Discovering the right place to check-in using web-based proximate selection

With information technology becoming increasingly embedded in our everyday physical world, there is a growing set of mobile applications that involve a connection with the digital representation of physical places. This association is normally initiated with a check-in procedure, through which a person asserts her presence at a particular place and determines the context for subsequent interactions. The common assumption is that a mobile application will be able to search the surrounding environment and present the user with the intended check-in target; however, in a world of ubiquitous place-based services, this assumption may no longer hold. A person in an urban environment would, at any moment, be surrounded by a large number of places, all of which could be regarded as possible interaction contexts for that person. In this work, we investigate the real-word challenges associated with wide-scale place selection and how the process can be affected by the place environment, by the position of the person in relation to the target place and by positioning errors. To study this reality, we used Google Places as a directory of georeferenced places. We conducted 14,400 nearby place queries structured around different combinations of our three independent variables. The results suggest that the overall performance is poor, except for low-density scenarios, and that this discovery process, albeit relevant, should always be combined with other place discovery approaches. The results also help to understand how this performance is affected by check-in positions and by the properties of the place environment.- (undefined

Non-medical risk factors as avoidable determinants of excess mortality in children with chronic kidney disease. A prospective cohort study in Nicaragua, a model low income country

Background: The widely recognized clinical and epidemiological relevance of the socioeconomic determinants of health-disease conditions is expected to be specifically critical in terms of chronic diseases in fragile populations in low-income countries. However, in the literature, there is a substantial gap between the attention directed towards the medical components of these problems and the actual adoption of strategies aimed at providing solutions for the associated socioeconomic determinants, especially in pediatric populations. We report a prospective outcome study on the independent contribution and reciprocal interaction of the medical and socioeconomic factors to the hard end-point of mortality in a cohort of children with chronic kidney disease in Nicaragua. Methods and Findings: Every child (n = 309) diagnosed with chronic kidney disease (CKD) and referred to the tertiary unit of Pediatric Nephrology in Managua (Nicaragua) from a network of nine hospitals serving 80% of the country's pediatric population was registered between January 2005 and December 2013. The three main socioeconomic determinants evaluated were family income, living conditions and the family's level of education. Further potential determinants of the outcomes included duration of exposure to disease, CKD stage at the first visit as suggested by the KDOQI guidelines in children, the time it took the patients to reach the reference centre and rural or urban context of life. Well-defined and systematically collected medical and socioeconomic data were available for 257 children over a mean follow-up period of 2.5\ub12.5 years. Mortality and lost to follow-up were considered as outcome endpoints both independently and in combination, because of the inevitably progressive nature of the disease. A high proportion (55%) of children presented in the advanced stages of CKD (CKD stage IV and V) at the first visit. At the end of follow-up, 145 (57%) of the 257 cohort children were alive, 47 (18%) were lost to follow-up and 65 (25%) had died. Cox regression analysis showed an independent contribution to mortality of CKD stage at diagnosis and of level of education, with overlapping HR values (HR and 95%CI: 2.66; 1.93-3.66 and 2.72; 1.71-4.33, respectively). Conclusions: The unfavourable socioeconomic and cultural background of the pediatric study cohort and the severity of kidney damage at diagnosis were the key determinants of the clinical risk conditions at baseline and of the mortality outcome. Long-term structural interventions on such backgrounds must be adopted to assure effectiveness of medical care and to assure an earlier diagnosis of CKD in these patients. The translation-extension of our results is currently underway with an agenda which includes: 1) better integration of chronic pediatric conditions into primary care strategies to promote prevention and early timely referral; 2) the consideration of socioeconomic conditions as a mandatory component of the packages of best-care; 3) the formulation and flexible adaptation of guidelines and educational programs, based on the information generated by a context-specific, epidemiological monitoring of needs and outcomes, guaranteed by an effective database

Lower risk of death and cardiovascular events in patients with diabetes initiating glucagon-like peptide-1 receptor agonists or sodium-glucose cotransporter-2 inhibitors: A real-world study in two Italian cohorts

Aim: To examine the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors compared with other antihyperglycaemic agents (AHAs) in large and unselected populations of the Lombardy and Apulia regions in Italy. Materials and Methods: An observational cohort study of first-time users of GLP-1RAs, SGLT2 inhibitors or other AHAs was conducted from 2010 to 2018. Death and cardiovascular (CV) events were evaluated using conditional Cox models in propensity-score-matched populations. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for each region and in a meta-analysis for pooled risks. Results: After propensity-score matching, the Lombardy cohort included 18 716 and 11 683 patients and the Apulia cohort 9772 and 6046 patients for the GLP-1RA and SGLT2 inhibitor groups, respectively. Use of GLP-1RAs was associated with lower rates of death (HR 0.61, CI 0.56-0.65, Lombardy; HR 0.63, CI 0.55-0.71, Apulia), cerebrovascular disease and ischaemic stroke (HR 0.70, CI 0.63-0.79; HR 0.72, CI 0.60-0.87, Lombardy), peripheral vascular disease (HR 0.72, CI 0.64-0.82, Lombardy; HR 0.80, CI 0.67-0.98, Apulia), and lower limb complications (HR 0.67, CI 0.56-0.81, Lombardy; HR 0.69, CI 0.51-0.93, Apulia). Compared with other AHAs, SGLT2 inhibitor use decreased the risk of death (HR 0.47, CI 0.40-0.54, Lombardy; HR 0.43, CI 0.32-0.57, Apulia), cerebrovascular disease (HR 0.75, CI 0.61-0.91, Lombardy; HR 0.72, CI 0.54-0.96, Apulia), and heart failure (HR 0.56, CI 0.46-0.70, Lombardy; HR 0.57, CI 0.42-0.77, Apulia). In the pooled cohorts, a reduction in heart failure was also observed with GLP-1RAs (HR 0.89, 95% CI 0.82-0.97). Serious adverse events were quite low in frequency. Conclusion: Our findings from real-world practice confirm the favourable effect of GLP-1RAs and SGLT2 inhibitors on death and CV outcomes across both regions consistently. Thus, these drug classes should be preferentially considered in a broad type 2 diabetes population beyond those with CV disease

Fatigue response of additively manufactured as-built 15-5 PH stainless steel and effects of machining and thermal and surface treatments

Additively produced 15-5 PH stainless steel has wide industrial applications, but the combined effects of heat treatment, machining, and shot-peening and their order have not been deeply investigated. This topic is addressed here by a 2-by-3 experimental plan that has involved S–N curve and fatigue limit determination, using vertically built cylindrical samples, tested under rotating bending. The obtained responses have been analyzed by an ANOVA-based statistical approach for comparison of fatigue trends. Results indicate that heat treatment without machining may be even detrimental for fatigue due to embrittlement. Conversely, machining with subsequent shot-peening, even without heat treatment, has a remarkable impact and leads to a doubled fatigue strength with respect to as-built material. This strength is also quite close to that achievable for wrought material. The study has been completed by micrography and fractography, to reveal the dependence of microstructure, crack initiation sites, and failure mode on the performed treatments

Fatigue response of additively manufactured Maraging Stainless Steel CX and effects of heat treatment and surface finishing

This paper deals with the novel topic of the fatigue response of additively manufactured Maraging Stainless Steel CX. A two-by-two factorial plan was arranged, to experimentally assess the effects of heat treatment and machining on the fatigue strength in both finite and infinite life domains. The two factors were regarded as on–off, taking the untreated unmachined condition as a reference for comparisons. Cylindrical specimens with vertical build orientation were involved in the fatigue campaign under four-point rotating bending. The results indicate that the fatigue strength may be remarkably incremented (up to five times) with respect to the as received conditions, especially thanks to surface smoothing and taking advantage of a very low porosity level. Heat treatment strengthening mechanisms were also interpreted in the light of optical and electron microscope observations. Fatigue enhancement arises from precipitate size increment throughout the conducted heat treatment, although the fracture mode turns to be more brittle

Effect of the position in the build chamber on the fatigue strength of DMLS produced maraging steel

Previous studies investigated the effects of build orientation, allowance for machining, heat and surface treatments on the fatigue response of DMLS produced Maraging steel. This work focuses on the potential effect of the position of the built part in the chamber on the generation of powder residuals and consequently on the fatigue strength. The retrieved S-N curves indicate the response keeps unaffected by this factor.The authors wish to acknowledge the support of European Commission through the project “Advanced design rules for optimal dynamic properties of additive manufacturing products – A_MADAM”, which has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 734455.Publishe

As fabricated DMLS produced 15-5PH stainless steel: effects of post-manufacture treatments

Previous investigations dealt with the effects of build orientation and allowance for machining on the fatigue strength of DMLS produced Stainless Steel 15-5 PH1. Additional studies on Maraging Steel in the “as built” condition, highlighted the heat or surface treatments that are able to enhance the fatigue strength. This work deals with an extensive experimental campaign involving as fabricated 15-5 PH1: the effects of heat treatment, machining and shot-peening. after machining have been assessed. The retrieved S-N curves have been compared by statistical methods, highlighting the beneficial effect of the post-machining peening treatment.The authors wish to acknowledge the support of European Commission through the project “Advanced design rules for optimal dynamic properties of additive manufacturing products – A_MADAM”, which has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 734455.Publishe

A randomized controlled trial of orthodontist-based brief advice to prevent child obesity

Objective: We conducted a randomized controlled trial to test whether brief exercise and diet advice provided during child patient visits to their orthodontic office could improve diet, physical activity, and age-and-genderadjusted BMI. Methods: We enrolled orthodontic offices in Southern California and Tijuana, Mexico, and recruited their patients aged 8-16 to participate in a two-year study. At each office visit, staff provided the children with "prescriptions" for improving diet and exercise behaviors. Multilevel models, which adjusted for clustering, determined differential group effects on health outcomes, and moderation of effects. Results: We found differential change in BMI favoring the intervention group, but only among male participants (p < 0.001; Cohen's d = 0.085). Of four dietary variables, only junk food consumption changed differentially, in favor of the intervention group (p = 0.020; d = 0.122); the effect was significant among overweight/obese (p = 0.001; d = 0.335) but not normal weight participants. Physical activity declined non-differentially in both groups and both genders. Conclusion: The intervention, based on the Geoffrey Rose strategy, had limited success in achieving its aims

Many analysts, one data set: making transparent how variations in analytic choices affect results

Twenty-nine teams involving 61 analysts used the same data set to address the same research question: whether soccer referees are more likely to give red cards to dark-skin-toned players than to light-skin-toned players. Analytic approaches varied widely across the teams, and the estimated effect sizes ranged from 0.89 to 2.93 (Mdn = 1.31) in odds-ratio units. Twenty teams (69%) found a statistically significant positive effect, and 9 teams (31%) did not observe a significant relationship. Overall, the 29 different analyses used 21 unique combinations of covariates. Neither analysts’ prior beliefs about the effect of interest nor their level of expertise readily explained the variation in the outcomes of the analyses. Peer ratings of the quality of the analyses also did not account for the variability. These findings suggest that significant variation in the results of analyses of complex data may be difficult to avoid, even by experts with honest intentions. Crowdsourcing data analysis, a strategy in which numerous research teams are recruited to simultaneously investigate the same research question, makes transparent how defensible, yet subjective, analytic choices influence research results