a ‘model’ Philippine-American citizen, his patrons offered Lala as evidence of U.S. benevolence and Philippine civilization potential shorn of citizenship. His embodied contradictions, then, extended to his position as a producer of colonial knowledge, a racialized commodity, and a representative Filipino in the United States when many in the archipelago would not recognize him as such. Lala's advocacy for American Empire, I contend, reflected an understanding of nationality born of diasporic merchant communities, while his precarious success in the middle-class economy of print and public speaking depended on his deft maneuvering between modalities of power hardening in terms of race. His career speaks more broadly to the entwined and contradictory processes of commerce, race formation, and colonial knowledge production.