bluuebunny/crossref_metadata_2025 huggingface dataset:
Turborotor Hybrid Gas Turbine Two-Phase Engine
Authors: Rashev Michael S.
Published: April 2015

This paper analyzes the performance of an improved gas turbine engine, namely a turborotor hybrid gas turbine two-phase gas turbine engine (THGTE).

The central part of a conventional gas turbine engine is modified by introducing a number of turborotors comprising radially curved blades, to define together with the housing of the engine peripheral rotating interblade chamber-reservoirs and interblade radially curved energy-transfer passageways at their respective radially inward ends. The turborotors have the capability of energy exchange with the working fluid during the charging and expansion phases of engine operation, thus to provide a basic engine. During the expansion phase the turborotor performs a radial inflow impulse turbine function, and can be used to drive the engine’s compressor, thus to omit its conventional driving turbine.

The turborotor hybrid engine, formed by compounding the basic or turborotor engine with a conventional compressor and a power turbine has about 2 times lower specific weight and can be used as a jet propulsion turbineless engine, requiring only a nozzle to accelerate the gas products which exit the respective turborotors.

Due to its diesel mode of operation, the overall fuel efficiency is in the range of 0.58 without the use of a heat exchanger. Also, its specific power output is increased about 3 times, due to combustion of the entire amount of air passing through the compressor, under a higher fuel efficiency, if the hybrid engine is compared to the conventional gas turbine engine (CGTE).

A first approximation analysis is provided on the basis of the existing state-of-the-art and theory of the radial flow turbomachines to substantiate the basic advantages of the hybrid gas turbine engine.
Hot-Wire Measurements of Velocity and Temperature Fluctuations in a Heated Turbulent Boundary Layer
Authors: Blair M. F. , Bennett J. C.
Published: April 2015

This paper describes the development of a multi-element hot-wire anemometry system designed to measure the fluctuating velocity and temperature in non-isothermal boundary layer flows. Special features of this system were that it utilized only standard constant-temperature anemometers and standard, commercially-available sensors. Although maximum frequency response for the present system was limited by the available signal digitization rates the probe/anemometry combination itself was shown to be capable of resolving signals to approximately 50 KHz. The performance of the system was evaluated by comparing velocity and temperature statistics measured in an equilibrium turbulent boundary layer flow with similar results from other investigations.
The Effects of Freestream Turbulence on the Profile Boundary Layer and Losses in a Compressor Cascade
Authors: Evans R. L.
Published: April 2015

The turbulent profile boundary layer on a one-foot chord compressor cascade blade has been measured with varying levels of freestream turbulence. Increased levels of freestream turbulence were found to increase the fullness of the velocity profiles, with a consequent decrease in displacement thickness and an increase in the skin friction coefficient. A small increase in freestream turbulence causes the cascade total-pressure loss to increase initially, while at the higher turbulence levels boundary layer separation was delayed, resulting in a decrease in the total-pressure loss and deviation angle.
Gas Turbine Exhaust Heat Recovery by Hybrid Steam/Ternary Aqueous Immiscible Liquid Cycle
Authors: Burnside B. M.
Published: April 2015

The concept of the dual pressure steam/pure organic hybrid immiscible liquid cycle applied to recover exhaust heat from gas turbines is extended to include organic mixtures. Thermodynamics of the resulting ternary working fluid cycle is presented. For the cycle arrangement analysed it is calculated that the ternary steam/nonane/decane cycle with the organic very nonane rich produces about 2% more work than the corresponding all steam cycle for a typical gas turbine exhaust temperature. It is estimated that this advantage can be raised to about 4% by adding additional heaters at the stack end of the heat recovery generator. The analysis shows that it is unnecessary to use a pure alkane organic. A mixture containing up to about 5% of alkanes with higher boiling points than nonane is adequate.
Design and Part-Load Behavior of a Receiver for a Solar-Heated Gas Turbine With a Parabolic Dish Collector
Authors: Bammert Karl , Seifert Peter
Published: April 2015

The present paper deals with the conversion of solar energy in a gas turbine plant with a parabolic dish collector. Particular consideration is devoted to the thermodynamic and mechanical design and partload behavior of the receiver. The incident sunlight is focussed by the parabolic dish and then beamed into the cavity receiver. Here the working medium of the gas turbine flows through tubes and is heated up to the receiver outlet temperature.

The task of the receiver is to transfer the radiated energy as efficiently as possible to the working medium. Furthermore the requiered heating surface should be small as possible i.e. optimum use must be made of the tube material with respect to its state of stress. It is shown which geometric and thermodynamic plant parameters influence these two design criteria. An optimum receiver design is presented on the basis of the results thus obtained. Finally, the variations in receiver efficiency and tube stressing when the gas turbine runs at constant speed or constant turbine inlet temperature, are investigated.
A Long-Term Field Test of Advanced Gas Turbine Airfoil Coatings Under a Severe Industrial Environment
Authors: Kubarych Kenneth G. , Boone Donald H. , Duncan Richard L.
Published: April 2015

Severe hot corrosion of gas turbine blades and vanes can result from the use of fuels contaminated with sodium and sulfur. A program has been initiated to survey currently available commercial as well as advanced developmental hot corrosion resistant coatings and select a list of coatings for application to Solar Centaur first-stage blades and vanes. A subsequent engine test program will be run on high-sulfur marine diesel fuel doped with sodium to produce severe hot corrosion conditions. The coatings will be tested in a rainbow fashion for a period up to 15,000 hours.
Indirect Fired Cycles: A Review
Authors: Culley James W. , Levine Philip
Published: April 2015

Indirect firing of combined Brayton and Rankine cycles has been considered as a means of utilizing solid fuels such as wood or coal for power generation. Combined cycles utilizing indirect firing offer potentially higher efficiencies than conventional direct fired Rankine cycles. Many thermodynamic alternatives exist for indirect firing; however, technical, economic, and commercial barriers must be overcome for each of these alternatives. This paper reviews several of the options for indirect fired cycles and considers the factors affecting their application to power generation systems.
The Selection and Introduction of the MS9001E Gas Turbine
Authors: Brandt D. E. , Kelly A. G.
Published: April 2015

This paper discusses the selection and integration of two 100 MW class uprated 50 Hz heavy duty gas turbines into an electric utility system which had significant prior experience with an earlier lower rated version. The new units have been installed in both simple and combined cycle application. Discussed are the various elements important to this selection including site considerations, economics, system requirements and prior gas turbine experience.

Although the uprated gas turbine model was evolved from a service-proven 60 Hz version the manufacturer implemented an extensive test program on one of the units to verify various design parameters and to confirm predicted performance. Stator parts and rotor components were fully instrumented in the simple cycle unit for these tests and results are discussed in this paper.

Presented are the extent of instrumentation and the test plan, the comparison of test data with analysis, the results of performance testing and the resulting modifications made to the Gas Turbine control system to enhance component life.
Current Status of Advanced Reheat Gas Turbine AGTJ-100A: Part 3 — Experimental Results of Shop Tests
Authors: Takeya Kazuo , Oteki Yasuo , Yasui Hajime
Published: April 2015

The outline of plans for the research and development of an advanced reheat gas turbine under the Moonlight Project (Agency of Industrial Science and Technology, Ministry of International Trade and Industry) has already been announced in 1981 at Houston (81-GT-28), while technical problems related to the pilot plant (Paper No. 83-TOKYO-IGTC-117) as well as performance and characteristics (Paper No. 83-TOKYO-IGTC-40) have been announced at the 1983 Tokyo International Gas Turbine Congress.

No-load shop tests conducted on the pilot reheat gas turbine during the period of May to July, 1983, were consummated with highly satisfactory results, so this paper is dedicated primarily to giving a description of the shop tests.
Fiber Metal Abradable Seals
Authors: Tolokan R. P. , Beaton M. S.
Published: April 2015

Fiber metal abradable seals are used to control clearances in the compressor and turbine sections of gas turbine engines. Fiber metal seals are good abradables that rub by the low energy mechanism of brittle fiber fracture over a wide range of rub conditions. Rub mechanisms are significantly influenced by features in the seal microstructure.

High temperature fiber metal seals have been developed with temperature capability to 1650°F (1170 K). These seals have been characterized to determine abradability, mechanical properties, temperature resistance and permeability.
Gasturbine for Pressurising a Fluidised Bed Combustion System
Authors: Dibelius G. H. , Croonenbrock R. , Pitt R. U.
Published: April 2015

Pressurised fluidised bed combustion (PFBC) promises even lower emissions of air pollutant substances than already achieved by atmospheric FBC and allows to burn low rank coal. The elevated heat-transfer rate results in a more compact design.

A PFBC-fired steam generator for the heat and power plant of the Technical University of Aachen (RWTH) is under construction.

Being part of RWTH’s heat and power supply, a high reliability and a wide range of operation is mandatory. With these two aims in mind a scheme consisting of a turbo-charger’s compressor followed by an electrically driven compressor was chosen for the supply of air. The turbocharger’s turbine is fed by stack-gas previously cleaned by means of a pressure-tube-filter at moderate temperatures. Both machines are serial products.

While the turbocharger’s speed is determined by the operating conditions, the electrically driven compressor is controlled by adjustable inlet guide vanes. In the pressurised mode of operation, the load of the steam-generator can be varied between some 30 % and 100 % of maximum output.

The turbocharger may be bypassed to operate the system at atmospheric conditions. in this mode, 15 % to some 50 % of the operating range is covered.
Cooling Characteristics of Film-Cooled Turbine Blades
Authors: Abe T. , Doi N. , Kawaguchi T. , Yamane T. , Kumagai T. , Yoshida T.
Published: April 2015

A series of experiments was performed to measure the cooling effectiveness of pin-fin type blades applicable to the first-stage blades of the high pressure turbine for the Advanced Gas Turbine of Japan (AGTJ-100A). Actual pin-fin type blades were used in three-dimensional hot cascade tests.

Resulting cooling effectiveness distributions in chordwise direction showed relatively small deviation from the high average value and closely corresponded with analytical predictions. Another major finding was that for film cooling blades, particularly with a shower head film cooling, it is essential in the cascade tests to set the ratio between the coolant and mainstream temperature at values the same as real conditions. This makes it possible to simulate cooling air flow distributions in the blades of high temperature actual turbines using low temperature tests. This is also applicable to vanes with a shower head film cooling.
A Computer Aided Design Method for Vaned Diffusers in Centrifugal Compressors
Authors: Bhinder F. S. , Al-Modafar M. M. H.
Published: April 2015

A procedure for designing the vaned diffusers incorporating wedge type vanes has been described. By transforming the geometrical data into the usual parameters for straight two-dimensional diffusers, the influence of some of the important variables on pressure recovery can be investigated. The results can then be used to select the values of these variables for optimum pressure recovery.
Centrifugal Compressor Surge Behaviour
Authors: Wachter J. , Rohne K.-H.
Published: April 2015

The unsteady behaviour of compressor systems near the surge line and during surge was investigated. Experimental examinations were carried out using a three stage centrifugal compressor of industrial design in different types of piping systems. The results obtained were compared with different theoretical models. It is demonstrated that the compressor system behaviour can be calculated adequately, if sufficient data concerning the transient characteristic of the compressor are available.
High Performance Ceramics for Heat Engine Applications
Authors: Torti Maurice L. , Hannoosh James G. , Hartline Stephen D. , Arvidson Dean B.
Published: April 2015

The properties, availability, and component experience of the Norton Company with high performance ceramics for heat engine applications will be reviewed. The monolithic systems SiC and Si3N4, as well as ZrO2 based coating systems will be described.
An Exploratory Study of Elementary Classroom Teachers’ Physical Activity Promotion From a Social Learning Perspective
Authors: Webster Collin A. , Buchan Heather , Perreault Melanie , Doan Rob , Doutis Panayiotis , Weaver Robert G.
Published: April 2015

Despite its recommended use, physical activity promotion in the academic classroom (PAPAC) has received little attention in terms of the factors that help to facilitate it. In this study, a social learning perspective was adopted to examine the role of physical activity biographies in generalist classroom teachers’ (CTs) PAPAC. CTs (N = 213) were assessed on their satisfaction with personal K-12 physical education (PE) experiences, perceived physical activity competence, self-reported physical activity, perceived PAPAC competence, and self-reported PAPAC. Structural equation modeling supported the hypothesized relationships between variables. Specifically, PE satisfaction predicted physical activity competence, which in turn predicted physical activity. Subsequently, physical activity predicted PAPAC competence, which predicted PAPAC. The specified model explained 41% of the variance in PAPAC, with PAPAC competence being the largest contributor. This study provides useful information for designing interventions to increase PAPAC, as it stresses the need to identify strategies that improve CTs’ physical activity-related, and PAPAC-related self-perceptions.
In Nonobese Children, Fitness and BMI Are Independent Predictors of Fasting Insulin
Authors: Watson Andrew M. , Eickhoff Jens , Nemeth Blaise A. , Carrel Aaron L.
Published: April 2015

Objective:

Although fitness and obesity have been shown to be independent predictors of cardiometabolic disease risk in obese children, this interaction is not well defined in nonobese children. The purpose of this study was to define the relationships between peak aerobic capacity, body composition, and fasting insulin levels in nonobese middle school children.

Study Design:

148 middle school children (mean age 11.0 ± 2.1 years, 49% male) underwent determination of body mass index (BMI) z-score, fasting glucose, fasting insulin, body composition by DXA scan (lean body mass and body fat percentage), and peak oxygen uptake per kg of lean body mass (VO2peak). Univariate correlations and multivariate regression analysis were used to identify independent predictors of fasting insulin using age, sex, percent body fat, body mass index z-score, and VO2peak.

Results:

fasting insulin was significantly related to VO2peak (r =−0.37, p < .001), percent body fat (r = .27, p < .001), and BMI z-score (r = .33, p = .002). After inclusion in the multivariate model, VO2peak (p = .018) and body mass index z-score (p = .043) remained significant predictors of fasting insulin, while age (p = .39), sex (p = .49), and percent body fat (p = .72) did not.

Conclusions:

Among nonobese middle school children, fasting insulin is independently related to aerobic fitness after accounting for age, sex, and body composition. Public health efforts to reduce cardiometabolic disease risk among all adolescents should include exercise programs to increase cardiovascular fitness.
Interventions to Increase Physical Activity in Children Aged 2-5 Years: A Systematic Review
Authors: Ling Jiying , Robbins Lorraine B. , Wen Fujun , Peng Wei
Published: April 2015

Comprehensive evaluation of prior interventions designed to increase preschoolers’ physical activity is lacking. This systematic review aimed to examine the effect of interventions on objectively measured physical activity in children aged 2–5 years. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. In May 2014, we searched PubMed, CINAHL, PsycINFO, ERIC, SPORTDiscus, Cochrane, and Embase. Two reviewers independently identified and appraised the studies. Twenty-four articles describing 23 independent studies and 20 unique interventions met inclusion criteria. Of the 8 interventions resulting in a significant effect in objectively measured physical activity, all were center-based and included a structured physical activity component, 6 included multiple components, 5 integrated theories or models, and 4 actively involved parents. Seven of the 8 were randomized controlled trials. Due to the heterogeneity of the study designs, physical activity measures, and interventions, drawing definitive conclusions was difficult. Although the overall intervention effect was less than optimal, the review indicated that theory-driven, multicomponent interventions including a structured physical activity component and targeting both parents and their children may be a promising approach for increasing preschoolers’ physical activity and warrant continued investigation using rigorous designs to identify those that are most effective.
Personalized genomic analyses for cancer mutation discovery and interpretation
Authors: Jones Siân , Anagnostou Valsamo , Lytle Karli , Parpart-Li Sonya , Nesselbush Monica , Riley David R. , Shukla Manish , Chesnick Bryan , Kadan Maura , Papp Eniko , Galens Kevin G. , Murphy Derek , Zhang Theresa , Kann Lisa , Sausen Mark , Angiuoli Samuel V. , Diaz Luis A. , Velculescu Victor E.
Published: April 2015

Analysis of matched tumor and normal DNA from the same patient improves accuracy of identification of actionable mutations, allowing better targeting of potential treatments.
Cultures of Needleless Connectors Are Useful for Ruling Out Central Venous Catheter Colonization
Authors: Guembe María , Pérez-Granda María Jesús , Cruces Raquel , Martín-Rabadán Pablo , Bouza Emilio
Published: April 2015

Semiquantitative cultures of skin surrounding intravascular catheter entry sites and catheter hubs have high negative predictive values for catheter tip colonization. However, culturing samples from the inner side of the hub requires the catheter to be manipulated, thus increasing the risk of migration of microorganisms into the bloodstream. Today, hubs are closed using needleless connectors (NCs). Cultures of NCs could predict catheter colonization. Our objective was to compare the yield of NC sonicate cultures for prediction of catheter colonization with that of hub cultures. For 6 months, we prospectively collected all short-term central lines and systems removed from patients admitted to the cardiac surgery postoperative care unit, irrespective of the reason for withdrawal. Hub cultures were obtained immediately before withdrawal and were cultured using a semiquantitative method. Catheter tips were cultured using the roll-plate technique and sonication, and NCs were cultured using a semiquantitative technique after sonication. We considered NCs to be colonized when ≥1 culture was positive. We collected a total of 75 central systems. The catheter colonization rate was 10.7%. The rates for hub and NC colonization were 6.7% and 12.0%, respectively. The validity values for hubs and NCs for prediction of catheter colonization were as follows: sensitivity, 25.0% and 87.5%; specificity, 95.5% and 97.0%; positive predictive value, 40.0% and 77.8%; negative predictive value, 91.4% and 98.5%; validity index, 88.0% and 96.0%, respectively. Cultures of closed NCs can be used to rule out catheter tip colonization and are superior to hub cultures in ruling out short-term central venous catheter colonization.
Functional Dynamics of the Gut Microbiome in Elderly People during Probiotic Consumption
Authors: Eloe-Fadrosh Emiley A. , Brady Arthur , Crabtree Jonathan , Drabek Elliott F. , Ma Bing , Mahurkar Anup , Ravel Jacques , Haverkamp Miriam , Fiorino Anne-Maria , Botelho Christine , Andreyeva Irina , Hibberd Patricia L. , Fraser Claire M.
Published: April 2015

A mechanistic understanding of the purported health benefits conferred by consumption of probiotic bacteria has been limited by our knowledge of the resident gut microbiota and its interaction with the host. Here, we detail the impact of a single-organism probiotic,
Lactobacillus rhamnosus
GG ATCC 53103 (LGG), on the structure and functional dynamics (gene expression) of the gut microbiota in a study of 12 healthy individuals, 65 to 80 years old. The analysis revealed that while the overall community composition was stable as assessed by 16S rRNA profiling, the transcriptional response of the gut microbiota was modulated by probiotic treatment. Comparison of transcriptional profiles based on taxonomic composition yielded three distinct transcriptome groups that displayed considerable differences in functional dynamics. The transcriptional profile of LGG
in vivo
was remarkably concordant across study subjects despite the considerable interindividual nature of the gut microbiota. However, we identified genes involved in flagellar motility, chemotaxis, and adhesion from
Bifidobacterium
and the dominant butyrate producers Roseburia and Eubacterium whose expression was increased during probiotic consumption, suggesting that LGG may promote interactions between key constituents of the microbiota and the host epithelium. These results provide evidence for the discrete functional effects imparted by a specific single-organism probiotic and challenge the prevailing notion that probiotics substantially modify the resident microbiota within nondiseased individuals in an appreciable fashion.

IMPORTANCE
Probiotic bacteria have been used for over a century to promote digestive health. Many individuals report that probiotics alleviate a number of digestive issues, yet little evidence links how probiotic microbes influence human health. Here, we show how the resident microbes that inhabit the healthy human gut respond to a probiotic. The well-studied probiotic
Lactobacillus rhamnosus
GG ATCC 53103 (LGG) was administered in a clinical trial, and a suite of measurements of the resident microbes were taken to evaluate potential changes over the course of probiotic consumption. We found that LGG transiently enriches for functions to potentially promote anti-inflammatory pathways in the resident microbes.
Efficiency of Conditionally Attenuated Salmonella enterica Serovar Typhimurium in Bacterium-Mediated Tumor Therapy
Authors: Frahm Michael , Felgner Sebastian , Kocijancic Dino , Rohde Manfred , Hensel Michael , Curtiss Roy , Erhardt Marc , Weiss Siegfried
Published: April 2015

Increasing numbers of cancer cases generate a great urge for new treatment options. Applying bacteria like
Salmonella enterica
serovar Typhimurium for cancer therapy represents an intensively explored option. These bacteria have been shown not only to colonize solid tumors but also to exhibit an intrinsic antitumor effect. In addition, they could serve as tumor-targeting vectors for therapeutic molecules. However, the pathogenic
S
. Typhimurium strains used for tumor therapy need to be attenuated for safe application. Here, lipopolysaccharide (LPS) deletion mutants (Δ
rfaL
, Δ
rfaG
, Δ
rfaH
, Δ
rfaD
, Δ
rfaP
, and Δ
msbB
mutants) of
Salmonella
were investigated for efficiency in tumor therapy. Of such variants, the Δ
rfaD
and Δ
rfaG
deep rough mutants exhibited the best tumor specificity and lowest pathogenicity. However, the intrinsic antitumor effect was found to be weak. To overcome this limitation, conditional attenuation was tested by complementing the mutants with an inducible arabinose promoter. The chromosomal integration of the respective LPS biosynthesis genes into the
araBAD
locus exhibited the best balance of attenuation and therapeutic benefit. Thus, the present study establishes a basis for the development of an applicably cancer therapeutic bacterium.

IMPORTANCE
Cancer has become the second most frequent cause of death in industrialized countries. This and the drawbacks of routine therapies generate an urgent need for novel treatment options. Applying appropriately modified
S
. Typhimurium for therapy represents the major challenge of bacterium-mediated tumor therapy. In the present study, we demonstrated that
Salmonella
bacteria conditionally modified in their LPS phenotype exhibit a safe tumor-targeting phenotype. Moreover, they could represent a suitable vehicle to shuttle therapeutic compounds directly into cancerous tissue without harming the host.
Changes in Expression Induced by Epstein-Barr Virus LMP1-CTAR1: Potential Role of bcl3
Authors: Edwards Rachel Hood , Marquitz Aron R. , Raab-Traub Nancy
Published: April 2015

The Epstein-Barr virus protein latent membrane protein 1 (LMP1) has two NF-κB activating domains within its intracellular carboxy terminus (carboxy-terminal activating region 1 [CTAR1] and CTAR2). LMP1-CTAR1 is required for B-lymphocyte transformation, is capable of transforming rodent fibroblasts, and uniquely activates phosphoinositol (PI3) kinase, the noncanonical NF-κB pathway, and expression of the epidermal growth factor receptor (EGFR). In this study, the effects of LMP1-CTAR1 on cellular gene expression were determined by high-throughput sequencing. Additionally, the binding of bcl3 was determined using chromatin immunoprecipitation (ChIP) and sequencing. LMP1-CTAR1 induced few changes in transcription with more genes showing decreased expression. Ingenuity pathway analysis indicated significant enrichment for genes involved in cancer and cellular movement, survival, growth, and proliferation pathways. ChIP in combination with high-throughput sequencing (ChIP-Seq) identified bcl3 binding for more than 2,000 genes in LMP1-CTAR1-expressing cells with more than 90% of the peaks at genes detected within the probable promoter region. Only a small subset of the genes with significant changes in expression had corresponding peaks in the bcl3 ChIP. However, both NFKB2 and PI3 kinase were identified in the bcl3 ChIP. Additionally, many of the predicted upstream regulators for the changes in expression were identified in the bcl3 ChIP. Analysis of the proteins in the NF-κB pathway revealed many changes identified by the high-throughput RNA sequencing (RNA-Seq) and bcl3 ChIP that would likely activate noncanonical NF-κB signaling and possibly inhibit canonical NF-κB signaling. These findings suggest that the two LMP1 signaling domains modulate their combined activity and that the bcl3 transcription factor is likely responsible for some of the unique effects of CTAR1 on cellular expression.

IMPORTANCE
The Epstein-Barr virus protein latent membrane protein 1 (LMP1) has potent effects on cell growth. LMP1 has two regions, carboxy-terminal activating region 1 (CTAR1) and CTAR2, that distinctly activate NF-κB, a transcription factor complex involved in activation of important host genes. In this study, analysis of the effects on cellular gene expression revealed that CTAR1 significantly affected cellular expression in part through effects on a specific form of NF-κB. The data suggest that LMP1 can activate a distinct subset of host gene expression through its CTAR1 domain which in combination with other signaling effects induced by the CTAR2 domain likely affects cell movement, survival, and growth.
Arrhythmias are not to blame for all cardiac syncope patients: left atrial myxoma causing syncope in a middle-aged man
Authors: Rajani Ali Raza , Muaz Reem Naif , Govindaswamy Pushpa Rani , Mian Muhammad Hamid
Published: April 2015

A 47-year-old man presented with a history of syncope that lasted for 3 min and was not accompanied by jerky movement of limbs or incontinence. After regaining consciousness, he felt generalised weakness. There was no history of chest pain or palpitation. ECG showed normal sinus rhythm. All blood investigations were normal. Transthoracic echocardiography showed a large multilobulated echo dense mass in the left atrium. The mass was prolapsing through the mitral valve during diastole. Transoesophageal echocardiography verified these findings and also showed the stalk of the mass attached to the interatrial septum near the fossa ovalis. The mass was highly suggestive of myxoma. The patient underwent surgical resection of the mass and histopathology confirmed the diagnosis of left atrial myxoma.
Prevalence, incidence and risk factors for overuse injuries of the wrist in young athletes: a systematic review
Authors: Kox Laura S , Kuijer P Paul F M , Kerkhoffs Gino M M J , Maas Mario , Frings-Dresen Monique H W
Published: April 2015

Background

Overuse wrist injuries can cause long-term symptoms in young athletes performing wrist-loading sports. Information on the prevalence, incidence and associated risk factors is required.

Purpose

We aimed to review the prevalence and incidence of overuse wrist injuries in young athletes and to identify associated risk factors. We focused on popular wrist-loading youth sports—gymnastics, tennis, field hockey, volleyball, judo and rowing.

Study design

Systematic review.

Methods

We conducted a literature search on athletes aged <18 years performing wrist-loading focus sports. Prevalence, incidence and/or risk factor ORs for overuse wrist injuries were extracted directly or calculated from reported data.

Results

The search identified six studies on prevalence, five on incidence, and one on risk factors. Prevalence rates were 32–73% forwrist painand 10–28% foroveruse wrist injury. Incidence rates were 7–9% forwrist painand 0.02–26% foroveruse wrist injury.The three criteria associated with wrist pain were (with OR): age of 10–14 years (11.5), training intensity (1.2), and earlier onset of gymnastics training (1.97).

Conclusions

Prevalence and incidence of overuse wrist injuries was high in multiple studies of gymnasts, and largely unknown in other wrist-loading focus sports. Three key risk factors for wrist pain in gymnasts were age between 10 and 14 years, earlier training commencement, and training intensity. Using ‘wrist pain’ in defining overuse, and further investigating risk factors can aid in identifying overuse wrist injuries in young athletes.
Cartilage issues in football—today's problems and tomorrow's solutions
Authors: Mithoefer Kai , Peterson Lars , Zenobi-Wong Marcy , Mandelbaum Bert R
Published: April 2015

Articular cartilage injury is prevalent in football players and results from chronic joint stress or acute traumatic injuries. Articular cartilage injury can often result in progressive painful impairment of joint function and limit sports participation. Management of articular cartilage injury in athletes aims to return the player to competition, and requires effective and durable joint surface restoration that resembles normal hyaline articular cartilage that can withstand the high joint stresses of football. Existing articular cartilage repair techniques can return the athlete with articular cartilage injury to high-impact sports, but treatment does not produce normal articular cartilage, and this limits the success rate and durability of current cartilage repair in athletes. Novel scientific concepts and treatment techniques that apply modern tissue engineering technologies promise further advancement in the treatment of these challenging injuries in the high demand athletic population. We review the current knowledge of cartilage injury pathophysiology, epidemiology and aetiology, and outline existing management algorithms, developing treatment options and future strategies to manage articular cartilage injuries in football players.
High prevalence of medication use in professional football tournaments including the World Cups between 2002 and 2014: a narrative review with a focus on NSAIDs
Authors: Tscholl Philippe M , Vaso Martin , Weber Alexis , Dvorak Jiri
Published: April 2015

The use of medication in international football has been monitored since the 2002 FIFA World Cup. Team physicians were asked to provide information on prescribed medication 72 h prior to each match for every player. 69% of adult male players reported using medication, with more than half the players using non-steroidal anti-inflammatory drugs (NSAIDs). Up to one-third of all players used NSAIDs prior to every match, regardless of whether they took the field or not. The mean intake of medication was significantly higher during the FIFA Women's World Cup (0.85 vs 0.77 substances per player and per match in men, p<0.001), whereas the use of NSAIDs was similar to that for men. In the Under-20 and Under-17 male competitions, the use of medication was lower as 60% of players used some kind of medication and 43% of the players used NSAIDs during the tournaments. Despite the potential side effects of medication, especially of NSAIDs in the recovery process after a sports activity, there is no evidence of decreasing intake. The reported incidence is alarming, and moreover is most probably underestimated, since self-medication by the players or treatment already prescribed by club physicians is not included in the published reports. Future studies should focus on the daily dosage, time of treatment and especially the medical indication for painkilling agents to better understand the underlying factors.
Fitness for purpose study of the Field Assessment Conditioning Tool (FACT): a research protocol
Authors: MacKinnon Ralph James , Kennedy Chris , Doherty Catherine , Shepherd Michael , Cole Joanne , Stenfors-Hayes Terese ,   on behalf of the INSPIRE Trauma Outreach Research Group (http://www.inspiresim.com)
Published: April 2015

Introduction

As part of a programme of research aiming to improve the outcomes of traumatically injured children, a multisource healthcare advocacy tool has been developed to allow trauma team members and hospital governance administrators to reflect and to act on complex trauma team-hospital systems interactions. We have termed this tool a Field Assessment Conditioning Tool (FACT). The FACT draws on quantitative data including clinical care points in addition to self-reflective qualitative data. The FACT is designed to provide feedback on this assessment data both horizontally across fellow potential team members and vertically to the hospital/organisation governance structure, enabling process gap identification and allowing an agenda of improvements to be realised. The aim of the study described in this paper is to explore the perceived fitness for purpose of the FACT to provide an opportunity for healthcare advocacy by healthcare professionals caring for traumatically injured children.

Methods and analysis

The FACT will be implemented and studied in three district hospitals, each around a major trauma centre in the UK, USA and New Zealand. Using a qualitative approach with standardised semi-structured interviews and thematic analysis we will explore the following question: Is the FACT fit for purpose in terms of providing a framework to evaluate, reflect and act on the individual hospital's own performance (trauma team—hospital interactions) in terms of readiness to receive traumatically injured children?

Ethics and dissemination

Ethics opinion was sought for each research host organisation participating and deemed not required. The results will be disseminated to participating sites, networks and published in high-impact journals.
Validity of self-reported diabetes among middle-aged and older Chinese adults: the China Health and Retirement Longitudinal Study
Authors: Yuan Xiaojing , Liu Tingting , Wu Lang , Zou Zhi-Yong , Li Changwei
Published: April 2015

Background

Self-reported diabetes has been found to be valid to evaluate people's diabetes status in the population of several countries. However, no such study has been conducted to assess the validity of self-reported diabetes in the Chinese population, the largest population with the highest rate of diabetes. The aim of our study is to evaluate the validity of self-reported diabetes among the middle-aged and older Chinese population.

Methods

Data from 11 601 participants, aged ≥45, of the China Health and Retirement Longitudinal Study (CHARLS) during 2011–2012, were analysed. Prevalent self-reported diabetes was compared with reference definition defined by fasting glucose, glycated haemoglobin and medication use. Sensitivity, specificity, positive predicted value, negative predicted value and κ value were calculated overall, by 5-year age groups, by education levels and by living areas.

Results

The sensitivity of prevalent self-reported diabetes was 41.5%, and the specificity was 98.6%. The sensitivity of self-reported diabetes increased with education levels, and was much higher among urban residents than rural residents (58.2% vs 35.0%). The specificity was above 98% among all age groups, in different education levels, and in rural and urban areas. Self-reported diabetes had substantial agreement with reference definition among participants with above vocational school education or those living in urban areas (κ=0.658 and 0.646, respectively).

Conclusions

Although the sensitivity of self-reported diabetes was poor among middle-aged and older Chinese adults, the specificity and positive predictive values were fairly good. Furthermore, self-reported diabetes performed well among those with more than vocational school educations or those living in urban areas.
001 PP: ONLINE CLINICAL MANAGEMENT PATHWAYS FOR CHLAMYDIA TREATMENT: ENRICHING FORMATIVE EVALUATION OF A COMPLEX E-HEALTH INTERVENTION
Authors: Aicken CRH , Estcourt CS , Gibbs J , Sonnenberg P , Mercer CH , Tickle L , Sutcliffe LJ , Sadiq ST , Shahmanesh M
Published: April 2015

Background

Novel online clinical management pathways for chlamydia (eSexualHealthClinic) are being developed, enabling people to receive treatment remotely from clinical settings, with minimal contact with healthcare-professionals. Development follows Medical Research Council complex interventions guidance, and is iteratively informed by qualitative research.

In a mixed-methods pilot study, the eSexualHealthClinic is being explored for acceptability and preliminary evidence of effectiveness, among people who tested positive for chlamydia through conventional services. They receive test-results by text-message, and are offered online care. After completing an automated consultation, they can collect antibiotics from community pharmacies. If they prefer, or if medically appropriate, they are managed in clinic.

Objective

To describe how the pilot study's qualitative component will deepen our understanding of its quantitative findings, further informing intervention development.

Methods

Ongoing semi-structured follow-up telephone-interviews with people who used the eSexualHealthClinic, exploring views and experiences. Interviews are informed by the Theory of Planned Behaviour, also considering expectations and previous experiences of healthcare, emotional and contextual factors, themes from our previous qualitative research, and allowing emergent themes. Since prevention of transmission is paramount for infection control, reasons for delayed treatment are explored.

Contribution of qualitative research

Interactions with the eSexualHealthClinic are time-logged, and participants are surveyed after completing care. These detailed quantitative data provide limited information on reasons for delays, (dis)satisfaction, and unmet needs. Qualitative research enables in-depth, contextualised exploration of these issues, including influences on care-seeking unanticipated by researchers, which cannot be examined quantitatively.

Integration of qualitative and quantitative findings will enable participants' care-seeking behaviour to be more fully understood, informing care-pathway refinement, for maximum clinical and public health benefit.

Discussion

Online healthcare is expanding. During development of novel web-based care-pathways, navigated with minimal supervision, understanding care-seeking behaviour through qualitative research is vital. This understanding is enhanced by mixed-methods design, where qualitative and quantitative research are mutually-enriching.
007 PP: COMBINED METHODOLOGY: DOING ETHNOGRAPHY WITH MULTI-SITED NARRATIVES
Authors: Masana L
Published: April 2015

This poster focuses on the different ways —the combined methodology— I used to obtain data for my doctoral research on the experience and management of chronic illness in Spain of adults who are in the prime of their lives, and how I analyzed them. The lived experience of chronicity was explored through illness narratives in a multi-sited ethnography: interviews conducted in the homes of the participants; observation of a therapeutic group in a hospital and in a mutual help group in a patients' association; informal ethnography; autoethnographic books and scientific articles, secondary analysis of other published material; and several digital narratives about personal or collective experiences with diverse chronic conditions located on the Internet. The goal was to show the cultural circulation of meanings attributed to chronicity and the socio-cultural constructions of several chronic illnesses, which was achieved through a thematic analysis. For this purpose, a microsocial sample was chosen according to its significance and theoretically (not statistically) representative ethnographic value concerning the common denominator of a shared experience of chronicity. This combined methodology, which includes ‘real’ and ‘virtual’ narratives, oral and written narratives, and primary and secondary data, challenges us to rethink our concepts of data and our methodological approaches to the ethnographic field.
004 OP: ENACTING PPI IN QUALITATIVE MENTAL HEALTH RESEARCH: PEER RESEARCHER INVOLVEMENT IN DATA ANALYSIS IN THE ‘CORE’ STUDY
Authors: Morant N , Lloyd-Evans B ,   CORE project team led by S. Johnson
Published: April 2015

Patient and public involvement (PPI) is now an expected component of UK publicly-funded health research. Compatibilities with PPI aims and values mean that qualitative research is often a vehicle for enacting PPI. This presentation focuses on the involvement of “peer researchers” (service users and carers) in qualitative data analysis, and offers critical reflections of the practicalities of this process in the context of mental health research and an academic-led project.

“CORE” (Crisis resolution team Optimisation and RElapse prevention) is a large NIHR-funded research project that aims to optimise the functioning of crisis resolution teams (CRTs). CRTs provide intensive home-based treatment for people experiencing an acute mental health crisis, as an alternative to hospital admission. They exist in all NHS Mental Health Trusts in England, but their performance and effectiveness is variable. The CORE project adopts a collaborative model of service user and carer involvement within an academic-led project. A large service user and carer working group contributes to a range of project activities including a qualitative study of stakeholders' views on current and best CRT practice, in which peer researchers have conducted interviews and been involved in data analysis.

Faced with a large data set of more than 100 pieces of data, and little existing guidance on peer researcher involvement in qualitative data analysis, we attempted to develop an approach that enabled genuine involvement and maximised the methodological benefits of collaboration. Additional aims were to build research skills and capacity, and to obtain feedback from participants about their experiences of this. Peer researcher involvement began in the early stages of thematic analysis, in order to maximise contributions to the development of thematic codes at the point when these were most fluid and open. This was part of a staged process that meshed the work and perspectives of peer researchers with those of the academic researcher team. The presentation will describe this process and the rationale behind it, and discuss critical issues such as whether academic-led collaborations perpetuate or have the capacity to challenge existing power inequalities that are greater in mental health than other healthcare contexts.
006 OP: METHODOLOGICAL LIMITATIONS AND ADVANCES IN STUDYING CULTURE AND MENTAL HEALTH: SIGNIFICANCE OF QUALITATIVE APPROACHES
Authors: Patel R
Published: April 2015

Social Epidemiology has had a long standing position in health research and covers distribution and determinants of health-related states in defined populations. The domain investigates patterns and causality, revealing health inequalities which aim to prevent and control health related issues. Understandably this field of research has advanced biological fields in exploring the relevance of social, cultural, environmental and economic factors that also play a fundamental role in ill health which is crucially ignored in biological standpoints. However, the dynamic of current societies is continuously changing and for example some areas in the UK are distinctively culturally diverse. By using my study of exploring reasons behind low reported rates of mental illness within the Gujarati community in Leicester I will argue that Social Epidemiology is limiting as method of studying in particular ethnic groups and mental health.

This presentation will firstly, address the current problems with epidemiological studies in this area such as ecological fallacy, cultural stereotypes and validity of official statistics. Secondly, I will argue that qualitative research and sociological approaches are progressive for studying mental health. With reference to interview data I will outline a few current cultural complexities such as religion, language and changing traditions faced by both first and second generation migrants.

Finally, I will conclude by proposing to progress mental health provision for ethnic groups there is much to be learnt about the intrinsic relationship culture has on mental health. Both qualitative methods and sociological approaches accommodate this required necessity. Having recognised the significance qualitative research has in health, we are faced with the problem of incorporating this in the universal province of the medical model of health which indeed is tricky and perhaps not one that is welcomed by all.