Aims
The aim of this study was to develop and evaluate machine-learning-based computerized adaptive tests (CATs) for the Oxford Hip Score (OHS), Oxford Knee Score (OKS), Oxford Shoulder Score (OSS), ...and the Oxford Elbow Score (OES) and its subscales.
Methods
We developed CAT algorithms for the OHS, OKS, OSS, overall OES, and each of the OES subscales, using responses to the full-length questionnaires and a machine-learning technique called regression tree learning. The algorithms were evaluated through a series of simulation studies, in which they aimed to predict respondents’ full-length questionnaire scores from only a selection of their item responses. In each case, the total number of items used by the CAT algorithm was recorded and CAT scores were compared to full-length questionnaire scores by mean, SD, score distribution plots, Pearson’s correlation coefficient, intraclass correlation (ICC), and the Bland-Altman method. Differences between CAT scores and full-length questionnaire scores were contextualized through comparison to the instruments’ minimal clinically important difference (MCID).
Results
The CAT algorithms accurately estimated 12-item questionnaire scores from between four and nine items. Scores followed a very similar distribution between CAT and full-length assessments, with the mean score difference ranging from 0.03 to 0.26 out of 48 points. Pearson’s correlation coefficient and ICC were 0.98 for each 12-item scale and 0.95 or higher for the OES subscales. In over 95% of cases, a patient’s CAT score was within five points of the full-length questionnaire score for each 12-item questionnaire.
Conclusion
Oxford Hip Score, Oxford Knee Score, Oxford Shoulder Score, and Oxford Elbow Score (including separate subscale scores) CATs all markedly reduce the burden of items to be completed without sacrificing score accuracy. Cite this article: Bone Jt Open 2022;3(10):786–794.
The olfactory epithelium of the sea catfish, Ariopsis felis, is found on a pinnate array of lamellae (the olfactory rosette) housed within a nasal chamber. The nasal anatomy of A. felis suggests an ...ability to capture external water currents. We prepared models from X-ray micro-computed tomography scans of two preserved specimens of A. felis. We then used dye visualisation and computational fluid dynamics to show that an external current induced a flow of water through a) the nasal chamber and b) the sensory channels of the olfactory rosette. The factors responsible for inducing flow through the nasal chamber are common to fishes from two other orders. The dye visualisation experiments, together with observations of sea catfishes in vivo, indicate that flow through the nasal chamber is regulated by a mobile nasal flap. The position of the nasal flap – elevated (significant flow) or depressed (reduced flow) – is controlled by the sea catfish's movements. Flow in the sensory channels of the olfactory rosette can pass through either a single channel or, via multiple pathways, up to four consecutive channels. Flow through consecutive sensory channels (olfactory resampling) is more extensive at lower Reynolds numbers (200 and 300, equivalent to swimming speeds of 0.5–1.0 total lengths s−1), coinciding with the mean swimming speed of the sea catfishes observed in vivo (0.6 total lengths s−1). Olfactory resampling may also occur, via a vortex, within single sensory channels. In conclusion, olfactory flow in the sea catfish is regulated and thoroughly sampled by novel mechanisms.
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•Flow through a pinnate array of olfactory sensory channels induced by external flow•Flow resampled via passage through consecutive sensory channels•Nasal recess instrumental in olfactory sampling•Olfactory flow regulated by nasal flap•Common themes in externally-induced olfactory flow in unrelated fishes
Olfactory flow in the sturgeon is externally driven Garwood, Russell J.; Behnsen, Julia; Haysom, Harriet K. ...
Comparative biochemistry and physiology. Part A, Molecular & integrative physiology,
September 2019, 2019-09-00, 20190901, Letnik:
235
Journal Article
Recenzirano
Odprti dostop
Fluid dynamics plays an important part in olfaction. Using the complementary techniques of dye visualisation and computational fluid dynamics (CFD), we investigated the hydrodynamics of the nasal ...region of the sturgeon Huso dauricus. H. dauricus offers several experimental advantages, including a well-developed, well-supported, radial array (rosette) of visible-by-eye olfactory sensory channels. We represented these features in an anatomically accurate rigid model derived from an X-ray scan of the head of a preserved museum specimen. We validated the results from the CFD simulation by comparing them with data from the dye visualisation experiments. We found that flow through both the nasal chamber and, crucially, the sensory channels could be induced by an external flow (caused by swimming in vivo) at a physiologically relevant Reynolds number. Flow through the nasal chamber arises from the anatomical arrangement of the incurrent and excurrent nostrils, and is assisted by the broad, cartilage-supported, inner wall of the incurrent nostril. Flow through the sensory channels arises when relatively high speed flow passing through the incurrent nostril encounters the circular central support of the olfactory rosette, decelerates, and is dispersed amongst the sensory channels. Vortices within the olfactory flow may assist odorant transport to the sensory surfaces. We conclude that swimming alone is sufficient to drive olfactory flow in H. dauricus, and consider the implications of our results for the three other extant genera of sturgeons (Acipenser, Pseudoscaphirhynchus and Scaphirhynchus), and for other fishes with olfactory rosettes.
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•Investigation of fluid dynamics governing odorant transport in the sturgeon•Swimming alone sufficient to drive olfactory flow•External flow captured very efficiently by sturgeon's nasal anatomy•Impact-based mechanism for dispersing olfactory flow may be similar in other fishes•Flow through the olfactory sensory channels of a fish can be externally induced
Hyperglycemia and adverse pregnancy outcomes Metzger, Boyd E; Lowe, Lynn P; Dyer, Alan R ...
The New England journal of medicine,
05/2008, Letnik:
358, Številka:
19
Journal Article
Recenzirano
Odprti dostop
It is controversial whether maternal hyperglycemia less severe than that in diabetes mellitus is associated with increased risks of adverse pregnancy outcomes.
A total of 25,505 pregnant women at 15 ...centers in nine countries underwent 75-g oral glucose-tolerance testing at 24 to 32 weeks of gestation. Data remained blinded if the fasting plasma glucose level was 105 mg per deciliter (5.8 mmol per liter) or less and the 2-hour plasma glucose level was 200 mg per deciliter (11.1 mmol per liter) or less. Primary outcomes were birth weight above the 90th percentile for gestational age, primary cesarean delivery, clinically diagnosed neonatal hypoglycemia, and cord-blood serum C-peptide level above the 90th percentile. Secondary outcomes were delivery before 37 weeks of gestation, shoulder dystocia or birth injury, need for intensive neonatal care, hyperbilirubinemia, and preeclampsia.
For the 23,316 participants with blinded data, we calculated adjusted odds ratios for adverse pregnancy outcomes associated with an increase in the fasting plasma glucose level of 1 SD (6.9 mg per deciliter 0.4 mmol per liter), an increase in the 1-hour plasma glucose level of 1 SD (30.9 mg per deciliter 1.7 mmol per liter), and an increase in the 2-hour plasma glucose level of 1 SD (23.5 mg per deciliter 1.3 mmol per liter). For birth weight above the 90th percentile, the odds ratios were 1.38 (95% confidence interval CI, 1.32 to 1.44), 1.46 (1.39 to 1.53), and 1.38 (1.32 to 1.44), respectively; for cord-blood serum C-peptide level above the 90th percentile, 1.55 (95% CI, 1.47 to 1.64), 1.46 (1.38 to 1.54), and 1.37 (1.30 to 1.44); for primary cesarean delivery, 1.11 (95% CI, 1.06 to 1.15), 1.10 (1.06 to 1.15), and 1.08 (1.03 to 1.12); and for neonatal hypoglycemia, 1.08 (95% CI, 0.98 to 1.19), 1.13 (1.03 to 1.26), and 1.10 (1.00 to 1.12). There were no obvious thresholds at which risks increased. Significant associations were also observed for secondary outcomes, although these tended to be weaker.
Our results indicate strong, continuous associations of maternal glucose levels below those diagnostic of diabetes with increased birth weight and increased cord-blood serum C-peptide levels.
•Olfaction in the garpike, Belone belone, is likely assisted by swimming.•Jaws and mouth may also assist in odorant capture.•Nasal regions show mild to strong asymmetry.•Variation in nasal morphology ...influences pattern of olfactory flow.•Different vortex-like structures were observed, including a suspected horseshoe vortex.
Fishes have several means of moving water to effect odorant transport to their olfactory epithelium (‘olfactory flow’). Here we show that olfactory flow in the adult garpike Belone belone (Belonidae, Teleostei), a fish with an unusual nasal region, can be generated by its motion relative to water (swimming, or an external current, or both). We also show how the unusual features of the garpike’s nasal region influence olfactory flow. These features comprise a triangular nasal cavity in which the olfactory epithelium is exposed to the external environment, a papilla situated within the nasal cavity, and an elongated ventral apex. To perform our investigation we first generated life-like plastic models of garpike heads from X-ray scans of preserved specimens. We then suspended these models in a flume and flowed water over them to simulate swimming. By directing filaments of dye at the static models, we were able to visualise flow in the nasal regions at physiologically relevant Reynolds numbers (700–2,000). We found that flow of water over the heads did cause circulation in the nasal cavity. Vortices may assist in this circulation. The pattern of olfactory flow was influenced by morphological variations and the asymmetry of the nasal region. The unusual features of the nasal region may improve odorant sampling in the garpike, by dispersing flow over the olfactory epithelium and by creating favourable conditions for odorant transport (e.g. steep velocity gradients). Unexpectedly, we found that the mouth and the base of the garpike’s jaws may assist the sampling process. Thus, despite its apparent simplicity, the garpike’s nasal region is likely to act as an effective trap for odorant molecules.
Introduction
Pregnant women are at higher risk of severe illness from coronavirus disease 2019 (COVID‐19) than non‐pregnant women of a similar age. Early in the COVID‐19 pandemic, it was clear that ...evidenced‐based guidance was needed, and that it would need to be updated rapidly. The National COVID‐19 Clinical Evidence Taskforce provided a resource to guide care for people with COVID‐19, including during pregnancy. Care for pregnant and breastfeeding women and their babies was included as a priority when the Taskforce was set up, with a Pregnancy and Perinatal Care Panel convened to guide clinical practice.
Main recommendations
As of May 2022, the Taskforce has made seven specific recommendations on care for pregnant women and those who have recently given birth. This includes supporting usual practices for the mode of birth, umbilical cord clamping, skin‐to‐skin contact, breastfeeding, rooming‐in, and using antenatal corticosteroids and magnesium sulfate as clinically indicated. There are 11 recommendations for COVID‐19‐specific treatments, including conditional recommendations for using remdesivir, tocilizumab and sotrovimab. Finally, there are recommendations not to use several disease‐modifying treatments for the treatment of COVID‐19, including hydroxychloroquine and ivermectin. The recommendations are continually updated to reflect new evidence, and the most up‐to‐date guidance is available online (https://covid19evidence.net.au).
Changes in management resulting from the guidelines
The National COVID‐19 Clinical Evidence Taskforce has been a critical component of the infrastructure to support Australian maternity care providers during the COVID‐19 pandemic. The Taskforce has shown that a rapid living guidelines approach is feasible and acceptable.
Tauopathies display a spectrum of phenotypes from cognitive to affective behavioral impairments; however, mechanisms promoting tau pathology and how tau elicits behavioral impairment remain unclear. ...We report a unique interaction between polyamine metabolism, behavioral impairment, and tau fate. Polyamines are ubiquitous aliphatic molecules that support neuronal function, axonal integrity, and cognitive processing. Transient increases in polyamine metabolism hallmark the cell's response to various insults, known as the polyamine stress response (PSR). Dysregulation of gene transcripts associated with polyamine metabolism in Alzheimer's disease (AD) brains were observed, and we found that ornithine decarboxylase antizyme inhibitor 2 (AZIN2) increased to the greatest extent. We showed that sustained AZIN2 overexpression elicited a maladaptive PSR in mice with underlying tauopathy (MAPT P301S; PS19). AZIN2 also increased acetylpolyamines, augmented tau deposition, and promoted cognitive and affective behavioral impairments. Higher-order polyamines displaced microtubule-associated tau to facilitate polymerization but also decreased tau seeding and oligomerization. Conversely, acetylpolyamines promoted tau seeding and oligomers. These data suggest that tauopathies launch an altered enzymatic signature that endorses a feed-forward cycle of disease progression. Taken together, the tau-induced PSR affects behavior and disease continuance, but may also position the polyamine pathway as a potential entry point for plausible targets and treatments of tauopathy, including AD.
Agricultural systems models worldwide are increasingly being used to explore options and solutions for the food security, climate change adaptation and mitigation and carbon trading problem domains. ...APSIM (Agricultural Production Systems sIMulator) is one such model that continues to be applied and adapted to this challenging research agenda. From its inception twenty years ago, APSIM has evolved into a framework containing many of the key models required to explore changes in agricultural landscapes with capability ranging from simulation of gene expression through to multi-field farms and beyond.
Keating et al. (2003) described many of the fundamental attributes of APSIM in detail. Much has changed in the last decade, and the APSIM community has been exploring novel scientific domains and utilising software developments in social media, web and mobile applications to provide simulation tools adapted to new demands.
This paper updates the earlier work by Keating et al. (2003) and chronicles the changing external challenges and opportunities being placed on APSIM during the last decade. It also explores and discusses how APSIM has been evolving to a “next generation” framework with improved features and capabilities that allow its use in many diverse topics.
•APSIM is an agricultural modelling framework used extensively worldwide.•It can simulate a wide range of agricultural systems.•It begins its third decade evolving into an agro-ecosystem framework.
In 1988, an important publication moved model calibration and forecasting beyond case studies and theoretical analysis. It reported on a somewhat idyllic graduate student modeling exercise where many ...of the system properties were known; the primary forecasts of interest were heads in pumping wells after a river was modified. The model was calibrated using manual trial‐and‐error approaches where a model's forecast quality was not related to how well it was calibrated. Here, we investigate whether tools widely available today obviate the shortcomings identified 30 years ago. A reconstructed version of the 1988 true model was tested using increasing parameter estimation sophistication. The parameter estimation demonstrated the inverse problem was non‐unique because only head data were available for calibration. When a flux observation was included, current parameter estimation approaches were able to overcome all calibration and forecast issues noted in 1988. The best forecasts were obtained from a highly parameterized model that used pilot points for hydraulic conductivity and was constrained with soft knowledge. Like the 1988 results, however, the best calibrated model did not produce the best forecasts due to parameter overfitting. Finally, a computationally frugal linear uncertainty analysis demonstrated that the single‐zone model was oversimplified, with only half of the forecasts falling within the calculated uncertainty bounds. Uncertainties from the highly parameterized models had all six forecasts within the calculated uncertainty. The current results outperformed those of the 1988 effort, demonstrating the value of quantitative parameter estimation and uncertainty analysis methods.
Article impact statement: The power of today's calibration and uncertainty tools and approaches is demonstrated by revisiting a landmark work from 30 years ago.
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