bluuebunny/crossref_metadata_2025 huggingface dataset:
A public health approach for preventing neural tube defects: folic acid fortification and beyond
Authors: Garrett Greg S. , Bailey Lynn B.
Published: February 2018

In this paper we review the evidence basis for prevention of folic acid–sensitive neural tube defects (NTDs) through public health interventions in women of reproductive age (WRA), the proven vehicles for delivery of folic acid, and what is needed to effectively scale these, and provide a snapshot of potential innovations that require future research. Our primary focus is on the global situation affecting large‐scale food fortification (LSFF) with folic acid, in particular the fortification of wheat flour and maize meal. Our overarching conclusion is that folic acid fortification is an evidence‐based intervention that reduces the prevalence of NTDs, and that LSFF with folic acid is underutilized. Thus, food fortification with folic acid should be a component of most national public health strategies, in particular where folate status is insufficient and a fortifiable food vehicle, processed by a centralized industry, is consumed regularly by WRA. The evidence shows that there is still much work needed (1) to build the enabling environment and expand programs where there is currently no legislation, (2) to improve the low quality of delivery of existing programs, and (3) to measure and sustain programs by generating new coverage data and demonstrating evidence of impact in low‐ and middle‐income countries.
A case of microscopic, multiple sclerosing pneumocytoma
Authors: Kawai Hitomi , Takayashiki Norio , Otani Haruo , Sakashita Shingo , Noguchi Masayuki
Published: February 2018

Sclerosing pneumocytoma is a rare tumor of the lung, commonly affecting middle‐aged women, and is mostly isolated. Although this tumor is thought to be derived from primitive respiratory epithelial cells, the characteristics of the precursor cells are still unknown. A 19‐year‐old woman presented with multiple nodules in the right lung. Partial resection of the right middle lobe was performed, and seven sclerosing pneumocytomas, including four that were microscopic, were detected. The latter showed a simple papillary pattern, and three of them consisted of only round cell‐like cells (single population). Interestingly, these round cell‐like cells were positive for both p63 and TTF‐1, but totally negative for SP‐A. On the other hand, the tumor cells of the other four sclerosing pneumocytomas showing a papillary pattern with a dual population, were diffusely positive for TTF‐1 and focally positive for SP‐A (only in surface cells), but negative or very focally positive for p63. It has been reported that p63‐positive stem cell‐like cells are present in the distal airway and have potential to differentiate into type II pneumocytes. The immunohistochemical features of these multiple microscopic lesions suggest that the p63‐TTF‐1 double‐positive cells are candidate precursor cells of sclerosing pneumocytoma.
A rare case of ectopic papillary thyroid carcinoma transformed into squamous cell carcinoma
Authors: Yasuoka Hironao , Nakamura Yasushi , Yoshida Ken‐ichi , Shimo Toshiro , Tori Masayuki , Matsui Yuuki , Sakamaki Yasushi , Tsujimoto Masahiko
Published: February 2018

A rare case of a metastatic ectopic papillary thyroid carcinoma (PTC) of the lung that transformed into a squamous cell carcinoma (SCC) that resembles pulmonary SCC is reported. A subcutaneous ectopic PTC in the left anterior neck area, together with a normal thyroid gland, were excised. The ectopic PTC showed thyroglobulin, TTF‐1 and PAX‐8 immunoreactivity and a BRAF V600E mutation. During the post‐operative follow‐up period, a rapidly growing 2 cm nodular lesion in the lower left lobe of the lung was detected. The lung tumor consisted of solid sheets and nests of squamous cells but without the nuclear features of PTC. Neither papillary nor follicular structures of cancer cells were identified. Carcinoma cells were positive for TTF‐1, PAX‐8, p40, CK14, and p63, while showing a high Ki‐67 labeling index and a BRAF V600E mutation. These results support our interpretation of a PTC that originated from ectopic thyroid tissue in the left anterior neck and that developed a lung metastasis showing squamous cell differentiation.
Loser! On the combined impact of emotional and person‐descriptive word meanings in communicative situations
Authors: Rohr Lana , Abdel Rahman Rasha
Published: February 2018

Humans have a unique capacity to induce intense emotional states in others by simple acts of verbal communication, and simple messages such asbadcan elicit strong emotions in the addressee. However, up to now, research has mainly focused on general emotional meaning aspects and paradigms of low personal relevance (e.g., word reading), thereby possibly underestimating the impact of verbal emotion. In the present study, we recorded ERPs while presenting emotional words differing in word‐inherent person descriptiveness (in that they may or may not refer to or describe a person; e.g., winner vs. sunflower). We predicted stronger emotional responses to person‐descriptive words. Additionally, we enhanced the relevance of the words by embedding them in social‐communicative contexts. We observed strong parallels in the characteristics of emotion and descriptiveness effects, suggesting a common underlying motivational basis. Furthermore, word‐inherent person descriptiveness affected emotion processing at late elaborate stages reflected in the late positive potential, with emotion effects found only for descriptive words. The present findings underline the importance of factors determining the personal relevance of emotional words.
Grassland seed bank and community resilience in a changing climate
Authors: Kiss Réka , Deák Balázs , Török Péter , Tóthmérész Béla , Valkó Orsolya
Published: February 2018

Plant dispersal and persistence strategies play an increasingly important role in the face of changing climate. Evaluating the restoration potential of soil seed banks as an important component of community resilience is crucial for developing effective grassland conservation and restoration strategies under climate change. Soil seed banks can act as a source for vegetation recovery by preserving species and supporting their establishment by assisting persistence and recolonization. In a systematic review of field and experimental seed bank studies, we evaluated the potential of seed banks in buffering climatic extremities and fluctuations. We found 42 papers testing the first‐order (temperature and precipitation changes) and second‐order effects of climate change (flooding and fire) on the seed bank in grasslands. We showed that persistent seed banks can support passive restoration especially in wetlands and habitats where unpredictable and frequent disturbance was typical in the historical timescale. We found that active restoration by seed addition will be most important in less disturbance‐adapted habitats characterized by species with transient seed banks. In such cases, the introduction of native matrix species that can tolerate the predicted climatic change should be prioritized at degraded sites.
Using Artificial Censoring to Improve Extreme Tail Quantile Estimates
Authors: Liu Yang , Salibián-Barrera Matías , Zamar Ruben H. , Zidek James V.
Published: February 2018

Under certain regularity conditions, maximum-likelihood-based inference enjoys several optimality properties, including high asymptotic efficiency. However, if the distribution of the data deviates slightly from the model proposed, the statistical properties of inference methods based on maximum likelihood can quickly deteriorate. We focus on the situation when the interest lies in one of the tails of the distribution, e.g. when we are estimating a high or low quantile. In this case, it may be natural, if slightly unorthodox, to consider models that fit well the corresponding tail of the sample, rather than its whole range. For example, if we are interested in estimating the fifth percentile, we can pretend that all observations above the 10th percentile have been censored and fit a parametric censored model to the lower tail of the sample. Such an approach, which we call ‘artificial censoring’, has been studied in the engineering literature. We study a data-dependent method to select the amount of artificial censoring and show that it compares favourably with the optimally chosen (‘oracle’) method, which is generally unavailable in practice. We also show that the artificial censoring approach can be applied to estimate tail dependence parameters in copula models, and that it performs well both in simulation and in real data studies.
Three novel HLA alleles discovered in Koreans, HLA‐A*26:118, DQB1*02:65 and DPB1*05:01:07
Authors: Park B. G. , Kim S.‐K. , Im J. , Yoon C. E. , Oh H. B.
Published: February 2018

Three novel HLA alleles, HLA‐A*26:118, DQB1*02:65 and DPB1*05:01:07, were identified and confirmed by monoallelic sequencing.
Antibodies to human neutrophil antigen HNA‐3b implicated in cases of neonatal alloimmune neutropenia
Authors: Lopes Larissa Barbosa , Abbas Samira Ali , Moritz Elyse , Martins Juliana Oliveira , Chiba Akemi Kuroda , Langhi Dante Mário , Bordin José O.
Published: February 2018

BACKGROUND

Neonatal alloimmune neutropenia results from maternal alloimmunization to human neutrophil antigens. The alloantibodies involved in neonatal alloimmune neutropenia are against human neutrophil antigens HNA‐1a, HNA‐1b, HNA‐1c, HNA‐1d, HNA‐2, HNA‐3a, HNA‐4a, HNA‐4b, and HNA‐5a; however, to date, antibodies specific to HNA‐3b have not been reported.

STUDY DESIGN AND METHODS

Blood samples from 10,000 unselected neonates were analyzed, resulting in the selection of 88 neutropenic newborns (neutrophil count <1.5 × 109/L) from 83 mothers (three pairs of twins and one triplet). HNA‐3 genotyping was performed by polymerase chain reaction‐restriction fragment length polymorphism to identify the cases of maternal‐fetal HNA‐3 incompatibility. Serologic studies for detecting maternal HNA‐3 alloantibodies were performed with the granulocyte agglutination test, the white blood cell immunofluorescence test, and a LABScreen Multi‐HNA Kit.

RESULTS

Genotyping studies identified 13 of 88 (14.8%) instances of maternal‐fetal HNA‐3 incompatibility, with all mothers typed as HNA‐3a/a and neonates typed as HNA‐3a/b. Serologic studies revealed that five of 13 (38.5%) mothers carried anti‐HNA‐3b plus human leukocyte antigen antibodies and that three of 13 (23.1%) mothers had anti‐HNA‐3b without human leukocyte antigen antibodies.

CONCLUSION

Here, we report the first three cases of neonatal alloimmune neutropenia associated with HNA‐3b antibodies resulting in a neonatal alloimmune neutropenia incidence of one in 3333 live births.
Dietetics and Nutrition Students Response to Grocery Store Tour Training Program
Authors: Hilliard Elizabeth D , Brunt Ardith , Froelich Christa , Borr Mari
Published: February 2018

Retail dietetics is a growing field, however, there is very little research available on effective teaching strategies for preparing students to enter this part of the profession. This paper is the second paper to report on the results of produce –focused grocery store tour training program. This paper focuses on the trained students’ perception of the program’s effectiveness. Twenty-five dietetics and nutrition students were trained in providing produce – based grocery store tours, and then gave store tours to other college students. Students completed a pre – and post – training survey rating their confidence in providing this type of education and on their intention to do so as part of their career. Students rated their confidence level in giving produce – based grocery store tours significantly higher after the training than before (p < 0.05). However, the training program did not significantly increase the student’s intention in pursuing a career that included giving grocery store tours. The results of this study indicate that a practical training program in giving store tours may increase students’ comfort level with doing so.
An Investigation About Actualization Levels of Learning Outcomes in Early Childhood Curriculum
Authors: Kazu İbrahim Yaşar , İş Abdulgafur
Published: February 2018

Understanding the characteristics of preschool-age children is an important and first step for supporting children’s healthy development and school readiness. Children may show different developmental features and come different social, socio-cultural background; however, they are in the same age. Reaching of education at a desired level will be achieved by a good curriculum which is organized and put in practice. Therefore, the curriculum should be organized by considering all students’ features. Therefore, the curriculum should be practicable and related with the needs of today’s world and social expectation for a good early childhood education programs. Accordingly, it is aimed to investigate the actualization levels of learning out comes related to developmental areas in early childhood education curriculum. Working group of the research is composed of 165 primary school teachers and 136 pre-school teachers working in districts and Centre of Sırnak, Turkey. Scanning method was used in the study. Two different questionnaires were prepared related with developmental areas of early childhood and the data was obtained through a questionnaires and analysed in SPSS package program. Questionnaires have two parts. In first part, there is personal information about teachers and in the other part there are statements about out-comes of developmental areas in the Early Childhood Curriculum. According to the results, the pre-school teachers gave a high score to the questionnaire by stating positive opinion towards the pre-school curriculum sufficiency and achievement. In addition, primary teachers gave lower scores on the questionnaire that the children achieved out comes. As a result, significant differences were found between pre-school and primary school teachers' views on all areas of development.
The Relationship Between Teacher Attitude and Self-Efficacy for Inclusive Practices in Turkey
Authors: Özokcu Osman
Published: February 2018

This study aims to investigate the relationship between Turkish teachers’ attitudes and their self-efficacy for inclusive practices using a relational survey design. Study participants included a total of 1163 preschool, classroom, subject-matter, and special-education teachers from four different geographical regions in Turkey. The data was collected using the Sentiments, Attitudes, and Concerns about Inclusive Education Scale (SACIE-R) and the Teacher Efficacy for Inclusive Practice (TEIP) Scale. The data were analyzed using the Pearson Product-Moment Correlation and Multiple Linear Regression tests with the help of SPSS. The results reported a positive significant relationship between teachers’ attitudes and self-efficacy for inclusive practices. Results also revealed teacher self-efficacy to be a significant predictor of their attitudes towards inclusive education.
Effect of kinetic energy and impact angle on carbon ejection from a free-standing graphene bombarded by kilo-electron-volt C60
Authors: Golunski Mikolaj , Postawa Zbigniew
Published: February 2018

Molecular dynamics computer simulations are employed to investigate the effect of the kinetic energy and impact angle on the ejection process from a free-standing graphene of thickness between 1 and 16 layers. The target is bombarded by C60 projectiles with kinetic energy between 5 and 40 keV and the impact angle ranging between 0° and 80°. The yields, kinetic energies, and ejection directions of atoms are monitored. Computer simulations are used to point to optimal conditions when a soft ejection of unfragmented molecules may occur, which may be invaluable information for the development of secondary ion mass spectrometry based on a transmission geometry.
Sleep and Final Exam Performance in Introductory Physics
Authors: Coletta Vincent , Wikholm Colin , Pascoe Daniel
Published: February 2018

Most physics instructors believe that adequate sleep is important in order for students to perform well on problem solving, and many instructors advise students to get plenty of sleep the night before an exam. After years of giving such advice to students at Loyola Marymount University (LMU), one of us decided to find out how many hours students actually do sleep the night before an exam, and how that would relate to their performance. The effect of inadequate sleep on exam performance was explored in a second-semester introductory physics course. At the end of the final exam, students reported the number of hours they slept the night before. Sleep deprivation corresponded to lower final exam scores. The main purpose of this study is to provide evidence that instructors can provide to their students to convince them that their time is better spent sleeping rather than studying all night before an exam.
Wavelength variation of a standing wave along a vertical spring
Authors: Welsch Dylan , Baker Blane
Published: February 2018

Hand-driven resonance can be observed readily in a number of mechanical systems including thin boards, rods, strings, and springs. In order to show such behavior in the vertical spring pictured in Fig. 1, a section of spring is grasped at a location about one meter from its free end and driven by small, circular motions of the hand. At driving frequencies of a few hertz, a dramatic standing wave is generated. One of the fascinating features of this particular standing wave is that its wavelength varies along the length of the spring.
A Person Stands on a Balance in an Elevator: What Happens When the Elevator Starts to Fall?
Authors: Baluković Jasmina , Slisko Josip , Cruz Adrián Corona
Published: February 2018

Physics textbook authors commonly introduce the concept of weightlessness (apparent or real) through a “thought experiment” in which a person weighs herself or himself in an elevator. When the elevator falls freely, the spring balance should show zero weight. There is an unresolved controversy about how this “zero reading” comes about. Drawings in some books, the first of which appeared in a book of Perelman 80 years ago, show that the person continues to be in contact with the balance. It means that “zero weight” arises as a consequence of “the fact” that the falling person and balance, although in contact, don’t press on each other. Drawings in other books, among them those elaborated by NASA, represent the person and the balance launched upward and floating separately in midair. Using a homemade “falling box” with attached video camera, we did initial experiments for a very simplified but basically similar situation. The results that we obtained suggest that, in a free-falling elevator, a real balance would hardly launch a person upward.
Modeling the Electric Potential and Surface Charge Density Near Charged Thunderclouds
Authors: Neel Matthew Stephen
Published: February 2018

Thundercloud charge separation, or the process by which the bottom portion of a cloud gathers charge and the top portion of the cloud gathers the opposite charge, is still not thoroughly understood. Whatever the mechanism, though, a charge separation definitely exists and can lead to electrostatic discharge via cloud-to-cloud lightning and cloud-to-ground lightning. We wish to examine the latter form, in which upward leaders from Earth connect with downward leaders from the cloud to form a plasma channel and produce lightning. Much of the literature indicates that the lower part of a thundercloud becomes negatively charged while the upper part becomes positively charged via convective charging, although the opposite polarity can certainly exist along with various, complex intra-cloud currents. It is estimated that >90% of cloud-to-ground lightning is “negative lightning,” or the flow of charges from the bottom of the cloud, while the remaining <10% of lightning strikes is “positive lightning,” or the flow of charges from the top of the cloud. We wish to understand the electric potential surrounding charged thunderclouds as well as the resulting charge density on the surface of Earth below them. In this paper we construct a simple and adaptable model that captures the very basic features of the cloud/ground system and that exhibits conditions favorable for both forms of lightning. In this way, we provide a practical application of electrostatic dipole physics as well as the method of images that can serve as a starting point for further modeling and analysis by students.
When Does Air Resistance Become Significant in Projectile Motion?
Authors: Mohazzabi Pirooz
Published: February 2018

In an article in this journal, it was shown that air resistance could never be a significant source of error in typical free-fall experiments in introductory physics laboratories. Since projectile motion is the two-dimensional version of the free-fall experiment and usually follows the former experiment in such laboratories, it seemed natural to extend the same analysis to this type of motion. We shall find that again air resistance does not play a significant role in the parameters of interest in a traditional projectile motion experiment.
Same concept…Different terms
Authors: Heafner Joe
Published: February 2018

Most introductory physics courses begin with the concept of an object (usually a particle) having a precise position or location in space (I will not address spacetime here) relative to something else, the origin of a three-dimensional coordinate system perhaps. My experience has been that physics students are inherently at home with this concept. In astronomy, we often begin by thinking about the sky. For the purposes of this article, I will simply define it as that which we see when we look away from Earth’s surface. It appears almost as a two-dimensional plane, perhaps even a curved surface. When we look at something in the sky, we really have no sense of distance. Indeed, when astronomers need the “position” of a star or planet in the sky, the quantity is two dimensional. Because the sky appears to wrap around Earth, celestial positions can be given entirely by angular quantities. Astronomers use right ascension and declination, respectively, as analogs of terrestrial longitude and latitude. Right ascension is the angular distance eastward around the celestial equator (the projection of Earth’s equator onto the celestial sphere) from the vernal equinox (where the celestial equator and the ecliptic intersect such that the Sun is moving from the Southern Hemisphere to the Northern Hemisphere) to the object and declination is the object’s angular distance north or south of the celestial equator. So to an astronomer, for the purposes of aiming a telescope, position refers to a two-dimensional quantity because in the sky there is no direct sense of depth or distance.
Splish-splash: Center of mass, stability, and a fun pool toy
Authors: Ashman Seth
Published: February 2018

Center of mass is a common topic in physics courses. It appears in relation to studies of stable and unstable equilibrium, momentum, and rotation. Science products suppliers frequently include gadgets that demonstrate the concepts of center of mass and stability, such as the classic balancing bird. Additionally, The Physics Teacher has featured articles studying the center of mass of a rotating baton, locating the center of mass of a hanging Slinky toy, and describing a wide range of interesting systems.
A steered response power approach with trade-off prewhitening for acoustic source localization
Authors: He Hongsen , Wang Xueyuan , Zhou Yingyue , Yang Tao
Published: February 2018

This paper proposes a steered response power (SRP) approach with trade-off prewhitening to acoustic source localization. To obtain effective compromise prefiltering of microphone signals, the sparsity of speech amplitude spectrum is used to establish a convex-constraint linear prediction model, which is solved by a split Bregman method. The presented approach unifies the traditional SRP and steered response power via phase transform prefiltering methods and achieves a good compromise between them from the perspective of localization performance. The superiority of the proposed method is demonstrated in noisy and reverberant environments.
Molecular Tools To Study Preharvest Food Safety Challenges
Authors: Kumar Deepak , Thakur Siddhartha
Published: February 2018

Preharvest food safety research and activities have advanced over time with the recognition of the importance and complicated nature of the preharvest phase of food production. In developed nations, implementation of preharvest food safety procedures along with strict monitoring and containment at various postharvest stages such as slaughter, processing, storage, and distribution have remarkably reduced the burden of foodborne pathogens in humans. Early detection and adequate surveillance of pathogens at the preharvest stage is of the utmost importance to ensure a safe meat supply. There is an urgent need to develop rapid, cost-effective, and point-of-care diagnostics which could be used at the preharvest stage and would complement postmortem and other quality checks performed at the postharvest stage. With newer methods and technologies, more efforts need to be directed toward developing rapid, sensitive, and specific methods for detection or screening of foodborne pathogens at the preharvest stage. In this review, we will discuss the molecular methods available for detection and molecular typing of bacterial foodborne pathogens at the farm. Such methods include conventional techniques such as endpoint PCR, real-time PCR, DNA microarray, and more advanced techniques such as matrix-assisted layer desorption ionization–time of flight mass spectrometry and whole-genome sequencing.
Community health workers improve disease control and medication adherence among patients with diabetes and/or hypertension in Chiapas, Mexico: an observational stepped-wedge study
Authors: Newman Patrick M , Franke Molly F , Arrieta Jafet , Carrasco Hector , Elliott Patrick , Flores Hugo , Friedman Alexandra , Graham Sophia , Martinez Luis , Palazuelos Lindsay , Savage Kevin , Tymeson Hayley , Palazuelos Daniel
Published: February 2018

Background

Non-communicable diseases (NCDs) contribute greatly to morbidity and mortality in low-income and middle-income countries (LMICs). Community health workers (CHWs) may improve disease control and medication adherence among patients with NCDs in LMICs, but data are lacking. We assessed the impact of a CHW-led intervention on disease control and adherence among patients with diabetes and/or hypertension in Chiapas, Mexico.

Methods

We conducted a prospective observational study among adult patients with diabetes and/or hypertension, in the context of a stepped-wedge roll-out of a CHW-led intervention. We measured self-reported adherence to medications, blood pressure and haemoglobin A1c at baseline and every 3 months, timed just prior to expansion of the intervention to a new community. We conducted individual-level mixed effects analyses of study data, adjusting for time and clustering by patient and community.

Findings

We analysed 108 patients. The CHW-led intervention was associated with a twofold increase in the odds of disease control (OR 2.04, 95% CI 1.15 to 3.62). It was also associated with optimal adherence assessed by 30-day recall (OR 1.86; 95% CI 1.15 to 3.02) and a positive self-assessment of adherence behaviour (OR 2.29; 95% CI 1.26 to 4.15), but not by 5-day recall.

Interpretation

A CHW-led adherence intervention was associated with disease control and adherence among adults with diabetes and/or hypertension. This study supports a role of CHWs in supplementing comprehensive primary care for patients with NCDs in LMICs.

Trial registration number

NCT02549495.
Public preferences for interventions to prevent emerging infectious disease threats: a discrete choice experiment
Authors: Cook Alex R , Zhao Xiahong , Chen Mark I C , Finkelstein Eric A
Published: February 2018

Objective

When faced with an emergent epidemic with high mortality and morbidity potential, policy makers must decide what public health interventions to deploy at different stages of the outbreak. However, almost nothing is known about how the public view these interventions or how they trade off risks (of disease) with inconvenience (of interventions). In this paper, we aim to understand public perceptions on pandemic interventions, as well as to identify if there are any distinct respondent preference classes.

Design

A discrete choice experiment.

Setting

This study was fielded in Singapore between November 2012 and February 2013.

Participants

A random sample of 500 Singapore residents aged 21 and over, including 271 women and 229 men, was analysed.

Outcome measures

Demographic information was collected from each participant. Participants were also shown a series of pairs of alternatives, each combining interventions and morbidity, mortality and cost outcomes and declared a preference for one combination. A random utility model was developed to determine the individual’s preference for interventions and a hierarchical cluster analysis was performed to identify distinct respondent preference classes.

Results

On average, participants preferred more intense interventions, and preferred scenarios with fewer deaths and lower tax. The number of infections did not significantly influence respondents’ responses. We identified two broad classes of respondents: those who were mortality averse and those who were expenditure averse. Education was found to be a predictor of group membership.

Conclusion

Overall, there was considerable support for government interventions to prevent or mitigate outbreaks of emerging infectious diseases, including those that greatly restricted individual liberties, as long as the restrictions showed a reasonable chance of reducing the adverse health effects of the outbreak.
Primary care management of headaches and how direct-access MRI fits: a qualitative study of UK general practitioners’ views
Authors: Underwood Raphael , Kilner Rachael , Ridsdale Leone
Published: February 2018

Objectives

To develop a better understanding of general practitioners’ (GPs) views and experiences of the management of patients with headaches and use of direct-access MRI scans, and observe outcomes of an educational session offered by a GP with a special interest (GPwSI) to GPs.

Design

A qualitative study using semistructured interviews, analysed using thematic analysis. A GPwSI in headaches visited practices delivering a talk on headache medication, diagnosis and management.

Setting

Sixteen (16) primary care family practices in South London, UK.

Participants

Twenty (20) GPs.

Results

Not all GPs were aware of the availability of direct-access MRI, but all acknowledged having used referral or direct scans to manage patients’ concern about their headaches. A normal scan result helped resolve uncertainty for patient and GP and helped management towards discussion of preventative treatment. However, patients with psychological and/or severe headache symptoms could not necessarily be reassured. GPs reported difficulty interpreting radiology reports, particularly incidental abnormalities. Those who received the educational talk gained knowledge in diagnosis and medication, improving their confidence in management.

Conclusions

Increased access to imaging, training in headache management, addressing physical and psychological symptoms and standardised reporting of scans may improve GPs’ use of direct-access MRI in the future.
Effectiveness of inhaled corticosteroids in real life on clinical outcomes, sputum cells and systemic inflammation in asthmatics: a retrospective cohort study in a secondary care centre
Authors: Demarche Sophie F , Schleich Florence N , Henket Monique A , Paulus Virginie A , Van Hees Thierry J , Louis Renaud E
Published: February 2018

Objectives

The impact of inhaled corticosteroids (ICS) on eosinophilic inflammation in asthma is well established, but their effect in a real-life setting has not been extensively studied. Our purpose was to investigate the effect of ICS on airway and systemic inflammation as well as on clinical outcomes in patients with asthma from clinical practice.

Design, setting and participants

We conducted a retrospective analysis on asthmatics from a secondary care centre in whom ICS were initiated/increased (n=101), stopped/decreased (n=60) or remained stable (n=63, used as a control group) between two visits with available sputum and blood cell counts.

Results

The median time between both visits ranged from 1 to 2 years. Initiating or increasing ICS (median variation (IQR): 800 (400–1200) µg beclomethasone equivalent dose per day) reduced sputum eosinophils and fractional exhaled nitric oxide (P<0.0001) and to a lesser extent blood eosinophils (P<0.0001), while withdrawing or decreasing ICS (median variation (IQR): 900 (500–1200) µg beclomethasone equivalentdose per day) resulted in increased sputum eosinophils (P=0.008). No change was found in patients with a stable dose. The effectiveness of ICS in improving asthma control, quality of life, forced expiratory volume in 1 s (FEV1), bronchial hyper-responsiveness and exacerbation rate was only observed in the eosinophilic phenotype (sputum eosinophils ≥3%, n=79). In non-eosinophilic asthmatics, stepping-down ICS resulted in an improvement in asthma control and quality of life, without any significant change in FEV1(n=38).

Conclusions

Our results confirm the effectiveness of ICS on eosinophilic inflammation in real life and demonstrate that their clinical benefit seems to be restricted to eosinophilic asthmatics. Our data also support a try for stepping-down ICS in non-eosinophilic asthmatics.
Paediatric hospital admission processes and outcomes: a qualitative study of parents’ experiences and priorities
Authors: Leyenaar JoAnna K , Rizzo Paul A , O’Brien Emily R , Lindenauer Peter K
Published: February 2018

Background

Hospital admission, like hospital discharge, represents a transition of care associated with changes in setting, healthcare providers and clinical management. While considerable efforts have focused on improving the quality and safety of hospital-to-home transitions, there has been little focus on transitions into hospital.

Objectives

Among children hospitalised with ambulatory care sensitive conditions, we aimed to characterise families’ experiences as they transitioned from outpatient to inpatient care, identify hospital admission processes and outcomes most important to families and determine how parental perspectives differed between children admitted directly and through emergency departments (ED).

Methods

We conducted semistructured interviews with parents of hospitalised children at four structurally diverse hospitals. We inquired about preadmission healthcare encounters, how hospital admission decisions were made and parents’ preferences regarding hospital admission processes and outcomes. Interviews were transcribed verbatim and analysed using a general inductive approach.

Results

We conducted 48 interviews. Participants were predominantly mothers (74%); 45% had children with chronic illnesses and 52% were admitted directly. Children had a median of two (IQR 1–3) healthcare encounters in the week preceding hospital admission, with 44% seeking care in multiple settings. Patterns of healthcare utilisation were influenced by (1) disease acuity and healthcare access; (2) past experiences; and (3) varied perspectives about primary care and ED roles as hospital gatekeepers. Participants’ hospital admission priorities included: (1) effective clinical care; (2) efficient admission processes; (3) safety and security; (4) timeliness; and (5) patient and family-centred processes of care.

Conclusions

Families received preadmission care in several settings and described varying degrees of care coordination during their admission processes. This research can guide improvements in hospitals’ admission systems, necessary to achieve health system integration and continuity of care.
The Freezing Threshold for
k
-Colourings of a Random Graph
Authors: Molloy Michael
Published: February 2018

We determine the exact value of the freezing threshold,

r
f
k

, for
k
-colourings of a random graph when
k
≥ 14. We prove that for random graphs with density above

r
f
k

, almost every colouring is such that a linear number of vertices are frozen, meaning that their colour cannot be changed by a sequence of alterations whereby we change the colours of
o
(
n
) vertices at a time, always obtaining another proper colouring. When the density is below

r
f
k

, then almost every colouring is such that every vertex can be changed by a sequence of alterations where we change
O
(log
n
) vertices at a time.

Frozen vertices are a key part of the clustering phenomena discovered using methods from statistical physics. The value of the freezing threshold was previously determined by the nonrigorous cavity method.
AI events
Authors: Rovatsos Michael
Published: February 2018

This section features information about upcoming events relevant to the readers of AI Matters, including those supported by SIGAI. We would love to hear from you if you are are organizing an event and would be interested in cooperating with SIGAI, or if you have announcements relevant to SIGAI. For more information about conference support visit sigai.acm.org/activities/requesting_sponsor-ship.html.
Blue sky ideas in artificial intelligence education from the EAAI 2017 new and future AI educator program
Authors: Eaton Eric , Koenig Sven , Schulz Claudia , Maurelli Francesco , Lee John , Eckroth Joshua , Crowley Mark , Freedman Richard G. , Cardona-Rivera Rogelio E. , Machado Tiago , Williams Tom
Published: February 2018

The 7th Symposium on Educational Advances in Artificial Intelligence (EAAI'17, co-chaired by Sven Koenig and Eric Eaton) launched the EAAI New and Future AI Educator Program to support the training of early-career university faculty, secondary school faculty, and future educators (PhD candidates or postdocs who intend a career in academia). As part of the program, awardees were asked to address one of the following "blue sky" questions:

1. How could/should Artificial Intelligence (AI) courses incorporate ethics into the curriculum?

2. How could we teach AI topics at an early undergraduate or a secondary school level?

3. AI has the potential for broad impact to numerous disciplines. How could we make AI education more interdisciplinary, specifically to benefit non-engineering fields?

This paper is a collection of their responses, intended to help motivate discussion around these issues in AI education.
Unemployment in the AI age
Authors: Su Grace
Published: February 2018

"Work saves us from three great evils: boredom, vice, and need" Voltaire said (Johnson & Indvik, 2004). Work is essential to the meaning of human life. To many people today, work means having a job. However, artificial intelligence (AI) will soon be able to take over many human jobs. A significant amount of social unrest will be caused by unemployment before the ethical issues of AI can be addressed. Thus, unemployment will be the most pressing social issue with respect to AI technologies.
You, me, or us
Authors: Blass Joseph A.
Published: February 2018

Autonomous systems are increasingly taking actions with moral consequences. While certain universal norms may be built into such systems, other areas should be personalizable to the end user. This essay motivates this problem, explores the ways such systems are already making decisions with moral ramifications, and proposes a path forward.
Sexbots
Authors: Wagner Christian
Published: February 2018

Recently I sat down with an older friend. During our conversation, it came up that I was researching the sex robots ("sexbots") industry. His initial reaction was to laugh in disbelief. "Are you kidding me? You mean like the robots in sci-fi?" My friend's disbelief makes sense; the idea of an actual industry for sex robots seems like a Hollywood movie in the tone of
Ex Machina.
However, the "sexbot industry" is real, and it's growing in popularity. According to a recent study from Tufts University, people find it "relatively permissible" to have sex with a robot. In fact, over 50 percent of people surveyed said they were open to using one (Scheutz, 2016).
Effects of teriparatide on morphology of aortic calcification in aged hyperlipidemic mice
Authors: Hsu Jeffrey J. , Lu Jinxiu , Umar Soban , Lee Jason T. , Kulkarni Rajan P. , Ding Yichen , Chang Chih-Chiang , Hsiai Tzung K. , Hokugo Akishige , Gkouveris Ioannis , Tetradis Sotirios , Nishimura Ichiro , Demer Linda L. , Tintut Yin
Published: February 2018

Calcific aortic vasculopathy correlates with bone loss in osteoporosis in an age-independent manner. Prior work suggests that teriparatide, the bone anabolic treatment for postmenopausal osteoporosis, may inhibit the onset of aortic calcification. Whether teriparatide affects the progression of preexisting aortic calcification, widespread among this patient population, is unknown. Female apolipoprotein E-deficient mice were aged for over 1 yr to induce aortic calcification, treated for 4.5 wk with daily injections of control vehicle (PBS), 40 µg/kg teriparatide (PTH40), or 400 µg/kg teriparatide (PTH400), and assayed for aortic calcification by microcomputed tomography (microCT) before and after treatment. In a followup cohort, aged female apolipoprotein E-deficient mice were treated with PBS or PTH400 and assayed for aortic calcification by serial microCT and micropositron emission tomography. In both cohorts, aortic calcification detected by microCT progressed similarly in all groups. Mean aortic 18F-NaF incorporation, detected by serial micropositron emission tomography, increased in the PBS-treated group (+14 ± 5%). In contrast, 18F-NaF incorporation decreased in the PTH400-treated group (−33 ± 20%, P = 0.03). Quantitative histochemical analysis by Alizarin red staining revealed a lower mineral surface area index in the PTH400-treated group compared with the PBS-treated group ( P = 0.04). Furthermore, Masson trichrome staining showed a significant increase in collagen deposition in the left ventricular myocardium of mice that received PTH400 [2.1 ± 0.6% vs. control mice (0.5 ± 0.1%), P = 0.02]. In summary, although teriparatide may not affect the calcium mineral content of aortic calcification, it reduces 18F-NaF uptake in calcified lesions, suggesting the possibility that it may reduce mineral surface area with potential impact on plaque stability.

NEW & NOTEWORTHY Parathyroid hormone regulates bone mineralization and may also affect vascular calcification, which is an important issue, given that its active fragment, teriparatide, is widely used for the treatment of osteoporosis. To determine whether teriparatide alters vascular calcification, we imaged aortic calcification in mice treated with teriparatide and control mice. Although teriparatide did not affect the calcium content of cardiovascular deposits, it reduced their fluoride tracer uptake.
Abstract P2-06-01: Molecular characterization of human malignant phyllodes tumors reveals potential targeted approaches
Authors: Moon H-G , Yun J , Hong BS , Lee E , Lee H-B , Han W , Kim J-I , Noh D-Y , Heo W , Hur S , Kang W , Lee C
Published: February 2018

Malignant phyllodes tumor (MPT) which belong to the fibroepithelial neoplasm spectrum is a rare type of breast malignancy, and currently there is no effective targeted approach available for MPT. In this study, we tried to identify key genomic alterations and biologic pathways in MPT by whole exome and RNA sequencing of nine MPT tissues. Whole exome sequencing revealed somatic alterations in EGFR, MED12, PIK3CA, PIK3R1, PDGFRA, PDGFRB, PTEN, and TP53. Transcriptome sequencing showed dysregulation of ECM-receptor interaction, focal adhesion, and PI3K-Akt signaling in MPTs when compared to normal breast or invasive breast cancer tissues. Based on the transcriptome profiles, the MPTs were classified into two subtypes; fibrous subtype with upregulation of stromal genes such as collagens and epithelial subtype with upregulation of E-cadherin and Claudins. The molecular classification of fibrous and epithelial subtypes was validated in 28 paraffin-embedded MPT tissues. The fibrous subtype showed higher mitotic index and increased risk for recurrence when compared to the epithelial subtype. We established a patient-derived xenograft model from one fibrous subtype MPT which harbored somatic mutation in PIK3R1 and PDGFRB. In that model, targeted treatment against PIK3CA/mTOR and PDGFR pathways effectively suppressed the tumor growth in vivo. Our data provide insights on the biologic understanding of MPT and suggest a clinically relevant molecular classification. Furthermore, we show that developing effective targeted approaches in MPT can be possible with genomic profiles and patient-derived xenograft models. The clinical efficacy of targeting PDGFR and PIK3CA/mTOR pathways in MPT should be tested in future clinical trials.

Citation Format: Moon H-G, Yun J, Hong BS, Lee E, Lee H-B, Han W, Kim J-I, Noh D-Y, Heo W, Hur S, Kang W, Lee C. Molecular characterization of human malignant phyllodes tumors reveals potential targeted approaches [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-06-01.
Cardiovascular and Patient Phenotype of Extended Haemodialysis: A Critical Analysis of Studying a Unique Patient Population
Authors: Mitsides Nicos , Cornelis Tom , Broers Natascha J.H. , Diederen Nanda M.P. , Brenchley Paul , van der Sande Frank M. , Schalkwijk Casper , Kooman Jeroen P. , Mitra Sandip
Published: February 2018

Background: Extended haemodialysis (EHD) has been associated with better outcomes compared to conventional (CHD) regimes. The cardiovascular (CV) profile of these patients has not been assessed in detail. Methods: We report baseline demographic and CV phenotype of 36 CHD and 36 EHD participants to a longitudinal multicentre study. We measured pulse wave velocity (PWV), 24-h ambulatory blood pressure, sublingual dark-field capillaroscopy and vascular biomarkers. Results: EHD patients were younger (p < 0.01), with less CV comorbidity (p = 0.04) and higher dialysis vintage (p < 0.01). Higher PWV in CHD (p = 0.02) was not independent of demographic differences in the 2 groups. Biomarker profiles were similar in EHD and CHD but abnormal compared to healthy controls. Conclusion: Although CV profiles in these 2 cohorts were similar, EHD patients were distinct from the CHD population in terms of age and dialysis vintage and appear to comprise a unique group. Direct comparison of outcomes in these groups is challenging due to clinical bias.