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This study assessed the impacts of a toll information sign with different toll lane configurations on queue length and collision risk at a toll plaza with an estimated high percentage of heavy vehicles (HVs). The toll information sign displays information about different toll payment methods for cars and HVs upstream of the toll booth. The impacts were assessed for the toll plaza of the Gordie Howe International Bridge under construction at the Windsor–Detroit international border crossing using a traffic simulation model. Results show that the toll information sign upstream of the toll plaza and converting the toll lanes with multiple toll payment methods to electronic toll collection (ETC)-only lanes reduced queue length and collision risk. However, increasing the number of HV-only lanes for a higher percentage of HVs increased lane-change collision risk. Thus, it is recommended that toll lane configurations be changed based on the percentage of HVs to reduce collision risk at a toll plaza.

This study develops a differential variable speed limit (DVSL) which assigns different speed limits for car and truck, and varies speed limits based on traffic conditions. The proposed DVSL algorithm changes speed limits in real time based on truck percentage and occupancy immediately upstream of the ramp and the average speed of the control road sections upstream of the ramp. DVSL algorithm also considers spatial coordination of speeds, which gradually changes the speed limits in successive road sections upstream of the ramp when the severe congestion occurs. The study tested the impacts of DVSL and three other speed limit strategies on delay and safety for a section of the Gardiner Expressway in Toronto, Canada using the VISSIM traffic simulation model. The other strategies are 1) uniform speed limit (USL), 2) differential speed limit for car and truck (DSL), and 3) USL & DSL (U&D) – i.e., USL at low truck percentage and DSL at high truck percentage. It was found that DVSL showed the lowest delays for both car and truck among the four strategies. This is mainly because DVSL increased the spacing between vehicles in the right lane upstream of the on-ramp and facilitated vehicles' merging into the mainline freeway. It was also found that DVSL showed the lowest likelihood of rear-end crash between the lead and following vehicles among the four strategies. This study demonstrates that the proposed DVSL algorithm can better control car and truck speeds to reduce delay and improve safety of car-truck mixed traffic flow on freeways.

Abstract Background A significant proportion of children and young people with juvenile idiopathic arthritis (JIA) do not achieve inactive disease during the first two years following diagnosis. Refinements to clinical care pathways have the potential to improve clinical outcomes but a lack of consistent and contemporaneous clinical data presently precludes standard setting and implementation of meaningful quality improvement programmes. This study was the first to pilot clinical data collection and analysis using the CAPTURE-JIA dataset, and to explore patient and clinician-reported feasibility and acceptability data. Methods A multiphase mixed-methods approach enabled prospective collection of quantitative data to examine the feasibility and efficacy of dataset collection and of qualitative data informing the context and processes of implementation. An initial paper pilot informed the design of a bespoke electronic data collection system (the Agileware system), with a subsequent electronic pilot informing the final CAPTURE-JIA data collection tool. Results Paper collection of patient data was feasible but time-consuming in the clinical setting. Phase 1 paper pilot data (121 patients) identified three themes: problematic data items (14/62 data items received >40% missing data), formatting of data collection forms and a clinician-highlighted need for digital data collection, informing Phase 2 electronic data collection tool development. Patients and families were universally supportive of the collection and analysis of anonymised patient data to inform clinical care. No apparent preference for paper / electronic data collection was reported by families. Phase 3 electronic pilot data (38 patients) appeared complete and the system reported to be easy to use. Analysis of the study dataset and a dummy longitudinal dataset confirmed that all eleven JIA national audit questions can be answered using the electronic system. Conclusions Multicentre CAPTURE-JIA data collection is feasible and acceptable, with a bespoke data collection system highlighted as the most satisfactory solution. The study is informing ongoing work towards a streamlined and flexible national paediatric data collection system to drive quality improvement in clinical care.

Abstract Our objective was to examine differences in cytokine/chemokine response in chronic hepatitis B(CHB) patients to understand the immune mechanism of HBsAg loss (functional cure) during antiviral therapy. We used an unbiased machine learning strategy to unravel the immune pathways in CHB nucleo(t)side analogue-treated patients who achieved HBsAg loss with peg-interferon-α(peg-IFN-α) add-on or switch treatment in a randomised clinical trial. Cytokines/chemokines from plasma were compared between those with/without HBsAg loss, at baseline, before and after HBsAg loss. Peg-IFN-α treatment resulted in higher levels of IL-27, IL-12p70, IL-18, IL-13, IL-4, IL-22 and GM-CSF prior to HBsAg loss. Probabilistic network analysis of cytokines, chemokines and soluble factors suggested a dynamic dendritic cell driven NK and T cell immune response associated with HBsAg loss. Bayesian network analysis showed a dominant myeloid-driven type 1 inflammatory response with a MIG and I-TAC central module contributing to HBsAg loss in the add-on arm. In the switch arm, HBsAg loss was associated with a T cell activation module exemplified by high levels of CD40L suggesting T cell activation. Our findings show that more than one immune pathway to HBsAg loss was found with peg-IFN-α therapy; by myeloid-driven Type 1 response in one instance, and T cell activation in the other.

A position sensing glove called SmartScan, which creates a 3D virtual model of a real object, is presented. The data from the glove is processed by a volume minimization algorithm to validate the position sensor data. This allows only data from the object’s surface to be retained. The data validation algorithm allows the user to progressively improve an image by repeatedly moving their hand over the object. In addition, the user can choose their own balance between feature resolution and invalid data rejection. The SmartScan glove is tested on a foot model and is shown to be robust against motion artifacts, having a mean accuracy of 2.9 mm (compared to a 3D model generated from optical imaging) without calibration.

Background and Objective Continuous sleep is important for cognitive function; studies have shown that disrupted sleep has a deleterious effect on hippocampus-dependent cognitive function, but the exact mechanism is unknown. The inflammasome NOD-like receptor protein-3 (NLRP-3) has been reported to cause memory and cognitive dysfunction, but no studies have examined whether NLRP-3 is up-regulated in the hippocampus by sleep fragmentation (SF). Therefore, we investigated whether SF affected NLRP-3 activation in the rat hippocampus in a wheel-based SF model. Methods We randomly divided 7-week-old male Wistar rats into 4-day SF, 4-day exercise control (EC), 8-day SF, and 8-day EC groups. SF was accomplished with a forced walking wheel with a 30-s on/90-s off cycle, and we set EC at 10 min on/30 min off. We performed Western blots to compare NLRP-3 expression levels, and we measured malondialdehyde (MDA) levels in the hippocampus with a commercial kit. Results The SF group had more but shorter NREM bouts. Western blot analysis revealed that 4 and 8 days of SF up-regulated the expression of the NLRP-3 complex in the hippocampus including ASC, caspase-1, and IL-1β. Thioredoxin-interacting protein expression also increased more in the SF group, and the MDA level increases were greater in the SF groups than in the corresponding EC groups. Conclusions SF up-regulates NLRP-3 in the hippocampus. Additional behavioral and mechanistic studies are required to clarify the role of NLRP-3 in the hippocampi of rats subjected to SF.

The kindergarten program, Tools of the Mind (Tools), has been shown to improve executive functions (as assessed by laboratory measures) and academic performance. The objective here was to see if Tools can improve executive functions in the real world (in the classroom), academic outcomes not previously investigated, reduce bullying and peer ostracism, and increase teachers' and students' joy in being in the classroom. This first randomized controlled trial of Tools in Canada included 351 kindergarten children (mean age 5.2 years at entry; 51% female) in 18 public schools. Stratified randomization resulted in teachers and students in both groups being closely matched. Teachers in both groups received the same number of training hours and same funds for new materials. Outcome measures were pre and post standardized academic skill assessments and teacher online survey responses. This study replicated that Tools improves reading and shows for the first time that it improves writing (far exceeding levels the school districts had seen before), self-control and attention-regulation in the real world (e.g., time on task without supervision), reduces teacher burnout and children being ostracized or excluded, and increases the joy students and teachers experience in school. By Spring, Tools teachers were still enthusiastic about teaching; control teachers were exhausted. These results were not only better than the control group but also better than Tools teachers experienced the year before Tools. Thus, children in a kindergarten curriculum that emphasized play, improving self-regulation, working together and helping one another, and hands-on learning performed better academically, showed less bullying and peer ostracism and more kindness and helping behavior than students in more traditional classes, and teacher enthusiasm for teaching soared. Tools reduced initial disparities separating children, schools, and teachers.

Background: The aim of this study is to understand how left-handed (LH) dental students perceive their education and identify areas for improvement in their training. Methods: All LH students in their senior clinical years of their programs, at the nine Australian dental schools, were invited to participate in the study, by completing an online questionnaire. Results: A total of 40 students responded to the survey. The clinical disciplines ranked most often in the top 3 for difficulty were operative (restorative) dentistry (73%), followed by similar percentages for periodontics (49%), prosthodontics (46%), oral surgery (45%) and endodontics (44%). Areas for improvement that ranked highest were instructors and supervisors, and dental chair orientation (both at 26%). Operating tools and equipment, and dental chair orientation (68%) were most often ranked in the top 3, followed by the interior design of the room (63%) and instructors and supervisors (61%). Keywords: dental education, left-handed dental students, perceived difficulties, improvements Conclusion: The findings suggest that LH students perceived greater difficulty from the inconvenience caused by inadequate design of the surgery and chair, and due to a lack of personalised teaching. The findings of this study support a need for alterations to learning environment to better support LH students in learning specific procedures and increasing access to individualised teaching approaches.

As there is frequently a reciprocal relationship between oleic acid and linoleic acid content in LDL after dietary supplementation, it is difficult to determine the independent effects of oleic and linoleic acid on LDL oxidation. It is also unknown whether monounsaturated fatty acid enrichment might reduce the generation of proinflammatory products that occur when the polyunsaturated fatty acidrich phospholipids within lipoproteins undergo mild oxidation. To address these issues, we exposed liposomes containing variable amounts of oleic, linoleic, and arachidonic acid to oxidizing conditions. Liposomes enriched in oleic acid but with constant amounts of linoleic acid were less susceptible to oxidation and had significantly greater lag times and time to half maximum conjugated diene formation. When mildly oxidized, liposomes containing either linoleic acid or arachadonic acid increased monocyte chemotaxis and monocyte adhesion to endothelial cells nearly 5-fold, demonstrating that oxidation products of both these polyunsaturated fatty acids are bioactive. The addition of a platelet activating factor receptor antagonist to endothelial cells inhibited stimulation of monocyte adhesion by oxidized liposomes, suggesting that some bioactive oxidation products of polyunsaturated fatty acids may resemble platelet activating factor in structure. In contrast, when liposomes were enriched in oleic acid, monocyte chemotaxis and monocyte adhesion were nearly completely inhibited. These results suggest that enriching lipoproteins with oleic acid may reduce oxidation both by a direct “antioxidant”-like effect and by reducing the amount of linoleic acid available for oxidation as well as reduce the generation of bioactive particles that occur during mild oxidation.—Lee, C., J. Barnett, and P. D. Reaven. Liposomes enriched in oleic acid are less susceptible to oxidation and have less proinflammatory activity when exposed to oxidizing conditions. J. Lipid Res. 1998. 39: 1239–1247.

Asymmetry is a prominent feature of human brains with important functional consequences. Many asymmetric traits show population bias, but little is known about the genetic and environmental sources contributing to inter-individual variance. Anatomic asymmetry has been observed in Old World monkeys, but the evidence for the direction and extent of asymmetry is equivocal and only one study has estimated the genetic contributions to inter-individual variance. In this study we characterize a range of qualitative and quantitative asymmetry measures in structural brain MRIs acquired from an extended pedigree of Old World vervet monkeys (n = 357), and implement variance component methods to estimate the proportion of trait variance attributable to genetic and environmental sources. Four of six asymmetry measures show pedigree-level bias and one of the traits has a significant heritability estimate of about 30%. We also found that environmental variables more significantly influence the width of the right compared to the left prefrontal lobe.