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• HRV indices predict multidimensional driving-related fatigue. • Lower RMSSD associated with greater fatigue in young drivers. • Higher LF/HF ratio linked to higher fatigue levels. • Findings support HRV metrics as fatigue biomarkers. • Applied research needed to validate real-world use. Driver fatigue significantly impairs performance and is a major risk factor for road crashes. However, fatigue is difficult to objectively measure and quantify. This study aimed to elucidate associations between heart rate variability (HRV) metrics and multidimensional fatigue construct encompassing objective and subjective measures in young drivers with self-reported short sleep. Eighty-four young adults underwent assessments during simulated driving. HRV indices RMSSD and LF/HF ratio were derived from an electrocardiogram, while relative Theta power, oculography drowsiness, lane position variability, and Karolinska Sleepiness Score measured fatigue. RMSSD negatively correlated with Theta power, and LF/HF ratio positively correlated with position variability. Exploratory factor analysis extracted three factors, with RMSSD and LF/HF loading onto one. Structural equation modelling tested the prediction of a latent fatigue construct from HRV. Two models demonstrated an acceptable fit. RMSSD negatively predicted fatigue, explaining 6.4 % of the variance, while the LF/HF ratio positively predicted fatigue, accounting for 3.7 % of the variance. In summary, HRV, particularly RMSSD, showed significant relationships with multidimensional fatigue. Lower RMSSD and higher LF/HF ratio are associated with greater fatigue levels. This study demonstrates that HRV indices exhibit significant relationships within a multidimensional model of fatigue incorporating objective performance, ocular, and subjective measures. The findings provide initial evidence towards using HRV for monitoring complex manifestations of fatigue, rather than single dimensions. Further applied research should investigate translating these findings to naturalistic settings and validating HRV thresholds predictive of on-road impairment. [ABSTRACT FROM AUTHOR]

• The case fatality rate of group A Streptococcus bacteremia can rise to 48%. • However, the optimal duration of antimicrobial treatment is uncertain. • In this study, the patients' all-cause 90-day mortality rate of 5.6% was low. • Importantly, all-cause mortality was no greater with shorter antibiotic courses. • Group A Streptococcus bacteremia can be safely treated with shorter courses of antimicrobial therapy. To determine if shorter courses of antibiotic therapy for group A Streptococcus (GAS) bacteremia are associated with excess mortality. In this retrospective study of consecutive cases of GAS bacteremia in tropical Australia, the duration of antibiotic therapy was correlated with 90-day all-cause mortality. There were 286 episodes of GAS bacteremia; the patients' median (interquartile range) age was 60 (48-71) years and 169/286 (59.1%) patients identified as an Indigenous Australian. There were 227/286 (79.4%) patients with a significant comorbidity. The all-cause 90-day mortality was 16/286 (5.6%); however, 12/16 (81.3%) patients died while still receiving their initial course of antibiotics and only 7/16 (43.8%) deaths were directly attributable to the GAS infection. After excluding patients who died while taking their initial course of antibiotics and those in whom the duration of therapy was uncertain, there was no difference in 90-day mortality between patients receiving ≤5 days of intravenous antibiotics and those receiving longer courses (1/137 [0.7%] vs 3/107 [2.8%], P -value = 0.32) nor in patients receiving ≤10 days of total therapy and those receiving longer courses (1/67 [1.5%] vs 3/178 [1.7%], P -value = 1.0). Even among patients with significant comorbidity, shorter antibiotic courses for GAS bacteremia are not associated with excess mortality. [ABSTRACT FROM AUTHOR]

There is a correlation between certain aspects of Buddhist philosophy and concepts of contemporary social thought such that knowledge of Buddhist ideas on personality construction can enhance our understanding of contemporary patterns of selfhood. This is the reason for Buddhism's continuing existence in today's fragmented societies. Some people adhere to the ancient philosophy as part of an alternative and transitory lifestyle while others permanently embrace the ancient philosophy in its purest form.

• Rickettsial infections are difficult to diagnose and usually treated empirically. • It is taught that fever typically resolves in patients after <48 hours of therapy. • It is taught that this can distinguish rickettsial infection from other pathogens. • In this series most patients' fever persisted for >48 hours after therapy commenced. • We should discard the dogma that fever settles rapidly in rickettsial infections. Clinicians are commonly taught that if patients with suspected rickettsial disease have continuing fever after 48 hours of anti-rickettsial therapy, an alternative diagnosis is likely. This retrospective study of patients hospitalised with scrub typhus and Queensland tick typhus (QTT) in tropical Australia, examined the time to defervescence after initiation of the patients' anti-rickettsial therapy. It also identified factors associated with delayed defervescence (time to defervescence >48 hours after antibiotic commencement). Of the 58 patients, 32 (56%) had delayed defervescence. The median (interquartile range (IQR)) age of patients with delayed defervescence was 52 (37-62) versus 40 (28-53) years in those who defervesced within 48 hours (p = 0.05). Patients with delayed defervescence were more likely to require Intensive Care Unit (ICU) admission than those who defervesced within 48 hours (12/32 (38%) versus 3/26 (12%), p = 0.02). Even among patients not requiring ICU care, patients with delayed defervescence required a longer hospitalisation than that those who defervesced within 48 hours (median (IQR): 6 (3-8) versus 3 (2-5) days, p = 0.006). A significant proportion of patients with confirmed scrub typhus and QTT will remain febrile for >48 hours after appropriate anti-rickettsial therapy. Delayed defervescence is more common in patients with severe disease. [ABSTRACT FROM AUTHOR]

It has been shown that language learners can benefit from a discovery-based learning process whereby they construct as well as consult their own specialist corpora and vocabulary portfolios, for the purposes of translator training (Castagnoli 2006), for general English (Smith 2011) and for academic English learning (Charles 2012; Smith 2015). In the present study, a cohort of 94 international students on an EAP module, majoring in Accounting and Finance, was divided into hands-on (treatment) and hands-off (control) groups. Both groups were subjected to a pre-test consisting of specialist terms that would be encountered on their course (not only in the EAP class, but also on the Accounting and Finance modules). The hands-on group spent about 20 min per weekly class constructing domain-specific DIY corpora and generating subject vocabulary portfolios. The results of a post-test indicated that the hands-on group had achieved a slightly greater improvement in domain vocabulary knowledge than the hands-off group (which used corpora and vocabulary lists provided by the teacher). A participant questionnaire showed that the students found the approaches useful for vocabulary learning. • Language learners can benefit from corpus-based approaches to learning. • Most corpus approaches involve consulting corpora made by others. • This project gives learners sense of ownership from creating their own corpora. • Helps learners engage with financial vocabulary in academic English. [ABSTRACT FROM AUTHOR]

While interest in using 3D scanning technology for crime scene investigation (CSI) has grown in recent years, a number of barriers still remain that prevent its wide adoption in the criminal justice system. One such barrier comes from the lack of tools that can validate a 3D scan and verify that it has not been manipulated. While a great deal of research has gone into the detection of manipulations for 2D images, the detection of manipulations for 3D scenes has yet to be fully realized. This paper introduces a series of techniques to detect if a 3D point cloud generated from a LiDAR scan has been subsequently manipulated. These techniques exploit fundamental structures inherent in the collection and storage of these types of data. While the proposed techniques are able to detect a number of different types of manipulations, their limitations are also discussed. The goal of this work is to provide a foundation for the creation of a validation toolkit that can ensure 3D scan data is valid and unaltered. • Method to detect manipulations in 3D scan data using the gradients of density. • Method to detect manipulations in 3D scan data using a spherical sampling. • Method to detect manipulations in 3D scan data using file structure analysis. • Discussion on limitations of the developed methods. • Discussion on the motivation and implications for these methods in the criminal justice system. [ABSTRACT FROM AUTHOR]

Total hip replacement with metal-on-polymer hip prostheses is the most common treatment for late-stage osteoarthritis. However, the wear debris generated from the polymer acetabular liner remains a problem. Alternative materials with claimed superior wear properties have been proposed to overcome this problem. In this study, the wear behaviour of carbon fibre reinforced polyether ether ketone (CFR PEEK) was investigated under different contact stresses that are observed in the natural hip joint. A 50-station pin-on-disc machine (SuperCTPOD) was used to investigate the wear behaviour of 50 CFR PEEK pins articulated against cobalt chromium (CoCr) discs under five different contact stresses, namely 1.11, 1.38, 1.61, 2.00 and 5.30 MPa. The results showed that the wear rates of the pins did not differ significantly between groups under different contact stresses. In addition, CFR PEEK produced lower wear rates than ultrahigh molecular weight polyethylene and cross-linked polyethylene. However, the weight of the CoCr discs was found to decrease significantly at the end of the wear test, which was indicative of metallic wear. The findings of this study indicated that, despite having relatively low wear rates, CFR PEEK is not a good alternative to be utilised against orthopaedic metals. [ABSTRACT FROM AUTHOR]

Wear of polyethylene is a current limitation in the long-term survival of reverse shoulder arthroplasties (RSAs). The purpose of this study was to investigate, for the first time, the influence of a combination of clinically relevant activities of daily living (ADLs) as patterns of motion and loading on the wear of ultra-high molecular-weight polyethylene (UHMWPE) in RSA. This physiological combined cycle, termed "repeated-motion-load", was applied on four new samples of a commercially available reverse shoulder prosthesis for five million cycles using the unique Newcastle Shoulder Wear Simulator. This resulted in a mean wear rate of 12.0 ± 3.9 mm3/million cycles for the UHMWPE components in combination with metallic glenospheres, while the average articulating UHMWPE surface roughness reduced from 692 ± 132 nm Sa to 42 ± 29 nm Sa. fx1 [ABSTRACT FROM AUTHOR]

Abstract Concerns have been published about the cases of non-conservatism when the BS 7910 option 2 Failure Assessment Curve (FAC) is used in the Strain Based Analysis and Design (SBAD) regime. An assessment of these concerns has been made using an analytical solution for the Crack Driving Force (CDF) associated with an infinite notched strip. It was shown that the option 2 FAC could underpredict the CDF for this case and that the level of error was bigger for lower levels of strain hardening. A modification to the option 2 FAC is proposed. The modification has been studied in other publications and has been shown to provide conservatism in all cases investigated to-date. Highlights • A modification to the option 2 FAC for SBAD is proposed. • Application in the SBAD regime provides conservatism. • A modification is proposed for the transition between the SSY and SBAD regimes. [ABSTRACT FROM AUTHOR]

Tourism can help regenerate post-colonial, post-conflict and post-disaster destinations (PCCDs), and national governments and destination marketing organisations (DMOs) play a central role in this. They face the dilemma of either consolidating tourism situations with seemingly safe, known, predictable steps, or taking more ambitious risk-prone, less tried-and-tested and more uncertain approaches. This choice can be portrayed as the respective exploitative and explorative dimensions of strategic conceptual framework of organisational ambidexterity (OA). This regional spotlight provides a conceptual analysis using the lens of OA to examine these dynamics. It focuses on the specific case of Haiti, set within the context of the Caribbean region. A range of OA effects in relation to tourist enclaves is identified. In particular, the spotlight argues for less segregation and separation between tourist and local populations, along with a need for DMOs to espouse more exploitative-explorative postures. In terms of wider implications, it can be argued that other Caribbean economies might learn lessons from the discussion of the Haitian case. [ABSTRACT FROM AUTHOR]

This systematic review explored the outcomes of current interventions to increase sleep duration in healthy young people (14–25 years). Nine databases were systematically searched, and 26 studies were included in this review. Quality assessment of the included studies was evaluated using two tools: the Newcastle-Ottawa scale, and Cochrane Risk of Bias. The interventions incorporated a range of strategies including behavioral (46.2%), educational (26.9%), a combination of behavioral and educational (15.4%), and other strategies such as physical therapy (11.5%). The findings indicate that behavioral and combination interventions were consistently effective in increasing sleep duration in healthy young people. Educational interventions alone were less effective at increasing young people's sleep duration. Of all the included studies, only one randomized control trial but none of the non-randomized trials were rated as good quality. Our findings suggest a combination of strategies with an emphasis on personalization of intervention could possibly maximize the chances of success at improving sleep duration in healthy young people. More high-quality studies with long-term assessments (≥ 6 months) should be conducted to test the efficacy and durability of interventions to increase sleep duration in young people, as well as the clinical implications to mental and physical health. [ABSTRACT FROM AUTHOR]

Insomnia and sleep apnoea are the two most common sleep disorders, found in 6% and 23-50% of the general population respectively. These disorders also frequently co-occur, with 39-58% of sleep apnoea patients reporting symptoms indicative of co-morbid insomnia. When these disorders co-occur, clinicians are faced with difficult treatment decisions, patients experience the additive detrimental impacts of both disorders, and the effectiveness of discrete treatments for each disorder may be impaired. A common finding is that co-morbid insomnia and sleep apnoea (COMISA) is more difficult to treat than either disorder presenting alone. Co-morbid insomnia reduces the initial acceptance of, and later adherence to, continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea. This has resulted in recent recommendations that treatment approaches should initially target COMISA patients' insomnia to remove this barrier to CPAP treatment, and improve patient outcomes. However, no randomised controlled trial outcomes investigating this treatment approach currently exist. The current article aims to review and integrate recent research examining the prevalence, characteristics, and theoretical mechanistic relationships between co-occurring insomnia and OSA, and discuss previous treatment attempts. [ABSTRACT FROM AUTHOR]

The term driving self-regulation is typically used to describe the practice of drivers who avoid driving in situations that they regard as unsafe because of perceived physical impairment. Older adults report using this strategy to improve safety while retaining mobility. Self-regulation is typically assessed using the driving avoidance items from the driving habits questionnaire (DHQ) and the driver mobility questionnaire (DMQ-A). However, the psychometric properties of these measures are not well understood. Using data from 277 older drivers, exploratory factor analysis was used to test the homogeneity of three driving self-regulation scales: the DHQ, DMQ-A, and an extended DMQ-A. Good internal consistency for each of the scales was identified (all α s ≥ .9). A one factor solution was identified for two of the measures (DHQ, DMQ-A) and a two factor solution accounting for over 70% of the score variance was identified for the third measure. The two factors assessed situations that may be avoided while driving because of the “external” (e.g., weather-related) or “internal” (e.g., passenger-related) driving environments, respectively. The findings suggest that the interpretation of an overall summated scale score, or single-item interpretations, may not be appropriate. Instead, driving self-regulation may be a multifaceted construct comprised of distinct dimensions that have not been identified previously but can be reliably measured. These data have implications for our understanding of driving self-regulation by older adults and the way in which this behavior is measured. [ABSTRACT FROM AUTHOR]

The paper investigates whether, how and in what circumstances boundary blurring or boundary maintenance is productive or destructive of sense in collaborative research based on a case study involving researchers from two universities and two principal organisational stakeholders in a local healthcare system in England between 2009 and 2012. Adopting a narrative method, using meeting observation, document analysis and interviews, we describe two key sets of activities in the evolution of collaboration, which allows us to tackle the question at two levels. Studying the production of documents and their use as boundary objects in project management meetings, we show how these were used to enable cooperation by establishing a truce between worldviews, giving participants a better feel for the game and a clearer perception of its stakes. Studying how the partnership expanded to take in other organisations besides the two formal partners, we show how the project accommodated pre-existing organisational interests but thereby sacrificed its experimental ethos. In showing how actors needed to subvert their experimental script to enact collaborative partnership, we argue for understanding and evaluating the latter as the co-produced outcome of disputes and co-orientations towards a practical ideal, not as an organisational format for knowledge co-production. [ABSTRACT FROM AUTHOR]

• How experts talk publicly about mental illness is a longstanding ethical concern. • Experts are communicable in two different ways – reportability and tellability. • Media dialogical networks are integrated categorially and narratively. • Media dialogical networking involves trade-offs between tellability and reportability. • Narrative translations of dialogical networks can reorder membership categories. This paper examines two controversies implicating psychiatrists in order to shine a light on the ethics of experts' media dialogical networking. Employing a dual approach to discourse underpinned by membership categorisation and narrative analysis, and making a corresponding distinction between communicability as reportability and as tellability, I show that MDNs are not just sequences of arguments and counter-arguments, but also sequences of happenings that redefine situations and reposition actors. In the cases examined, each expert is accused of inappropriate behaviour – public talk unbecoming of experts. I reconstruct the interactive negotiations around communication ethics between experts and journalists in interviews and show how these interactions and the distributed reactions they provoked elsewhere in the controversy-related MDNs were narrativised in summarising news reports and interview introductions, positioning experts more as protagonists than as category incumbents. Taking media dialogical networking as social practice and performative discursive repertoire, I show how its dual – narrative-routine – performance involves trade-offs between reportability and tellability, rendering problematic any simple rule covering experts' voice entitlements, i.e. knowing when, where and how it is appropriate to offer a professional opinion. The public conversation about mental illness, however, is enriched by these imbrications. [ABSTRACT FROM AUTHOR]

Purpose Young adults regularly experience restricted sleep due to a range of social, educational, and vocational commitments. Evidence suggests that extended periods of sleep deprivation negatively impact affective and inhibitory control mechanisms leading to behavioral consequences such as increased emotional reactivity and impulsive behavior. It is less clear whether acute periods of restricted sleep produce the same behavioral consequences.Methods Nineteen young adults (m = 8 and f = 12) with habitual late bedtime (after 22:30 h) and wake time (after 06:30 h) completed a range of objective and subjective measures assessing sleepiness (psychomotor vigilance task and Karolinska sleepiness scale), inhibitory control (emotional go/no-go task and a balloon analog risk task), and affect (positive and negative affective schedule). Testing was counterbalanced across participants and occurred on two occasions once following restricted sleep and once following habitual sleep 1 week apart.Results Compared with habitual sleep, sleep restriction produced significantly slower performance on the psychomotor vigilance task and higher subjective ratings of sleepiness on the Karolinska sleepiness scale. Sleep restriction also caused a significant decrease in positive affect but no change in negative affect on the affective schedule. Inhibitory control efficiency was significantly differentiated, with participants showing an increase in risk taking on the balloon analog risk task, but there was no evidence of increased reactivity to negative stimuli on the emotional go/no-go task.Conclusions Results suggest that even acute periods of sleep loss may cause deficits in affective experiences and increase impulsive and potentially high-risk behavior in young adults. [ABSTRACT FROM AUTHOR]

Night-waking is typical across infancy and early childhood, inevitably disrupting family sleep. For some children, sleep problems develop and endure throughout childhood. This systematic review focused on fathers, and synthesised the evidence pertaining to the effects of children's sleep (from birth to 12 years) on fathers' health and wellbeing. A total of 29 studies were included. Key outcomes reported for fathers were: sleep and fatigue; mental and general health; and family functioning. An association between child sleep and father's sleep was observed when child's sleep was measured via actigraphy or paternal report, but not when measured via maternal report, suggesting that mothers may not always be aware of disruptions that awaken fathers. Findings showed poorer child sleep was associated with poorer general health and wellbeing among fathers, however, associations of poor child sleep with depression were fewer, and less frequent than those reported for mothers in the same households. Poor child sleep was negatively associated with the quality of family relationships, both within the couple and between parent and child. Future studies seeking to understand the interplay of child sleep and family wellbeing should apply objective measurement of sleep and integrate formal measures of family dynamics into the study design. [ABSTRACT FROM AUTHOR]

Insomnia and obstructive sleep apnea (OSA) commonly co-occur. Approximately 30-50% of patients with OSA report clinically significant insomnia symptoms, and 30-40% of patients with chronic insomnia fulfil diagnostic criteria for OSA. Compared to either insomnia or OSA alone, co-morbid insomnia and sleep apnea (COMISA) is associated with greater morbidity for patients, complex diagnostic decisions for clinicians, and reduced response to otherwise effective treatment approaches. Potential bi-directional causal relationships between the mechanisms and manifestations of insomnia and OSA could play an integral role in the development and management of COMISA. A greater understanding of these relationships is required to guide personalized diagnostic and treatment approaches for COMISA. This review summarizes the available evidence of bi-directional relationships between COMISA, including epidemiological research, case studies, single-arm treatment studies, randomized controlled treatment trials, and objective sleep study data. This evidence is integrated into a conceptual model of COMISA to help refine the understanding of potential bi-directional causal relationships between the two disorders. This theoretical framework is essential to help guide future research, improve diagnostic tools, determine novel therapeutic targets, and guide tailored sequenced and multi-faceted treatment approaches for this common, complex, and debilitating condition. [ABSTRACT FROM AUTHOR]

Abstract: Self-regulation is often promoted as a coping strategy that may allow older drivers to drive safely for longer. Self-regulation depends upon drivers making an accurate assessment of their own ability and having a willingness to practice self-regulatory behaviors to compensate for changes in ability. The current study explored the relationship between older drivers’ cognitive ability, their driving confidence and their use of self-regulation. An additional study aim was to explore the relationship between these factors and older drivers’ interest in driving programs. Seventy Australian drivers aged 65 years and over completed a questionnaire about their driving and a brief screening measure of cognitive ability (an untimed Clock Drawing Test). While all participants reported high levels of confidence regarding their driving ability, and agreed that they would continue driving in the foreseeable future, a notable proportion performed poorly on the Clock Drawing Test. Compared to older drivers who successfully completed the Clock Drawing Test, those who failed the cognitive test were significantly less likely to report driving self-regulation, and showed significantly less interest in being involved in driving programs. Older drivers with declining cognitive abilities may not be self-regulating their driving. This group also appears to be unlikely to self-refer to driving programs. [Copyright &y& Elsevier]

Abstract: A case of left atrial leiomyosarcoma is reported. A forty year-old woman presented to hospital with a history of shortness of breath and tachycardia. Imaging revealed a left atrial mass which was surgically resected and shown to be a leiomyosarcoma. Adjuvant treatment with external beam radiotherapy was prescribed. The treatment planning was complicated by previous radiotherapy for a left sided primary breast tumour one year previously. Primary cardiac neoplasms are rare, with leiomyosarcoma representing a tiny proportion of these. Limited data is available on the effectiveness of treatment regimes for cardiac leiomyosarcoma due to its rarity. Treatment planning considerations and the strategy adopted for this case are discussed. [Copyright &y& Elsevier]

Abstract: The chevron and scarf osteotomies are commonly used for the surgical management of hallux valgus (HV). However, there is debate as to whether one osteotomy provides more 1–2 intermetatarsal (1–2 IMA) correction than the other. The objective of this systematic review and meta-analysis was to compare the effectiveness of 3 types of first metatarsal osteotomy for reducing the 1–2 IMA in HV correction: the chevron osteotomy, the long plantar arm (modified) chevron osteotomy, and the scarf osteotomy. A systematic search for eligible studies was performed of the following databases: Medline, Embase (Ovid), CINAHL (EBSCO Host), and The Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Clinical Trials. Only English-language studies previous to May 2010 were included in the review. Additional hand and electronic content searches of relevant foot and orthopaedic journals were performed. Criteria for inclusion in this analysis included systematic reviews of randomized controlled trials, prospective and retrospective cohort studies, and case-control studies, as well as case-series studies involving the chevron, scarf, or long plantar arm chevron osteotomy of >20 participants with a minimum of 80% follow-up. Quality of evidence of the included studies was assessed with the Grading of Recommendations Assessment, Development and Evaluation system. All pooled analyses were based on a fixed effects model. There was a total of 1351 participants who underwent either a chevron (n = 1028), scarf (n = 300), or long plantar arm chevron osteotomy (n = 23). Only one study for the long plantar arm chevron group fitted the eligibility criteria for this review; however, it was not amenable to meta-analysis. The chevron osteotomy was associated with a mean reduction of 1–2 IMA from preoperative to postoperative of 5.33° (95% confidence interval, 5.12 to 5.54, p < .001), and the scarf osteotomy was associated with a mean reduction of 6.21° (95% confidence interval, 5.70 to 6.72, p < .001). There was a statistically significant 0.88° increase in the correction of the 1–2 IMA in favor of the scarf osteotomy compared with the chevron osteotomy. The studies included in this review were of very low- to low-quality evidence. Our findings indicate that the scarf osteotomy provides greater correction of the 1–2 IMA when used for HV correction. However, only a weak recommendation in favor of the scarf osteotomy can be made based on the low quality of evidence of the studies included in this analysis. [ABSTRACT FROM AUTHOR]