Sensitivity and specificity of the Gastrointestinal Short Form Questionnaire in diagnosis of gastroesophageal reflux disease

Introduction: Gastrointestinal Short Form Questionnaire (GSFQ) is a questionnaire for gastroesophageal reflux disease (GERD) diagnosis, with a version in Spanish language, not yet compared to an objective test. Aims: To establish GSFQ diagnostic performance against 24-hour pH monitoring carried out in two tertiary care hospitals. Methods: Consecutive adult patients with typical GERD symptoms (heartburn, regurgitation) referred for pH monitoring fulfilled the GSFQ (score range 0-30, proportional to probability of GERD). Diagnosis of GERD was established when acid exposure time in distal esophagus was superior to 4.5% or symptom association probability was greater than 95%. Receiver-operator characteristic (ROC) curves were calculated and best cut-off score determined, with corresponding sensitivity, specificity and likelihood ratios (LR) (95% confidence interval for each). Results: One hundred and fifty-two patients were included (59.9% women, age 47.9 ± 13.9; 97.4% heartburn; 71.3% regurgitation). pH monitoring was abnormal in 65.8%. Mean GSFQ score was 11.2 ± 6. Area under ROC was 56.5% (47.0-65.9%). Optimal cut-off score was 13 or greater: sensitivity 40% (30.3-50.3%), specificity 71.2% (56.9-82.9%), positive LR 1.39 (0.85-2.26) and negative LR 0.84 (0.67-1.07). Exclusion of questions 1 and 3 of the original GSFQ, easily interpreted as referred to dyspepsia and not GERD, improved only marginally the diagnostic performance: AUROC 59.1%. Conclusion: The GSFQ does not predict results of pH monitoring in patients with typical symptoms in a tertiary care setting.

Transcriptional dynamics of the developing sweet cherry (Prunus avium L.) fruit: sequencing, annotation and expression profiling of exocarp-associated genes

The exocarp, or skin, of fleshy fruit is a specialized tissue that protects the fruit, attracts seed dispersing fruit eaters, and has large economical relevance for fruit quality. Development of the exocarp involves regulated activities of many genes. This research analyzed global gene expression in the exocarp of developing sweet cherry (Prunus avium L., 'Regina'), a fruit crop species with little public genomic resources. A catalog of transcript models (contigs) representing expressed genes was constructed from de novo assembled short complementary DNA (cDNA) sequences generated from developing fruit between flowering and maturity at 14 time points. Expression levels in each sample were estimated for 34 695 contigs from numbers of reads mapping to each contig. Contigs were annotated functionally based on BLAST, gene ontology and InterProScan analyses. Coregulated genes were detected using partitional clustering of expression patterns. The results are discussed with emphasis on genes putatively involved in cuticle deposition, cell wall metabolism and sugar transport. The high temporal resolution of the expression patterns presented here reveals finely tuned developmental specialization of individual members of gene families. Moreover, the de novo assembled sweet cherry fruit transcriptome with 7760 full-length protein coding sequences and over 20 000 other, annotated cDNA sequences together with their developmental expression patterns is expected to accelerate molecular research on this important tree fruit crop.

A short treatise on the game of whist : containing the laws of the game and also some rules whereby a beginner may, with due attention to them attain to the playing it well ... /

In folder.

Diabetes text-message self-management support program (SMS4BG): A pilot study

BACKGROUND: The increasing prevalence of diabetes and costly long-term complications associated with poor glycemic control are issues facing health services worldwide. Diabetes self-management, with the support of health care providers, is critical for successful outcomes, however, frequent clinical contact is costly. Text messages via short message service (SMS) have the advantage of instant transmission at low cost and, given the ubiquity of mobile phones, may be the ideal platform for the delivery of diabetes self-management support. A tailored text message-based diabetes support intervention called Self-Management Support for Blood Glucose (SMS4BG) was developed. The intervention incorporates prompts around diabetes education, management, and lifestyle factors (healthy eating, exercise, and stress management), as well as blood glucose monitoring reminders, and is tailored to patient preferences and clinical characteristics. OBJECTIVE: To determine the usability and acceptability of SMS4BG among adults with poorly controlled diabetes. METHODS: Adults (aged 17 to 69 years) with type 1 (n=12) or type 2 diabetes (n=30), a hemoglobin A1c (HbA1c) over 70 mmol/mol (8.6%), and who owned a mobile phone (n=42) were recruited to take part in a 3-month pilot study of SMS4BG. At registration, participants selected the modules they would like to receive and, where appropriate, the frequency and timing of blood glucose monitoring reminders. Patient satisfaction and perceptions of the usability of the program were obtained via semistructured phone interviews conducted at completion of the pilot study. HbA1c was obtained from patient records at baseline and completion of the pilot study. RESULTS: Participants received on average 109 messages during the 3-month program with 2 participants withdrawing early from the study. Follow-up interviews were completed with 93% of participants with all reporting SMS4BG to be useful and appropriate to their age and culture. Participants reported a range of perceived positive impacts of SMS4BG on their diabetes and health behaviors. HbA1c results indicated a positive impact of the program on glycemic control with a significant decrease in HbA1c from baseline to follow-up. CONCLUSIONS: A tailored text message-based intervention is both acceptable and useful in supporting self-management in people with poorly controlled diabetes. A randomized controlled trial of longer duration is needed to assess the efficacy and sustainability of SMS4BG.

Text message and internet support for coronary heart disease self-management: results from the text4heart randomized controlled trial

BACKGROUND: Mobile technology has the potential to deliver behavior change interventions (mHealth) to reduce coronary heart disease (CHD) at modest cost. Previous studies have focused on single behaviors; however, cardiac rehabilitation (CR), a component of CHD self-management, needs to address multiple risk factors. OBJECTIVE: The aim was to investigate the effectiveness of a mHealth-delivered comprehensive CR program (Text4Heart) to improve adherence to recommended lifestyle behaviors (smoking cessation, physical activity, healthy diet, and nonharmful alcohol use) in addition to usual care (traditional CR). METHODS: A 2-arm, parallel, randomized controlled trial was conducted in New Zealand adults diagnosed with CHD. Participants were recruited in-hospital and were encouraged to attend center-based CR (usual care control). In addition, the intervention group received a personalized 24-week mHealth program, framed in social cognitive theory, sent by fully automated daily short message service (SMS) text messages and a supporting website. The primary outcome was adherence to healthy lifestyle behaviors measured using a self-reported composite health behavior score (≥3) at 3 and 6 months. Secondary outcomes included clinical outcomes, medication adherence score, self-efficacy, illness perceptions, and anxiety and/or depression at 6 months. Baseline and 6-month follow-up assessments (unblinded) were conducted in person. RESULTS: Eligible patients (N=123) recruited from 2 large metropolitan hospitals were randomized to the intervention (n=61) or the control (n=62) group. Participants were predominantly male (100/123, 81.3%), New Zealand European (73/123, 59.3%), with a mean age of 59.5 (SD 11.1) years. A significant treatment effect in favor of the intervention was observed for the primary outcome at 3 months (AOR 2.55, 95% CI 1.12-5.84; P=.03), but not at 6 months (AOR 1.93, 95% CI 0.83-4.53; P=.13). The intervention group reported significantly greater medication adherence score (mean difference: 0.58, 95% CI 0.19-0.97; P=.004). The majority of intervention participants reported reading all their text messages (52/61, 85%). The number of visits to the website per person ranged from zero to 100 (median 3) over the 6-month intervention period. CONCLUSIONS: A mHealth CR intervention plus usual care showed a positive effect on adherence to multiple lifestyle behavior changes at 3 months in New Zealand adults with CHD compared to usual care alone. The effect was not sustained to the end of the 6-month intervention. A larger study is needed to determine the size of the effect in the longer term and whether the change in behavior reduces adverse cardiovascular events. TRIAL REGISTRATION: ACTRN 12613000901707; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364758&isReview=true (Archived by WebCite at http://www.webcitation.org/6c4qhcHKt).

Scalable nonparametric Bayesian multilevel clustering

Multilevel clustering problems where the con-tent and contextual information are jointly clustered are ubiquitous in modern datasets. Existing works on this problem are limited to small datasets due to the use of the Gibbs sampler. We address the problem of scaling up multi-level clustering under a Bayesian nonparametric setting, extending the MC2 model proposed in (Nguyen et al., 2014). We ground our approach in structured mean-field and stochastic variational inference (SVI) and develop a tree-structured SVI algorithm that exploits the interplay between content and context modeling. Our new algorithm avoids the need to repeatedly go through the corpus as in Gibbs sampler. More crucially, our method is immediately amendable to parallelization, facilitating a scalable distributed implementation on the Apache Spark platform. We conduct extensive experiments in a variety of domains including text, images, and real-world user application activities. Direct comparison with the Gibbs-sampler demonstrates that our method is an order-of-magnitude faster without loss of model quality. Our Spark-based implementation gains an-other order-of-magnitude speedup and can scale to large real-world datasets containing millions of documents and groups.

Optical Waveguides and Structures for Short Haul Optical Communication Channels within Printed Circuit Boards

Optical waveguides have shown promising results for use within printed circuit boards. These optical waveguides have higher bandwidth than traditional copper transmission systems and are immune to electromagnetic interference. Design parameters for these optical waveguides are needed to ensure an optimal link budget. Modeling and simulation methods are used to determine the optimal design parameters needed in designing the waveguides. As a result, optical structures necessary for incorporating optical waveguides into printed circuit boards are designed and optimized. Embedded siloxane polymer waveguides are investigated for their use in optical printed circuit boards. This material was chosen because it has low absorption, high temperature stability, and can be deposited using common processing techniques. Two sizes of waveguides are investigated, 50 $unit{mu m}$ multimode and 4 - 9 $unit{mu m}$ single mode waveguides. A beam propagation method is developed for simulating the multimode and single mode waveguide parameters. The attenuation of simulated multimode waveguides are able to match the attenuation of fabricated waveguides with a root mean square error of 0.192 dB. Using the same process as the multimode waveguides, parameters needed to ensure a low link loss are found for single mode waveguides including maximum size, minimum cladding thickness, minimum waveguide separation, and minimum bend radius. To couple light out-of-plane to a transmitter or receiver, a structure such as a vertical interconnect assembly (VIA) is required. For multimode waveguides the optimal placement of a total internal reflection mirror can be found without prior knowledge of the waveguide length. The optimal placement is found to be either 60 µm or 150 µm away from the end of the waveguide depending on which metric a designer wants to optimize the average output power, the output power variance, or the maximum possible power loss. For single mode waveguides a volume grating coupler is designed to couple light from a silicon waveguide to a polymer single mode waveguide. A focusing grating coupler is compared to a perpendicular grating coupler that is focused by a micro-molded lens. The focusing grating coupler had an optical loss of over -14 dB, while the grating coupler with a lens had an optical loss of -6.26 dB.

DOING MORE WITH SHORT PERIOD DATA: DETERMINING MAGNITUDES FROM CLIPPED AND OVER-RUN SEISMIC DATA AT MOUNT ST. HELENS

How can we calculate earthquake magnitudes when the signal is clipped and over-run? When a volcano is very active, the seismic record may saturate (i.e., the full amplitude of the signal is not recorded) or be over-run (i.e., the end of one event is covered by the start of a new event). The duration, and sometimes the amplitude, of an earthquake signal are necessary for determining event magnitudes; thus, it may be impossible to calculate earthquake magnitudes when a volcano is very active. This problem is most likely to occur at volcanoes with limited networks of short period seismometers. This study outlines two methods for calculating earthquake magnitudes when events are clipped and over-run. The first method entails modeling the shape of earthquake codas as a power law function and extrapolating duration from the decay of the function. The second method draws relations between clipped duration (i.e., the length of time a signal is clipped) and the full duration. These methods allow for magnitudes to be determined within 0.2 to 0.4 units of magnitude. This error is within the range of analyst hand-picks and is within the acceptable limits of uncertainty when quickly quantifying volcanic energy release during volcanic crises. Most importantly, these estimates can be made when data are clipped or over-run. These methods were developed with data from the initial stages of the 2004-2008 eruption at Mount St. Helens. Mount St. Helens is a well-studied volcano with many instruments placed at varying distances from the vent. This fact makes the 2004-2008 eruption a good place to calibrate and refine methodologies that can be applied to volcanoes with limited networks.

A clustering-based failure mode and effect analysis model and its application to the edible bird nest industry

Failure mode and effect analysis (FMEA) is a popular safety and reliability analysis tool in examining potential failures of products, process, designs, or services, in a wide range of industries. While FMEA is a popular tool, the limitations of the traditional Risk Priority Number (RPN) model in FMEA have been highlighted in the literature. Even though many alternatives to the traditional RPN model have been proposed, there are not many investigations on the use of clustering techniques in FMEA. The main aim of this paper was to examine the use of a new Euclidean distance-based similarity measure and an incremental-learning clustering model, i.e., fuzzy adaptive resonance theory neural network, for similarity analysis and clustering of failure modes in FMEA; therefore, allowing the failure modes to be analyzed, visualized, and clustered. In this paper, the concept of a risk interval encompassing a group of failure modes is investigated. Besides that, a new approach to analyze risk ordering of different failure groups is introduced. These proposed methods are evaluated using a case study related to the edible bird nest industry in Sarawak, Malaysia. In short, the contributions of this paper are threefold: (1) a new Euclidean distance-based similarity measure, (2) a new risk interval measure for a group of failure modes, and (3) a new analysis of risk ordering of different failure groups.

Text2PreventCVD: Protocol for a systematic review and individual participant data meta-analysis of text-message based interventions for the prevention of cardiovascular diseases.

Introduction Text message interventions have been shown to be effective in prevention and management of several non-communicable disease risk factors. However, the extent to which their effects might vary in different participants and settings is uncertain. We aim to conduct a systematic review and individual participant data (IPD) meta-analysis of randomised clinical trials examining text message interventions aimed to prevent cardiovascular diseases (CVD) through modification of cardiovascular risk factors (CVRFs). Methods and analysis Systematic review and IPD meta-analysis will be conducted according to Preferred Reporting Items for Systematic review and Meta-Analysis of IPD (PRISMA-IPD) guidelines. Electronic database of published studies (MEDLINE, EMBASE, PsycINFO and Cochrane Library) and international trial registries will be searched to identify relevant randomised clinical trials. Authors of studies meeting the inclusion criteria will be invited to join the IPD meta-analysis group and contribute study data to the common database. The primary outcome will be the difference between intervention and control groups in blood pressure at 6-month follow-up. Key secondary outcomes include effects on lipid parameters, body mass index, smoking levels and self-reported quality of life. If sufficient data is available, we will also analyse blood pressure and other secondary outcomes at 12 months. IPD meta-analysis will be performed using a one-step approach and modelling data simultaneously while accounting for the clustering of the participants within studies. This study will use the existing data to assess the effectiveness of text message-based interventions on CVRFs, the consistency of any effects by participant subgroups and across different healthcare settings. Ethics and dissemination Ethical approval was obtained for the individual studies by the trial investigators from relevant local ethics committees. This study will include anonymised data for secondary analysis and investigators will be asked to check that this is consistent with their existing approvals. Results will be disseminated via scientific forums including peer-reviewed publications and presentations at international conferences.

Texture for Script identification

The problem of determining the script and language of a document image has a number of important applications in the field of document analysis, such as indexing and sorting of large collections of such images, or as a precursor to optical character recognition (OCR). In this paper, we investigate the use of texture as a tool for determining the script of a document image, based on the observation that text has a distinct visual texture. An experimental evaluation of a number of commonly used texture features is conducted on a newly created script database, providing a qualitative measure of which features are most appropriate for this task. Strategies for improving classification results in situations with limited training data and multiple font types are also proposed.