The epiphyseal scar: changing perceptions in relation to skeletal age estimation.

BACKGROUND: It is imperative that all methods applied in skeletal age estimation and the criteria on which they are based have a strong evidential basis. The relationship between the persistence of epiphyseal scars and chronological age, however, has remained largely untested. AIMS: To assess the relationships between the level of persistence of the epiphyseal scar and chronological age, biological sex and side of the body in relation to the interpretation of epiphyseal scars in methods of skeletal age estimation. SUBJECTS AND METHODS: A sample of radiographic images was obtained from the Tayside NHS Trust, Ninewells Hospital, Dundee, UK. This included images of four anatomical regions from living female and male individuals aged between 20-50 years. RESULTS: Some remnant of an epiphyseal scar was found in 78-99% of individuals examined in this study. The level of persistence of epiphyseal scars was also found to vary between anatomical regions. CONCLUSION: The overall relationship between chronological age and the level of persistence or obliteration of the epiphyseal scar was found to be of insufficient strength to support a causative link. It is, therefore, necessary that caution is employed in their interpretation in relation to skeletal age estimation practices

The NIH-NIAID Filariasis Research Reagent Resource Center

Filarial worms cause a variety of tropical diseases in humans; however, they are difficult to study because they have complex life cycles that require arthropod intermediate hosts and mammalian definitive hosts. Research efforts in industrialized countries are further complicated by the fact that some filarial nematodes that cause disease in humans are restricted in host specificity to humans alone. This potentially makes the commitment to research difficult, expensive, and restrictive. Over 40 years ago, the United States National Institutes of Health–National Institute of Allergy and Infectious Diseases (NIH-NIAID) established a resource from which investigators could obtain various filarial parasite species and life cycle stages without having to expend the effort and funds necessary to maintain the entire life cycles in their own laboratories. This centralized resource (The Filariasis Research Reagent Resource Center, or FR3) translated into cost savings to both NIH-NIAID and to principal investigators by freeing up personnel costs on grants and allowing investigators to divert more funds to targeted research goals. Many investigators, especially those new to the field of tropical medicine, are unaware of the scope of materials and support provided by the FR3. This review is intended to provide a short history of the contract, brief descriptions of the fiilarial species and molecular resources provided, and an estimate of the impact the resource has had on the research community, and describes some new additions and potential benefits the resource center might have for the ever-changing research interests of investigators

Feasibility and validity of International Classification of Diseases based case mix indices

BACKGROUND: Severity of illness is an omnipresent confounder in health services research. Resource consumption can be applied as a proxy of severity. The most commonly cited hospital resource consumption measure is the case mix index (CMI) and the best-known illustration of the CMI is the Diagnosis Related Group (DRG) CMI used by Medicare in the U.S. For countries that do not have DRG type CMIs, the adjustment for severity has been troublesome for either reimbursement or research purposes. The research objective of this study is to ascertain the construct validity of CMIs derived from International Classification of Diseases (ICD) in comparison with DRG CMI. METHODS: The study population included 551 acute care hospitals in Taiwan and 2,462,006 inpatient reimbursement claims. The 18(th )version of GROUPER, the Medicare DRG classification software, was applied to Taiwan's 1998 National Health Insurance (NHI) inpatient claim data to derive the Medicare DRG CMI. The same weighting principles were then applied to determine the ICD principal diagnoses and procedures based costliness and length of stay (LOS) CMIs. Further analyses were conducted based on stratifications according to teaching status, accreditation levels, and ownership categories. RESULTS: The best ICD-based substitute for the DRG costliness CMI (DRGCMI) is the ICD principal diagnosis costliness CMI (ICDCMI-DC) in general and in most categories with Spearman's correlation coefficients ranging from 0.938-0.462. The highest correlation appeared in the non-profit sector. ICD procedure costliness CMI (ICDCMI-PC) outperformed ICDCMI-DC only at the medical center level, which consists of tertiary care hospitals and is more procedure intensive. CONCLUSION: The results of our study indicate that an ICD-based CMI can quite fairly approximate the DRGCMI, especially ICDCMI-DC. Therefore, substituting ICDs for DRGs in computing the CMI ought to be feasible and valid in countries that have not implemented DRGs

The future of successful aging in Alaska

Background. There is a paucity of research on Alaska Natives and their views on whether or not they believe they will age successfully in their home and community. There is limited understanding of aging experiences across generations. Objective. This research explores the concept of successful aging from an urban Alaska Native perspective and explores whether or not they believe they will achieve a healthy older age. Design. A cultural consensus model (CCM) approach was used to gain a sense of the cultural understandings of aging among young Alaska Natives aged 50 years and younger. Results. Research findings indicate that aging successfully is making the conscious decision to live a clean and healthy life, abstaining from drugs and alcohol, but some of Alaska Natives do not feel they will age well due to lifestyle factors. Alaska Natives see the inability to age well as primarily due to the decrease in physical activity, lack of availability of subsistence foods and activities, and the difficulty of living a balanced life in urban settings. Conclusions. This research seeks to inform future studies on successful aging that incorporates the experiences and wisdom of Alaska Natives in hopes of developing an awareness of the importance of practicing a healthy lifestyle and developing guidelines to assist others to age well

The influence of the atmospheric boundary layer on nocturnal layers of noctuids and other moths migrating over southern Britain

Insects migrating at high altitude over southern Britain have been continuously monitored by automatically-operating, vertical-looking radars over a period of several years. During some occasions in the summer months, the migrants were observed to form well-defined layer concentrations, typically at heights of 200-400 m, in the stable night-time atmosphere. Under these conditions, insects are likely to have control over their vertical movements and are selecting flight heights which are favourable for long-range migration. We therefore investigated the factors influencing the formation of these insect layers by comparing radar measurements of the vertical distribution of insect density with meteorological profiles generated by the UK Met. Office’s Unified Model (UM). Radar-derived measurements of mass and displacement speed, along with data from Rothamsted Insect Survey light traps provided information on the identity of the migrants. We present here three case studies where noctuid and pyralid moths contributed substantially to the observed layers. The major meteorological factors influencing the layer concentrations appeared to be: (a) the altitude of the warmest air, (b) heights corresponding to temperature preferences or thresholds for sustained migration and (c), on nights when air temperatures are relatively high, wind-speed maxima associated with the nocturnal jet. Back-trajectories indicated that layer duration may have been determined by the distance to the coast. Overall, the unique combination of meteorological data from the UM and insect data from entomological radar described here show considerable promise for systematic studies of high-altitude insect layering

Automating unobtrusive personalized services in ambient media environments

The final publication is available at Springer via http://dx.doi.org/10.1007/s11042-013-1634-2In the age of ambient media, people are surrounded by lots of physical objects (media objects) for rendering the digital world in the natural environment. These media objects should interact with users in a way that is not disturbing for them. To address this issue, this work presents a design and automation strategy for augmenting the world around us with personalized ambient media services that behave in a considerate manner. That is, ambient services are capable of adjusting its obtrusiveness level (i.e., the extent to which each service intrudes the user¿s mind) by using the appropriate media objects for each user¿s situation.This work has been developed with the support of MICINN, under the project EVERYWARE TIN2010-18011, and the support of the Christian Doppler Forschungsgesellschaft and the BMWFJ, Austria.Serral Asensio, E.; Gil Pascual, M.; Valderas Aranda, PJ.; Pelechano Ferragud, V. (2014). Automating unobtrusive personalized services in ambient media environments. Multimedia Tools and Applications. 71(1):159-178. https://doi.org/10.1007/s11042-013-1634-2S159178711Bencomo N, Grace P, Flores-Cortés CA, Hughes D, Blair GS (2008) Genie: supporting the model driven development of reflective, component-based adaptive systems. In: ICSE, pp 811–814Blumendorf M, Lehmann G, Albayrak S (2010) Bridging models and systems at runtime to build adaptive user interfaces. In: Proc. of EICS 2010. ACM, pp 9–18Brown DM (2010) Communicating design: developing web site documentation for design and planning, 2nd edn. New Riders PressCalinescu R (2011) When the requirements for adaptation and high integrity meet. In: Proceedings of the 8th workshop on assurances for self-adaptive systems, ASAS ’11. ACM, New York, pp 1–4Filieri A, Ghezzi C, Tamburrelli G (2011) Run-time efficient probabilistic model checking. In: Proceedings of the 33rd International Conference on Software Engineering, ICSE ’11. ACM, New York, pp 341–350Gershenfeld N, Krikorian R, Cohen D (2004) The internet of things. Sci Am 291(4):46–51Gibbs WW (2005) Considerate computing. Sci Am 292(1):54–61Gulliksen J, Goransson B, Boivie I, Blomkvist S, Persson J, Cajander A (2003) Key principles for user-centred systems design. Behav Inform Technol 22:397–409Hinckley K, Horvitz E (2001) Toward more sensitive mobile phones. In: Proc. of the UIST ’01, pp 191–192Ho J, Intille SS (2005) Using context-aware computing to reduce the perceived burden of interruptions from mobile devices. In: Proc. of CHI ’05. ACM, pp 909–918Horvitz E, Kadie C, Paek T, Hovel D (2003) Models of attention in computing and communication: from principles to applications. Commun ACM 46:52–59Ju W, Leifer L (2008) The design of implicit interactions: making interactive systems less obnoxious. Des Issues 24(3):72–84Kortuem G, Kawsar F, Fitton D, Sundramoorthy V (2010) Smart objects as building blocks for the internet of things. IEEE Internet Comput 14(1):44–51Lewis JR (1995) Ibm computer usability satisfaction questionnaires: psychometric evaluation and instructions for use. Int J Hum Comput Interact 7(1):57–78Lugmayr A, Risse T, Stockleben B, Laurila K, Kaario J (2009) Semantic ambient media—an introduction. Multimed Tools Appl 43(3):337–359Mattern F (2003) From smart devices to smart everyday objects. In: Proc. Smart Objects Conf. (SOC 03). Springer, pp 15–16Morin B, Barais O, Jezequel JM, Fleurey F, Solberg A (2009) Models run.time to support dynamic adaptation. Comput 42(10):44–51Nelson L, Churchill EF (2005) User experience of physical-digital object systems: implications for representation and infrastructure. Paper presented at smart object systems workshop, in cojunction with ubicomp 2005Paternò F (2002) Concurtasktrees: an engineered approach to model-based design of interactive systems. In: L.E. Associates (ed) The handbook of analysis for human-computer interaction, pp 483–500Paternò F (2003) From model-based to natural development. HCI International, pp 592–596Ramchurn SD, Deitch B, Thompson MK, Roure DCD, Jennings NR, Luck M (2004) Minimising intrusiveness in pervasive computing environments using multi-agent negotiation. MobiQuitous ’04, pp 364–372Runeson P, Höst M (2009) Guidelines for conducting and reporting case study research in software engineering. Empir Softw Eng 14(2):131–164Schmidt A (2000) Implicit human computer interaction through context. Pers Technol 4(2–3):191–199Serral E, Valderas P, Pelechano V (2010) Supporting runtime system evolution to adapt to user behaviour. In: Proc. of CAiSE’10, pp 378–392Serral E, Valderas P, Pelechano V (2010) Towards the model driven development of context-aware pervasive systems. PMC 6(2):254–280Siegemund F (2004) A context-aware communication platform for smart objects. In: Proc of the int conf on pervasive computing. Springer, pp 69–86Streitz NA, Rocker C, Prante T, Alphen Dv, Stenzel R, Magerkurth C (2005) Designing smart artifacts for smart environments. Comput 38(3):41–49. doi: 10.1109/MC.2005.92Thiesse F, Kohler M (2008) An analysis of usage-based pricing policies for smart products. Electron Mark 18(3):232–241. doi: 10.1080/10196780802265751Vastenburg MH, Keyson DV, de Ridder H (2008) Considerate home notification systems: a field study of acceptability of notifications in the home. Pers Ubiquit Comput 12(8):555–56

Smoke-free legislation and the incidence of paediatric respiratory infections and wheezing/asthma: interrupted time series analyses in the four UK nations

We investigated the association between introduction of smoke-free legislation in the UK (March 2006 for Scotland, April 2007 for Wales and Northern Ireland, and July 2007 for England) and the incidence of respiratory diseases among children. We extracted monthly counts of new diagnoses of wheezing/asthma and RTIs among children aged 0–12 years from all general practices in the Clinical Practice Research Datalink during 1997–2012. Interrupted time series analyses were performed using generalised additive mixed models, adjusting for underlying incidence trends, population size changes, seasonal factors, and pandemic influenza, as appropriate. 366,642 new wheezing/asthma diagnoses and 4,324,789 RTIs were observed over 9,536,003 patient-years. There was no statistically significant change in the incidence of wheezing/asthma after introduction of smoke-free legislation in England (incidence rate ratio (IRR) 0.94, 95% CI 0.81–1.09) or any other UK country (Scotland: IRR 0.99, 95% CI 0.83–1.19; Wales: IRR 1.09, 95% CI 0.89–1.35; Northern Ireland: IRR 0.96, 95% CI 0.76–1.22). Similarly no statistically significant changes in RTI incidence were demonstrated (England: IRR 0.95, 95% CI 0.86–1.06; Scotland: IRR 0.96, 95% CI 0.83–1.11; Wales: IRR 0.97, 95% CI 0.86–1.09; Northern Ireland: IRR 0.90, 95% CI 0.79–1.03). There were no demonstrable reductions in the incidence of paediatric wheezing/asthma or RTIs following introduction of smoke-free legislation in the UK

Large-scale genome-wide association studies and meta-analyses of longitudinal change in adult lung function.

BACKGROUND: Genome-wide association studies (GWAS) have identified numerous loci influencing cross-sectional lung function, but less is known about genes influencing longitudinal change in lung function. METHODS: We performed GWAS of the rate of change in forced expiratory volume in the first second (FEV1) in 14 longitudinal, population-based cohort studies comprising 27,249 adults of European ancestry using linear mixed effects model and combined cohort-specific results using fixed effect meta-analysis to identify novel genetic loci associated with longitudinal change in lung function. Gene expression analyses were subsequently performed for identified genetic loci. As a secondary aim, we estimated the mean rate of decline in FEV1 by smoking pattern, irrespective of genotypes, across these 14 studies using meta-analysis. RESULTS: The overall meta-analysis produced suggestive evidence for association at the novel IL16/STARD5/TMC3 locus on chromosome 15 (P  =  5.71 × 10(-7)). In addition, meta-analysis using the five cohorts with ≥3 FEV1 measurements per participant identified the novel ME3 locus on chromosome 11 (P  =  2.18 × 10(-8)) at genome-wide significance. Neither locus was associated with FEV1 decline in two additional cohort studies. We confirmed gene expression of IL16, STARD5, and ME3 in multiple lung tissues. Publicly available microarray data confirmed differential expression of all three genes in lung samples from COPD patients compared with controls. Irrespective of genotypes, the combined estimate for FEV1 decline was 26.9, 29.2 and 35.7 mL/year in never, former, and persistent smokers, respectively. CONCLUSIONS: In this large-scale GWAS, we identified two novel genetic loci in association with the rate of change in FEV1 that harbor candidate genes with biologically plausible functional links to lung function

Personalization for unobtrusive service interaction

Increasingly, mobile devices play a key role in the communication between users and the services embedded in their environment. With ever greater number of services added to our surroundings, there is a need to personalize services according to the user needs and environmental context avoiding service behavior from becoming overwhelming. In order to prevent this information overload, we present a method for the development of mobile services that can be personalized in terms of obtrusiveness (the degree in which each service intrudes the user's mind) according to the user needs and preferences. That is, services can be developed to provide their functionality at different obtrusiveness levels depending on the user by minimizing the duplication of efforts. On the one hand, we provide mechanisms for describing the obtrusiveness degree required for a service. On the other hand, we make use of Feature Modeling techniques in order to define the obtrusiveness level adaptation in a declarative manner. An experiment was conducted in order to put in practice the proposal and evaluate the user acceptance for the personalization capabilities provided by our approach. © Springer-Verlag London Limited 2011.This work has been developed with the support of MICINN under the project EVERYWARE TIN2010-18011 and co-financed with ERDF, in the grants program FPU.Gil Pascual, M.; Giner Blasco, P.; Pelechano Ferragud, V. (2012). Personalization for unobtrusive service interaction. Personal and Ubiquitous Computing. 16(5):543-561. https://doi.org/10.1007/s00779-011-0414-0S543561165Abrams M, Phanouriou C, Batongbacal AL, Williams SM, Shuster JE (1999) Uiml: an appliance-independent xml user interface language. In: WWW ’99. Elsevier, North-Holland, pp 1695–1708Ballagas R, Borchers J, Rohs M, Sheridan JG (2006) The smart phone: a ubiquitous input device. IEEE Pervas Comput 5(1):70Balme L, Demeure A, Barralon N, Coutaz J, Calvary G (2004) Cameleon-rt: a software architecture reference model for distributed, migratable, and plastic user interfaces. In: EUSAI, pp 291–302Benavides D, Cortés RA, Trinidad P (2005) Automated reasoning on feature models. In: LNCS, advanced information systems engineering: 17th international conference, CAiSE 2005 3520, pp 491–503Blomquist A, Arvola M (2002) Personas in action: ethnography in an interaction design team. In: Proceedings of NordiCHI ’02. ACM, New York, NY, pp 197–200Bright A, Kay J, Ler D, Ngo K, Niu W, Nuguid A (2005) Adaptively recommending museum tours. In: Nick Ryan Tullio Salmon Cinotti GR (ed) Proceedings of workshop on smart environments and their applications to cultural heritage. Archaeolingua, pp 29–32Brown DM (2010) Communicating design: developing web site documentation for design and planning, 2nd edn. 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In: Proceedings of SPLCDuarte C, Carriço L (2006) A conceptual framework for developing adaptive multimodal applications. In: Proceedings of IUI ’06. ACM, New York, pp 132–139Evans (2003) Domain-driven design: tacking complexity In the heart of software. Addison-Wesley Longman Publishing Co., Inc., BostonsFavre JM (2004) Foundations of model (Driven) (Reverse) engineering: models—Episode I: stories of the fidus papyrus and of the solarus. In: Bezivin J, Heckel R (eds) Language engineering for model-driven software development, no. 04101, Dagstuhl seminar proceedings. Dagstuhl, GermanyFischer G (2001) User modeling in human–computer interaction. User Model User-Adap Inter 11(1–2):65–86Gibbs WW (2005) Considerate computing. Scientific American 292(1):54–61Giner P, Cetina C, Fons J, Pelechano V (2010) Developing mobile workflow support in the internet of things. IEEE Pervas Comput 9(2):18–26Giner P, Cetina C, Fons J, Pelechano V (2011) Implicit interaction design for pervasive workflows. Pers Ubiquit Comput 1–10Gulliksen J, Goransson B, Boivie I, Blomkvist S, Persson J, Cajander A (2003) Key principles for user-centred systems design. Behav Inform Technol 22:397–409Hinckley K, Horvitz E (2001) Toward more sensitive mobile phones. In: Proceedings of the UIST ’01. ACM, New York, pp 191–192Ho J, Intille SS (2005) Using context-aware computing to reduce the perceived burden of interruptions from mobile devices. In: Proceedings of CHI ’05. ACM, New York, pp 909–918Horvitz E, Kadie C, Paek T, Hovel D (2003) Models of attention in computing and communication: from principles to applications. Commun ACM 46(3):52–59Ju W, Leifer L (2008) The design of implicit interactions: making interactive systems less obnoxious. Des Issues 24(3):72–84Lewis JR (1995) Ibm computer usability satisfaction questionnaires: psychometric evaluation and instructions for use. 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Ab-Externo AAV-Mediated Gene Delivery to the Suprachoroidal Space Using a 250 Micron Flexible Microcatheter

The current method of delivering gene replacement to the posterior segment of the eye involves a three-port pars plana vitrectomy followed by injection of the agent through a 37-gauge cannula, which is potentially wrought with retinal complications. In this paper we investigate the safety and efficacy of delivering adeno-associated viral (AAV) vector to the suprachoroidal space using an ab externo approach that utilizes an illuminated microcatheter.6 New Zealand White rabbits and 2 Dutch Belted rabbits were used to evaluate the ab externo delivery method. sc-AAV5-smCBA-hGFP vector was delivered into the suprachoroidal space using an illuminated iTrackTM 250A microcatheter. Six weeks after surgery, the rabbits were sacrificed and their eyes evaluated for AAV transfection using immunofluorescent antibody staining of GFP.Immunostaining of sectioned and whole-mounted eyes demonstrated robust transfection in all treated eyes, with no fluorescence in untreated control eyes. Transfection occurred diffusely and involved both the choroid and the retina. No apparent adverse effects caused by either the viral vector or the procedure itself could be seen either clinically or histologically.The ab externo method of delivery using a microcatheter was successful in safely and effectively delivering a gene therapy agent to the suprachoroidal space. This method presents a less invasive alternative to the current method of virally vectored gene delivery