bluuebunny/crossref_metadata_2025 huggingface dataset:
Physicochemical, microbiological, and sensory characterization of ‘Nduja, a typical sausage from Calabria, southern Italy
Authors: Chiavari Cristiana , Grazia Luigi , Benevelli Marzia , Faustini Lorena , Coloretti Fabio
Published: October 2018

Physicochemical parameters, microbiota, and sensory profile of 13 samples of ‘Nduja, a typical sausage from Calabria, Southern Italy, were determined. The chemical composition is characterized by a wide variability, confirming the differences between the producers' recipes. A common feature is the presence of fibers and sugars due to the addition of pepper (about 25%). The presence of sugars in the ripened product confirms that the fermentations were incomplete, as evidenced by the low counts of lactic acid bacteria and coagulase negative cocci. No spoilage bacteria were found. It has been verified that the pepper limit microbial growth, lowering pH and Aw in the mixture, so that Nduja may be considered a meat preserve, not a fermented sausage. Total biogenic amines content was <200 mg/kg, mainly cadaverine, histamine, and tyramine. Finally, as regards the sensory aspect, a trained panel identified 12 specific descriptors.

Practical applications

Although ‘Nduja is produced artisanally and in a circumscribed area, having followed the migratory flows of Calabrian people it is known and diffused worldwide. Despite this diffusion, however, studies of the chemical composition, the microbiological, and the sensory characteristics are poor. This study provides information about the chemical and microbiological composition of different samples of ‘Nduja. The safety aspects, due to the massive addition of peppers, have also been verified. These traits are useful for producers who must guarantee a safe product to consumers. This paper is the first to show the sensory aspects of ‘Nduja in detail, creating a specific sensory profile with proper descriptors. All this information could help in drafting a protocol for Community Protected Geographical Indication when required.
Hepatic encephalopathy: Sometimes more portal than hepatic
Authors: Aller Maria‐Angeles , Arias Natalia , Blanco‐Rivero Javier , Arias Jorge L , Arias Jaime
Published: October 2018

Hepatic encephalopathy is a severe complication of both chronic and acute liver diseases. The term hepatic encephalopathy stems from the belief that hepatic insufficiency is its fundamental etiopathogenic factor. However, most clinical cases show liver failure along with mesenteric venous portal hypertension. This portal hypertension would explain the abnormal mechanical forces suffered by the digestive tract in the early stages of the disorder. These forces could regulate some gut biochemical pathological pathways in a process known as mechanotransduction. Thus, portal hypertension would begin with the establishment of a mechanotransduced afferent or sensory inflammatory gut‐brain pathway, resulting in functional and structural changes in the central nervous system. In this review, we will revisit the term “hepatic encephalopathy” in light of new results where portal hypertension occurs before liver failure and is accompanied by brain changes. Moreover, we will point out cellular links that can explain the microbiota, immune, gut, and brain axis disturbances found in this disorder.
Comparison of semen characteristics and sperm cryopreservation in common marmoset (Callithrix jacchus) and black‐tufted‐ear marmoset (Callithrix penicillata)
Authors: Arakaki Paloma Rocha , Nichi Marcílio , Monteiro Frederico Ozanan Barros , Muniz José Augusto Pereira Carneiro , Guimarães Marcelo Alcindo de Barros Vaz , Valle Rodrigo del Rio do
Published: October 2018

Background

The common marmoset (Callithrix jacchus) is one of the most studied Neotropical primates regarding reproduction. However, little has been reported on the black‐tufted‐ear marmoset (Callithrix penicillata), which may produce fertile hybrids with other Callithrix. This is the first study to evaluate sperm freezing from black‐tufted‐ear marmoset.

Methods

Testicles from all animals were measured, and semen was collected by penile vibrostimulation. Samples were analyzed after collection, after chilling and addition of glycerol, and after thawing.

Results and Conclusions

Fresh semen from both species was similar in many aspects. Additionally, there is a relationship between total motility, plasma membrane integrity, and acrosome integrity observed in sperm samples from both species. We managed to evaluate fresh and thawed sperm with suitable methods for use under zoo or field conditions. However, TEST egg yolk with glycerol at 4% and 6% concentration was not effective for sperm protection in both species during cryopreservation.
Primed From the Start: Syntactic Priming During the First Days of Language Learning
Authors: Weber Kirsten , Christiansen Morten H. , Indefrey Peter , Hagoort Peter
Published: October 2018

New linguistic information must be integrated into our existing language system. Using a novel experimental task that incorporates a syntactic priming paradigm into artificial language learning, we investigated how new grammatical regularities and words are learned. This innovation allowed us to control the language input the learner received, while the syntactic priming paradigm provided insight into the nature of the underlying syntactic processing machinery. The results of the present study pointed to facilitatory syntactic processing effects within the first days of learning: Syntactic and lexical priming effects revealed participants’ sensitivity to both novel words and word orders. This suggested that novel syntactic structures and their meaning (form–function mapping) can be acquired rapidly through incidental learning. More generally, our study indicated similar mechanisms for learning and processing in both artificial and natural languages, with implications for the relationship between first and second language learning.
Egalitarianism: An evolutionary perspective
Authors: Bagnoli Lidia , Negroni Giorgio
Published: October 2018

Two parties bargain over a pie, the size of which is determined by their previous investment decisions. Investment costs are heterogenoeus. The bargaining rule is sensitive to investment behavior. Our main result is that egalitarianism is more likely to emerge in situations in which private property over the fruits of one's own independent investment is not secured.
The superiority of three‐dimensional physical models to two‐dimensional computer presentations in anatomy learning
Authors: Wainman Bruce , Wolak Liliana , Pukas Giancarlo , Zheng Eric , Norman Geoffrey R
Published: October 2018

Background

Although several studies (Anat Sci Educ, 8 [6], 525, 2015) have shown that computer‐based anatomy programs (three‐dimensional visualisation technology [3DVT]) are inferior to ordinary physical models (PMs), the mechanism is not clear. In this study, we explored three mechanisms: haptic feedback, transfer‐appropriate processing and stereoscopic vision.

Methods

The test of these hypotheses required nine groups of 20 students: two from a previous study (Anat Sci Educ, 6 [4], 211, 2013) and seven new groups. (i) To explore haptic feedback from physical models, participants in one group were allowed to touch the model during learning; in the other group, they could not; (ii) to test ‘transfer‐appropriate processing’ (TAP), learning ( PM or 3DVT) was crossed with testing (cadaver or two‐dimensional display of cadaver); (iii) finally, to examine the role of stereo vision, we tested groups who had the non‐dominant eye covered during learning and testing, during learning, or not at all, on both PM and 3DVT. The test was a 15‐item short‐answer test requiring naming structures on a cadaver pelvis. A list of names was provided.

Results

The test of haptic feedback showed a large advantage of the PM over 3DVT regardless of whether or not participants had haptic feedback: 67% correct for the PM with haptic feedback, 69% for PM without haptic feedback, versus 41% for 3DVT (p < 0.0001). In the study of TAP, the PM had an average score of 74% versus 43% for 3DVT (p < 0.0001) regardless of two‐dimensional versus three‐dimensional test outcome. The third study showed that the large advantage of the PM over 3DVT (28%) with binocular vision nearly disappeared (5%) when the non‐dominant eye was covered for both learning and testing.

Conclusions

A physical model is superior to a computer projection, primarily as a consequence of stereoscopic vision with the PM. The results have implications for the use of digital technology in spatial learning.
Challenges, success factors and pitfalls: implementation of distributed medical education
Authors: Saxena Anurag , Lawrence Kathy , Desanghere Loni , Smith‐Windsor Tom , White Gill , Florizone Dan , McGartland Sinead , Stobart Kent
Published: October 2018

Objectives

There are only a few descriptive reports on the implementation of distributed medical education (DME) and these provide accounts of successful implementation from the senior leadership perspective. In Saskatchewan, over a period of 4 years (2010–2014), four family medicine residency sites were established and two additional sites could not be developed. The aim of this study was to identify challenges, success factors and pitfalls in DME implementation based upon experiences of multiple stakeholders with both successful and unsuccessful outcomes.

Methods

Data were obtained through document analysis (n = 64, spanning 2009–2016; perspectives of government, senior leadership, management and learners), focus groups of management and operations personnel (n = 10) and interviews of senior leaders (n = 4). Challenges and success factors were ascertained through categorisation. Iterative coding guided by three sensitising frameworks was used to determine themes in organisational dynamics.

Results

Both challenges and success factors included contextual variables, governance, inter‐ and intra‐organisational relationships (most common success factor), resources (most common challenge), the learning environment and pedagogy. Management and operations were only a challenge. Organisational themes affecting the outcome and the pitfalls included the pace of development across multiple sites, collaborative governance, continuity in senior leadership, operations alignment and reconciliation of competing goals.

Conclusions

Emerging opportunities for DME can be leveraged through collaborative governance, aligned operations and resolution of competing goals, even in constrained contexts, to translate political will into success; however, there are pitfalls that need to be avoided. Our findings based upon multi‐stakeholder perspectives add to the body of knowledge on deployment, carefully considering the conditions for success and associated pitfalls.
Baseline concentration of misfolded α‐synuclein aggregates in cerebrospinal fluid predicts risk of cognitive decline in Parkinson's disease
Authors: Ning H. , Wu Q. , Han D. , Yao T. , Wang J. , Lu W. , Lv S. , Jia Q. , Li X.
Published: October 2018

Background

The prognostic significance of misfolded α‐synuclein (α‐Syn) aggregates in Parkinson's disease (PD) has not been well investigated. The aim of this study was to reveal the relationship between misfolded α‐Syn aggregate concentration in cerebrospinal fluid (CSF) and cognitive decline risk in PD.

Methods

A total of 278 patients with PD were retrospectively included. They were diagnosed between 2011 and 2013. The end‐point was 2016, and the follow‐up period was 54.3 ± 10.0 months. Cognitive decline was defined as a 4‐point decrease in the Mini‐Mental State Examination score during follow‐up. Misfolded α‐Syn aggregate concentration in baseline CSF was measured using the protein misfolding cyclic amplification (PMCA) technique. Time to reach 50% of the maximum fluorescence value was recorded.

Results

The PMCA technique successfully detected the level of misfolded α‐Syn aggregates in CSF with a sensitivity of 85.3% and a specificity of 91.4%. The time to reach 50% of the maximum fluorescence value was shorter in the patients with cognitive decline than in the patients without cognitive decline (190.7 ± 40.1 h vs. 240.8 ± 45.6 h, P < 0.001). Multifactorial Cox regression analysis revealed that reaching 50% of the maximum fluorescence value in ≤219 h at baseline was associated with increased risk of cognitive decline during the follow‐up (HR: 4.90, 95% CI: 2.75–8.74, P < 0.001).

Conclusion

Baseline concentration of misfolded α‐Syn aggregates in CSF measured by the PMCA technique predicts risk of cognitive decline in PD.
Improved self‐perceived performance for continence problems in patients with Parkinson's disease after deep brain stimulation
Authors: Nakamura Kumiko , Yamanaka Yoshitaka , Higuchi Yoshinori , Hirano Shigeki , Kuroiwa Ryota , Abe Midori , Murata Astushi , Iwadate Yasuo , Kuwabara Satoshi , Yamamoto Tatsuya
Published: October 2018

Background

Deep brain stimulation (DBS) is known to improve motor complications in patients with Parkinson's disease (PD); however, we lack information on how it changes self‐perceived performance for activities of daily living.

Aim

We assessed the degree of change in self‐perceived performance for activities of daily living after DBS.

Method

We applied the Canadian Occupational Performance Measure (COPM) in 21 patients with PD who underwent DBS before and 1 year after surgery and examined the relationship among the COPM score, motor and cognitive functions, and health‐related quality of life (HRQoL).

Results

Patients prioritized continence problems, gait, and household work. Self‐perceived performance satisfaction (5.46→8.38, P = 0.02) and execution (5.85→8.88, P = 0.01) for continence problems improved significantly after surgery. Self‐perceived performance satisfaction for gait tended to improve after surgery. Self‐perceived performance for household work did not change after surgery. Self‐perceived performance for continence problems negatively correlated with PD questionnaire (PDQ‐39; r = −0.827, P = 0.007) before surgery and Mini‐Mental State Examination (MMSE; r = −0.918, P = 0.028) after surgery.

Conclusion

The self‐perceived performance for continence problems improved significantly after DBS and was associated with HRQoL before surgery and MMSE after surgery.
Chinese adults' nutrition label literacy in Hong Kong: Implications for nurses
Authors: Law Queenie Pui Sze , Yau Alice Hoi Ying , Chung Joanne Wai Yee
Published: October 2018

The study aimed to investigate Chinese adults' nutrition label literacy in Hong Kong. It employed a web‐based survey with structured questions. A total of 368 Chinese adults aged 18‐59 participated in the survey and their nutrition label literacy was measured by the Newest Vital Sign (NVS). About two‐thirds (68%) of the participants had limited nutrition literacy skills. Although they were able to identify correctly the calorie and sugar content of food products, 44% and 48% of them had difficulty in determining the consumption of calories and serving food sizes respectively. Another finding from the survey was that those with lower education level and of older age had significantly lower mean nutrition label literacy scores, which indicated that they were at higher risk for food insecurity. The findings showed that the nutrition label literacy level of Hong Kong's general public is quite low. This study can provide insights for nurses and healthcare professionals on how to educate people with lower education level and/or of advanced age to use nutrition labels more effectively and to further nutrition label literacy study and research, particularly in Hong Kong.
Occupational therapy practice in oncology care: Results from a survey
Authors: Stein Duker Leah I. , Sleight Alix G.
Published: October 2018

The everyday landscape of occupational therapy (OT) in oncology is underexplored, hindering targeted improvements. The purpose of the present study was to identify the OT interventions commonly provided and reimbursed in oncology. A survey utilizing snowball sampling was disseminated online to OT working in oncology care; 167 surveys were received from 21 states in the United States. Results found that over 90% of therapists reported focusing on physical impairment, weakness, fatigue, and activities of daily living. Interventions for emotional/social support, self‐advocacy, quality of life, lifestyle management, and cognitive impairment were not directly billed. More than 90% of therapists reported that, in the absence of barriers, they would address quality of life, emotional difficulties, lifestyle management, and home safety. Overall, the findings suggested that OT in the United States primarily provide physical interventions for oncology patients. However, they also provide psychosocial services and client/caregiver education, but often do not bill directly for this care. Reimbursement structures should be modified to allow for the direct billing of mental/psychosocial and educational interventions in OT for cancer care.
Forest diversity effects on insect herbivores: do leaf traits matter?
Authors: Muiruri Evalyne W. , Barantal Sandra , Iason Glenn R. , Salminen Juha‐Pekka , Perez‐Fernandez Estefania , Koricheva Julia
Published: October 2018

Insect herbivore damage and abundance are often reduced in diverse plant stands. However, few studies have explored whether this phenomenon is a result of plant diversity effects on host plant traits.

We explored indirect effects of tree species diversity on herbivory via changes in leaf traits in a long‐term forest diversity experiment in Finland. We measured 16 leaf traits and leaf damage by four insect guilds (chewers, gall formers, leaf miners and rollers) on silver birch (Betula pendula) trees growing in one‐, two‐, three‐ and five‐species mixtures.

A decline in the frequency of birch in mixed stands resulted in reduced leaf area. This, in turn, mediated the reduction in chewing damage in mixed stands. In contrast, associational resistance of birch to leaf miners was not trait‐mediated but driven directly by concurrent declines in birch frequency as tree species richness increased.

Our results show that leaf trait variation across the diversity gradient might promote associational resistance, but these patterns are driven by an increase in the relative abundance of heterospecifics rather than by tree species richness per se. Therefore, accounting for concurrent changes in stand structure and key foliar traits is important for the interpretation of plant diversity effects and predictions of associational patterns.
Geographical Leadership Mobility and Policy Isomorphism: Narrowing the Regional Inequality of Social Spending in China
Authors: Zhu Xufeng , Meng Tianguang
Published: October 2018

The link between geographical leadership mobility and policy isomorphism is rarely discussed in the extant literature. We argue that the geographical leadership mobility encourages local executives to converge their development experiences in their original working jurisdictions and their current positions. The distinct Chinese political personnel system provides an ideal environment that allows researchers to examine the isomorphic effects of geographical leadership mobility. This research builds a dataset of local social spending between 1998 and 2011 as well as a database of the leadership mobility history of provincial executives in China. Results of the spatial panel analysis (SPA) demonstrate that the geographical leadership mobility (i.e., horizontal, top‐down, and bottom‐up) of governors stimulates the regional isomorphism of provincial education and health care spending. The empirical findings affirm the effectiveness of the effort of the Chinese central government in narrowing the regional inequality of social welfare provision through the geographical mobility of local leadership.
Risk‐Based Policy Narratives
Authors: Lawlor Andrea , Crow Deserai
Published: October 2018

The Narrative Policy Framework (NPF) was developed to provide theoretical and empirical grounding for inquiries into questions about the interplay between communication and policy processes. In our previous work, we argued for the inclusion of framing analysis within the broader NPF structure in order to account for the ways in which problems, solutions, and characters are portrayed to citizens. The study presented here seeks to further develop these complementary approaches to understanding the construction of policy narratives in the important domain of hazards and disaster policy. Communication of risk is central to political and policy dialogue. By accurately and effectively communicating risks, the problem definitions and associated solutions may be more closely aligned with expert risk assessments, actors may mobilize to affect change, and policy change may be more likely. We examine the construction of risk within narratives to analyze how the narrative construction of chronic versus urgent risk may influence policy discussions. In this paper, we link NPF concepts of setting, plot, and moral of the story to frames of risk. This study advances NPF scholarship by linking these theoretical approaches and establishing how framing analysis can aid in measuring narrative concepts.
Victims of Health‐Care Reform: Hirschman's Rhetoric of Reaction in the Shadow of Federalism
Authors: Smith‐Walter Aaron
Published: October 2018

This paper harnesses the Narrative Policy Framework's articulation of characters as vital components of policy narratives to enhance the analytical traction of Albert O. Hirschman's typology of reactionary and progressive rhetoric. Using content analysis of transcripts containing policy narratives presented in federal legislative, executive, and judicial venues, this paper presents an analysis of the rhetorical use of victims as surrogates for an underlying conflict over fundamental values of liberty and equity in debates surrounding the Affordable Care Act (ACA) in the United States. This research finds that Hirschman's rhetorical typology continues to be useful in analyzing the development of the welfare state, while benefitting from its pairing with the NPF's focus on the characters which occupy policy narratives. Victims are strategically deployed in policy narratives around the ACA. Reactionary rhetoric had a statistically significant association with the value of liberty and portraying state and local governments as victims of federal overreach. Progressive rhetoric had a strong and statistically significant association with the invocation of family as victim whereas those using reactionary rhetoric type more often employed government as victim. These differences in the types of victims can be understood as reflecting a conflict between the values of equity and liberty in federal relations undergirding the U.S. health‐care system, shifting control of state‐level government, and as differences between the political makeup of the Democratic and Republican parties.
Fracking Bad Guys: The Role of Narrative Character Affect in Shaping Hydraulic Fracturing Policy Preferences
Authors: Zanocco Chad , Song Geoboo , Jones Michael
Published: October 2018

Recent growth in unconventional oil and gas development is controversial, fueling an ongoing U.S. policy debate. Central to these discussions is hydraulic fracturing, or “fracking,” a well‐stimulation technique that has become synonymous with unconventional oil and gas extraction methods. This research applies the Narrative Policy Framework (NPF) to explore how culturally nuanced narratives shape individuals' policy preferences toward fracking regulations. A census‐balanced internet panel from Oregon and Arkansas (n = 1,145) is used to conduct a survey experiment where participants are randomly assigned to four groups and exposed to information regarding fracking practices. The control group receives a baseline fact list while three treatment groups are exposed to one of three culturally distinct narratives: an egalitarian narrative, a hierarch narrative, or an individualist narrative. Applying ANOVA and causal mediation analysis to this experimental data, we show that while there is nodirecteffect of narrative treatments on the formation of individuals' fracking policy preferences, culturally nuanced narrativesdoinfluence attitudes on fracking policiesindirectlythrough their effects on individuals' reactions towardsvillaincharacters presented in the narratives. These findings describe a more complex cognitive interplay between narrative communication and policy preference formation than depicted in extant NPF scholarship, thereby challenging commonly held NPF assertions.
The emergence of the ‘planetary boundaries’ concept in international environmental law: A proposal for a framework convention
Authors: Fernández Edgar Fernández , Malwé Claire
Published: October 2018

Grounded in the application of the precautionary principle, the planetary boundaries framework attempts to define a safe operating space where human activities can take place without the risk of transgressing the Earth system's ecological thresholds, thus maintaining the planet's Holocene‐like conditions. Since its emergence in 2009, the scientific concept of planetary boundaries has gradually gained recognition in the political arena. This concept has been introduced in the European Union's legal instruments, and it has been included in documents issued at the request of or by the United Nations Secretary‐General. However, the concept has not yet been integrated into the legal documents of the United Nations’ organs. This article argues for the adoption of a framework convention on planetary boundaries as an effective means for integrating the planetary boundaries approach into international law.
Health system decentralization and recentralization in Italy: Ideas, discourse, and institutions
Authors: Terlizzi Andrea
Published: October 2018

This paper explores the dynamics of health system decentralization and recentralization in Italy, investigating why and how the territorial organization of the health system has changed over time. Drawing from discursive and historical institutionalism, the explanatory framework revolves around the role of ideational and institutional factors. The methods include process tracing and interpretive‐discourse analysis. Empirical material is drawn from documents and in‐depth interviews to experts and decision‐makers. Through the analysis of the reform trajectories in light of decentralization and recentralization processes, the paper shows that the territorial organization of the Italian health system has changed through a mechanism of gradual transformative change that I here call ideational and institutional bricolage, which involves the interplay between ideas, discourse, and institutions.
Micro‐relief analysis with skin capacitive imaging
Authors: Bontozoglou Christos , Zhang Xu , Xiao Perry
Published: October 2018

Background

In this study, the performance of capacitive imagining in skin micro‐relief analysis was investigated. This measurement principle has been used for skin hydration measurements over the last decade and it is commercially available by various manufacturers. Strengthening its potential for new applications could offer an affordable and portable multi‐purpose device for in vivo skin research. Previous studies in the literature have used a wide range of optical devices to determine how the skin surface topographic features are affected by chronological age, environmental influences and living habits.

Material and methods

A capacitive system was used in order to capture hydration images from the middle volar forearm of twelve volunteers. The visual output of the system was studied and image processing algorithms were adapted to automatically extract skin micro‐relief features. The change in the skin network of lines during arm extension, the lines’ anisotropy index and the number of closed polygons per skin surface area were plotted against the subjects’ chronological age. The results were compared with optical measurements from the literature to validate our algorithms and evaluate the capacitive imaging in skin micro‐relief analysis.

Results

The change in the intensity of primary and secondary lines during arm extension and the number of closed polygons per surface area were in agreement with the literature. The anisotropy index output gave inconclusive results.

Conclusions

The experimental results show that the capacitive systems could only extract two‐dimensional skin topographic features.
Teachers’ gender considerations during elementary mathematics lesson design
Authors: Amador Julie M.
Published: October 2018

As teachers design lessons, their considerations influence their instructional practice. Researchers have found that teachers often have preconceived ideas about gender and large‐scale assessment data show gender differences in mathematics achievement. Given the differences in gender performance, and recognizing the role that gender considerations may play in teaching, this study focuses on teachers’ considerations of gender during the lesson planning and implementation process. Findings indicate that teachers in the study minimally consider gender when planning lessons and evidence shows a lack of explicit gender considerations during instructional practice and in conversations about teaching. Results imply that considerations of gender may be quite implicit, which raises concerns about the implications of gender perceptions for student learning in mathematics.
Urban‐rural and sex differentials in tuberculosis mortality in Bangladesh: results from a population‐based survey
Authors: Sarker Malabika , Homayra Fahmida , Rawal Lal B. , Kabir Razin , Aftab Afzal , Bari Rahmatul , Dzokoto Agnes , Shargie Estifanos Biru , Islam Shayla , Islam Akramul , Mahbub Latif A. H. M.
Published: October 2018

Objective

To assess tuberculosis mortality in Bangladesh through a population‐based survey using a Verbal Autopsy tool.

Methods

Nationwide mortality survey employing the WHO‐recommended Verbal Autopsy (VA) tool, and using InsilicoVA, a data‐driven method, to assign the cause of death. Using a three‐stage cluster sampling method, 3997 VA interviews were conducted in both urban and rural areas of Bangladesh. Cause‐specific mortality fractions (CSMF) were estimated using Bayesian probabilistic models.

Results

6.8% of total deaths in the population were due to TB [95% CI: (5.1, 8.9)], comprising 12.0% [95% CI: (11.1, 12.8)] and 6.42% [95% CI: (5.4, 7.3)] of total male and female deaths, respectively. This proportion was highest among adults age 15–49 years [12.2%, 95% CI: (9.4, 14.6)]. The urban population is more likely to die from TB, and urban males have highest CSMF [13.6%, 95% CI: (9.1, 16.9)].

Conclusion

Our survey results show that TB is the fifth major cause of death in the general population and that sex and place of residence (urban/rural) have a significant effect on TB mortality in Bangladesh. The underlying causes of higher rates of TB‐related deaths in urban areas and particularly among urban males, who have better knowledge and higher enrollment in the DOTS Program, need to be explored.
Packed red cells versus whole blood transfusion for severe paediatric anaemia, pregnancy‐related anaemia and obstetric bleeding: an analysis of clinical practice guidelines from sub‐Saharan Africa and evidence underpinning recommendations
Authors: Kohli Neeraj , Bhaumik Soumyadeep , Jagadesh Soushieta , Sales Reneepearl Kim , Bates Imelda
Published: October 2018

Objective

Blood component transfusion is increasingly promoted in sub‐Saharan Africa (SSA), but is resource‐intensive so whole blood is often used. We examined SSA recommendations about whole blood and packed red cell transfusions for pregnancy‐related bleeding or anaemia, and paediatric anaemia, and evaluated the evidence underpinning these recommendations.

Method

Relevant SSA guidelines were identified using five electronic databases, websites for SSA Ministries of Health, blood transfusion services and WHO. To facilitate comparisons, indications for transfusing packed red cells or whole blood within these guidelines and reasons given for these recommendations were recorded on a pre‐designed matrix. The AGREE II tool was used to appraise guidelines that gave a reason for recommending either packed red cells or whole blood. We systematically searched MEDLINE, CINAHL, Global Health, Cochrane library and NHSBT Transfusion Evidence Library, using PRISMA guidelines, for clinical studies comparing whole blood with packed red cells or combined blood components in obstetric bleeding or anaemia, or paediatric anaemia. Characteristics and findings of included studies were extracted in a standardised format and narratively summarised.

Results

32 English language guidelines from 15 SSA countries mentioned packed red cell or whole blood use for our conditions of interest. Only seven guidelines justified their recommendation for using packed red cells or whole blood. No recommendations or justifications had supporting citations to research evidence. 33 full‐text papers, from 11 234 citations, were reviewed but only one study met our inclusion criteria. This was a single‐centre study in post‐partum haemorrhage.

Conclusion

Evidence comparing whole blood and packed red cell transfusion for common paediatric and maternal indications is virtually absent in SSA. Therefore, it is unclear whether policies promoting red cells over whole blood transfusion are clinically appropriate. Building a relevant evidence base will help develop effective policies promoting the most appropriate use of blood in African settings.
Systematic reviews of guidelines and studies for single versus multiple unit transfusion strategies
Authors: Shih Andrew W. , Liu Aixin , Elsharawi Radwa , Crowther Mark A. , Cook Richard J. , Heddle Nancy M.
Published: October 2018

BACKGROUND

Recent recommendations indicate that one red blood cell (RBC) unit should be transfused at a time, with reassessment after each transfusion, which may be extrapolated from literature supporting restrictive transfusion triggers rather than specific evidence. Therefore, two systematic reviews were performed to identify the following: 1) RBC transfusion guidelines and review articles to determine if single‐ or multiple‐unit transfusion strategies are recommended and 2) studies comparing strategies for evidence of benefit.

STUDY DESIGN AND METHODS

MEDLINE, EMBASE, CINAHL, Web of Science, National Guideline Clearinghouse, and Trip Database were searched (inception to June 2017). For the first review, the proportion of articles with single/multiple‐unit recommendations was assessed and stratified by article type. For the second review, the primary outcome was RBC use. Secondary outcomes included proportion of transfusion episodes using a single‐unit strategy, length of stay, and mortality.

RESULTS

The first review identified 145 articles for analysis, with 51 transfusion guidelines. Only 14 guidelines (27%) made a recommendation, with most (93%) recommending single‐unit transfusions. The second review identified seven cohort studies comparing preimplementation and postimplementation of a policy encouraging single‐unit transfusion strategies. Meta‐analysis could not be performed for outcomes given inconsistencies in reporting. RBC use decreased by approximately 10 to 41% across studies.

CONCLUSION

Transfusion guidelines lack recommendations to transfuse to a single‐unit strategy. Mostly retrospective cohort studies (six of seven) are inconsistent in outcome reporting but suggest improved RBC use. Further high‐quality studies could identify the benefits of a single‐unit transfusion strategy, determine the applicability to different clinical settings, and inform future practice guidelines.
Uncertainty analysis of parameters in non‐point source pollution simulation: case study of the application of the Soil and Water Assessment Tool model to Yitong River watershed in northeast China
Authors: Yan Xueman , Lu Wenxi , An Yongkai , Chang Zhenbo
Published: October 2018

Uncertainty analysis of the model parameters in non‐point source pollution (NPSP) simulation is important because of its great effects on predictions and decision‐making. Understanding the main parameters that effect the uncertainty of NPSP is necessary to provide the basis for formulating control measures. In this study, two methods were applied to conduct parameter uncertainty analysis for Soil and Water Assessment Tool (SWAT). Sobol’ method was used to screen out the model parameters with great effects on the runoff, sediment, total nitrogen (TN) and total phosphorus (TP). The results obtained by sensitivity analysis were used subsequent model calibration and further uncertainty analysis. Monte Carlo (MC) method was employed to analyse the effects of parameter uncertainty on the model outputs. However, such problems are time‐consuming because the MC method required to invoke simulation model thousands of times. To address this challenge, a kriging surrogate model was developed to improve the overall calculation efficiency. The results obtained by sensitivity analysis showed that curve number value (CN2), soil evaporation compensation factor (ESCO), universal soil loss equation support practice factor (USLE_P) and initial organic nitrogen concentration in soil layer (SOL_ORGN) had significant effects on the SWAT outputs. The uncertainty analysis results showed that the uncertainty of runoff is the lowest, followed by TP and TN, and the uncertainty of sediment was the greatest. The kriging surrogate model has the ability to solve this time‐consuming problem rapidly with a high degree of accuracy, and thus it is very robust.
A conceptual model of riparian forest restoration for natural flood management
Authors: Dixon Simon J. , Sear David A. , Nislow Keith H.
Published: October 2018

There is an increasing emphasis on using natural processes, including riparian forest restoration, to enhance the ecological, hydrological and geomorphological functioning of watercourses. However, we have insufficient knowledge on how the supply and retention of in‐channel wood from riparian forest stands changes with age, with inferences typically based on data from terrestrial forests. This presents a challenge in estimating the efficacy and functional lifespan of restoration projects. In this paper, we use a riparian forest growth model to show there is a lag of up to 40–50 years between the start of forest growth and trees delivering wood to the channel that is large enough to resist fluvial transport, anchor logjams and so increase channel complexity and hydraulic resistance. Resource managers need to account for realistic timescales over which changes promoted by riparian woodland restoration will occur and may need to consider using interim engineered logjams as the forest develops.
Effect of Dimple Intrusions and Curvature Radius of Rounded Corner Triangular Duct on Fluid Flow and Heat Transfer
Authors: Kumar Rajneesh , Khurana Sourabh , Kumar Anoop , Goel Varun
Published: October 2018

The sharp corner significantly affects the flow through triangular duct. In the corners, flow gets stagnant, which results in poor heat transfer. Therefore, in the present study, one corner of the duct is kept rounded with variable curvature radius values (Rc). The curvature radius is selected in such a way that it varied from the minimum value (i.e., Rc = 0.33 times duct height; h) to a maximum value (i.e., Rc = 0.67h,which named as conventional duct in the work). In addition to this, the combined effect of both rounded corner and dimple-shaped intrusion has also been studied on flow of air and heat transfer and for this purpose; the relative streamwise distance (z/e) is varied from 6 to 14 with constant relative transverse distance (x/e) that is10. Steady-state, turbulent flow heat transfer under thermal boundary conditions is analyzed for Reynolds number from 5600 to 17,700. ANSYS (Fluent) 12.1 software is used to perform numerical simulations and good match has been observed between the simulated and experimental results. Due to rounded corner and dimple intrusions, velocity near the corner region has higher value in comparison to the conventional duct. The uniform temperature distribution is seen in the case of dimple intruded duct as compared to conventional and rounded corner duct (with Rc value of 0.33h). In comparison to conventional duct, the heat transfer increased about 21–25%, 13–20%, and 5–8%, for the Rc value of 0.33h, 0.49h, and 0.57h, respectively, but the combination of rounded corner and dimple-shaped intrusion augments heat transfer by 46–94%, 75–127%, 60–110%, for the z/e value of 6, 10, and 14, respectively, with the Reynolds number increase from 5600 to 17,700.
Examining the Aerodynamic Drag and Lift Characteristics of a Newly Developed Elliptical-Bladed Savonius Rotor
Authors: Alom Nur , Saha Ujjwal K.
Published: October 2018

The elliptical-bladed Savonius wind turbine rotor has become a subject of interest because of its better energy capturing capability. Hitherto, the basic parameters of this rotor such as overlap ratio, aspect ratio, and number of blades have been studied and optimized numerically. Most of these studies estimated the torque and power coefficients (CT and CP) at given flow conditions. However, the two important aerodynamic forces, viz., the lift and the drag, acting on the elliptical-bladed rotor have not been studied. This calls for a deeper investigation into the effect of these forces on the rotor performance to arrive at a suitable design configuration. In view of this, at the outset, two-dimensional (2D) unsteady simulations are conducted to find the instantaneous lift and drag forces acting on an elliptical-bladed rotor at a Reynolds number (Re) = 0.892 × 105. The shear stress transport (SST) k–ω turbulence model is used for solving the unsteady Reynolds averaged Navier–Stokes equations. The three-dimensional (3D) unsteady simulations are then performed which are then followed by the wind tunnel experiments. The drag and lift coefficients (CD and CL) are analyzed for 0–360 deg rotation of rotor with an increment of 1 deg. The total pressure, velocity magnitude, and turbulence intensity contours are obtained at various angles of rotor rotation. For the elliptical-bladed rotor, the average CD, CL, and CP, from 3D simulation, are found to be 1.31, 0.48, and 0.26, respectively. The average CP for the 2D elliptical profile is found to be 0.34, whereas the wind tunnel experiments demonstrate CP to be 0.19.
Capturing Radial Mixing in Axial Compressors With Computational Fluid Dynamics
Authors: Cozzi Lorenzo , Rubechini Filippo , Giovannini Matteo , Marconcini Michele , Arnone Andrea , Schneider Andrea , Astrua Pio
Published: October 2018

The current industrial standard for numerical simulations of axial compressors is the steady Reynolds-averaged Navier–Stokes (RANS) approach. Besides the well-known limitations of mixing planes, namely their inherent inability to capture the potential interaction and the wakes from the upstream blades, there is another flow feature which is lost, and which is a major accountable for the radial mixing: the transport of streamwise vorticity. Streamwise vorticity is generated for various reasons, mainly associated with secondary and tip-clearance flows. A strong link exists between the strain field associated with the vortices and the mixing augmentation: the strain field increases both the area available for mixing and the local gradients in fluid properties, which provide the driving potential for the mixing. In the rear compressor stages, due to high clearances and low aspect ratios, only accounting for the development of secondary and clearance flow structures, it is possible to properly predict the spanwise mixing. In this work, the results of steady and unsteady simulations on a heavy-duty axial compressor are compared with experimental data. Adopting an unsteady framework, the enhanced mixing in the rear stages is properly captured, in remarkable agreement with experimental distributions. On the contrary, steady analyses strongly underestimate the radial transport. It is inferred that the streamwise vorticity associated with clearance flows is a major driver of radial mixing, and restraining it by pitch-averaging the flow at mixing planes is the reason why the steady approach cannot predict the radial transport in the rear part of the compressor.
Kinematics of Continuum Robots With Constant Curvature Bending and Extension Capabilities
Authors: Garriga-Casanovas Arnau , Rodriguez y Baena Ferdinando
Published: October 2018

Continuum robots are becoming increasingly popular due to the capabilities they offer, especially when operating in cluttered environments, where their dexterity, maneuverability, and compliance represent a significant advantage. The subset of continuum robots that also belong to the soft robots category has seen rapid development in recent years, showing great promise. However, despite the significant attention received by these devices, various aspects of their kinematics remain unresolved, limiting their adoption and obscuring their potential. In this paper, the kinematics of continuum robots with the ability to bend and extend are studied, and analytical, closed-form solutions to both the direct and inverse kinematics are presented. The results obtained expose the redundancies of these devices, which are subsequently explored. The solution to the inverse kinematics derived here is shown to provide an analytical, closed-form expression describing the curve associated with these redundancies, which is also presented and analyzed. A condition on the reachable end-effector poses for robots with six actuation degrees-of-freedom (DOFs) is then distilled. The kinematics of robot layouts with over six actuation DOFs are subsequently considered. Finally, simulated results of the inverse kinematics are provided, verifying the study.
Productivity Model for Water-Producing Gas Well in a Dipping Gas Reservoir With an Aquifer Considering Stress-Sensitive Effect
Authors: Huang Xiaoliang , Guo Xiao , Zhou Xiang , Lu Xinqian , Shen Chen , Qi Zhilin , Li Jiqiang
Published: October 2018

The development process of a dipping gas reservoir with an aquifer considering stress sensitivity is complex. With gas development, formation pressure decreases, stress-sensitive effect decreases permeability and porosity, and formation water could flow into the development gas well and gather in the wellbore. The accumulation of water may lead to a lower gas rate. Simultaneously, the gravity action of fluid caused by formation dip angle affects gas well productivity. However, few studies have investigated a deliverability model for a water-producing gas well with a dipping gas reservoir considering stress sensitivity. For this reason, it is important to determine the relationships between gas well productivity and stress sensitivity, formation angle, and water production. In this research, a new mathematical model of deliverability was developed for a water-producing gas well with a dipping gas reservoir considering stress sensitivity. Additionally, a new equation was developed for gas well productivity. By analyzing a typical dipping gas reservoir with an aquifer, the level of influence on gas well productivity was determined for stress sensitivity, formation angle, and water–gas ratio (WGR). The work defined the relationships between gas well productivity and stress sensitivity, formation angle, and WGR. The results indicate that deliverability increases with an increase in formation angle, and growth rate hits its limit at an angle of 40 deg. Due to the influence of formation angle, fluid gravity leads to production pressure differences in gas wells. When bottom-hole flow pressure equaled formation pressure, gas well production was not 0 × 104 m3/d, the angle was large, and gas well production was greater. Deliverability and stress sensitivity hold a linear relationship: the stronger the stress sensitivity, the lower the deliverability of the gas well, with the stress sensitivity index from 0 to 0.06 MPa−1 and the deliverability decrease rate at 37.2%. Deliverability and WGR hold an exponential relationship: when WGR increased from 0.5 to 15.0 m3/104 m3, the deliverability decrease rate was 71.8%. The model and the equations can be used to predict gas deliverability in a dipping gas reservoir with an aquifer considering stress sensitivity. It can also be used to guide the development process for a dipping gas reservoir with an aquifer.