Sampled Policy Gradient for Learning to Play the Game Agar.io

In this paper, a new offline actor-critic learning algorithm is introduced: Sampled Policy Gradient (SPG). SPG samples in the action space to calculate an approximated policy gradient by using the critic to evaluate the samples. This sampling allows SPG to search the action-Q-value space more globally than deterministic policy gradient (DPG), enabling it to theoretically avoid more local optima. SPG is compared to Q-learning and the actor-critic algorithms CACLA and DPG in a pellet collection task and a self play environment in the game Agar.io. The online game Agar.io has become massively popular on the internet due to intuitive game design and the ability to instantly compete against players around the world. From the point of view of artificial intelligence this game is also very intriguing: The game has a continuous input and action space and allows to have diverse agents with complex strategies compete against each other. The experimental results show that Q-Learning and CACLA outperform a pre-programmed greedy bot in the pellet collection task, but all algorithms fail to outperform this bot in a fighting scenario. The SPG algorithm is analyzed to have great extendability through offline exploration and it matches DPG in performance even in its basic form without extensive sampling

A Lifestyle Modification Program for Community Dwelling Adults with Obesity

Obesity is significantly rising among adults in the United States. The Center for Disease Control (CDC, 2009e), estimates that obesity increased by 15% to 32.9% within a 20 year span (1985 – 2008). Clinical obesity is defined as having a BMI 30 and over; it is correlated with secondary complications that include hypertension, type II diabetes, osteoarthritis, cardiovascular diseases, cancers, cerebral vascular accidents, sleep apnea, and respiratory illnesses (CDC, 2009d; World Health Organization [WHO], 2009). Beyond the many health consequences caused by obesity, there are also psychosocial, genetic, and discriminatory aspects of this disease that negatively impact the quality of life and participation in occupations (Clark, Reingold, & Salles-Jordan, 2006). Occupational therapists can provide education and intervention focusing on lifestyle modification to increase participation in occupations, and improve quality of life (Blanchard, 2006; Clark, et al. 2006). The CDC (2009g) describes that 10-minute bouts of moderate to vigorous intensity in the form of meaningful activities such as lawn mowing, dancing, or biking to the store is adequate for raising heart rates and starting the path to physical fitness. This approach fits well with the role of occupational therapy. A comprehensive literature review was conducted on obesity and the impact it has on activities of daily living. Key areas explored include medications, genetics, psychological impacts and discrimination, impact on activities of daily living, sedentary lifestyles, impact of socio-economic status on health, dietary modifications, as well as effective holistic intervention strategies. The literature indicated a need for a lifestyle modification program for community dwelling adults who are overweight or obese. The Step It Up to A Better You is a lifestyle modification program consisting of one-hour educational sessions for 12-weeks. The overall goal is to gain a healthy lifestyle with enhanced quality of life and ability to participate in one’s meaningful daily activities. The sessions include educational resources on motivation, nutrition, physical activity, exploring community resources, psychosocial well-being, and a lifestyle maintenance plan

Olfactory ensheathing glia are required for embryonic olfactory axon targeting and the migration of gonadotropin-releasing hormone neurons.

Kallmann's syndrome is caused by the failure of olfactory axons and gonadotropin-releasing hormone (GnRH) neurons to enter the embryonic forebrain, resulting in anosmia and sterility. Sox10 mutations have been associated with Kallmann's syndrome phenotypes, but their effect on olfactory system development is unknown. We recently showed that Sox10 is expressed by neural crest-derived olfactory ensheathing cells (OECs). Here, we demonstrate that in homozygous Sox10(lacZ/lacZ) mouse embryos, OEC differentiation is disrupted; olfactory axons accumulate in the ventromedial olfactory nerve layer and fewer olfactory receptor neurons express the maturation marker OMP (most likely owing to the failure of axonal targeting). Furthermore, GnRH neurons clump together in the periphery and a smaller proportion enters the forebrain. Our data suggest that human Sox10 mutations cause Kallmann's syndrome by disrupting the differentiation of OECs, which promote embryonic olfactory axon targeting and hence olfactory receptor neuron maturation, and GnRH neuron migration to the forebrain.This work was supported by the Wellcome Trust [grant 091555 to C.V.H.B. and P.B.], a Griffith University Encouragement Research grant to J.A.S., and Deutsche Forschungsgemeinschaft [grant We1326/9 to M.W.].This is the final version of the article. It was first available from The Company of Biologists via http://dx.doi.org/10.1242/bio.2013524

P-182: 24-hour ambulatory blood-pressure effects of valsartan + hydrochlorothiazide combinations compared with amlodipine in hypertensive patients at increased cardiovascular risk

In a randomised, double-blind trial, the effects on 24-hr ABP of the combination valsartan 160 mg od and hydrochlorothiazide (HCTZ) 25 or 12.5 mg during 24 weeks of therapy were compared with the effects of amlodipine 10 mg monotherapy (group A10) in 474 stage-II hypertensive patients with additional cardiovascular risk factors. After a two-week single-blind placebo run-in period, patients were randomised to receive valsartan 160 mg od or amlodipine 5 mg od. At Week 4, HCTZ 12.5 mg (group V160/HCTZ12.5) and 25 mg (group V160/HCTZ25) were added to the valsartan groups and in the A10 patients the amlodipine dose was force-titrated to 10 mg od. All treatments reduced BP as well as night-time and daytime BP levels from baseline. 24-hr SBP was reduced by 15.9 ±1.0 mmHg (least-squares mean change ±SE), 19.3 ±1.0 mmHg and 16.1 ±1.1 mmHg in the V160/HCTZ12.5, V160/HCTZ25 and A10 groups, respectively and 24-hr DBP was reduced by 9.3 ±0.6 mmHg, 11.4 ±0.6 mmHg and 9.6 ±0.7 mmHg in the three groups. The differences between the V160/HCTZ25 group and the A10 group were significant (p<0.05) for the changes in 24-hr systolic BP as well as for changes in daytime systolic BP and night-time diastolic BP. Control rates defined as ABPM ≤130/80 mmHg were: 48.4%, 60.8% and 50.9% in the V160/HCTZ12.5, V160/25 and A10 groups, respectively; the differences between the V160/HCTZ25 group and the other two treatment groups were significant at p<0.05. (See Figure) In conclusion, the fixed-dose combination of valsartan 160 mg + HCTZ 25 mg od is an attractive therapeutic option measured on the effects on 24-hr ABPM, night-time and daytime BP reduction and control rates in hypertensive patients at additional cardiovascular ris

Characterisation of a Coriolis flow meter for fuel consumption measurements in realistic drive cycle tests

When testing light-duty and heavy-duty vehicles on chassis dynamometers, as in the WLTP, or engines on engine test benches, as in the WHDC, it is required to measure the fuel consumption. In the preferable case, the measurement of the fuel consumption is carried out with suitable flow meters. These require high measurement accuracy in a wide flow range, independent of the fuel type, as the flow rate range is often very large and depends on the power range of the vehicle engines. Moreover, the fuel flow rate in the test cycles is very dynamically related to the loads. In the scope of the ongoing EMPIR Joint Research Project 20IND13 SAFEST the dynamic flow behaviour as well as the measurement accuracy of flow meters for different types of fuels are investigated. This paper presents first results from the realisation of dynamic flow profiles, and flow measurements with a Coriolis Flow Meter with different representative fuels in a wide density and viscosity range and a wide flow rate range at different fuel temperatures

Measuring Quality of Care: A Rasch Validity Analysis of the Good Nursing Care Scale

BACKGROUND: Patient-centeredness is emphasized in both health policies and practice, calling for reliable instruments for the evaluation of the quality of nursing care.PURPOSE: The purpose was to analyze the psychometric properties of the Good Nursing Care Scale (GNCS) in a sample of surgical patients and nurses.METHODS: An explorative cross-sectional study design was used. Data were collected with the 40-item GNCS from surgical patients (n = 476) and nurses (n = 167) in Finland. The data were analyzed with Rasch analysis.RESULTS: The GNCS provided evidence of unidimensionality with acceptable goodness-of-fit to the Rasch model in both samples. Person-separation validity was acceptable. Person misfit was reasonable. The Rasch-equivalent Cronbach α was 0.81 (patient data) and 0.88 (nurse data).CONCLUSIONS: The findings support that the GNCS is a psychometrically sound instrument that can be used in measuring the quality of nursing care, from the perspective of both patients and nurses.</div

Local treatment of pressure ulcers in long-term care: a correlational cross-sectional study

Objective:To analyse the treatment of pressure ulcers (PU) in long-term care.Method:In this correlational cross-sectional study, data was collected between November 2015 and January 2016 from older people with PUs in private and public long-term care facilities in Finland. Data collection was conducted by trained nurses using the Pressure Ulcer Patient Instrument (PUP-Ins). Outcomes measured were: prevalence and localisation of PU, local PU treatment, frequency (how often/week/day) and duration (minutes/week or day) of PU treatment.Results:In total, 112 patients with 158 PUs were identified (a prevalence rate of 5%). PUs were located most often on the heel (38%), hip (13%), buttocks (10%) and lateral malleolus (9.5%). The most frequently used PU treatment was skin protecting agents and local wound care products. The most typical treatment in category I, II and III PUs were foam dressings. In category III PUs, ribbon gauze dressings were also used. The most typical products for category IV PUs were complex dressings. Category I PUs received more treatment per day or week than other categories of PUs.Conclusion:PU treatment is inconsistent and often conducted with varying methods and products. Holistic patient care must be the focus. Nurses in long-term care settings might benefit from in-depth in-service education focusing on the treatment of PUs. More research is needed about nurses' competence in PU treatment.</p

Evaluating the content validity of two versions of an instrument used in measuring pediatric pain knowledge and attitudes in the Ghanaian context

In this article, we compared the content validity of two instruments used in measuring pediatric pain knowledge and attitudes. This was considered necessary due to the universal differences in culture, semantics and healthcare resources in different parts of the globe. Thirteen (13) pediatric experts in Ghana assessed the content validity of two instruments: the 42-item Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain (PNKAS) and the 41-item Pediatric Healthcare Providers' Knowledge and Attitudes Survey Regarding Pain (PHPKASRP). The relevance and clarity of each item on these instruments were rated on a four-point likert scaled options from 1 (not relevant/ not clear) to 4 (very relevant/ very clear). The item-level content validity index (I-CVI) was calculated by dividing the number of experts who rated an item with 3 or 4 by the total number of experts. The average scale-level content validity index (S-CVI/Ave) was also estimated by summing up the I-CVIs of all items and dividing them by the total number of items. The I-CVIs on the PNKAS ranged from 0.62 to 1.00 for the relevance component and 0.69 to 1.00 for the clarity component. The I-CVIs on the PHPKASRP ranged from 0.62 to 1.00 for both the relevance and clarity components. The S-CVI/Ave were 0.87 and 0.89 for the relevance and clarity aspects on the PNKAS respectively. The S-CVI/Ave for the PHPKASRP instrument were 0.86 and 0.89 for the relevance and clarity aspects correspondingly. At the end of the validation process, 5 items were revised on both instruments whilst 37 and 36 items were maintained on the PNKAS and PHPKASRP instruments respectively. The PNKAS and PHPKASRP have an acceptable level of content validity in the Ghanaian context and recommended for educational and research purposes. Other forms of validity and reliability of these instruments should also be examined in future studies.</p