bluuebunny/crossref_metadata_2025 huggingface dataset:
Reduction of Primary Energy Consumption Through Distributed Thermal Storage in Buildings Connected With a District Heating Network
Authors: Baccino Giorgia , Cosentino Sara , Guelpa Elisa , Sciacovelli Adriano , Verda Vittorio
Published: March 2016

One of the possible options for increasing the primary energy efficiency in district heating networks (DHNs) consists in flattening the thermal load diagram of the plants. This can be obtained through thermal storage. Storage generally allows one to increase the percentage of heat produced through CHP plants, waste heat or renewable systems.

In this work, a numerical approach to analyze possible effects of distributed storage on the primary energy consumption is presented. This is based on the availability of detailed information about the thermal substations that connect the users to the DHN and a thermo-fluid dynamic model of the network. First, the analysis of a user of the district heating network is proposed in order to show the operating conditions of the heat exchanger in the thermal substation. Then the model of the network is presented and an application is proposed. This application allows us to discuss how the thermal request of a user modifies along the network because of the heat capacity of the network itself and mixing with the mass flow rates at different temperatures. Therefore, the thermal load that the plants should fulfill is different than the simple summation of the thermal request of the users.

This tool allows one to link the thermal thermal request of the users to the thermal load of the plant and thus to the global primary energy consumption. It can be then applied to the evaluation of possible variation of thermal request profile of the users.
Pumping System Assessment in Water Treatment Plants: Case Study: Mexicali, Baja California, México
Authors: Gil Samaniego Ramos Margarita , Campbell Ramírez Héctor Enrique , León Silvia Vanessa Medina , Corral Juan Ceballos
Published: March 2016

Energy and hydraulic efficiency are important goals for the sustainable development of water supply systems.

The objective of these systems is to guarantee the delivery of enough water with good quality to populations. Although in order to achieve that, energy for pumping is needed, representing the main cost for the companies to operate the systems, since the energy costs vary with the amount of pumped water and the daily energy tariff.

Water and energy are critical resources that affect virtually all aspects of daily life. Ensuring these resources are available in sufficient quantities when and where society needs them entails significant investments in planning, infrastructure development, operations and maintenance bills.

Ever-increasing utility costs reduce profits, erode capital and maintenance budgets, increase product costs, and reduce competitiveness.

Pumping systems are critically important to the operations of a water treatment plant. The amount of energy consumed by many long-running pumping systems often results in a substantial addition to a plant’s annual operation costs. Therefore, these systems are a natural target to reduce energy consumption. Producers and users of pumps must design highly efficient pumping systems. The efficiency of these systems must be evaluated involving the multiple factors that often are difficult to understand for many users, consequently they overlook the energy costs and energy reduction potential on these systems. Methodologies that can maximize energy cost savings while satisfying system performance criteria should be sought for the design and management of the water distribution systems.

This paper compares operating characteristic curves (OC curves) from a pump manufacturer with the curves obtained with field data, and evaluates the efficiency of the pumping system of raw water of a water treatment plant in Mexicali, Baja California, México, which consists on a group of parallel identical pumps. The assessment also analyses the potential savings in costs and emissions of GHG related to the energy consumption of the pumping system if the operation conditions were the optimal, with the objective of minimize negative effects to the sustainable development of the region. Measurements of hydraulic and electrical parameters of the pumping system were made and efficiencies calculated. Actual characteristic operation curves were plotted and compared to those from the pump’s manufacturer and up to 31% (average) difference in the efficiencies was found. Also emission factors of the electrical generation system of the state were applied to obtain the amounts of actual GHG emissions due to the operation of the pumps. The software PSAT was used to compute potential annual savings in MWh and costs and the results employed to calculate possible reduction in emissions.
Optimal Operation and Sensitivity Analysis of a Large District Heating Network Through POD Modeling
Authors: Cosentino Sara , Guelpa Elisa , Melli Roberto , Sciacovelli Adriano , Sciubba Enrico , Toro Claudia , Verda Vittorio
Published: March 2016

District heating networks (DHNs) are crucial infrastructures for the implementation of energy efficiency and CO2 reduction plans, especially in countries with continental climate. DHNs are often complex systems and their energy performance may be largely affected by the operating conditions.

Optimal operation of DHNs involves the optimization of the pumping system. This is particularly important for large networks and for low temperature networks. A common practice to perform optimization consists in using a phyical model. Nevertheless, simulation and optimization of DHNs may involve large computational resources, because of thire possible large extension and the number of scenarios to be examined. A reduced model, obtained from the physical model, can be effectively applied to multiple simulations of a network, with significant reduction of the computational time and resources.

In this paper, a large district heating system, which supplies heating to a total volume of buildings of about 50 million of cubic meters, is considered. The use of a reduced model based on proper orthogonal decomposition (POD) is investigated. Various operating conditions corresponding to partial load operation are analyzed using a fluid-dynamic model of the network. Results show that optimal settings are not particularly regular with respect to load variation. This means that any variation in the thermal load generally involves changes in the set points of all groups. For this reason, a sensitivity analysis is performed using the POD model in order to check the opportunities to limit the number of variations in the pumping settings without significant penalization of the total pumping power.

The proposed approach is shown to be very effective for the optimal management of complex district heating systems.
Thermodynamic and Economic Evaluation of a Novel Mixed-Refrigerant Process for the Liquefaction of Natural Gas
Authors: Bin Omar M. N. , Morosuk T. , Tsatsaronis G.
Published: March 2016

LNG technology has been in use since the 1960s and is constantly evolving. During the last 20 years the total cost of LNG technology per unit of product has decreased by 30% due to improvements of the liquefaction processes and shipping. A novel process for the liquefaction of natural gas (LNG production) combines the advantages of the three large-scale LNG processes that use a mixed refrigerant: C3MR, DMR and AP-X. The novel process is a very promising one as it consists of the three stages: pre-cooling of natural gas, liquefaction, and sub-cooling. This paper discusses the development of the novel LNG process, its simulation, as well as the results from the energy, exergy and economic analyses.
Engine Performance and Emission Products of Pure Diesel and Multi-Feedstock Blended Biodiesel
Authors: Belion Kosgei , Mensah Patrick F. , Akwaboa Stephen , Woldesenbet Eyassu , Stubblefield Michael , Adjaottor Albert
Published: March 2016

Due to the ever-reducing conventional petroleum resources, considerable research on renewable energy sources such as biodiesel as a possible “greener” substitute fuel for internal combustion engines is needed. This study aims to compare the engine performance and emission results of various blends of pure diesel and a multi-feedstock (MFS) biodiesel when used in a naturally aspirated air-cooled, single-cylinder direct injection diesel engine. The engine was coupled to a dynamometer for torque measurement and output data transmitted to a PC for post-processing and displayed using customized programs in the computer. Engine combustion products — Nitrogen Oxide emissions (NOx), Hydrocarbons (HCs), Carbon monoxide (CO) and Carbon dioxide (CO2) — were measured and are presented alongside performance properties including brake-specific fuel consumption (BSFC), engine efficiency, torque and power. The experimental results show that, relative to diesel, biodiesel had approximately 3–24% decrease in torque, 4–11% decrease in power, 11–32% increase in BSFC and 8–29% general reduction in engine efficiency. However, biodiesel reduced the emissions of CO (1.5–6%), CO2 (13–34%) and unburned HCs (3–25%), while NOx emissions were increased significantly (12–48%). These results indicate that smaller percentages of biodiesel (20% or less) could be blended with pure diesel and used in a diesel engine, without any engine modifications, as an alternative and environmentally friendly fuel and without significantly compromising engine performance.
Combining plasma profiling TOFMS with TOF-SIMS depth profiling for microelectronic applications
Authors: Tempez Agnès , Legendre Sébastien , Barnes Jean-Paul , Nolot Emmanuel
Published: March 2016

Time-of-flight secondary ion mass spectrometry (TOF-SIMS) is routinely used for depth profiling of microelectronic materials but interpretation of results can sometimes be hampered by artifacts such as matrix effects. Plasma profiling time-of-flight mass spectrometry (PP-TOFMS) provides direct measurement of the elemental composition of materials as a function of depth, with nanometer resolution and higher sputter rates than for TOF-SIMS. Here, the two techniques are compared on a range of multilayers used for microelectronic applications. Although depth resolution and sensitivity are less in the PP-TOFMS profiles, both techniques were able to determine the composition, detect contamination, and characterize diffusion as a function of annealing. Indeed, the use of both techniques on the same sample is complementary: (1) the PP-TOFMS profiles can be in most cases easily semiquantified using the ion beam ratio, whereas standards are required for the SIMS analysis and (2) simpler PP-TOFMS mass spectra with low contributions from molecular adducts allow for spontaneous detection of unexpected contaminants.
Development of a prosaposin-derived therapeutic cyclic peptide that targets ovarian cancer via the tumor microenvironment
Authors: Wang Suming , Blois Anna , El Rayes Tina , Liu Joyce F. , Hirsch Michelle S. , Gravdal Karsten , Palakurthi Sangeetha , Bielenberg Diane R. , Akslen Lars A. , Drapkin Ronny , Mittal Vivek , Watnick Randolph S.
Published: March 2016

A cyclic prosaposin-derived peptide targets ovarian cancer cells through the fatty acid translocase CD36.
Staphylococcus aureus
α toxin potentiates opportunistic bacterial lung infections
Authors: Cohen Taylor S. , Hilliard Jamese J. , Jones-Nelson Omari , Keller Ashley E. , O’Day Terrence , Tkaczyk Christine , DiGiandomenico Antonio , Hamilton Melissa , Pelletier Mark , Wang Qun , Diep Binh An , Le Vien T. M. , Cheng Lily , Suzich JoAnn , Stover C. Kendall , Sellman Bret R.
Published: March 2016

S. aureus
α toxin promotes opportunistic co-infection, which can be neutralized with a pathogen-specific antibody.
Planting the right seeds
Authors: Parekkadan Biju
Published: March 2016

Hormone-producing cells from the stomach can be reprogrammed to secrete insulin and partly reverse diabetes in mice.
Delineation of Steroid-Degrading Microorganisms through Comparative Genomic Analysis
Authors: Bergstrand Lee H. , Cardenas Erick , Holert Johannes , Van Hamme Jonathan D. , Mohn William W.
Published: March 2016

Steroids are ubiquitous in natural environments and are a significant growth substrate for microorganisms. Microbial steroid metabolism is also important for some pathogens and for biotechnical applications. This study delineated the distribution of aerobic steroid catabolism pathways among over 8,000 microorganisms whose genomes are available in the NCBI RefSeq database. Combined analysis of bacterial, archaeal, and fungal genomes with both hidden Markov models and reciprocal BLAST identified 265 putative steroid degraders within only
Actinobacteria
and
Proteobacteria
, which mainly originated from soil, eukaryotic host, and aquatic environments. These bacteria include members of 17 genera not previously known to contain steroid degraders. A pathway for cholesterol degradation was conserved in many actinobacterial genera, particularly in members of the
Corynebacterineae
, and a pathway for cholate degradation was conserved in members of the genus
Rhodococcus
. A pathway for testosterone and, sometimes, cholate degradation had a patchy distribution among
Proteobacteria
. The steroid degradation genes tended to occur within large gene clusters. Growth experiments confirmed bioinformatic predictions of steroid metabolism capacity in nine bacterial strains. The results indicate there was a single ancestral 9,10-seco-steroid degradation pathway. Gene duplication, likely in a progenitor of
Rhodococcus
, later gave rise to a cholate degradation pathway.
Proteobacteria
and additional
Actinobacteria
subsequently obtained a cholate degradation pathway via horizontal gene transfer, in some cases facilitated by plasmids. Catabolism of steroids appears to be an important component of the ecological niches of broad groups of
Actinobacteria
and individual species of
Proteobacteria
.

IMPORTANCE
Steroids are ubiquitous growth substrates for environmental and pathogenic bacteria, and bacterial steroid metabolism has important pharmaceutical and health applications. To date, the genetics and biochemistry of microbial steroid degradation have mainly been studied in a few model bacteria, and the diversity of this metabolism remains largely unexplored. Here, we provide a bioinformatically derived perspective of the taxonomic distribution of aerobic microbial steroid catabolism pathways. We identified several novel steroid-degrading bacterial groups, including ones from marine environments. In several cases, we confirmed bioinformatic predictions of metabolism in cultures. We found that cholesterol and cholate catabolism pathways are highly conserved among certain actinobacterial taxa. We found evidence for horizontal transfer of a pathway to several proteobacterial genera, conferring testosterone and, sometimes, cholate catabolism. The results of this study greatly expand our ecological and evolutionary understanding of microbial steroid metabolism and provide a basis for better exploiting this metabolism for biotechnology.
Local Action with Global Impact: Highly Similar Infection Patterns of Human Viruses and Bacteriophages
Authors: Mariano Rachelle , Khuri Sawsan , Uetz Peter , Wuchty Stefan
Published: March 2016

While host-virus interaction interfaces have been previously investigated, relatively little is known about the indirect interactions of pathogen and host proteins required for viral infection and host cell function. Therefore, we investigated the topological relationships of human and bacterial viruses and how they interact with their hosts. We focused on those host proteins that are directly targeted by viruses, those that are required for infection, and those that are essential for both human and bacterial cells (here,
E. coli
). Generally, we observed that targeted, required, and essential proteins in both hosts interact in a highly intertwined fashion. While there exist highly similar topological patterns, we found that human viruses target transcription factors through methylases and acetylases, proteins that played no such role in bacteriophages.
Family income and young adolescents’ perceived social position: associations with self-esteem and life satisfaction in the UK Millennium Cohort Study
Authors: Bannink Rienke , Pearce Anna , Hope Steven
Published: March 2016

Background

Self-esteem and life satisfaction are important aspects of positive mental health in young people, and both are socially distributed. However, the majority of evidence is based on socioeconomic characteristics of the family. As children enter adolescence and gain independence, perceptions of their own social position are likely to influence mental health.

Design and objectives

Using data on 11-year-olds from the UK Millennium Cohort Study, we investigated associations of both family income and young adolescents’ perception of their social position with self-esteem and life satisfaction. We hypothesised that there would be differences in the impact of perceived social position on positive mental health when investigating the full scale scoring distribution or the bottom of the distribution. Therefore, we estimated proportional odds for having greater positive mental health (across the distribution of scores) and ORs for poor outcomes (lowest 10% scores).

Results

The likelihood of greater self-esteem and life satisfaction increased with income; similarly, the risk of having poor self-esteem and life satisfaction increased as income decreased. Young adolescents who perceived their family as poorer than their friends (instead of about the same) were less likely to have greater self-esteem and life satisfaction and were more likely to have poor outcomes. Young adolescents who perceived their family as richer were more likely to have poor self-esteem, but were not less likely to have greater self-esteem. For life satisfaction, young adolescents who perceived their families as richer were less likely to have greater and more likely to have poor life satisfaction.

Conclusions

Policies to redistribute income in families with children are likely to benefit the mental health of young people. However, it is also important to consider the impact of social comparison on young people's mental health as they enter adolescence.
Spontaneous tumour lysis syndrome secondary to the transformation of chronic myelomonocytic leukaemia into acute myeloid leukaemia
Authors: Langridge Alexander , Musgrave Kathryn , Upadhye Yogesh
Published: March 2016

A 78-year-old man, with a 6-year history of stable chronic myelomonocytic leukaemia (CMML), presented with general deterioration and worsening pancytopenia. Bone marrow biopsy showed that his disease had transformed into acute myeloid leukaemia (AML). He was started on a supportive transfusion regimen and did not receive any chemotherapy or corticosteroids. Several weeks later, he developed acute renal failure and was admitted to a medical admissions ward. Spontaneous tumour lysis syndrome (sTLS, grade 1) was diagnosed, as per the Cairo and Bishop criteria. He was treated with intravenous fluids, rasburicase and allopurinol. His renal function improved and he recovered from the sTLS. The authors believe that this is the first published case of sTLS occurring as a result of CMML transforming into AML; it highlights the importance of recognising sTLS as a cause of renal failure and electrolyte disturbance before cancer treatment begins.
Acromegaly-induced cardiomyopathy with dobutamine-induced outflow tract obstruction
Authors: Abdelsalam Mahmoud A , Nippoldt Todd B , Geske Jeffrey B
Published: March 2016

A 50-year-old man with a history of acromegaly was referred for preoperative cardiac evaluation preceding trans-sphenoidal resection of a pituitary macroadenoma. Dobutamine stress echocardiography was negative for myocardial ischaemia. Resting left ventricular (LV) LV ejection fraction (LVEF) was 64% and there was hypertrophy of ventricular septum (18 mm) without resting LV outflow tract obstruction. With 40 µg/kg/min of dobutamine, the LVEF became hyperdynamic at 80%, and there was a maximal instantaneous LV outflow tract gradient of 77 mm Hg. There was no delayed myocardial enhancement on cardiac MRI and the pattern of hypertrophy was concentric. Acromegaly-induced cardiomyopathy can mimic hypertrophic cardiomyopathy in the setting of dobutamine provocation. Because cardiomyopathy is an important cause of mortality in acromegaly, diagnosis and appropriate management are critical to improve survival.
Long-term survival in a patient with brain metastases of papillary thyroid carcinoma
Authors: Guelho Daniela , Ribeiro Cristina , Melo Miguel , Carrilho Francisco
Published: March 2016

We present the case of a 43-year-old woman who underwent total thyroidectomy with bilateral lymphadenectomy for a papillary thyroid carcinoma (PTC), solid variant (T4bN1bMx), with V600EBRAFmutation. After ablative therapy, she presented undetectable thyroglobulin (Tg) but progressively increasing anti-Tg antibodies (TgAbs). During follow-up, nodal, lung and brain metastases were identified. She was submitted to surgical excision of lung lesions, radiosurgery of brain metastases and five radioiodine treatments. The latest brain MRI showed no lesions, pulmonary CT showed stable micronodules and there was progressive reduction in TgAbs. This is a peculiar case of a PTC with lung and brain metastatic lesions detected through TgAbs. Initial histological and molecular study suggested a more aggressive clinical behaviour, which was eventually confirmed. Although PTC brain metastases are extremely rare and present poor prognosis, our patient presented a good response to treatment and longer survival than usually reported for similar cases.
Bowel perforation after endoscopic submucosal dissection due to colon cancer and successful endoscopic treatment using an Ovesco clip
Authors: Kryzauskas Marius , Stanaitis Juozas , Vaicekauskas Rolandas , Mikalauskas Saulius
Published: March 2016

An 83-year-old woman under intravenous anaesthesia underwent endoscopic submucosal dissection due to early well-differentiated colon cancer with no deep invasion (pT1). Wide perforation in the deep site of excision of the descending colon was identified and an Ovesco clip placed to close the defect. The patient was discharged from the hospital on day 4 after the procedure, with no abdominal pain and no peritoneal signs of inflammation. Follow-up CT and colonoscopy were performed after 6 months, and no recurrence was observed.
Adult jejunojejunal intussusception in the face of jejunal adenocarcinoma: two infrequently encountered entities
Authors: Elmoghrabi Adel , Mohamed Mohamed , McCann Michael , Sachwani-Daswani Gul
Published: March 2016

Adult intussusception and small bowel adenocarcinoma are rarely encountered together. Intussusception should be considered in the differential diagnosis of adult patients presenting with abdominal pain, especially those with unremitting symptoms. Concomitant anaemia should lower the threshold for suspicion of underlying malignancy. Jejunal adenocarcinoma represents a rare, but possible aetiology.
Spontaneous intraperitoneal rupture of a postpartum rectus sheath haematoma
Authors: Elmoghrabi Adel , Mohamed Mohamed , McCann Michael , Sachwani-Daswani Gul
Published: March 2016

A 35-year-old woman presented to the emergency department (ED) with acute severe abdominal pain at 4 days postpartum. CT of the abdomen revealed a type II rectus sheath haematoma for which she was initially treated conservatively and discharged. A few hours later, she returned to the ED with a picture suggestive of peritonitis. Exploratory laparoscopy was performed and revealed haemoperitoneum and a ruptured area on the posterior rectus sheath. Approximately 2 L of blood was aspirated. Haemostatic control was achieved and closed suction drains secured in position. The patient was discharged in stable condition on postadmission day 6. She continued to follow-up on an outpatient basis and was doing well 3 months postoperatively.
Comparison of cognitive and neuropsychiatric profiles in hospitalised elderly medical patients with delirium, dementia and comorbid delirium–dementia
Authors: Leonard Maeve , McInerney Shane , McFarland John , Condon Candice , Awan Fahad , O'Connor Margaret , Reynolds Paul , Meaney Anna Maria , Adamis Dimitrios , Dunne Colum , Cullen Walter , Trzepacz Paula T , Meagher David J
Published: March 2016

Objectives

Differentiation of delirium and dementia is a key diagnostic challenge but there has been limited study of features that distinguish these conditions. We examined neuropsychiatric and neuropsychological symptoms in elderly medical inpatients to identify features that distinguish major neurocognitive disorders.

Setting

University teaching hospital in Ireland.

Participants and measures

176 consecutive elderly medical inpatients (mean age 80.6±7.0 years (range 60–96); 85 males (48%)) referred to a psychiatry for later life consultation-liaison service with Diagnostic and Statistical Manual of Mental Disorders (DSM) IV delirium, dementia, comorbid delirium–dementia and cognitively intact controls. Participants were assessed cross-sectionally with comparison of scores (including individual items) for the Revised Delirium Rating Scale (DRS-R98), Cognitive Test for Delirium (CTD) and Neuropsychiatric Inventory (NPI-Q).

Results

The frequency of neurocognitive diagnoses was delirium (n=50), dementia (n=32), comorbid delirium–dementia (n=62) and cognitively intact patients (n=32). Both delirium and comorbid delirium–dementia groups scored higher than the dementia group for DRS-R98 and CTD total scores, but all three neurocognitively impaired groups scored similarly in respect of total NPI-Q scores. For individual DRS-R98 items, delirium groups were distinguished from dementia groups by a range of non-cognitive symptoms, but only for impaired attention of the cognitive items. For the CTD, attention (p=0.002) and vigilance (p=0.01) distinguished between delirium and dementia. No individual CTD item distinguished between comorbid delirium–dementia and delirium. For the NPI-Q, there were no differences between the three neurocognitively impaired groups for any individual item severity.

Conclusions

The neurocognitive profile of delirium is similar with or without comorbid dementia and differs from dementia without delirium. Simple tests of attention and vigilance can help to distinguish between delirium and other presentations. The NPI-Q does not readily distinguish between neuropsychiatric disturbances in delirium versus dementia. Cases of suspected behavioural and psychological symptoms of dementia should be carefully assessed for possible delirium.
Effect of acupuncture on sleep quality and hyperarousal state in patients with primary insomnia: study protocol for a randomised controlled trial
Authors: Guo Jing , Huang Wei , Tang Chu-ying , Wang Gui-Ling , Zhang Fan , Wang Lin-peng
Published: March 2016

Introduction

Primary insomnia (PI) is commonly defined as a state of having disturbed daytime activities due to poor night-time sleep quality. Studies have demonstrated that it is a disorder of 24 h hyperarousal, expressed in terms of physiological, cognitive and cortical activation. Acupuncture is considered to be beneficial to restore the normal sleep–wake cycle. The aim of the trial is to assess the therapeutic effects of acupuncture on sleep quality and hyperarousal state in patients with PI.

Methods and analysis

This study is a randomised, patient-assessor-blinded, sham controlled trial. –88 eligible patients with PI will be randomised in a ratio of 1:1 to the intervention group (real acupuncture) and control group (sham acupuncture, superﬁcial insertion at irrelevant acupuncture points). Acupuncture intervention will be given to all participants three times a week for 4 weeks, followed up for 8 weeks.

The primary outcome measures are the Pittsburgh Sleep Quality Index (PSQI) and Hyperarousal scale (HAS). The secondary outcomes are Fatigue scale-14 (FS-14), polysomnography (PSG), heart rate variability (HRV) and Morning Salivary Cortisol Level (MSCL). Outcomes will be evaluated at baseline, post-treatment period and 8 weeks follow-up. All main analyses will be carried out on the basis of the intention-to-treat principle.

Ethics/dissemination

This protocol has been approved by the Medical Ethical Committee of Beijing Traditional Chinese Medicine Hospital (Beijing TCM Hospital) on 5 January 2015. The permission number is 2014BL-056-02. The study will present data concerning the clinical effects of treating primary insomnia with acupuncture. The results will help to demonstrate if acupuncture is an effective therapy for improving sleep quality in association with a decreased hyperarousal level as a possible underlying mechanism. The findings from this study will be shared with the healthcare professionals, general public and relevant organisations through publication of manuscripts and conference presentations.

Trial registration number

ISRCTN16079489; Pre-results.
Are you ready? Exploring readiness to engage in exercise among people living with HIV and multimorbidity in Toronto, Canada: a qualitative study
Authors: Simonik Alya , Vader Kyle , Ellis Denine , Kesbian Dirouhi , Leung Priscilla , Jachyra Patrick , Chan Carusone Soo , O'Brien Kelly K
Published: March 2016

Objectives

Our aim was to explore readiness to engage in exercise among people living with HIV and multimorbidity.

Design

We conducted a descriptive qualitative study using face-to-face semistructured interviews with adults living with HIV.

Setting

We recruited adults (18 years or older) who self-identified as living with HIV and 2 or more additional health-related conditions from a specialty hospital in Toronto, Canada.

Participants

14 participants with a median age of 50 years and median number of 9 concurrent health-related conditions participated in the study. The majority of participants were men (64%) with an undetectable viral load (71%).

Outcome measures

We asked participants to describe their readiness to engage in exercise and explored how contextual factors influenced their readiness. We analysed interview transcripts using thematic analysis.

Results

We developed a framework to describe readiness to engage in exercise and the interplay of factors and their influence on readiness among adults with HIV and multimorbidity. Readiness was described as a diverse, dynamic and fluctuating spectrum ranging from not thinking about exercise to routinely engaging in daily exercise. Readiness was influenced by the complex and episodic nature of HIV and multimorbidity comprised of physical impairments, mental health challenges and uncertainty from HIV and concurrent health conditions. This key factor created a context within which 4 additional subfactors (social supports, perceptions and beliefs, past experience with exercise, and accessibility) may further hinder or facilitate an individual's position along the spectrum of readiness to exercise.

Conclusions

Readiness to engage in exercise among people living with HIV is a dynamic and fluctuating construct that may be influenced by the episodic nature of HIV and multimorbidity and 4 subfactors. Strategies to facilitate readiness to exercise should consider the interplay of these factors in order to enhance physical activity and subsequently improve health outcomes of people with HIV and multimorbidity.
Tweeting links to Cochrane Schizophrenia Group reviews: a randomised controlled trial
Authors: Adams C E , Jayaram M , Bodart A Y M , Sampson S , Zhao S , Montgomery A A
Published: March 2016

Objective

To assess the effects of using health social media on web activity.

Design

Individually randomised controlled parallel group superiority trial.

Setting

Twitter and Weibo.

Participants

170 Cochrane Schizophrenia Group full reviews with an abstract and plain language summary web page.

Interventions

Three randomly ordered slightly different 140 character or less messages, each containing a short URL to the freely accessible summary page sent on specific times on one single day. This was compared with no messaging.

Outcome

The primary outcome was web page visits at 1 week. Secondary outcomes were other metrics of web activity at 1 week.

Results

85 reviews were randomised to each of the intervention and control arms. Google Analytics allowed 100% follow-up within 1 week of completion. Intervention and control reviews received a total of 1162 and 449 visits, respectively (IRR 2.7, 95% CI 2.2 to 3.3). Fewer intervention reviews had single page only visits (16% vs 31%, OR 0.41, 0.19 to 0.88) and users spent more time viewing intervention reviews (geometric mean 76 vs 31 s, ratio 2.5, 1.3 to 4.6). Other secondary metrics of web activity all showed strong evidence in favour of the intervention.

Conclusions

Tweeting in this limited area of healthcare increases ‘product placement’ of evidence with the potential for that to influence care.

Trial registration number

ISRCTN84658943.
Mortality and use of psychotropic medication in patients with stroke: a population-wide, register-based study
Authors: Jennum Poul , Baandrup Lone , Iversen Helle K , Ibsen Rikke , Kjellberg Jakob
Published: March 2016

Objectives

The study sought to describe whether psychotropic medication may have long-term side effects in patients with stroke compared with controls.

Setting

Use of national register data from healthcare services were identified from the Danish National Patient Registry in Denmark. Information about psychotropic medication use was obtained from the Danish Register of Medicinal Product Statistics.

Objectives

We aimed to evaluate all-cause mortality in relation to the use of benzodiazepines, antidepressants and antipsychotics in patients with stroke and matched controls.

Participants

Patients with a diagnosis of stroke and either no drug use or preindex use of psychotropic medication (n=49 968) and compared with control subjects (n=86 100) matched on age, gender, marital status and community location.

Primary outcome measure

All-cause mortality.

Results

All-cause mortality was higher in patients with previous stroke compared with control subjects. Mortality HRs were increased for participants prescribed serotonergic antidepressant drugs (HR=1.699 (SD=0.030), p=0.001 in patients; HR=1.908 (0.022), p<0.001 in controls, respectively), tricyclic antidepressants (HR=1.365 (0.045), p<0.001; HR=1.733 (0.022), p<0.001), benzodiazepines (HR=1.643 (0.040), p<0.001; HR=1.776 (0.053), p<0.001), benzodiazepine-like drugs (HR=1.776 (0.021), p<0.001; HR=1.547 (0.025), p<0.001), first-generation antipsychotics (HR=2.001 (0.076), p<0.001; HR=3.361 (0.159), p<0.001) and second-generation antipsychotics (HR=1.645 (0.070), p<0.001; HR=2.555 (0.086), p<0.001), compared with no drug use. Interaction analysis suggested statistically significantly higher mortality HRs for most classes of psychotropic drugs in controls compared with patients with stroke.

Conclusions

All-cause mortality was higher in patients with stroke and controls treated with benzodiazepines, antidepressants and antipsychotics than in their untreated counterparts. Our findings suggest that care should be taken in the use and prescription of such drugs, and that they should be used in conjunction with adequate clinical controls.
Variation in preparation for gastroscopy: lessons towards safer and better outcomes
Authors: Callaghan J L , Neale J R , Boger P C , Sampson A P , Patel P
Published: March 2016

Objective

To identify the methods employed within the UK practice prior to diagnostic gastroscopy and compare with published guidelines for patients undergoing general anaesthesia.

Design

National Health Service (NHS) endoscopy units were invited to take part in a structured telephone survey to determine the length of time patients are kept nil-by-mouth (NBM) for food and fluids prior to gastroscopy, and whether a preprocedure mucolytic drink was used.

Methods

212 NHS Trusts providing endoscopy services were identified from the Joint Advisory Group on GI Endoscopy. Trusts were excluded if they were children's hospitals (n=5).

Results

207 NHS Trusts were telephoned. 193 completed the survey (93%), 11 Trusts declined and there was no response from 3 Trusts. 13 separate policies regarding NBM timings were identified. 51 Trusts (21%) used the timings ratified by Surgical and Anaesthetic Societies (6 h NBM for food, 2 h for clear fluid). 135 Trusts (70%) used a policy which starved patients in excess of the standard surgical guidelines. No Trust used a mucolytic drink prior to gastroscopy.

Conclusions

The survey revealed large variation in NHS Trust's policies regarding the times patients were starved prior to gastroscopy. Results of surgical studies demonstrate increased risk of significant pulmonary aspiration with increased fluid-starvation periods, 68% of NHS endoscopy policy would be deemed excessive by surgical practice. There is no routine use of a mucolytic drink to improve mucosal visualisation in the UK practice.
Assays for measurement of TNF antagonists in practice
Authors: Vande Casteele Niels
Published: March 2016

Tumour necrosis factor (TNF) antagonist drug exposure is correlated with clinical, endoscopic and pathophysiological outcomes during induction and maintenance therapy. Measuring drug concentrations is therefore a useful tool when treating to target and optimising therapy. One of the main factors leading to suboptimal drug exposure is the formation of antidrug antibodies (ADAs), due to an immunogenic reaction of the immune system towards the non-self protein. The development of ADA does pose important concerns for drug efficacy and for safety as ADAs have been associated with acute infusion reactions, hypersensitivity reactions and serum sickness. Various assays exist to measure serum drug and ADA concentrations, either offered as a service in a specialised laboratory or commercially available as a kit. It is unclear how the performance of these assays relates to each other, until recently various comparative studies were carried out. The majority of these studies show that indeed a good correlation exists between the assays that measure drug, but that absolute concentrations can differ across tests. This is particularly relevant in clinical practice when a specific threshold or drug concentration range is targeted. For ADA assays, drug sensitivity or the ability of the assay to measure ADA in the presence of drug remains an important issue, especially for drugs with a higher dosing frequency. In addition, standardisation across ADA assays is difficult, making it hard to compare quantitative or semiquantitative (low/medium/high) results across assays and across studies.
Clinical diffusion mismatch better discriminates infarct growth than mean transit time–diffusion weighted imaging mismatch in patients with middle cerebral artery–M1 occlusion and limited infarct core
Authors: Nogueira Raul G , Kemmling Andre , Souza Leticia M , Payabvash Seyedmehdi , Hirsch Joshua A , Yoo Albert J , Lev Michael H
Published: March 2016

Background and purpose

Our purpose was to compare clinical diffusion mismatch (CDM) and mean transit time (MTT)-diffusion mismatch as predictors of infarct growth in patients with proximal middle cerebral artery (MCA) occlusion and small infarct core on presentation.

Methods

Retrospective analysis of consecutive stroke patients with: (1) MCA-M1 occlusion; (2) MRI performed ≤10 h from symptoms onset; and (3) baseline MRI-diffusion weighted imaging (DWI) volume ≤25 mL. Definitions included: CDM=baseline National Institutes of Health Stroke Scale (NIHSS) score ≥8 and DWI volume ≤25 mL; MTT-DWI mismatch=visually assessed unthresholded MTT lesion ((MTT-DWI))/DWI) ≥20% and ≥10 mL larger than the DWI lesion; and significant infarct growth (>20% (≥5 mL) increase in infarct volume on follow-up). Uni-/multivariate analyses were performed to define the predictors of infarct growth.

Results

63 stroke patients with MCA-M1 occlusions and MRI within 10 h of onset were evaluated. 20 patients were excluded on the basis of DWI volume >25 mL leaving 43 patients (mean age 75.8 years; median NIHSS=13) in the study cohort. On univariate analysis, larger admission DWI volume (p<0.0001), baseline NIHSS score ≥8 (p=0.001), lack of IV and/or endovascular treatment (p=0.021), glucose levels >125 mg/dL (p=0.024), poor CT angiography collaterals (p=0.046), and lower admission Alberta Stroke Program Early CT score (ASPECTS) (p=0.049) predicted infarct growth. Baseline NIHSS score ≥8 was the only independent predictor of stroke growth in the multivariate analysis (p=0.001). All patients had MTT-DWI mismatch >20%. There was no significant association between the amount of MTT-DWI mismatch and infarct growth (p=0.33).

Conclusions

CDM is the most powerful predictor of infarct growth in patients with MCA-M1 occlusion and small infarct core. Most of these patients will have a significant oligemic MTT lesion regardless of admission NIHSS score.
Performance evaluation of crumb rubber and paraffin modified stone mastic asphalt
Authors: Kök Baha Vural , Yilmaz Mehmet , Akpolat Mustafa
Published: March 2016

Recently, crumb rubber (CR) obtained from waste tires and Fischer–Tropsch paraffin are mostly used in bitumen modification to improve the performance of bituminous mixtures. Each of these additives affects the different properties of mixtures. There are limited studies in the literature about the combined usage of additive in the same mixture to utilize the different characteristics. In this study, the stability, stiffness, fatigue resistance, permanent deformation resistance, and moisture susceptibility characteristics of the stone mastic asphalt prepared with the bitumen modified with CR and paraffin were examined and compared with the control mixture. It was determined that CR-modified mixtures showed significantly more elastic characteristics. The mixture in which the 10% CR and 3% paraffin were used together gave better results in terms of moisture susceptibility and fatigue resistance when compared with the control mixture. It was determined that the use of paraffin together with CR contributed to the improved performance, and was in accordance with the CR in terms of mechanical characteristics of stone mastic asphalt.
Anisotropic universe and thermodynamical illustration of the interacting generalized ghost dark energy
Authors: Fayaz Vahid
Published: March 2016

We describe the thermodynamical interpretation of the interaction between ghost and general ghost dark energy (GDE) and dark matter in a non-isotropic universe. At first, the presence or absence of interaction between GDE and dark matter in both flat and non-isotropic geometry is discussed. Then, this investigation was extended to the non-interaction and interacting general ghost dark energy in a non-isotropic universe. Additionally, the probable relationship between the thermal fluctuations of the system and the assumed mutual interaction is investigated. Finally, we show that if one wants to solve the coincidence problem by using this mutual interaction, then the coupling constants of the interaction will be constrained. We extend our procedure to the first law of thermodynamics at the apparent horizon of a Bianchi type I universe, and assuming that the associated entropy with apparent horizon has a quantum corrected relation. Our study shows that, with the local equilibrium assumption, the generalized second law of thermodynamics is fulfilled in a region enclosed by the apparent horizon.
Protective effects of combined β-caryophyllene and silymarin against ketoprofen-induced hepatotoxicity in rats
Authors: Kelany Mohamed Elsayed , Abdallah Mohamed Abdelmohsen
Published: March 2016

Ketoprofen (Ket), widely utilized in treatment of many inflammatory disorders, is found to induce liver toxicity especially with overdose. This study aimed to evaluate the possible protective effects of concomitant β-caryophyllene (Cary) and silymarin (Sily) against Ket-induced hepatotoxicity in rats. Forty adult male albino rats were divided into 5 groups (each n = 8): the control group received distilled water for 6 weeks; the Ket-treated group received distilled water for 5 weeks and Ket in a dose of 8 mg·kg−1·day−1 p.o. for the 6th week; the Cary + Ket treated group received Cary in a dose of 200 mg·kg−1·day−1 orally for 6 weeks and Ket for the 6th week; the Sily + Ket treated group received Sily in the dose of 150 mg·kg−1·day−1 for 6 weeks and Ket for the 6th week; and the Cary + Sily + Ket treated group received Sily and Cary for 6 weeks and Ket for the 6th week. At end of the experiment, serum ALT, AST, and albumin and liver total antioxidant capacity (t.TAC) and malondialdehyde (t.MDA) were measured in all rats. Ket increased serum ALT and AST and t.MDA and decreased t.TAC. Cary and Sily improved these changes. Combined Cary and Sily restored these liver changes to nearly normal. Combined Cary and Sily is hepatoprotective, with the ability to scavenge oxidants against Ket-induced hepatotoxicity in rats.
Thermodynamic products for Sen black hole
Authors: Pradhan Parthapratim
Published: March 2016

We investigate the properties of inner and outer horizon thermodynamics of Sen black hole (BH) both in Einstein frame (EF) and string frame (SF). We also compute area (or entropy) product, area (or entropy) sum of the said BH in EF as well as SF. In the EF, we observe that the area (or entropy) product is universal, whereas area (or entropy) sum is not universal. On the other hand, in the SF, area (or entropy) product and area (or entropy) sum don’t have any universal behaviour because they all are depends on Arnowitt–Deser–Misner (ADM) mass parameter. We also verify that the first law is satisfied at the Cauchy horizon as well as event horizon (EH). In addition, we also compute other thermodynamic products and sums in the EF as well as in the SF. We further compute the Smarr mass formula and Christodoulou’s irreducible mass formula for Sen BH. Moreover, we compute the area bound and entropy bound for both the horizons. The upper area bound for EH is actually the Penrose like inequality, which is the first geometric inequality in BHs. Furthermore, we compute the central charges of the left and right moving sectors of the dual CFT in Sen/CFT correspondence using thermodynamic relations. These thermodynamic relations on the multi-horizons give us further understanding the microscopic nature of BH entropy (both interior and exterior).
The contact angle for a droplet on homogeneous and spherical concave surfaces
Authors: Hu Ai-Jun , Lv Bao-Zhan , Wang Xiao-Song , Zhou Long
Published: March 2016

Wetting of droplets on homogeneous and spherical concave rough surfaces is investigated based on thermodynamics. In this study, neglecting the droplet gravity and the thickness of the precursor film of the liquid–vapor interface, the three-phase system is divided into six parts using Gibbs concept of dividing surface. The system Helmholtz free energy is established based on thermodynamics. Supposing the temperature and chemical potential to be constant, a new generalized Young’s equation of the equilibrium contact angle for a spherical droplet on a spherical concave rough surfaces is obtained including the line tension effects. Under certain conditions, this generalized Young’s equation is the same as the Rusanov’s equation.