bluuebunny/crossref_metadata_2025 huggingface dataset:
Chikungunya virus infection impairs osteogenic differentiation of bone marrow-derived mesenchymal stem cells
Authors: Roy Enakshi , Shi Wen , Duan Bin , Reid St Patrick
Published: September 2019

Chikungunya virus (CHIKV) is a positive-sense, single-stranded RNA virus, belonging to the genus alphavirus in the familyTogaviridae. The virus is spread by theAedesspecies (sp.) mosquitoes in tropical and subtropical regions of the world. CHIKV causes Chikungunya fever (CHIKF), where the acute stage of infection is characterized by high fever, headache, rash, and polyarthralgia. In 30-40% of cases, patients develop a chronic stage with debilitating joint pain persisting for months to years imposing a burden on the population in terms of disability adjusted life years (DALY). Presently, no vaccines or treatment options are available for this infection. Prior investigations reveal that CHIKV infection is associated with bone pathology; however, the molecular mechanism underlying CHIKV-induced bone pathology remains poorly defined. Studies show that disruption of osteogenic differentiation and function of bone marrow-derived mesenchymal stem cells (BMMSCs) can lead to bone pathologies. However, to date pathogenesis of CHIKV infection in this context has not been studied. In the current study, we investigated the susceptibility of BMMSCs to CHIKV and studied the effect of infection on BMMSCs-derived osteogenic cells. To our knowledge, for the first time we report that CHIKV can productively infect BMMSCs. We observed a decrease in the intracellular and extracellular alkaline phosphatase (ALP) activity and reduction in calcium phosphate deposition in infected cells compared to mock-infected control. Thus, we conclude that CHIKV infects BMMSCs and disrupts function of osteogenic cells.

Importance

Although studies have shown association of bone pathology and CHIKV infection, the pathogenesis of infection causing altered bone homeostasis is not fully understood. Here, we demonstrate for the first time that BMMSCs are susceptible to CHIKV infection. Furthermore, we observe that infection causes disruption in the function of BMMSC- derived osteogenic cells. Impaired function of these osteogenic cells will likely lead to a disruption in bone homeostasis and in part, provides a mechanism for the observed bone pathology associated with CHIKV pathogenesis.
Ser/Thr kinase Trc controls neurite outgrowth inDrosophilaby modulating microtubule-microtubule sliding
Authors: Norkett Rosalind , del Castillo Urko , Lu Wen , Gelfand Vladimir I.
Published: September 2019

Correct neuronal development requires tailored neurite outgrowth. Neurite outgrowth is driven by microtubule sliding – the transport of microtubules along each other. We have recently demonstrated that a “mitotic” kinesin-6 (Pavarotti inDrosophila) effectively inhibits microtubule-sliding and neurite outgrowth. However, mechanisms of Pavarotti regulation in interphase cells and specifically in neurite outgrowth are unknown. Here, we use a combination of live imaging and biochemical methods to show that the inhibition of microtubule sliding by Pavarotti is controlled by phosphorylation. We identify the Ser/Thr NDR kinase Tricornered (Trc) as a Pavarotti-dependent regulator of microtubule sliding in neurons. Further, we show that Trc-mediated phosphorylation of Pavarotti promotes its interaction with 14-3-3 proteins. 14-3-3 binding is necessary for Pavarotti to interact with microtubules and inhibit sliding. Thus, we propose a pathway by which microtubule sliding can be up or down regulated in neurons to control neurite outgrowth, and establish parallels between microtubule sliding in mitosis and post-mitotic neurons.
Rapid accumulation of mutations in growing mycelia of a hypervariable fungus Schizophyllum commune
Authors: Bezmenova Aleksandra V. , Zvyagina Elena A. , Fedotova Anna V. , Kasianov Artem S. , Neretina Tatiana V. , Penin Aleksey A. , Bazykin Georgii A. , Kondrashov Alexey S.
Published: September 2019

The number of mutations that occur per nucleotide per generation varies between species by several orders of magnitude. In multicellular eukaryotes, the per generation mutation rate depends both on the per cell division mutation rate and on the number of germline cell divisions per generation. In a range of species, from fungi to humans, the number of germline cell divisions is lower than that of somatic cells, reducing the mutation burden on the offspring. The basidiomycete Schizophyllum commune has the highest level of genetic polymorphism known among eukaryotes. In a previous study, it was also found to have a high per generation mutation rate, probably contributing to its high polymorphism. However, this rate has been measured only in a breeding experiment on Petri dishes, and it is unclear how this result translates to natural populations. Here, we used an experimental design that measures the rate of accumulation of de novo mutations in a linearly growing mycelium. We show that S. commune accumulates mutations at a uniform rate of 1.4·10−7 substitutions per nucleotide per meter of growth, which is 3 orders of magnitude higher than the corresponding rates in the oak Quercus robur and the fungus Armillaria gallica. This figure is consistent with the estimate obtained before, and suggests the lack of a dedicated germline in this system. If so, even a low per cell division mutation rate can translate into a very high per generation mutation rate when the number of cell divisions between consecutive meioses is large.
A roadmap for BIM adoption and implementation in developing countries: the Pakistan case
Authors: Girginkaya Akdag Suzan , Maqsood Uzair
Published: September 2019

Purpose

Digital media is reshaping architectural design by introducing new tools, methods and workflows. Among various AEC tools, Building Information Modeling (BIM) has gained popularity due to its collaboration platform enabling cross-disciplinary teamwork during whole life cycle of buildings. BIM has further transformed culture and processes associated with design, construction and operation of buildings, hence triggering new building regulations in developed countries. However, in developing countries, BIM implementation is facing several barriers, such as lack of investment in technology and training, hesitation in quitting traditional tools and practices, etc. The purpose of this paper is to highlight potentials of BIM for developing countries, which are in need of more sustainable policies for enhancing their economic and environmental performances.

Design/methodology/approach

Throughout the text, a literature review on BIM including its dimensions and benefits, impacts on architectural design and adoption in global and local contexts is provided. In case study, surveys and structured interviews are conducted with BIM user and non-BIM user architects throughout Pakistan. Beyond 2D/3D modeling, the use of BIM applications for sustainable design process such as scheduling (4D), cost estimation (5D), performance analysis and facilities management (6D) is investigated.

Findings

Using analytical tools of an online surveying tool and SPSS statistical software, barriers and motivations for BIM implementation in Pakistan are determined. Strategies for further BIM adoption and implementation via “education and training institutions” and “supporting organizations and institutions” are defined.

Originality/value

As a developing country, Pakistan shall be moving the barriers for the spread of BIM technology. Recent research covered the entire AEC sector (Masood et al., 2014; Sohu et al., 2017; Ali et al., 2018), yet this paper focuses specifically on architectural design and practice field. In order to find out experiences and expectations about BIM technology in the architecture sector, professionals are surveyed and four chief architects are interviewed. How far have Pakistani architects adopted BIM? For which project types and scales is BIM more serviceable for them? Which BIM applications are they implementing to overcome the limitations in their professional practice? In Pakistan, where sustainability, in terms of scheduling, cost estimation, performance analysis and facilities management, is an indispensible measure for local practices, has implementation of BIM technology achieved sustainability in architectural design process? What are the motivations of Pakistani architects for becoming BIM users in future?
Sociocultural factors as determinants of female entrepreneurs’ business strategies
Authors: Cullen Ufi
Published: September 2019

Purpose

This paper aims to contribute to the understanding of the impact of social institutions, and, in particular, of national culture, on business success, further considering how these institutions influence entrepreneurial decisions around partnership structure and networking strategies, for instance. It additionally examines how the female entrepreneur finds her way around these institutions to help her business succeed, evaluating whether this success is a culture-independent phenomenon that can be achieved through using similar, potentially advantageous strategies regardless of national context or whether adjustments are required before entering a foreign market.

Design/methodology/approach

The data were collected through a survey study from 240 established female entrepreneurs with 120 from each country. Two existing surveys were used to create the questions. The target sample group was comprised of successful female businesses within northwest England and western Turkey. These regions were selected due to their convenience and accessibility. Only successful businesses or, in other words, established entrepreneurs were accepted to this study. The business success criteria were: age of business (>5 years); stability or growth recorded on profitability; sales volume; and number of employees within the last financial year.

Findings

The findings showed significant differences between the two groups of established female entrepreneurs in their demographic characteristics, networking pattern, work pattern, business structure and perceived impediments at different stages of business venturing. The findings assert that the cultural dimensions of power distance and individualism have the most significant impact upon the established female entrepreneurs’ business strategies.

Originality/value

To date, limited studies have examined the country-specific factors, which may account for variance in women entrepreneurs’ behaviour and subsequent outcomes. This study attempts to close this gap through taking a closer look at the country-specific sociocultural factors creating differences in established female entrepreneurs’ business strategies within the context of Turkey and the UK. Should any female business strategy have become successful in one country, then policymakers and women support organisations can work on developing ways for benchmarking. Moreover, this study aims to guide female entrepreneurs to develop feasible international market entry strategies to ensure survival in today’s global market.
Partnership working across sectors: a multi-professional perspective
Authors: El-Farargy Nancy
Published: September 2019

Purpose

The Public Bodies (Joint Working) (Scotland) Act 2014 set the framework for the integration of adult health and social care services. Teams, organisations and sectors are now required to work in partnership and interdependently to deliver shared outcomes for the people they serve. The purpose of this paper is to explore any features, practices and behaviours that could influence effective partnership working across sectors.

Design/methodology/approach

A questionnaire was designed and distributed to a range of stakeholders working in health, social care and the third sector. With reference to the changing health and social care reform agenda, the aims of the survey were to gather views, experiences and perceptions of working across sectors, and any workforce development needs.

Findings

The majority of respondents were from the NHS (80.3 per cent, 118/147), and experiences were largely drawn from those working with the third sector. The utility of working with the third sector was positively highlighted; however, there were limited opportunities to fully engage. Whilst formal education and training was welcomed, workforce development needs were mostly related to fostering relationships and building mutual trust.

Originality/value

This paper highlights views, perceptions, enablers and barriers to integrated care in Scotland. Whilst the Scottish integration landscape is currently not fully fledged, insights into prevailing attitudes towards integrated care, by a cohort of the Scottish health and care workforce, are offered. In particular, reflections by the NHS workforce to working with third sector services are discussed.
Numerical model for the fire protection performance and the design of intumescent coatings on structural steel exposed to natural fires
Authors: Weisheim Waldemar , Schaumann Peter , Sander Lisa , Zehfuß Jochen
Published: September 2019

Purpose

This paper aims to deal with the experimental and numerical investigations of the fire protection performance of a waterborne intumescent coating (IC) on structural steel in case of natural fires. Based on own small-scale laboratory tests, an advanced numerical model is developed to simulate the fire protection performance of the investigated coating in case of arbitrary fire scenarios. The insulation efficiency of the coating is described within the model by temperature and heating rate-dependent material properties, such as expansion factors, thermal conductivity and heat capacity. The results of the numerical model are compared to own large-scale fire tests of an unloaded I-section beam and column.

Design/methodology/approach

As natural fires can show arbitrary regimes, the material properties of the waterborne IC are investigated for various heating rates. Based on these investigations, a material model for the IC is implemented in the finite element program ABAQUS. With the help of user subroutines, the material properties of the coating are introduced for both the heating and cooling phase of natural fires, allowing for two- and three-dimensional thermomechanical analyses of coated steel elements.

Findings

The results of the performed small-scale laboratory tests show a heating rate-dependent behavior of the investigated coating. The mass loss as well as the expansion of the coating change with the heating rate. Moreover, the material properties obtained on small scale are valid for large scale. Therefore, a material model could be developed that is suitable to reproduce the results of the large-scale fire tests. Additionally, with the help of the numerical model, a dimensioning approach for the dry film thickness (DFT) of the investigated coating is derived for arbitrary natural fires.

Research limitations/implications

The material properties presented in this paper are only valid for the investigated waterborne IC and the parameter area that was chosen. However, the developed modeling approach for the fire protection performance of ICs is general and can be applied for every coating that is part of the intumescent product family.

Originality/value

Until now, only few research works have been carried out on the fire protection performance of ICs under non-standard fire exposure. This paper deals extensively with the material properties and the material modeling of a waterborne IC exposed to natural fires. Especially, the laboratory examinations and the numerical simulations are unique and allow for new evaluation possibilities of ICs.
The role of competition, innovation, and regulation on financial intermediary risk
Authors: Schaffer Marc
Published: September 2019

Purpose

This macroeconomic analysis chronicles the risk behavior of market-based financial intermediaries and traditional depository institutions from 1980 to 2010 and assesses the role that competition, financial innovation and regulation played in their evolving risk behaviors. The paper aims to discuss these issues.

Design/methodology/approach

Using a two-part CAPM framework in line with Campbell et al. (2001), risk measures are constructed through the decomposition of industry-level risk and firm-level idiosyncratic risk. These constructed measures are used in a VAR model with a historical decomposition approach to assess the impact of the three factors on the relative risk behavior of these firms.

Findings

The results indicate that the market-based and traditional intermediaries exhibited a period of diverging relative average firm-level risk behavior followed by a period of converging risk behavior. Using the derived firm-level risk measures, the impact of competition, financial innovation and regulatory changes on explaining these changing risk behaviors is explored. The results suggest that regulatory changes (i.e. deregulation) can best explain the relative risk behavior over the divergence period through late 1999 relative to the other two variables. The period from November 1999 through the financial crisis marks the converging risk behaviors across these intermediaries. Over this period, the changing nature of competition played the most important role in driving these behaviors.

Originality/value

The key contribution of this analysis highlights the evolutionary changes in the risk behaviors of market-based and traditional financial intermediaries and the factors driving both their diverging and converging nature over time.
“My smartwatch told me to see a sleep doctor”: a study of activity tracker use
Authors: Pingo Zablon , Narayan Bhuva
Published: September 2019

Purpose

The purpose of this paper is to investigate the use of wearable health and fitness trackers in everyday life, and users’ motivations and their understanding and use of the data derived from devices, and understand the results using the lens of information behaviours.

Design/methodology/approach

The study used a qualitative, constructionist approach, based on 21 interviews with users of a range of wearable activity trackers used for health and fitness.

Findings

Findings show that the lifelogging devices have become companion tools that enable users to take information from their bodily indicators and make some decisions about their health and fitness, and also track the results when they act on it, thus giving them a sense of gratification and a sense of control over their own health.

Practical implications

The findings have implications on how health professionals can talk to their lifelogging patients about how to deal with and understand the information provided by their activity-tracking devices. Some participants in the study already discuss these data regularly with their health professionals.

Originality/value

As the self-tracking practices attract wide range research interests from human–computer interaction, information systems, digital sociology, health informatics and marketing among others. This study provides important everyday information-seeking perspective that contributes to the understanding of the practices of how people make sense of the data, how the data improves their wellbeing, i.e. physical health improvement or fitness, and implications to users health behaviour. Additionally the study adds to the lifelogging literature through a constructionist, qualitative approach rather than a technological deterministic approach.
The challenge of detecting prey: Private and social information use in predatory bats
Authors: Page Rachel A. , Bernal Ximena E.
Published: September 2019

In the evolutionary arms race between predators and their prey, prey often evolve to be as cryptic as they can, while predators in turn hone their sensory strategies to detect prey. Examinations of the sensory strategies implemented by predators to detect their prey, as well as the ecological consequences of these interactions, are at the crux of understanding and predicting predator–prey dynamics.

We review the sensory strategies used by predators that rely on private information (attending directly to cues and signals generated by their prey) and those that gather social information (attending to the signals and behaviours of others). We focus our enquiry on bats, an ideal group to shed light on these questions given their ecological diversity, varied foraging strategies and wide range of social behaviours.

We discuss the costs and benefits of using private and social information for foraging. We investigate diverse strategies of information use and examine the effects different predatory strategies have on predator sensory systems.

We provide an overview of the sensory ecology of information use in hunting in bats and, by identifying current gaps in knowledge, highlight fruitful directions for future research.

A free Plain Language Summary can be found within the Supporting Information of this article.
Predicting biodiversity loss in island and countryside ecosystems through the lens of taxonomic and functional biogeography
Authors: Farneda Fábio Z. , Grelle Carlos E. V. , Rocha Ricardo , Ferreira Diogo F. , López‐Baucells Adrià , Meyer Christoph F. J.
Published: September 2019

We investigate how variation in patch area and forest cover quantified for three different spatial scales (buffer size of 500, 1500 and 3000 m radius) affects species richness and functional diversity of bat assemblages in two ecosystems differing in fragment–matrix contrast: a landbridge island system in Panama and a countryside ecosystem in the Brazilian Amazon. Bats were sampled on 11 islands and the adjacent mainland in Panama, and in eight forest fragments and nearby continuous forest in Brazil. Species–area relationships (SAR) were assessed based on Chao1 species richness estimates, and functional diversity–area relationships (FAR) were quantified using Chao1 functional diversity estimates measured as the total branch length of a trait dendrogram. FARs were calculated using three trait sets: considering five species functional traits (FARALL), and trait subsets reflecting ‘diet breadth’ (FARDIET) and ‘dispersal ability’ (FARDISPERSAL). We found that in both study systems, FARALLwas less sensitive to habitat loss than SAR, in the sense that an equal reduction in habitat loss led to a disproportionately smaller loss of functional diversity compared to species richness. However, the inhospitable and static aquatic matrix in the island ecosystem resulted in more pronounced species loss with increasing loss of habitat compared to the countryside ecosystem. Moreover, while we found a significant FARDISPERSALfor the island ecosystem in relation to forest cover within 500 m landscape buffers, FARDIETand FARDISPERSALwere not significant for the countryside ecosystem. Our findings highlight that species richness and functional diversity in island and countryside ecosystems scale fundamentally differently with habitat loss, and suggest that key bat ecological functions, such as pollination, seed dispersal and arthropod suppression, may be maintained in fragments despite a reduction in species richness. Our study reinforces the importance of increasing habitat availability for decreasing the chances of losing species richness in smaller fragments.
Effectiveness of a percutaneous left ventricular assist device in preventing acute hemodynamic decompensation during catheter ablation of ventricular tachycardia in advanced heart failure patients: A retrospective single‐center analysis
Authors: Neuzner Jörg , Dietze Thomas , Paliege Robert , Gradaus Rainer
Published: September 2019

Introduction

Acute hemodynamic decompensation during catheter ablation of ventricular tachycardia is associated with increased mortality. We assessed the effectiveness of mechanical circulatory support using a micro‐axial percutaneous assist device in preventing acute hemodynamic decompensation.

Methods and results

Twenty‐six consecutive patients with structural heart disease undergoing 28 ventricular tachycardia ablations between May 2013 and October 2017 were included. All patients presenting with left ventricular ejection fraction <25%, symptomatic heart failure and arrhythmia associated hemodynamic decompensation underwent catheter ablation with mechanical circulatory support (Impella 2.5; Impella CP, Abiomed, Danvers, MA). Electro‐anatomic mapping was performed using Ensite NavX (Abbott, Chicago, IL) or Rhythmia (Boston Scientific, Marlborough, MA) mapping systems. Mapping/ablation strategy included a substrate and activation mapping/ablation. Of the 26 patients, 80% had ischemic cardiomyopathy, the mean age was 68 ± 9 years; mean left ventricular ejection fraction 19.6% ± 3%, mean PAAINESD score was 21 ± 3. Mean tachycardia cycle length was 348 ± 76 ms (range 280‐500 ms). The assist device was used pre‐emptively in 25 patients and as rescue therapy in one patient. All ventricular tachycardias occurring during substrate ablation were activation mapped and ablated. The ablation procedure was accomplished in 25 of 26 patients, acute decompensation occurred only in one patient receiving circulatory support as bail‐out therapy.

Conclusion

In patients with advanced heart failure and a high probability of acute hemodynamic decompensation during catheter ablation, mechanical circulatory support prevented acute decompensation in 25 of 26 patients. Thus, mechanical circulatory support facilitates catheter ablation of unstable ventricular tachycardia in a critically ill patient population.
Surgical resection versus radiofrequency ablation very early‐stage HCC (≤2 cm Single HCC): A propensity score analysis
Authors: Chu Hee Ho , Kim Jin Hyoung , Kim Pyo Nyun , Kim So Yeon , Lim Young‐Suk , Park Seong Ho , Ko Heung‐Kyu , Lee Sung‐Gyu
Published: September 2019

Background & aim

Hepatocellular carcinoma (HCC) is increasingly being detected at a very early‐stage due to the wide implementation of the surveillance of at‐risk patient populations combined with improved imaging technologies. Whether patients with HCC at a very early stage can be offered local ablation as a first‐line treatment option still remains controversial. We retrospectively compared the effectiveness of surgical resection (SR) and radiofrequency ablation (RFA) for Barcelona Clinic Liver Cancer (BCLC) very early‐stage HCC in patients with long‐term follow‐up.

Methods

Propensity score analysis using inverse probability weighting (IPW) from a large‐volume liver centre. We included adult patients who between 2000 and 2013 received a diagnosis of very early‐stage HCC (BCLC stage 0; a single tumour ≤2 cm, Child‐Pugh A class, eastern cooperative oncology group [ECOG] 0) and who were treated with SR or RFA as the first‐line treatment.

Results

We identified 1208 patients, 631 in the SR group and 577 in the RFA group. The median follow‐up time was 86.2 months. After propensity score analysis using IPW, the 15‐year overall survival rates were 60.4% and 51.6% in the SR and RFA group respectively. RFA group showed poorer overall survival than SR group (adjusted hazard ratio, 1.29; P = .0378). The 15‐year recurrence‐free survival rates were 37% and 23.6% in the SR and RFA group respectively (P < .001).

Conclusion

For patients with very early‐stage HCC, the SR group was associated with better overall and recurrence‐free patient survival compared to the RFA group. Therefore, SR should be considered as the first‐line treatment for these patients.
Beyond accuracy: Epistemic flaws with statistical generalizations
Authors: Munton Jessie
Published: September 2019

What, if anything, is epistemically wrong with beliefs involving accurate statistical generalizations about demographic groups? This paper argues that there is a perfectly general, underappreciated epistemic flaw which affects both ethically charged and uncharged statistical generalizations. Though common to both, this flaw can also explain why demographic statistical generalizations give rise to the concerns they do. To identify this flaw, we need to distinguish between the accuracy and the projectability of statistical beliefs. Statistical beliefs are accompanied by an implicit representation of the statistic's modal profile. Their modal profile determines the circumstances in which they can legitimately be projected to unobserved instances. Errors in that implicit content can be compatible with the accuracy of the “bare” statistic, whilst systematically leading to downstream errors in reasoning, in a manner which reveals an epistemic flaw with an important aspect of the belief state itself.
Asymptotic Description of Forced Response Vibration Saturation by Friction Forces
Authors: Martel Carlos , Martín Juan A.
Published: September 2019

The estimation of the final vibration amplitude of a turbomachinery bladed disk is of extreme practical importance; it is an essential information for the prediction of the level of high cycle fatigue of the blades and for the subsequent estimation of its operative life span. The forced response vibration is saturated by the nonlinear damping introduced by the friction forces at the interfaces between blade and disk (and/or at the included dampers). The computation of the final amplitude of the limit cycle oscillation requires to solve a quite complicated nonlinear problem. In the case of a tuned bladed disk, this problem can be reduced to a single sector calculation with phase lag boundary conditions. The solution of this one-sector problem requires to consider many harmonics in order to capture the details of the nonlinear time periodic oscillation that sets in. If the small unavoidable differences among blades (mistuning) are also taken into account, then the situation becomes even more complicated because the solution of the mistuned vibration problem requires to consider not only a single sector but also the complete bladed disk. The possibility of applying multiple scales techniques to drastically simplify this problem is explored in this paper. The idea is to exploit the fact that all relevant effects present (forcing, nonlinear friction, and mistuning) are, in most practical situations, small effects that develop in a time scale that is much longer than that associated with the natural elastic vibration frequency of the tuned system. A mass-spring model with microslip nonlinear friction is used to represent the forced bladed disk. The multiple scales method is used to asymptotically derive simplified models for both tuned and mistuned configurations. The results of the asymptotic model are compared with those from the mass-spring system and used to analyze the particular characteristics of the nonlinear friction effects on the final vibration states.
Considerations for Using Additive Manufacturing Technology in Centrifugal Compressor Research
Authors: Meier Matthew A. , Gooding William J. , Fabian John , Key Nicole
Published: September 2019

An additive manufactured (AM) vaned diffuser for use in a centrifugal compressor research facility was designed and implemented. Utilizing an AM process to manufacture the diffuser reduces the long lead time that is associated with conventionally manufactured diffusers, and it increases the instrumentation capabilities within the flow path. Several AM techniques and a variety of plastic and metal materials were evaluated for this application. A high-temperature, stereolithography (SL) resin was chosen because of the tight dimensional tolerances maintained by the SL process. Utilizing a high-temperature plastic also results in manufacturing costs that are significantly less than using a metal material. Samples of the chosen material were subjected to mechanical testing to investigate the effects of build direction and to verify its properties in the high-temperature compressor environment. To fit within the manufacturing space of an SL machine, the AM diffuser consists of seven radially symmetric sections that are assembled to form a complete flow path. Considerations for modifying the research facility to allow for this unique installation are presented. Precision measurements of the AM components were obtained to compare printed and modeled geometry, and they demonstrate close alignment of flow path dimensions.
Efficiency Prediction of Centrifugal Pump Using the Modified Affinity Laws
Authors: Agarwal Rahul , Patil Abhay , Morrison Gerald
Published: September 2019

This research is a continuation of efforts aimed at establishing the modified affinity laws for viscosity to predict the pump performance directly from a plot in terms of dimensionless numbers, i.e., flow coefficient, Reynolds number, head coefficient, and efficiency. The group has earlier proposed modified head coefficient affinity law. This work proposes and validates a similar efficiency plot that completes the set of modified affinity laws that include all the input and output parameters for a specific pump design and type. A wide range of viscosities and flow rates are considered for CFD analysis to have a comprehensive set of data that includes enough data points to comment on both the laminar and turbulent flow cases categorized based on the hydraulic Reynolds number (2300). Initial analysis shows some inconsistency based on laminar versus turbulent simulation model selection which is addressed in the latter part of this work. In general, two curves can be constructed for laminar and turbulent flow cases. These curves have different axes parameters (exponents of the dimensionless numbers) depending on the plot being for a laminar or a turbulent flow case. Validation with established experimental data shows good agreement in terms of the variation of axes parameters (their exponents) depending on the pump type for a single suction impeller and a double suction impeller pump. The distinction between laminar and turbulent flow cases is found to be applicable to established experimental data as well.
Rare brown tumour of the mandible secondary to tertiary hyperparathyroidism in a renal transplant recipient
Authors: Guéroult Aurélien M , Cameron Malcolm
Published: September 2019

Brown tumours are rare osteolytic lesions that occur secondary to hyperparathyroidism (HPT). In 2% of all cases, the craniofacial bones are affected, most frequently the mandible. HPT is classified according to aetiology into three types, of which tertiary HPT is the rarest. Here we present the case of a 42-year-old man who had received a renal transplant 16 years previously and was referred due to swelling on the right side of his jaw. An orthopantomogram revealed a multilocular radiolucency in the right body of the mandible. The bony lesion was treated by surgical enucleation. After histopathological examination of the lesion, the diagnosis of brown tumour of the mandible secondary to tertiary HPT was reached. The patient’s recovery was uneventful and follow-up radiography showed good bone healing.
Surgeon perceived most important factors to achieve the best hospital performance on colorectal cancer surgery: a Dutch modified Delphi method
Authors: van Groningen Julia Tessa , Marang-van de Mheen Perla J , Henneman Daniel , Beets Geerard L , Wouters Michel W J M
Published: September 2019

Objectives

Hospital variation in risk-adjusted outcomes after colorectal cancer surgery has been shown. However, explanatory factors are not sufficiently clear. The objective of this study was to identify factors perceived by gastrointestinal surgeons as important to achieve excellent casemix-adjusted outcomes after colorectal cancer surgery.

Design

Based on literature and experts’ opinion, 86 factors associated with serious complications, failure to rescue and mortality were listed. These were presented to gastrointestinal surgeons through two web-based surveys and an expert meeting. Participants were asked to choose their top 10 of most important factors.

Participants

Dutch gastrointestinal surgeons (n=52) of different hospitals and different hospital types (general/teaching/academic).

Results

Of 31 invited experts for the first survey and meeting, 71% responded. Of 130 invited surgeons, 34 responded to the second survey. Factors deemed important were: procedural hospital volume (46% in top 10), specialised surgeons performing surgery, (elective 87%, emergency 60% and reoperations 62% in top 10), accessibility of, and daily ward rounds by specialised surgeons (41% and 38% in top 10), preoperative screening for malnutrition (57% in top 10), a protocol for recognition of anastomotic leakage and rapid reintervention (54% and 49% in top 10).

Conclusion

Procedural hospital volume, specialisation of surgeons, screening for malnutrition, early recognition of complications followed by rapid action were perceived as most important factors to achieve good outcomes by gastrointestinal surgeons.
Salt content of sauces in the UK and China: cross-sectional surveys
Authors: Tan Monique , He Feng J , Ding Jingmin , Li Yuan , Zhang Puhong , MacGregor Graham A
Published: September 2019

Objectives

(1) To assess the changes in the salt content of sauces in the UK in the past 10 years; (2) to compare the salt content of sauces in China with equivalent products sold in the UK and (3) to calculate the proportion of sauce products meeting the salt targets set by the UK Department of Health (DoH).

Design

Cross-sectional surveys from the nutrition information panels of sauces.

Setting

Major retailers in London, Beijing and Shijiazhuang operating at data collection times.

Main outcome measure

Salt content of sauces.

Results

Relative change in the median salt content of UK products ranged from −70.6% to +3.0% in sauces for which salt targets were set, whereas it ranged from −27.1% to +111.5% in sauces without targets. Median salt contents were on average 4.4-fold greater in Chinese sauces compared with their UK equivalents surveyed during the same period (2015–2017). Only 13.4% of the Chinese products met the UK 2017 salt targets, compared with 70.0% of UK products.

Conclusion

In the UK, the target-based approach contributed to the reduction in the salt content of sauces over the course of the past 10 years. Currently, large variations in salt content exist within the same categories of sauces and 70% of the products have met DoH’s 2017 targets, demonstrating that further reductions are possible and lower salt targets should be set. In China, salt content of sauces is extremely high with similarly large variations within same categories of sauces, demonstrating the feasibility of reducing their salt content. As processed foods (including sauces) are expected to become an important contributor to salt intake in China, national salt reduction efforts such as setting salt targets would be a valuable, proactive strategy.
Counselling for physical activity, life-space mobility and falls prevention in old age (COSMOS): protocol of a randomised controlled trial
Authors: Edgren Johanna , Karinkanta Saija , Rantanen Taina , Daly Robin , Kujala Urho M , Törmäkangas Timo , Sievänen Harri , Kannus Pekka , Heinonen Ari , Sipilä Sarianna , Kannas Lasse , Rantalainen Timo , Teittinen Outi , Nikander R
Published: September 2019

Introduction

The most promising way to promote active life years in old age is to promote regular participation in physical activity (PA). Maintaining lower extremity muscle function with good balance has been associated with fewer falls and the need of help from others. This article describes the design and intervention of a randomised controlled trial (RCT) investigating the effectiveness of a health and PA counselling programme on life-space mobility and falls rates in community-dwelling older adults at the Health Kiosk and/or Service Centre.

Methods and analysis

Community-dwelling men and women (n=450) aged 65 years and over with early phase mobility limitation will be recruited to a 24-month RCT with a 24-month follow-up. Participants will be randomly allocated into either a health and PA counselling group (intervention) or relaxation group (control intervention). All participants will receive five group specific face-to-face counselling sessions and 11 phone calls. The counselling intervention will include individualised health counselling, strength and balance training, and guidance to regular PA. The control group will receive relaxation exercises. Outcomes will be assessed at baseline, 12, 24 and 48 months. Primary outcomes are average life-space mobility score and falls rates. Life-space mobility will be assessed by a validated questionnaire. Falls rates will be recorded from fall diaries. Secondary outcomes are data on fall-induced injuries and living arrangements, number of fallers, fracture risk, mean level of PA, physical performance, quality of life, mood, cognition, balance confidence and fear of falling. Data will be analysed using the intention-to-treat principle. Cost-effectiveness of the programme will be analysed. Ancillary analyses are planned in participants with greater adherence.

Ethics and dissemination

Ethical approval was obtained from the Ethics Committee of the Tampere University Hospital (R15160). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences.

Trial registration

ISRCTN65406039; Pre-results.
Pulmonary embolism following complex trauma: UK MTC observational study
Authors: Glover Thomas E , Sumpter Joanna E , Ercole Ari , Newcombe Virginia F J , Lavinio Andrea , Carrothers Andrew D , Menon David K , O’Leary Ronan
Published: September 2019

Objectives

To describe the incidence of pulmonary embolism (PE) in a critically ill UK major trauma centre (MTC) patient cohort.

Methods

A retrospective, multidataset descriptive study of all trauma patients requiring admission to level 2 or 3 care in the East of England MTC from 1 November 2014 to 1 May 2017. Data describing demographics, the nature and extent of injuries, process of care, timing of PE prophylaxis, tranexamic acid (TXA) administration and CT scanner type were extracted from the Trauma Audit and Research Network database and hospital electronic records. PE presentation was categorised as immediate (diagnosed on initial trauma scan), early (within 72 hours of admission but not present initially) and late (diagnosed after 72 hours).

Results

Of the 2746 trauma patients, 1039 were identified as being admitted to level 2 or 3 care. Forty-eight patients (4.6%) were diagnosed with PE during admission with 14 immediate PEs (1.3%). Of 32.1% patients given TXA, 6.3% developed PE compared with 3.8% without TXA (p=0.08).

Conclusion

This is the largest study of the incidence of PE in UK MTC patients and describes the greatest number of immediate PEs in a civilian complex trauma population to date. Immediate PEs are a rare phenomenon whose clinical importance remains unclear. Tranexamic acid was not significantly associated with an increase in PE in this population following its introduction into the UK trauma care system.
BET 2: Treating migraines with diclofenac instead of a triptan
Authors: Bérczi Beatrix , Sneath Paula
Published: September 2019

A shortcut review was carried out to establish whether diclofenac is better than a triptan in treating migraine. 32 papers were found of which only 1 addressed this question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. It is concluded that there is insufficient evidence that either treatment is superior to the other for migraine therapy.
PP11 Relationship between hospital characteristics and survival outcomes in out of hospital cardiac arrest (OHCA) patients treated and transported by yorkshire ambulance service (YAS)
Authors: Platt Anthony
Published: September 2019

Background

There is mounting evidence that post resuscitation care, should include early angiography and primary percutaneous coronary intervention (PPCI) in OHCA where a cardiac cause is suspected. In Yorkshire, the ambulance service can transport patients with a return of spontaneous circulation (ROSC), directly to a regional PPCI unit, if their ECG shows ST elevation myocardial infarction (STEMI) and the PPCI units accept. The aim of this study was to evaluate transport decisions, hospital characteristics and outcome in the form of 30 day survival rates of post-ROSC patients with presumed cardiac aetiology.

Methods

OHCA patient care records (PCRs) between January and July 2017 were reviewed. Patients were eligible for inclusion if they were: an adult non-traumatic OHCA: achieved ROSC on scene, and were transported to hospital. Descriptive statistics were used to analyse the data.

Results

478 patients met the inclusion criteria. 361/478 (75.6%) patients had an ECG recorded, with 149/361 (41.3%) documented cases of STEMI and 88/149 (59.1%) referred to a PPCI unit. 40/88 (45.5%) of referrals made were accepted by PPCI. Patients taken directly to PPCI were most likely to survive to 30 days (25/39, 53.8%). 34/126 (27.0%) patients survived to 30 days after transport to an emergency department (ED) at a PPCI- capable hospital, and 50/310 (16.1%) survived if taken to ED at a non-PPCI capable hospital.

Conclusion

Work is required to ensure post-ROSC patients receive a 12 lead ECG, and those with STEMI are referred to PPCI, as survival was greatest in this group. 30 day survival was better for patients taken to ED at a hospital with PPCI facilities, than an ED at a general hospital. Discussion needs to take place between YAS and the relevant hospitals in the region to ensure patients are transported to the appropriate destination.
PP12 An evaluation of the role of SCAS in the attendance to call-outs and the transport to hospital of older people with dementia
Authors: Lofthouse-Jones Chloe , Pocock Helen , King Phil , Jadzinski Patryk , England Ed , Taylor Sarah , Cavalier Julian , Fogg Carole
Published: September 2019

Background

Our previous work has shown that 35% of ambulance attendances by SCAS are to people aged 75 and over; 17% of these have dementia. The research literature suggests that older people with cognitive impairment/dementia experience longer stays, or die, in hospital. It is unclear whether factors such as call time or availability of social care impact conveyance rates. The aim of this study was to explore the impact of out-of-hours call-outs and social care provision on ambulance conveyance rates for people aged ≥75 years, including patients with dementia.

Methods

For this service evaluation, electronic records for patients aged ≥75 years attended by SCAS were extracted over one year. The proportion of conveyed patients according to a dementia record, out-of-hours call, time of year, triage grade, social care provision and indices of deprivation were calculated. Univariate and multivariate analyses identified factors which may influence conveyance.

Results

A total of 111,548 electronic records were included, 16.5% with dementia. 63.7% of calls resulted in conveyance (59.1% with dementia). Conveyances reduced in out-of-hours periods for all patients. 13.6% more patients living alone and 16.5% more patients living with family were conveyed to hospital if there was no care package in place. Adjusted for other factors, having a care package reduced the risk of conveyance in older people living alone by 36% (Odds ratio 0.64, 95% Confidence interval 0.62–0.67).

Conclusions

Availability of social care and time of call appear to be important determinants of conveyance in older people, both in those with and without dementia. More research is needed to improve needs assessments and local referral services and pathways.