Τετάρτη 29 Ιουνίου 2016
IJGI, Vol. 5, Pages 105: Discovering Land Cover Web Map Services from the Deep Web with JavaScript Invocation Rules
Automatic discovery of isolated land cover web map services (LCWMSs) can potentially help in sharing land cover data. Currently, various search engine-based and crawler-based approaches have been developed for finding services dispersed throughout the surface web. In fact, with the prevalence of geospatial web applications, a considerable number of LCWMSs are hidden in JavaScript code, which belongs to the deep web. However, discovering LCWMSs from JavaScript code remains an open challenge. This paper aims to solve this challenge by proposing a focused deep web crawler for finding more LCWMSs from deep web JavaScript code and the surface web. First, the names of a group of JavaScript links are abstracted as initial judgements. Through name matching, these judgements are utilized to judge whether or not the fetched webpages contain predefined JavaScript links that may prompt JavaScript code to invoke WMSs. Secondly, some JavaScript invocation functions and URL formats for WMS are summarized as JavaScript invocation rules from prior knowledge of how WMSs are employed and coded in JavaScript. These invocation rules are used to identify the JavaScript code for extracting candidate WMSs through rule matching. The above two operations are incorporated into a traditional focused crawling strategy situated between the tasks of fetching webpages and parsing webpages. Thirdly, LCWMSs are selected by matching services with a set of land cover keywords. Moreover, a search engine for LCWMSs is implemented that uses the focused deep web crawler to retrieve and integrate the LCWMSs it discovers. In the first experiment, eight online geospatial web applications serve as seed URLs (Uniform Resource Locators) and crawling scopes; the proposed crawler addresses only the JavaScript code in these eight applications. All 32 available WMSs hidden in JavaScript code were found using the proposed crawler, while not one WMS was discovered through the focused crawler-based approach. This result shows that the proposed crawler has the ability to discover WMSs hidden in JavaScript code. The second experiment uses 4842 seed URLs updated daily. The crawler found a total of 17,874 available WMSs, of which 11,901 were LCWMSs. Our approach discovered a greater number of services than those found using previous approaches. It indicates that the proposed crawler has a large advantage in discovering LCWMSs from the surface web and from JavaScript code. Furthermore, a simple case study demonstrates that the designed LCWMS search engine represents an important step towards realizing land cover information integration for global mapping and monitoring purposes.
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IJERPH, Vol. 13, Pages 650: Seroprevalence of Antibodies against Measles, Rubella and Varicella among Asylum Seekers Arriving in Lower Saxony, Germany, November 2014–October 2015
The number of asylum seekers arriving in Germany has increased rapidly since 2014 and cases of vaccine-preventable diseases at reception centres were reported. Asylum seekers 12 years and older arriving in Lower Saxony were serologically screened for antibodies against measles, rubella and varicella between November 2014 and October 2015. We calculated the seroprevalence from the screening data by disease, country of origin and age group and compared them to literature-based herd immunity thresholds in order to identify immunisation gaps. In total, 23,647 specimens were included in our study. Although the vast majority of asylum seekers tested positive for antibodies against measles, rubella and varicella, the seroprevalences were not sufficient to ensure herd immunity. The seroprevalences varied substantially between countries of origin and increased with age. Immunisation of asylum seekers against measles, rubella and varicella is needed and the detailed information on seroprevalences among subgroups of asylum seekers can be used for targeted immunisations at reception centres.
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Molecules, Vol. 21, Pages 863: Phenolic Profiles and Antioxidant Activity of Lotus Root Varieties
Lotus root attracts increasing attention mainly because of its phenolic compounds known as natural antioxidants. Its thirteen varieties were systematically analyzed on the content, distribution, composition and antioxidant activity of phenolic compounds for a better understanding of this aquatic vegetable. The respective mean contents of total phenolics in their flesh, peel and nodes were 1.81, 4.30 and 7.35 mg gallic acid equivalents (GAE)/g fresh weight (FW), and those of total flavonoids were 3.35, 7.69 and 15.58 mg rutin equivalents/g FW. The phenolic composition determined by a high-performance liquid chromatography method varied significantly among varieties and parts. The phenolics of flesh were mainly composed of gallocatechin and catechin; those of peel and node were mainly composed of gallocatechin, gallic acid, catechin and epicatechin. The antioxidant activities of phenolic extracts in increasing order were flesh, peel and node; their mean concentrations for 50% inhibition of 2,2-diphenyl-1-picrylhydrazyl radical were 46.00, 26.43 and 21.72 µg GAE/mL, and their mean values representing ferric reducing antioxidant power were 75.91, 87.66 and 100.43 µg Trolox equivalents/100 µg GAE, respectively. "Zoumayang", "Baheou", "No. 5 elian" and "Guixi Fuou" were the hierarchically clustered varieties with relatively higher phenolic content and stronger antioxidant activity as compared with the others. Especially, their nodes and peels are promising sources of antioxidants for human nutrition.
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Sensors, Vol. 16, Pages 1010: Robust Behavior Recognition in Intelligent Surveillance Environments
Intelligent surveillance systems have been studied by many researchers. These systems should be operated in both daytime and nighttime, but objects are invisible in images captured by visible light camera during the night. Therefore, near infrared (NIR) cameras, thermal cameras (based on medium-wavelength infrared (MWIR), and long-wavelength infrared (LWIR) light) have been considered for usage during the nighttime as an alternative. Due to the usage during both daytime and nighttime, and the limitation of requiring an additional NIR illuminator (which should illuminate a wide area over a great distance) for NIR cameras during the nighttime, a dual system of visible light and thermal cameras is used in our research, and we propose a new behavior recognition in intelligent surveillance environments. Twelve datasets were compiled by collecting data in various environments, and they were used to obtain experimental results. The recognition accuracy of our method was found to be 97.6%, thereby confirming the ability of our method to outperform previous methods.
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Publications, Vol. 4, Pages 19: Obstacles to Scholarly Publishing in the Social Sciences and Humanities: A Case Study of Vietnamese Scholars
Publishing scientific research is very important in contributing to the knowledge of a discipline and in sharing research findings among scientists. Based on the quantity and quality of publications, one can evaluate the research capacity of a researcher or the research performance of a university or a country. However, the number of quality publications in Vietnam is very low in comparison with those in the other countries in the region or in the world, especially in the fields of social sciences and humanities. Employing both quantitative and qualitative approaches, the current study investigates university lecturers' attitudes towards research and publication and the obstacles to local and international publication at one of the main universities in social sciences and humanities in Vietnam. The study found the main barriers to publication are funding and time for research and publication, among many other obstacles. From the analysis of the data, the study would also argue that lecturers' obstacles to publication may vary across faculties (or disciplines), ages, qualifications, education, research and publication experience. The findings in this study may be applied to other institutions in Vietnam or in other countries where English is used as a foreign language.
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Energies, Vol. 9, Pages 505: High Pressure Oxydesulphurisation of Coal—Effect of Oxidizing Agent, Solvent, Shear and Agitator Configuration
The ambient temperature high pressure oxydesulphurisation technique was investigated to reduce the sulphur content. Prince of Wales coal was chosen for this study. The focus of the study was to investigate the reduction of both pyritic and organic sulphur while changing the KMnO4/Coal ratio, agitation speed, agitator configuration, and shear. The effect of different concentrations of acetone as a solvent and effect of particle size on the sulphur removal was also studied by a series of experimental runs at ambient temperature. Heating value recovery was found to be increased with the decreased KMnO4/Coal ratio and with decreased acetone concentration. It was found that sulphur removal was enhanced with the increase in shear using a turbine impeller. The effect of particle size was more significant on the pyritic sulphur removal as compared to the organic sulphur removal while heating value recovery was found to increase with decreased desulphurization tome for both, under atmospheric and high pressure.
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Sustainability, Vol. 8, Pages 592: Integrated Multi-Trophic Recirculating Aquaculture System for Nile Tilapia (Oreochlomis niloticus)
Three densities of the sex-reversed male Nile tilapia, Oreochromis niloticus (20, 25, 50 fish/m3) were cultivated in an integrated multi-trophic recirculating aquaculture system (IMRAS) that involves the ecological relationship between several living organisms, i.e., phytoplankton, zooplankton, and aquatic plants. The results indicated that, by providing proper interdependency between various species of living organisms, the concentrations of ammonia, nitrite, nitrate, and phosphate in the system were maintained below dangerous levels for Nile tilapia throughout the cultivation period. The highest wet weight productivity of Nile tilapia of 11 ± 1 kg was achieved at a fish density of 50 fish/m3. The aquatic plants in the treatment tank could effectively uptake the unwanted nitrogen (N) and phosphorus (P) compounds with the highest removal efficiencies of 9.52% and 11.4%, respectively. The uptake rates of nitrogen and phosphorus by aquatic plants could be ranked from high to low as: Egeria densa > Ceratophyllum demersum > Vallisneria spiralis and Vallisneria americana > Hygrophila difformis. The remaining N was further degraded through nitrification process, whereas the remaining P could well precipitate in the soil sediment in the treatment tank.
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High birth weight in a suburban hospital in Cameroon: an analysis of the clinical cut-off, prevalence, predictors and adverse outcomes
Background and aims
High birth weight (HBW) increases the risk of maternal and fetal morbidity and mortality. Its prevalence and adverse outcomes may be reduced if risk factors are identified and managed during pregnancy. The cut-off value for HBW remains debatable. The objectives of this study were to identify the optimal cut-off value and determine the prevalence, predictors and adverse outcomes of HBW in a suburban area of Cameroon.
DesignA 6-year retrospective register analysis and a 3-month prospective phase.
SettingA secondary care level (regional) hospital in the city of Buea (southwest region of Cameroon).
ParticipantsWomen who delivered in this hospital over a 6-year period (retrospective phase) and consenting pregnant mothers and their infants (singletons, born at >28 weeks gestation) (prospective phase).
Outcome measures90th centile of birth weights; prevalence of HBW defined as birth weight above the 90th centile; sociodemographic, maternal and obstetrical factors associated with HBW; maternal and neonatal adverse outcomes of HBW.
ResultsOf the 4941 newborns reviewed in registers, the 90th centile of birth weights was 3850 g. Using this new cut-off, we obtained a prevalence of 14.0% for HBW in the 200 newborns included in the prospective phase. This was significantly higher than the prevalence (9.5%) yielded when the traditional cut-off of 4000 g was used (p=0.003). None of the factors assessed was independently associated with HBW. Newborns with HBW were more likely to have shoulder dystocia (p<0.01), and their mothers more likely to suffer from prolonged labour (p=0.01) and postpartum haemorrhage (p<0.01).
ConclusionsThe results of this study suggest that the cut-off for HBW in this population should be 3850 g. Thus, 3 of every 10 babies born with HBW in this hospital are likely not receiving optimal postnatal care because 4000 g is currently used to qualify for additional support.
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Risk factors associated with RSV hospitalisation in the first 2 years of life, among different subgroups of children in NSW: a whole-of-population-based cohort study
Background
Data on risk factors for respiratory syncytial virus (RSV)-associated hospitalisation in Australian children may be informative for preventive measures.
MethodsA whole-of-population-based study was conducted to identify comparable risk factors for RSV hospitalisation in different subgroups of children aged <2 years in New South Wales. The cohort was divided into Indigenous children and high-risk and standard risk non-Indigenous children. Data on risk factors were obtained from the Perinatal Data Collection. RSV hospitalisations were ascertained from the Admitted Patient Data Collection. Adjusted HRs were calculated for each subgroup. Population-attributable risk associated with risk factors was estimated.
ResultsFour factors were associated with increased risk of RSV hospitalisation: maternal smoking during pregnancy, male sex, multiparity and birth during the first half of the RSV season. Increase in relative socioeconomic advantage was associated with decreased risk of hospitalisation. Among high and standard risk non-Indigenous children, the hazard was approximately double for children born to multiparous women compared to those born to primiparous women and among Indigenous children the hazard was approximately double among those born during the first half of the RSV season. Maternal smoking during pregnancy was associated with a 26–45% increased risk across subgroups and accounted for 17% (95% CI 9.3% to 24%) of RSV hospitalisations in Indigenous children, 5% (95% CI 2.5% to 8%) in high-risk and 6% (95% 5% to 7%) in standard risk non-Indigenous children.
DiscussionPromoting avoidance of smoking during pregnancy may help in lowering the disease burden, with Indigenous children likely to benefit most.
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Regional variation of patient behaviour and reasons for consultation in the general practice of Northern Germany: protocol for an observational study
Introduction
Inappropriate supply and an increasing demand on the healthcare system have been of concern for health policy in Germany for at least 15 years. In the primary care setting, this especially relates to an undersupply of general practitioners (GPs) in the countryside. In addition, there seem to be other regional differences, for example, a difference in accessing primary and secondary care between rural and urban areas. Despite these findings, regional differences in health services have not been studied extensively in Germany. Therefore, this study aims to explore regional variations of patient populations and reasons for accessing primary medical care.
Methods and analysisWe will conduct a cross-sectional observational study based on standardised interviews with 240 GPs and ~1200 patients. Data collection started on 10 June 2015 and will probably be completed by 31 October 2016. We will include all districts and cities within 100 km from Hamburg and assign them according to the type of regions: rural, urban and environs. All eligible GPs will be invited to participate. Each practice will recruit up to 15 patients, aged 18 years or older. Questionnaires are based on a preliminary qualitative study and were pretested. Data will be analysed with descriptive statistics and regression modelling strategies adjusted for confounders and the GP-induced cluster structure.
Ethics and disseminationOur study was approved by the Ethics Committee of the Medical Association of Hamburg and is conducted in accordance with the Declaration of Helsinki. Study participants give written informed consent before data collection and data is pseudonymised. Survey data and person identifiers are stored separately in locked cabinets and have restricted availability. The results of our study will be presented at conferences and published in peer-reviewed journals.
Trial registration numberNCT02558322; Pre-results.
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Estimated association between dwelling soil contamination and internal radiation contamination levels after the 2011 Fukushima Daiichi nuclear accident in Japan
Objectives
Measurement of soil contamination levels has been considered a feasible method for dose estimation of internal radiation exposure following the Chernobyl disaster by means of aggregate transfer factors; however, it is still unclear whether the estimation of internal contamination based on soil contamination levels is universally valid or incident specific.
MethodsTo address this issue, we evaluated relationships between in vivo and soil cesium-137 (Cs-137) contamination using data on internal contamination levels among Minamisoma (10–40 km north from the Fukushima Daiichi nuclear power plant), Fukushima residents 2–3 years following the disaster, and constructed three models for statistical analysis based on continuous and categorical (equal intervals and quantiles) soil contamination levels.
ResultsA total of 7987 people with a mean age of 55.4 years underwent screening of in vivo Cs-137 whole-body counting. A statistically significant association was noted between internal and continuous Cs-137 soil contamination levels (model 1, p value <0.001), although the association was slight (relative risk (RR): 1.03 per 10 kBq/m2 increase in soil contamination). Analysis of categorical soil contamination levels showed statistical (but not clinical) significance only in relatively higher soil contamination levels (model 2: Cs-137 levels above 100 kBq/m2 compared to those <25 kBq/m2, RR=1.75, p value <0.01; model 3: levels above 63 kBq/m2 compared to those <11 kBq/m2, RR=1.45, p value <0.05).
ConclusionsLow levels of internal and soil contamination were not associated, and only loose/small associations were observed in areas with slightly higher levels of soil contamination in Fukushima, representing a clear difference from the strong associations found in post-disaster Chernobyl. These results indicate that soil contamination levels generally do not contribute to the internal contamination of residents in Fukushima; thus, individual measurements are essential for the precise evaluation of chronic internal radiation contamination.
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Retrospective analysis of changing characteristics of treatment-seeking smokers: implications for further reducing smoking prevalence
Objective
The goal of the current study was to empirically compare successive cohorts of treatment-seeking smokers who enrolled in randomised clinical trials in a region of the USA characterised by strong tobacco control policies and low smoking prevalence, over the past three decades.
DesignRetrospective treatment cohort comparison.
SettingData were collected from 9 randomised clinical trials conducted at Stanford University and the University of California, San Francisco, between 1990 and 2013.
ParticipantsData from a total of 2083 participants were included (Stanford, n=1356; University of California San Francisco, n=727).
Primary and secondary outcomesOne-way analysis of variance and covariance, 2 and logistic regression analyses were used to examine relations between nicotine dependence, cigarettes per day, depressive symptoms and demographic characteristics among study cohorts.
ResultsSimilar trends were observed at both settings. When compared to earlier trials, participants in more recent trials smoked fewer cigarettes, were less nicotine-dependent, reported more depressive symptoms, were more likely to be male and more likely to be from a minority ethnic/racial group, than those enrolled in initial trials (all p's<0.05). Analysis of covariances revealed that cigarettes per day, nicotine dependence and current depressive symptom scores were each significantly related to trial (all p's<0.001).
ConclusionsOur findings suggest that more recent smoking cessation treatment-seeking cohorts in a low prevalence region were characterised by less smoking severity, more severe symptoms of depression and were more likely to be male and from a minority racial/ethnic group.
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Group-based exercise in daily clinical practice to improve physical fitness in men with prostate cancer undergoing androgen deprivation therapy: study protocol
Introduction
Level 1 evidence supports the use of supervised exercise to mitigate the adverse effects of androgen deprivation therapy (ADT) in men with prostate cancer. The data, however, have been generated in controlled research settings and might not be transferable to daily clinical practice. This article describes the design of an ongoing prospective observational study to evaluate the potential benefits of exercise in daily clinical practice.
Methods and analysisMen diagnosed with prostate cancer starting or already receiving ADT at our facility are invited to participate in a 12-week exercise programme implemented as the standard of care. Exclusion criteria are opioid-demanding treatment for skeletal pain, an Eastern Cooperative Oncology Group (ECOG) performance status above 2 or the inability to perform floor and machine exercises independently. The intervention consists of an initial educational session of 11/2 hours followed by 12 weeks of group-based supervised training two times a week. The focus of the exercise is progressive resistance training in combination with aerobic training. Participants are measured at baseline, after 12 weeks and after 24 weeks as part of the programme. Primary endpoints of this study are changes in physical fitness evaluated by the 30 s Chair-Stand Test and Graded Cycling Test with Talk Test. Secondary endpoints include changes in quality of life, body composition and safety of exercise. Inclusion started in August 2014, with 169 participants being included by December 2015.
Ethics and disseminationThe study has been reviewed by the Scientific Ethical Committee of the Capital Region of Denmark (reference number H-3-2013-FSP39). The results of the study will be published in peer-reviewed international journals and will be presented at national and international conferences and symposiums.
Trial registration numberNCT02631681; Pre-results.
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Young adolescent girls are at high risk for adverse pregnancy outcomes in sub-Saharan Africa: an observational multicountry study
Objectives
One of Africa's most important challenges is to improve maternal and neonatal health. The identification of groups at highest risk for adverse pregnancy outcomes is important for developing and implementing targeted prevention programmes. This study assessed whether young adolescent girls constitute a group at increased risk for adverse birth outcomes among pregnant women in sub-Saharan Africa.
SettingData were collected prospectively as part of a large randomised controlled clinical trial evaluating intermittent preventive treatment of malaria in pregnancy (NCT00811421—Clinical Trials.gov), conducted between September 2009 and December 2013 in Benin, Gabon, Mozambique and Tanzania.
ParticipantsOf 4749 participants, pregnancy outcomes were collected for 4388 deliveries with 4183 live births including 83 multiple gestations. Of 4100 mothers with a singleton live birth delivery, 24% (975/4100) were adolescents (≤19 years of age) and 6% (248/4100) were aged ≤16 years.
Primary and secondary outcome measuresPrimary outcomes of this predefined analysis were preterm delivery and low birth weight.
ResultsThe overall prevalence of low birthweight infants and preterm delivery was 10% (371/3851) and 4% (159/3862), respectively. Mothers aged ≤16 years showed higher risk for the delivery of a low birthweight infant (OR: 1.96; 95% CI 1.35 to 2.83). Similarly, preterm delivery was associated with young maternal age (≤16 years; OR: 2.62; 95% CI 1.59 to 4.30). In a subanalysis restricted to primiparous women: preterm delivery, OR 4.28; 95% CI 2.05 to 8.93; low birth weight, OR: 1.29; 95% CI 0.82 to 2.01.
ConclusionsYoung maternal age increases the risk for adverse pregnancy outcomes and it is a stronger predictor for low birth weight and preterm delivery than other established risk factors in sub-Saharan Africa. This finding highlights the need to improve adolescent reproductive health in sub-Saharan Africa.
Trial registration numberNCT00811421; Post-results.
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Perceptions of risk and predictive testing held by the first-degree relatives of patients with rheumatoid arthritis in England, Austria and Germany: a qualitative study
Objectives
The family members of patients with rheumatoid arthritis (RA) are at increased risk of developing RA and are potential candidates for predictive testing. This study explored the perceptions of first-degree relatives of people with RA about being at risk of RA and engaging in predictive testing.
Methods34 first-degree relatives (siblings and offspring) of patients with RA from the UK, Germany and Austria participated in semistructured interviews about their perceptions of RA risk and the prospect of predictive testing. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.
ResultsFirst-degree relatives were aware of their susceptibility to RA, but were unsure of the extent of their risk. When considering their future risk, some relatives were concerned about the potential impact that RA would have on their lives. Relatives were concerned that knowing their actual risk would increase their anxiety and would affect decisions about their future. Also, relatives were concerned about the levels of uncertainty associated with predictive testing. Those in favour of knowing their future risk felt that they would need additional support to understand the risk information and cope with the emotional impact of this information.
ConclusionsIdentifying individuals at risk of RA may allow targeted interventions to reduce the risk and consequence of future disease; however, relatives have concerns about predictive testing and risk information. The development of strategies to quantify and communicate risk needs to take these views into account and incorporate approaches to mitigate concerns and minimise the psychological impact of risk information.
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Sensors, Vol. 16, Pages 1008: An Enhanced Technique for Ultrasonic Flow Metering Featuring Very Low Jitter and Offset
This paper proposes a new, improved method for water flow metering. It applies to a transit time ultrasonic flow meter device. In principle, the flow of a given liquid in a pipe is obtained by measuring the transit times of an ultrasonic wave in the upstream and downstream directions. The difference between these times is, in theory, linearly proportional to the liquid flow velocity. However, the fainter the flow is, the smaller the transit time difference (TTD) is. This difference can be as low as a few picoseconds, which gives rise to many technical difficulties in measuring such a small time difference with a given accuracy. The proposed method relies on measuring the TTD indirectly by computing the phase difference between the steady-state parts of the received signals in the upstream and downstream directions and by using a least-square-sine-fitting technique. This reduces the effect of the jitter noise and the offset, which limit measurement precision at very low flow velocity. The obtained measurement results illustrate the robustness of the proposed method, as we measure the TTD at no-flow conditions, with a precision as low as 10 ps peak-to-peak and a TTD offset of zero, within a temperature range from room temperature to 80 °C. This allows us to reach a smaller minimum detectable flow when compared with previous techniques. The proposed method exhibits a better trade-off between measurement accuracy and system complexity. It can be completely integrated in an ASIC (application specific integrated circuit) or incorporated in a CPU- or micro-controller-based system.
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Sensors, Vol. 16, Pages 1003: Game Theory Meets Wireless Sensor Networks Security Requirements and Threats Mitigation: A Survey
We present a study of using game theory for protecting wireless sensor networks (WSNs) from selfish behavior or malicious nodes. Due to scalability, low complexity and disseminated nature of WSNs, malicious attacks can be modeled effectively using game theory. In this study, we survey the different game-theoretic defense strategies for WSNs. We present a taxonomy of the game theory approaches based on the nature of the attack, whether it is caused by an external attacker or it is the result of an internal node acting selfishly or maliciously. We also present a general trust model using game theory for decision making. We, finally, identify the significant role of evolutionary games for WSNs security against intelligent attacks; then, we list several prospect applications of game theory to enhance the data trustworthiness and node cooperation in different WSNs.
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Sensors, Vol. 16, Pages 999: A 75-ps Gated CMOS Image Sensor with Low Parasitic Light Sensitivity
In this study, a 40 × 48 pixel global shutter complementary metal-oxide-semiconductor (CMOS) image sensor with an adjustable shutter time as low as 75 ps was implemented using a 0.5-μm mixed-signal CMOS process. The implementation consisted of a continuous contact ring around each p+/n-well photodiode in the pixel array in order to apply sufficient light shielding. The parasitic light sensitivity of the in-pixel storage node was measured to be 1/8.5 × 107 when illuminated by a 405-nm diode laser and 1/1.4 × 104 when illuminated by a 650-nm diode laser. The pixel pitch was 24 μm, the size of the square p+/n-well photodiode in each pixel was 7 μm per side, the measured random readout noise was 217 e− rms, and the measured dynamic range of the pixel of the designed chip was 5500:1. The type of gated CMOS image sensor (CIS) that is proposed here can be used in ultra-fast framing cameras to observe non-repeatable fast-evolving phenomena.
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Materials, Vol. 9, Pages 529: Ceramic Spheres—A Novel Solution to Deep Sea Buoyancy Modules
Ceramic-based hollow spheres are considered a great driving force for many applications such as offshore buoyancy modules due to their large diameter to wall thickness ratio and uniform wall thickness geometric features. We have developed such thin-walled hollow spheres made of alumina using slip casting and sintering processes. A diameter as large as 50 mm with a wall thickness of 0.5–1.0 mm has been successfully achieved in these spheres. Their material and structural properties were examined by a series of characterization tools. Particularly, the feasibility of these spheres was investigated with respect to its application for deep sea (>3000 m) buoyancy modules. These spheres, sintered at 1600 °C and with 1.0 mm of wall thickness, have achieved buoyancy of more than 54%. As the sphere's wall thickness was reduced (e.g., 0.5 mm), their buoyancy reached 72%. The mechanical performance of such spheres has shown a hydrostatic failure pressure above 150 MPa, corresponding to a rating depth below sea level of 5000 m considering a safety factor of 3. The developed alumina-based ceramic spheres are feasible for low cost and scaled-up production and show great potential at depths greater than those achievable by the current deep-sea buoyancy module technologies.
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Sensors, Vol. 16, Pages 1002: Quantum Random Number Generation Using a Quanta Image Sensor
A new quantum random number generation method is proposed. The method is based on the randomness of the photon emission process and the single photon counting capability of the Quanta Image Sensor (QIS). It has the potential to generate high-quality random numbers with remarkable data output rate. In this paper, the principle of photon statistics and theory of entropy are discussed. Sample data were collected with QIS jot device, and its randomness quality was analyzed. The randomness assessment method and results are discussed.
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MCA, Vol. 21, Pages 27: Some Properties of a Function Originating from Geometric Probability for Pairs of Hyperplanes Intersecting with a Convex Body
In the paper, the authors derive an integral representation, present a double inequality, supply an asymptotic formula, find an inequality, and verify complete monotonicity of a function involving the gamma function and originating from geometric probability for pairs of hyperplanes intersecting with a convex body.
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Sensors, Vol. 16, Pages 1000: Robust Control for the Segway with Unknown Control Coefficient and Model Uncertainties
The Segway, which is a popular vehicle nowadays, is an uncertain nonlinear system and has an unknown time-varying control coefficient. Thus, we should consider the unknown time-varying control coefficient and model uncertainties to design the controller. Motivated by this observation, we propose a robust control for the Segway with unknown control coefficient and model uncertainties. To deal with the time-varying unknown control coefficient, we employ the Nussbaum gain technique. We introduce an auxiliary variable to solve the underactuated problem. Due to the prescribed performance control technique, the proposed controller does not require the adaptive technique, neural network, and fuzzy logic to compensate the uncertainties. Therefore, it can be simple. From the Lyapunov stability theory, we prove that all signals in the closed-loop system are bounded. Finally, we provide the simulation results to demonstrate the effectiveness of the proposed control scheme.
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Energies, Vol. 9, Pages 501: Analysis and Controller Design of a Universal Bidirectional DC-DC Converter
In this paper, first the operating principles of a non-isolated universal bidirectional DC-DC converter are studied and analyzed. The presented power converter is capable of operating in all power transferring directions in buck/boost modes. Zero voltage switching can be achieved for all the power switches through proper modulation strategy design, therefore, the presented converter can achieve high efficiency. To further improve the efficiency, the relationship between the phase-shift angle and the overall system efficiency is analyzed in detail, an adaptive phase-shift (APS) control method which determines the phase-shift value between gating signals according to the load level is then proposed. As the modulation strategy is a software-based solution, there is no requirement for additional circuits, therefore, it can be implemented easily and instability and noise susceptibility problems can be reduced. To validate the correctness and the effectiveness of the proposed method, a 300 W prototyping circuit is implemented and tested. A low cost dsPIC33FJ16GS502 digital signal controller is adopted in this paper to realize the power flow control, DC-bus voltage regulation and APS control. According to the experimental results, a 12.2% efficiency improvement at light load and 4.0% efficiency improvement at half load can be achieved.
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Evaluating a Nationwide Recreational Football Intervention: Recruitment, Attendance, Adherence, Exercise Intensity, and Health Effects
The present study evaluated a nationwide exercise intervention with Football Fitness in a small-scale society. In all, 741 adult participants (20–72 yrs) were successfully recruited for Football Fitness training in local football clubs, corresponding to 2.1% of the adult population. A preintervention test battery including resting heart rate (RHR), blood pressure, and body mass measurements along with performance tests (Yo-Yo Intermittent Endurance level 1 (Yo-Yo IE1), the Arrowhead Agility Test, and the Flamingo Balance Test) were performed (). Training attendance () was 1.6 ± 0.2 sessions per week (range: 0.6–2.9), corresponding to 28.8 ± 1.0 sessions during the 18 wk intervention period. After 18 wks mean arterial pressure (MAP) was −2.7 ± 0.7 mmHg lower (; ) with even greater () reductions for those with baseline MAP values >99 mmHg (−5.6 ± 1.5 mmHg; ). RHR was lowered () by 6 bpm after intervention (77 ± 1 to 71 ± 1 bpm). Yo-Yo IE1 performance increased by 41% (540 ± 27 to 752 ± 45 m), while agility and postural balance were improved () by ~6 and ~45%, respectively. In conclusion, Football Fitness was shown to be a successful health-promoting nationwide training intervention for adult participants with an extraordinary recruitment, a high attendance rate, moderate adherence, high exercise intensity, and marked benefits in cardiovascular health profile and fitness.
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Foods, Vol. 5, Pages 49: Effects of Two-Step Transamidation of Wheat Semolina on the Technological Properties of Gluten
Celiac disease (CD) is an immune-mediated disorder caused by the ingestion of wheat gluten. A lifelong, gluten-free diet is required to alleviate symptoms and to normalize the intestinal mucosa. We previously found that transamidation reaction by microbial transglutaminase (mTG) was effective in down-regulating the gliadin-specific immune response in CD patients. In this study, the two-step transamidation protocol was adopted to treat commercial wheat semolina on a pilot scale. The effectiveness of the enzymatic reaction was tested by means of consolidated biochemical and immunological methods on isolated prolamins. We found that water-insoluble gliadin and glutenin yields decreased in wheat semolina to 5.9% ± 0.3% and 11.6% ± 0.1%, respectively, after a two-step transamidation reaction. Using DQ8 transgenic mice as a model of gluten sensitivity, we observed a dramatic reduction in IFN-γ production in spleen cells challenged in vitro with the residual insoluble gliadin from transamidated semolina (N = 6; median values: 850 vs. 102; control vs. transamidated semolina, p < 0.05). The technological properties of treated wheat semolina were then tested by manufacturing classical pasta (spaghetti). Notably, the spaghetti manufactured with transamidated semolina had only minor changes in its features before and after cooking. In conclusion, the two-step transamidation reaction modified the immunogenic epitopes of gliadins also on a pilot-scale level without influencing the main technological properties of semolina. Our data shed further light on a detoxification strategy alternative to the current gluten-free diet and may have important implications for the management of CD patients.
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Sensors, Vol. 16, Pages 1006: A Proof-of-Concept for Semantically Interoperable Federation of IoT Experimentation Facilities
The Internet-of-Things (IoT) is unanimously identified as one of the main pillars of future smart scenarios. The potential of IoT technologies and deployments has been already demonstrated in a number of different application areas, including transport, energy, safety and healthcare. However, despite the growing number of IoT deployments, the majority of IoT applications tend to be self-contained, thereby forming application silos. A lightweight data centric integration and combination of these silos presents several challenges that still need to be addressed. Indeed, the ability to combine and synthesize data streams and services from diverse IoT platforms and testbeds, holds the promise to increase the potentiality of smart applications in terms of size, scope and targeted business context. In this article, a proof-of-concept implementation that federates two different IoT experimentation facilities by means of semantic-based technologies will be described. The specification and design of the implemented system and information models will be described together with the practical details of the developments carried out and its integration with the existing IoT platforms supporting the aforementioned testbeds. Overall, the system described in this paper demonstrates that it is possible to open new horizons in the development of IoT applications and experiments at a global scale, that transcend the (silo) boundaries of individual deployments, based on the semantic interconnection and interoperability of diverse IoT platforms and testbeds.
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Sensors, Vol. 16, Pages 1007: Development of a Calibration Strip for Immunochromatographic Assay Detection Systems
With many benefits and applications, immunochromatographic (ICG) assay detection systems have been reported on a great deal. However, the existing research mainly focuses on increasing the dynamic detection range or application fields. Calibration of the detection system, which has a great influence on the detection accuracy, has not been addressed properly. In this context, this work develops a calibration strip for ICG assay photoelectric detection systems. An image of the test strip is captured by an image acquisition device, followed by performing a fuzzy c-means (FCM) clustering algorithm and maximin-distance algorithm for image segmentation. Additionally, experiments are conducted to find the best characteristic quantity. By analyzing the linear coefficient, an average value of hue (H) at 14 min is chosen as the characteristic quantity and the empirical formula between H and optical density (OD) value is established. Therefore, H, saturation (S), and value (V) are calculated by a number of selected OD values. Then, H, S, and V values are transferred to the RGB color space and a high-resolution printer is used to print the strip images on cellulose nitrate membranes. Finally, verification of the printed calibration strips is conducted by analyzing the linear correlation between OD and the spectral reflectance, which shows a good linear correlation (R2 = 98.78%).
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Energies, Vol. 9, Pages 498: Flexible Grouping for Enhanced Energy Utilization Efficiency in Battery Energy Storage Systems
As a critical subsystem in electric vehicles and smart grids, a battery energy storage system plays an essential role in enhancement of reliable operation and system performance. In such applications, a battery energy storage system is required to provide high energy utilization efficiency, as well as reliability. However, capacity inconsistency of batteries affects energy utilization efficiency dramatically; and the situation becomes more severe after hundreds of cycles because battery capacities change randomly due to non-uniform aging. Capacity mismatch can be solved by decomposing a cluster of batteries in series into several low voltage battery packs. This paper introduces a new analysis method to optimize energy utilization efficiency by finding the best number of batteries in a pack, based on capacity distribution, order statistics, central limit theorem, and converter efficiency. Considering both battery energy utilization and power electronics efficiency, it establishes that there is a maximum energy utilization efficiency under a given capacity distribution among a certain number of batteries, which provides a basic analysis for system-level optimization of a battery system throughout its life cycle. Quantitative analysis results based on aging data are illustrated, and a prototype of flexible energy storage systems is built to verify this analysis.
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IJGI, Vol. 5, Pages 104: Application of GPS Trajectory Data for Investigating the Interaction between Human Activity and Landscape Pattern: A Case Study of the Lijiang River Basin, China
The interaction between human activity and landscape pattern has been a hot research topic during the last few decades. However, scholars used to measure human activity by social, economic and humanistic indexes. These indexes cannot directly reflect human activity and are not suitable for fine-grained analysis due to the coarse spatial resolution. In view of the above problems, this paper proposes a method that obtains the intensity of human activity from GPS trajectory data, collects landscape information from remote sensing images and further analyzes the interaction between human activity and landscape pattern at a fine-grained scale. The Lijiang River Basin is selected as the study area. Experimental results show that human activity and landscape pattern interact synergistically in this area. Built-up land and water boost human activity, while woodland restrains human activity. The effect of human activity on landscape pattern differs by the land cover category. Overall, human activities make natural land, such as woodland and water, scattered and fragmented, but cause man-built land, such as built-up land and farmland, clustered and regular. Nevertheless, human activities inside and outside urban areas are the opposite. The research findings in this paper are helpful for designing and implementing sustainable management plans.
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Remote Sensing, Vol. 8, Pages 553: Application of Helmert Variance Component Based Adaptive Kalman Filter in Multi-GNSS PPP/INS Tightly Coupled Integration
The integration of the Global Positioning System (GPS) and the Inertial Navigation System (INS) based on Real-time Kinematic (RTK) and Single Point Positioning (SPP) technology have been applied as a powerful approach in kinematic positioning and attitude determination. However, the accuracy of RTK and SPP based GPS/INS integration mode will degrade visibly along with the increasing user-base distance and the quality of pseudo-range. In order to overcome such weaknesses, the tightly coupled integration between GPS Precise Point Positioning (PPP) and INS was proposed recently. Because of the rapid development of the multi-constellation Global Navigation Satellite System (multi-GNSS), we introduce the multi-GNSS into the tightly coupled integration of PPP and INS in this paper. Meanwhile, in order to weaken the impacts of the GNSS observations with low quality and the inaccurate state model on the performance of the multi-GNSS PPP/INS tightly coupled integration, the Helmert variance component estimation based adaptive Kalman filter is employed in the algorithm implementation. Finally, a set of vehicle-borne GPS + BeiDou + GLONASS and Micro-Electro-Mechanical-Systems (MEMS) INS data is analyzed to evaluate the performance of such algorithm. The statistics indicate that the performance of the multi-GNSS PPP/INS tightly coupled integration can be enhanced significantly in terms of both position accuracy and convergence time.
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Cosmetics, Vol. 3, Pages 21: Contact Allergy to Hair Dyes
Many strong and extreme sensitizing chemicals, such as para-phenylenediamine (PPD), toluene-2,5-diamine (TDA) and other aromatic amines or cross-reacting substances, are ingredients in hair dye products. The chemistry of hair dyeing and the immunological reactions to the potent sensitizing hair dye components are complex and have not been fully clarified up until now. Recently 2-methoxymethyl-p-phenylenediamine (ME-PPD), a PPD derivate with moderate skin-sensitizing properties, was developed. Although developed for the prevention of sensitization, ME-PPD appears to be tolerated in some PPD/TDA-allergic individuals.
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Materials, Vol. 9, Pages 525: Photoresist Design for Elastomeric Light Tunable Photonic Devices
An increasing interest in tunable photonic structures is growing within the photonic community. The usage of Liquid Crystalline Elastomer (LCE) structures in the micro-scale has been motivated by the potential to remotely control their properties. In order to design elastic photonic structures with a three-dimensional lithographic technique, an analysis of the different mixtures used in the micro-printing process is required. Previously reported LCE microstructures suffer damage and strong swelling as a limiting factor of resolution. In this article, we reported a detailed study on the writing process with four liquid crystalline photoresists, in which the percentage of crosslinker is gradually increased. The experiments reveal that exploiting the crosslinking degree is a possible means in which to obtain suspended lines with good resolution, quite good rigidity, and good elasticity, thereby preserving the possibility of deformation by light irradiation.
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Differences in Impact of Definitional Elements on Mortality Precludes International Comparisons of Sepsis Epidemiology-A Cohort Study Illustrating the Need for Standardized Reporting.
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Histone Deacetylase Inhibition Protects Mice Against Lethal Postinfluenza Pneumococcal Infection.
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Cumulative Fluid Balance and Mortality in Septic Patients With or Without Acute Kidney Injury and Chronic Kidney Disease.
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Epidemiology of cancers in Lahore, Pakistan, 2010-2012: a cross-sectional study
Objectives
To estimate the population-level cancer estimates for the Lahore district, which is part of the Punjab Cancer Registry (PCR), Pakistan. The average population per year of Lahore was estimated at 9.8 million in 2010–2012.
DesignA cross-sectional study.
SettingThe Registry has 19 collaborating centres in Lahore that report their data to the Central Office located within a tertiary care cancer treatment facility in Lahore, Pakistan.
ParticipantsPatients belonging to Lahore, of any age-group, and diagnosed with cancer in 2010–2012, were included in the study. They were followed up between July and October 2015 to determine their vital status.
Outcome measuresSummaries were generated for gender, the basis of diagnosis, diagnoses and deaths. The Age-Standardized Incidence Rates (ASIR) were computed per 100 000 population, by gender and cancer site. Five-year age categories were created from 0–4 until 70–74, followed by 75+ years. Death counts were reported by site.
ResultsBetween 2010 and 2012, in Lahore, a total of 15 840 new cancers were diagnosed in 43% male patients and 57% female patients; 93.5% were microscopically confirmed and 6.5% non-microscopically. In females, the ASIR was 105.1 and in males, it was 66.7. ASIRs of leading cancers among women were breast 47.6, ovary 4.9 and corpus uteri 3.6, whereas among men they were prostate 6.4, bladder 5.0, and trachea, bronchus and lung 4.6. A total of 5134 deaths were recorded.
ConclusionsIn Lahore, the ASIR was higher in women than in men. Among women and men, breast cancer and prostate cancer, respectively, were the leading cancer types. These estimates can be used for health promotion and policymaking in the region.
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Association of physical activity with cognition, metacognition and academic performance in children and adolescents: a protocol for systematic review and meta-analysis
Introduction
Schools provide a relevant context for improving children's and adolescents' physical and mental health by increasing physical activity during school hours and/or beyond. The interest in the relationship between physical activity programmes and cognition during development has recently increased, with evidence suggesting a positive association. We present a protocol of systematic reviews and meta-analysis of intervention studies that, by determining the effects of chronic physical exercise on children's and adolescents' cognitive and metacognitive functions, cognitive life skills, academic behaviours and achievement, aims to ensure procedural objectivity and transparency, and maximise the extraction of relevant information to inform policy development.
MethodsThis protocol is guided by Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and by the Cochrane Collaboration Handbook. Databases to be utilised for a thorough selection of the pertinent literature are MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, PsycINFO and ERIC. Selection is proposed to encompass an international and a national publication level, with inclusion of experimental studies written in English or in Spanish, respectively. Also, relevant references included in the selected studies will be considered suitable for review as supplemental sources.
We present an integrated approach to the methodological quality assessment of the selected studies, including the Jadad Scale for the assessment of the quality of randomised controlled trials and the Quality Assessment Tool for Quantitative Studies for pre–post studies and non-randomised controlled trials. The pre–post interventions mean differences will be the primary indicator of the intervention outcome.
Statistical analysisA subgroup analysis is proposed based on cognitive functions and their neural correlates, metacognitive functions and cognitive life skills, academic achievement areas and academic behaviours.
Trial registration numberPROSPERO CRD42015029913
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Lumbar intervertebral disc degeneration and related factors in Korean firefighters
Objectives
The job of firefighting can cause lumbar burden and low back pain. This study aimed to identify the association between age and lumbar intervertebral disc degeneration and whether the association differs between field and administrative (non-field) firefighters.
MethodsSubjects were selected using a stratified random sampling method. Firefighters were stratified by geographic area, gender, age and type of job. First, 25 fire stations were randomly sampled considering regional distribution. Then firefighters were stratified by gender, age and their job and randomly selected among the strata. A questionnaire survey and MRI scans were performed, and then four radiologists used Pfirrmann classification methods to determine the grade of lumbar intervertebral disc degeneration.
ResultsPfirrmann grade increased with lumbar intervertebral disc level. Analysis of covariance showed that age was significantly associated with lumbar intervertebral disc degeneration (p<0.05). The value of β (parameter estimate) was positive at all lumbar intervertebral disc levels and was higher in the field group than in the administrative group at each level. In logistic regression analysis, type of job was statistically significant only with regard to the L4–5 intervertebral disc (OR 3.498, 95% CI 1.241 to 9.860).
ConclusionsLumbar intervertebral disc degeneration is associated with age, and field work such as firefighting, emergency and rescue may accelerate degeneration in the L4–5 intervertebral disc. The effects of field work on lumbar intervertebral disc degeneration were not clear in discs other than at the level L4–5.
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Prevalence of clinically significant decisional conflict: an analysis of five studies on decision-making in primary care
Objectives
Unresolved clinically significant decisional conflict (CSDC) in patients following a consultation with health professionals is often the result of inadequate patient involvement in decision-making and may result in poor outcomes. We sought to identify the prevalence of CSDC in studies on decision-making in primary care and to explore its risk factors.
SettingWe performed a secondary analysis of existing data sets from studies conducted in Primary Care Practice-Based Research Networks in Québec and Ontario, Canada.
ParticipantsEligible studies included a patient-reported measure on the 16-item Decisional Conflict Scale (DCS) following a decision made with a healthcare professional with no study design restriction.
Primary and secondary outcome measuresCSDC was defined as a score ≥25/100 on the DCS. The prevalence of CSDC was stratified by sex; and patient-level logistic regression analysis was performed to explore its potential risk factors. Data sets of studies were analysed individually and qualitatively compared.
Results5 projects conducted between 2003 and 2010 were included. They covered a range of decisions: prenatal genetic screening, antibiotics for acute respiratory infections and miscellaneous. Altogether, the 5 projects gathered data from encounters with a total of 1338 primary care patients (69% female; range of age 15–83). The prevalence of CSDC in patients varied across studies and ranged from 10.3% (95% CI 7.2% to 13.4%) to 31.1% (95% CI 26.6% to 35.6%). Across the 5 studies, risk factors of CSDC included being male, living alone and being 45 or older.
ConclusionsPrevalence of CSDC in patients who had enrolled in studies conducted in primary care contexts was substantial and appeared to vary according to the type of decision as well as to patient characteristics such as sex, living arrangement and age. Patients presenting risk factors of CSDC should be offered tools to increase their involvement in decision-making.
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Protocol for a cluster randomised trial of a communication skills intervention for physicians to facilitate survivorship transition in patients with lymphoma
Introduction
Survivors of cancer often describe a sense of abandonment post-treatment, with heightened worry, uncertainty, fear of recurrence and limited understanding of what lies ahead. This study examines the efficacy of a communication skills training (CST) intervention to help physicians address survivorship issues and introduce a new consultation focused on the use of a survivorship care plan for patients with Hodgkin's lymphoma and diffuse large B-cell lymphoma.
Methods and analysisSpecifically, this randomised, 4-site trial will test the efficacy of a survivorship planning consultation (physicians receive CST and apply these skills in a new survivorship-focused office visit using a survivorship plan) with patients who have achieved complete remission after completion of first-line therapy versus a control arm in which physicians are trained to subsequently provide a time-controlled, manualised wellness rehabilitation consultation focused only on discussion of healthy nutrition and exercise as rehabilitation postchemotherapy. The primary outcome for physicians will be uptake and usage of communication skills and maintenance of these skills over time. The primary outcome for patients is changes in knowledge about lymphoma and adherence to physicians' recommendations (eg, pneumococcus and influenza vaccinations); secondary outcomes will include perceptions of the doctor–patient relationship, decreased levels of cancer worry and depression, quality of life changes, satisfaction with care and usage of healthcare. This study will also examine the moderators and mediators of change within our theoretical model derived from Leventhal's Common-Sense Model of health beliefs.
Ethics and disseminationThis study was approved by the Institutional Review Boards at Memorial Sloan Kettering Cancer Centers and all other participating sites. This work is funded by the National Cancer Institute (R01 CA 151899 awarded to DWK and SH as coprincipal investigators). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute (NCI) or the National Institutes of Health (NIH). The study findings will be disseminated to the research and medical communities through publication in peer-reviewed journals and through presentations at local, national and international conferences.
Trial registration numberNCT01483664.
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Sources of social support associated with health and quality of life: a cross-sectional study among Canadian and Latin American older adults
Objectives
To examine whether the association between emotional support and indicators of health and quality of life differs between Canadian and Latin American older adults.
DesignCross-sectional analysis of the International Mobility in Aging Study (IMIAS). Social support from friends, family members, children and partner was measured with a previously validated social network and support scale (IMIAS-SNSS). Low social support was defined as ranking in the lowest site-specific quartile. Prevalence ratios (PR) of good health, depression and good quality of life were estimated with Poisson regression models, adjusting for age, gender, education, income and disability in activities of daily living.
SettingKingston and Saint-Hyacinthe in Canada, Manizales in Colombia and Natal in Brazil.
Participants1600 community-dwelling adults aged 65–74 years, n=400 at each site.
Outcome measuresLikert scale question on self-rated health, Center for Epidemiological Studies Depression Scale and 10-point analogical quality-of-life (QoL) scale.
ResultsRelationships between social support and study outcomes differed between Canadian and Latin American older adults. Among Canadians, those without a partner had a lower prevalence of good health (PR=0.90; 95% CI 0.82 to 0.98), and those with high support from friends had a higher prevalence of good health (PR=1.09; 95% CI 1.01 to 1.18). Among Latin Americans, depression was lower among those with high levels of support from family (PR=0.63; 95% CI 0.48 to 0.83), children (PR=0.60; 95% CI 0.45 to 0.80) and partner (PR=0.57; 95% CI 0.31 to 0.77); good QoL was associated with high levels of support from children (PR=1.54; 95% CI 1.20 to 1.99) and partner (PR=1.31; 95% CI 1.03 to 1.67).
ConclusionsAmong older adults, different sources of support were relevant to health across societies. Support from friends and having a partner were related to good health in Canada, whereas in Latin America, support from family, children and partner were associated with less depression and better QoL.
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Study protocol for the randomised controlled trial: combined multimarker screening and randomised patient treatment with ASpirin for evidence-based PREeclampsia prevention (ASPRE)
Introduction
Pre-eclampsia (PE) affects 2–3% of all pregnancies and is a major cause of maternal and perinatal morbidity and mortality. Prophylactic use of low-dose aspirin in women at risk for PE may substantially reduce the prevalence of the disease. Effective screening for PE requiring delivery before 37 weeks (preterm PE) can be provided by a combination of maternal factors, uterine artery Doppler, mean arterial pressure, maternal serum pregnancy-associated plasma protein A and placental growth factor at 11–13 weeks' gestation, with a detection rate of 75% at a false-positive rate of 10%. We present a protocol (V.6, date 25 January 2016) for the ASpirin for evidence-based PREeclampsia prevention (ASPRE) trial, which is a double-blinded, placebo-controlled, randomised controlled trial (RCT) that uses an effective PE screening programme to determine whether low-dose aspirin given to women from 11 to 13 weeks' gestation will reduce the incidence of preterm PE.
Methods and analysisAll eligible women attending for their first trimester scan will be invited to participate in the screening study for preterm PE. Those found to be at high risk of developing preterm PE will be invited to participate in the RCT. Further scans will be conducted for assessment of fetal growth and biomarkers. Pregnancy and neonatal outcomes will be collected and analysed. The first enrolment for the pilot study was in April 2014. As of April 2016, 26 670 women have been screened and 1760 recruited to the RCT. The study is registered on the International Standard Randomised Controlled Trial Number (ISRCTN) registry.
Trial registration numberISRCTN13633058.
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Minority ethnicity patient satisfaction and experience: results of the National Cancer Patient Experience Survey in England
Objectives
This study sought to explore the differential patient satisfaction reported by patients with cancer who are from ethnic minority backgrounds, examining patient-reported experience of interacting with medical and nursing staff.
SettingAs a secondary analysis, we collated data collected over two consecutive annual rounds of the National Cancer Patient Experience Survey (NCPES) from September 2012 to November 2013.
ParticipantsThere were 138 878 responses from 155 hospital trusts across the National Health Service in England, representing a response rate of 63.9% based on the total identified cohort of patients receiving cancer care over those 2 years.
OutcomesWe used the results of the annual survey, which sought to assess overall patient satisfaction along with patient experience of interacting with clinical nurse specialists, hospital doctors and ward nurses.
ResultsEthnic minority patients reported lower satisfaction and less positive experiences of care overall. While some of this difference appeared related to demographic and socioeconomic variation, ethnic minority patients remained less positive than those in the White British group, after statistical adjustment. Ethnic minority patients also reported lower confidence in, and less understanding of, healthcare professionals, including clinical nurse specialists, doctors and ward nurses.
ConclusionsGiven the diversity of the British population, as well as the clustering of ethnic minority patients in certain urban areas, a better understanding of the expectations and additional needs of ethnic minority patients is required to improve their experience of and satisfaction with cancer care.
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PReventing early unplanned hOspital readmission aFter critical ILlnEss (PROFILE): protocol and analysis framework for a mixed methods study
Introduction
Survivors of critical illness experience multidimensional disabilities that reduce quality of life, and 25–30% require unplanned hospital readmission within 3 months following index hospitalisation. We aim to understand factors associated with unplanned readmission; develop a risk model to identify intensive care unit (ICU) survivors at highest readmission risk; understand the modifiable and non-modifiable readmission drivers; and develop a risk assessment tool for identifying patients and areas for early intervention.
Methods and analysisWe will use mixed methods with concurrent data collection. Quantitative data will comprise linked healthcare records for adult Scottish residents requiring ICU admission (1 January 2000–31 December 2013) who survived to hospital discharge. The outcome will be unplanned emergency readmission within 90 days of index hospital discharge. Exposures will include pre-ICU demographic data, comorbidities and health status, and critical illness variables representing illness severity. Regression analyses will be used to identify factors associated with increased readmission risk, and to develop and validate a risk prediction model. Qualitative data will comprise recorded/transcribed interviews with up to 60 patients and carers recently experiencing unplanned readmissions in three health board regions. A deductive and inductive thematic analysis will be used to identify factors contributing to readmissions and how they may interact. Through iterative triangulation of quantitative and qualitative data, we will develop a construct/taxonomy that captures reasons and drivers for unplanned readmission. We will validate and further refine this in focus groups with patients/carers who experienced readmissions in six Scottish health board regions, and in consultation with an independent expert group. A tool will be developed to screen for ICU survivors at risk of readmission and inform anticipatory interventions.
Ethics and disseminationData linkage has approval but does not require ethical approval. The qualitative study has ethical approval. Dissemination with key healthcare stakeholders and policymakers is planned.
Trial registration numberUKCRN18023.
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What evidence is there for a delay in diagnostic coding of RA in UK general practice records? An observational study of free text
Objectives
Much research with electronic health records (EHRs) uses coded or structured data only; important information captured in the free text remains unused. One dimension of EHR data quality assessment is 'currency' or timeliness, that is, data are representative of the patient state at the time of measurement. We explored the use of free text in UK general practice patient records to evaluate delays in recording of rheumatoid arthritis (RA) diagnosis. We also aimed to locate and quantify disease and diagnostic information recorded only in text.
SettingUK general practice patient records from the Clinical Practice Research Datalink.
Participants294 individuals with incident diagnosis of RA between 2005 and 2008; 204 women and 85 men, median age 63 years.
Primary and secondary outcome measuresAssessment of (1) quantity and timing of text entries for disease-modifying antirheumatic drugs (DMARDs) as a proxy for the RA disease code, and (2) quantity, location and timing of free text information relating to RA onset and diagnosis.
ResultsInflammatory markers, pain and DMARDs were the most common categories of disease information in text prior to RA diagnostic code; 10–37% of patients had such information only in text. Read codes associated with RA-related text included correspondence, general consultation and arthritis codes. 64 patients (22%) had DMARD text entries >14 days prior to RA code; these patients had more and earlier referrals to rheumatology, tests, swelling, pain and DMARD prescriptions, suggestive of an earlier implicit diagnosis than was recorded by the diagnostic code.
ConclusionsRA-related symptoms, tests, referrals and prescriptions were recorded in free text with 22% of patients showing strong evidence of delay in coding of diagnosis. Researchers using EHRs may need to mitigate for delayed codes by incorporating text into their case-ascertainment strategies. Natural language processing techniques have the capability to do this at scale.
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Correction: Protocol for an open-label, single-arm trial of HIV pre-exposure prophylaxis (PrEP) among people at high risk of HIV infection: the NSW Demonstration Project PRELUDE
Vaccher S, Grulich A, McAllister J, et al. Protocol for an open-label, single-arm trial of HIV pre-exposure prophylaxis (PrEP) among people at high risk of HIV infection: the NSW Demonstration Project PRELUDE. BMJ Open 2016;6:e012179. The author affiliations are incorrect in this manuscript. Corrected affiliations are given below:
Authors
S Vaccher,1 A Grulich,1 J McAllister,2 D J Templeton,1,3 M Bloch,1,4 A McNulty,5 J Holden,6 I M Poynten,1 G Prestage,1 I Zablotska,1 on behalf of the PRELUDE Study Team
Author affiliations
1Kirby Institute, UNSW Australia, Kensington, New South Wales, Australia
2St Vincent's Hospital, Darlinghurst, New South Wales, Australia
3RPA Sexual Health, Sydney Local Health District, Camperdown, New South Wales, Australia
4Holdsworth House Medical Practice, Darlinghurst, New South Wales, Australia
5Sydney Sexual Health Centre, Sydney, New South Wales, Australia
6Centre for Population Health, NSW Ministry of Health, North Sydney, New South Wales, Australia
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Evaluating the accessibility and utility of HIV-related point-of-care diagnostics for maternal health in rural South Africa: a study protocol
Introduction
Poor healthcare access is a major barrier to receiving antenatal care and a cause of high maternal mortality in South Africa (SA). 'Point-of-care' (POC) diagnostics is a powerful emerging healthcare approach to improve healthcare access. This study focuses on evaluating the accessibility and utility of POC diagnostics for maternal health in rural SA primary healthcare (PHC) clinics in order to generate a model framework of implementation of POC diagnostics in rural South African clinics.
Method and analysesWe will use several research methods, including a systematic review, quasi-experiments, survey, key informant interviews and audits. We will conduct a systematic review and experimental study to determine the impact of POC diagnostics on maternal health. We will perform a cross-sectional case study of 100 randomly selected rural primary healthcare clinics in KwaZulu-Natal to measure the context and patterns of POC diagnostics access and usage by maternal health providers and patients. We will conduct interviews with relevant key stakeholders to determine the reasons for POC deficiencies regarding accessibility and utility of HIV-related POC diagnostics for maternal health. We will also conduct a vertical audit to investigate all the quality aspects of POC diagnostic services including diagnostic accuracy in a select number of clinics. On the basis of information gathered, we will propose a model framework for improved implementation of POC diagnostics in rural South African public healthcare clinics. Statistical (Stata-13) and thematic (NVIVO) data analysis will be used in this study.
Ethics and disseminationThe study protocol was approved by the Ethics Committee of the University of KwaZulu-Natal (BE 484/14) and the KwaZulu-Natal Department of Health based on the Helsinki Declaration (HRKM 40/15). Findings of this study will be disseminated electronically and in print. They will be presented to conferences related to HIV/AIDS, diagnostics, maternal health and strengthening of health systems.
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Comparison of contemporary preoperative risk models at predicting acute kidney injury after isolated coronary artery bypass grafting: a retrospective cohort study
Objectives
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with short-term and long-term adverse outcomes. The European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II, the Society of Thoracic Surgeons (STS) score and Age, Creatinine and Ejection Fraction (ACEF) score, have been widely used for predicting the operative risk of cardiac surgery. The aim of this study is to investigate the discriminant ability among current available models in predicting postoperative AKI.
MethodsFrom January 2010 to December 2012, 353 patients who underwent isolated CABG were enrolled. The clinical characteristics, outcomes and scores of prognostic models were collected. The primary outcome was postoperative AKI, defined based on the Kidney Disease Improving Global Outcome (KDIGO) Clinical Practice Guideline for AKI, in 2012.
Results102 patients (28.9%) developed postoperative AKI. For AKI prediction, EuroSCORE II, STS score and ACEF score were all good tools for stage-3 AKI. The ACEF score was shown to have satisfied discriminant ability to predict postoperative AKI with area under a receiver operating characteristic curve: 0.781±0.027, (95% CI 0.729 to 0.834, p value <0.001). Multivariate logistic analysis identified that lower ejection fraction and higher serum creatinine were independent risk factors for AKI.
ConclusionsThe simple and extremely user-friendly ACEF score can accurately identify the risk of postoperative AKI and has shown satisfactory discriminant ability when compared with other systems. The ACEF score might be the easiest tool for predicting postoperative AKI.
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Utility of models to predict 28-day or 30-day unplanned hospital readmissions: an updated systematic review
Objective
To update previous systematic review of predictive models for 28-day or 30-day unplanned hospital readmissions.
DesignSystematic review.
Setting/data sourceCINAHL, Embase, MEDLINE from 2011 to 2015.
ParticipantsAll studies of 28-day and 30-day readmission predictive model.
Outcome measuresCharacteristics of the included studies, performance of the identified predictive models and key predictive variables included in the models.
ResultsOf 7310 records, a total of 60 studies with 73 unique predictive models met the inclusion criteria. The utilisation outcome of the models included all-cause readmissions, cardiovascular disease including pneumonia, medical conditions, surgical conditions and mental health condition-related readmissions. Overall, a wide-range C-statistic was reported in 56/60 studies (0.21–0.88). 11 of 13 predictive models for medical condition-related readmissions were found to have consistent moderate discrimination ability (C-statistic ≥0.7). Only two models were designed for the potentially preventable/avoidable readmissions and had C-statistic >0.8. The variables 'comorbidities', 'length of stay' and 'previous admissions' were frequently cited across 73 models. The variables 'laboratory tests' and 'medication' had more weight in the models for cardiovascular disease and medical condition-related readmissions.
ConclusionsThe predictive models which focused on general medical condition-related unplanned hospital readmissions reported moderate discriminative ability. Two models for potentially preventable/avoidable readmissions showed high discriminative ability. This updated systematic review, however, found inconsistent performance across the included unique 73 risk predictive models. It is critical to define clearly the utilisation outcomes and the type of accessible data source before the selection of the predictive model. Rigorous validation of the predictive models with moderate-to-high discriminative ability is essential, especially for the two models for the potentially preventable/avoidable readmissions. Given the limited available evidence, the development of a predictive model specifically for paediatric 28-day all-cause, unplanned hospital readmissions is a high priority.
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A school-based intervention incorporating smartphone technology to improve health-related fitness among adolescents: rationale and study protocol for the NEAT and ATLAS 2.0 cluster randomised controlled trial and dissemination study
Introduction
Physical inactivity has been described as a global pandemic. Interventions aimed at developing skills in lifelong physical activities may provide the foundation for an active lifestyle into adulthood. In general, school-based physical activity interventions targeting adolescents have produced modest results and few have been designed to be 'scaled-up' and disseminated. This study aims to: (1) assess the effectiveness of two physical activity promotion programmes (ie, NEAT and ATLAS) that have been modified for scalability; and (2) evaluate the dissemination of these programmes throughout government funded secondary schools.
Methods and analysisThe study will be conducted in two phases. In the first phase (cluster randomised controlled trial), 16 schools will be randomly allocated to the intervention or a usual care control condition. In the second phase, the Reach, Effectiveness, Adoption, Implementation and Maintenance (Re-AIM) framework will be used to guide the design and evaluation of programme dissemination throughout New South Wales (NSW), Australia. In both phases, teachers will be trained to deliver the NEAT and ATLAS programmes, which will include: (1) interactive student seminars; (2) structured physical activity programmes; (3) lunch-time fitness sessions; and (4) web-based smartphone apps. In the cluster RCT, study outcomes will be assessed at baseline, 6 months (primary end point) and 12-months. Muscular fitness will be the primary outcome and secondary outcomes will include: objectively measured body composition, cardiorespiratory fitness, flexibility, resistance training skill competency, physical activity, self-reported recreational screen-time, sleep, sugar-sweetened beverage and junk food snack consumption, self-esteem and well-being.
Ethics and disseminationThis study has received approval from the University of Newcastle (H-2014-0312) and the NSW Department of Education (SERAP: 2012121) human research ethics committees. This study is funded by the Australian Research Council (FT140100399) and the NSW Department of Education.
Trial registration numberACTRN12615000360516; Pre-results.
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Association between markers of glucose metabolism and risk of colorectal cancer
Objectives
Independent epidemiological studies have evaluated the association between markers of glucose metabolism (including fasting glucose, fasting insulin, homeostasis model of risk assessment-insulin resistance (HOMA-IR), glycated haemoglobin (HbA1c) and C peptide) and the risk of colorectal cancer (CRC). However, such associations have not been systematically analysed and no clear conclusions have been drawn. Therefore, we addressed this issue using a meta-analysis approach.
DesignSystematic review and meta-analysis.
Data sourcesPubMed and EMBASE were searched up to May 2015.
Primary and secondary outcome measuresEither a fixed-effects or random-effects model was adopted to estimate overall ORs for the association between markers of glucose metabolism and the risk of CRC. In addition, dose–response, meta-regression, subgroup and publication bias analyses were conducted.
Results35 studies involving 25 566 patients and 5 706 361 participants were included. Higher levels of fasting glucose, fasting insulin, HOMA-IR, HbA1c and C peptide were all significantly associated with increased risk of CRC (fasting glucose, pooled OR=1.12, 95% CI 1.06 to 1.18; fasting insulin, pooled OR=1.42, 95% CI 1.19 to 1.69; HOMA-IR, pooled OR=1.47, 95% CI 1.24 to 1.74; HbA1c, pooled OR=1.22, 95% CI 1.02 to 1.47 (with borderline significance); C peptide, pooled OR=1.27, 95% CI 1.08 to 1.49). Subgroup analysis suggested that a higher HOMA-IR value was significantly associated with CRC risk in all subgroups, including gender, study design and geographic region. For the relative long-term markers, the association was significant for HbA1c in case–control studies, while C peptide was significantly associated with CRC risk in both the male group and colon cancer.
ConclusionsThe real-time composite index HOMA-IR is a better indicator for CRC risk than are fasting glucose and fasting insulin. The relative long-term markers, HbA1c and C peptide, are also valid predictors for CRC risk. Considering the included case–control studies in the current analysis, more cohort studies are warranted to enhance future analysis.
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Preferences for ARV-based HIV prevention methods among men and women, adolescent girls and female sex workers in Gauteng Province, South Africa: a protocol for a discrete choice experiment
Introduction
For the past few decades, condoms have been the main method of HIV prevention. Recent advances in antiretroviral (ARV)-based prevention products have substantially changed the prevention landscape, yet little is known about how popular these products will be among potential users, or whether new methods might be used in conjunction with, or instead of, condoms. This study will use a discrete choice experiment (DCE) to (1) explore potential users' preferences regarding HIV prevention products, (2) quantify the importance of product attributes and (3) predict the uptake of products to inform estimates of their potential impact on the HIV epidemic in South Africa. We consider preferences for oral pre-exposure prophylaxis; a vaginal microbicide gel; a long-acting vaginal ring; a SILCS diaphragm used in concert with gel; and a long-acting ARV-based injectable.
Methods and analysisThis study will gather data from 4 populations: 200 women, 200 men, 200 adolescent girls (aged 16–17 years) and 200 female sex workers. The DCE attributes and design will be developed through a literature review, supplemented by a thematic analysis of qualitative focus group discussions. Extensive piloting will be carried out in each population through semistructured interviews. The final survey will be conducted using computer tablets via a household sample (for women, men and adolescents) and respondent-driven sampling (for female sex workers), and DCE data analysed using a range of multinomial logit models.
Ethics and disseminationThis study has been approved by the University of the Witwatersrand Human Research Ethics Committee and the Research Ethics Committee at the London School of Hygiene and Tropical Medicine. Findings will be presented to international conferences and peer-reviewed journals. Meetings will be held with opinion leaders in South Africa, while results will be disseminated to participants in Ekurhuleni through a public meeting or newsletter.
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Correction: Protocol for the Electroencephalography Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES) study: a pragmatic, randomised clinical trial
Wildes TS, Winter AC, Maybrier HR, et al. Protocol for the Electroencephalography Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES) study: a pragmatic, randomised clinical trial. BMJ Open 2016;6:e011505.
Two authors' names are incorrect in this manuscript. 'J Leung' should be cited as 'JM Leung' and 'RL Hueneke' should be cited as 'R Hueneke.'
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Protocol for the 'Virtual Traveller cluster-randomised controlled trial: a behaviour change intervention to increase physical activity in primary-school Maths and English lessons
Introduction
Physical activity (PA) has been shown to be an important factor for health and educational outcomes in children. However, a large proportion of children's school day is spent in sedentary lesson-time. There is emerging evidence about the effectiveness of physically active lessons: integrating physical movements and educational content in the classroom. 'Virtual Traveller' is a novel 6-week intervention of 10-min sessions performed 3 days per week, using classroom interactive whiteboards to integrate movement into primary-school Maths and English teaching. The primary aim of this project is to evaluate the effect of the Virtual Traveller intervention on children's PA, on-task behaviour and student engagement.
Methods and analysisThis study will be a cluster-randomised controlled trial with a waiting-list control group. Ten year 4 (aged 8–9 years) classes across 10 primary schools will be randomised by class to either the 6-week Virtual Traveller intervention or the waiting-list control group. Data will be collected 5 times: at baseline, at weeks 2 and 4 of the intervention, and 1 week and 3 months postintervention. At baseline, anthropometric measures, 4-day objective PA monitoring (including 2 weekend days; Actigraph accelerometer), PA and on-task behaviour observations and student engagement questionnaires will be performed. All but anthropometric measures will be repeated at all other data collection points. Changes in overall PA levels and levels during different time-periods (eg, lesson-time) will be examined. Changes in on-task behaviour and student engagement between intervention groups will also be examined. Multilevel regression modelling will be used to analyse the data. Process evaluation will be carried out during the intervention period.
Ethics and disseminationThe results of this study will be disseminated through peer-review publications and conference presentations. Ethical approval was obtained through the University College London Research Ethics Committee (reference number: 3500-004).
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Sensors, Vol. 16, Pages 1001: Silica-gel Particles Loaded with an Ionic Liquid for Separation of Zr(IV) Prior to Its Determination by ICP-OES
A new ionic liquid loaded silica gel amine (SG-APTMS-N,N-EPANTf2) was developed, as an adsorptive material, for selective adsorption and determination of zirconium, Zr(IV), without the need for a chelating intermediate. Based on a selectivity study, the SG-APTMS-N,N-EPANTf2 phase showed a perfect selectivity towards Zr(IV) at pH 4 as compared to other metallic ions, including gold [Au(III)], copper [Cu(II)], cobalt [Co(II)], chromium [Cr(III)], lead [Pb(II)], selenium [Se(IV)] and mercury [Hg(II)] ions. The influence of pH, Zr(IV) concentration, contact time and interfering ions on SG-APTMS-N,N-EPANTf2 uptake for Zr(IV) was evaluated. The presence of incorporated donor atoms in newly synthesized SG-APTMS-N,N-EPANTf2 phase played a significant role in enhancing its uptake capacity of Zr(IV) by 78.64% in contrast to silica gel (activated). The equilibrium and kinetic information of Zr(IV) adsorption onto SG-APTMS-N,N-EPANTf2 were best expressed by Langmuir and pseudo second-order kinetic models, respectively. General co-existing cations did not interfere with the extraction and detection of Zr(IV). Finally, the analytical efficiency of the newly developed method was also confirmed by implementing it for the determination of Zr(IV) in several water samples.
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Αλέξανδρος Γ. Σφακιανάκης Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,0030693260717...
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heory of COVID-19 pathogenesis Publication date: November 2020Source: Medical Hypotheses, Volume 144Author(s): Yuichiro J. Suzuki ScienceD...
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