bluuebunny/crossref_metadata_2025 huggingface dataset:
Chatter Avoidance in Parallel Turning With Unequal Pitch Angle Using Observer-Based Cutting Force Estimation
Authors: Sakata Shinya , Kadota Takashi , Yamada Yuki , Nakanishi Kenichi , Yoshioka Hayato , Suzuki Norikazu , Kakinuma Yasuhiro
Published: January 2018

Parallel turning is garnering attention as one of the most important technologies for multitasking machine tools. This is because a potential exists to enhance the stability limits compared to the turning operation using a single tool when cutting conditions are properly selected. Although stability prediction models for parallel turning have been developed in recent years, in-process monitoring and in-process chatter techniques are almost not discussed. In this study, to suppress chatter vibration, an unequal pitch turning method was proposed. In this method, the upper tool was controlled based on the optimum pitch angle calculated from spindle speed and chatter frequency. Chatter frequency was identified from estimated cutting force by a disturbance observer (DOB). From the result of the parallel turning test, it is clear that chatter vibration can be avoided by controlling the upper tool based on optimum pitch angle. Meanwhile, the pitch angle difference that can suppress chatter had a certain range. Subsequently, the robustness of the optimum pitch angle difference is experimentally evaluated by both the continuous moving test and the stepwise moving test of the pitch angle.
Discharge Coefficients for Circular Side Outlets
Authors: Czetany Laszlo , Lang Peter
Published: January 2018

Fluid distributors are widely used in various industrial and ventilation applications. For the appropriate design of such distributors, the discharge coefficient has to be known to predict the energy and fluid distribution performance. Despite the vast amount of experimental data published, no generally applicable equations are available. Therefore, a new equation is presented for sharp-edged circular side outlets, which can be widely used for calculating the discharge coefficient. The equation is developed by regression with nonlinear least squares combined with genetic algorithm on experimental data available in the literature. The equation covers a wider range than the others presented in the literature.
Study on the Compression-Resilience and Sealing Performance of New Metal-to-Metal Contact Gasket
Authors: Xianjun Zhou , Haodong Zhai , Weipeng Wen , Yanze Wu
Published: January 2018

The compression-resilience performance of new metal-to-metal contact (MMC) gasket at different temperatures was studied by compression-resilience test, and the influences on sealing performance of gasket caused by internal pressure of medium and assembly stress were studied by sealing test. Then the influences on performance of gasket caused by internal pressure of medium, bolt pretightening force, and temperature were studied through finite element method of ANSYS. According to the results of test and numerical analysis, conclusions are as follows: The new MMC gasket has good high-temperature stability from results of tests at different temperatures. When the MMC occurs between flange and gasket, the contact stress of new MMC gasket is about 50 MPa. When applying loads, the limiting ring of gasket is able to bear parts of bolt loads, and when reducing loads, its resilience can compensate loss of gasket stress. In this case, the stress on sealing surface of gasket remains stable so that the leakage rate can keep in a stable range. Because of its unique structure in design, the inner contact stress of new MMC gasket increases with the rise of internal pressure of medium so that in a certain range, the leakage rate changes gently, which shows that the gasket has a certain self-sealing ability. Besides, the new MMC gasket is able to adapt to high temperature and fluctuation of internal pressure of medium.
Estimation of Effective Thermal and Mechanical Properties of Particulate Thermal Interface Materials by a Random Network Model
Authors: Vaitheeswaran Pavan Kumar , Subbarayan Ganesh
Published: January 2018

Particulate thermal interface materials (TIMs) are commonly used to transport heat from chip to heat sink. While high thermal conductance is achieved by large volume loadings of highly conducting particles in a compliant matrix, small volume loadings of stiff particles will ensure reduced thermal stresses in the brittle silicon device. Developing numerical models to estimate effective thermal and mechanical properties of TIM systems would help optimize TIM performance with respect to these conflicting requirements. Classical models, often based on single particle solutions or regular arrangement of particles, are insufficient as real-life TIM systems contain a distribution of particles at high volume fractions, where classical models are invalid. In our earlier work, a computationally efficient random network model (RNM) was developed to estimate the effective thermal conductivity of TIM systems (Kanuparthi et al., 2008, “An Efficient Network Model for Determining the Effective Thermal Conductivity of Particulate Thermal Interface Materials,” IEEE Trans. Compon. Packag. Technol., 31(3), pp. 611–621; Dan et al., 2009, “An Improved Network Model for Determining the Effective Thermal Conductivity of Particulate Thermal Interface Materials,” ASME Paper No. InterPACK2009-89116.) . This model is extended in this paper to estimate the effective elastic modulus of TIMs. Realistic microstructures are simulated and analyzed using the proposed method. Factors affecting the modulus (volume fraction and particle size distribution (PSD)) are also studied.
Using Pounds-Solids to Optimize Plant Efficiency
Authors: Gerow Gordon P. , Stanley Robert C.
Published: January 2018

The first words in Dransfield’s book on “Engineering Systems and Automatic Control” are: “A machine or process is restrained to operate in a predetermined manner; that is, it is controlled. Restraint is usually achieved by controlling a selected physical variable vital to the performance of the particular machine.”

It is the intent of this paper to propose pounds-solids as the variable, vital to the operation of a citrus processing plant. Contents of this paper describe a methodology for commercially measuring pounds-solids and using this information to optimize plant efficiency.

Paper published with permission.
Multiple Stage Pressing
Authors: Cook Ralph W.
Published: January 2018

The first citrus feed mills built in Florida used Louisville or Davenport presses. The Louisville press was a horizontal roller press. The Davenport press used two flat perforated cones. These presses had several problems in common, the edges of the peel mass did not get pressed much and the pressure was released before discharging the press cake, giving reabsorption of the press liquor. Most of the installations changed to vertical or horizontal screw press by 1960. Since then, there has been only modest improvements.

Paper published with permission.
The Information Explosion: UCF-STAC The Gateway to Information
Authors: Pozefsky AI , Jenkins David R.
Published: January 2018

The pace of research and development has been accelerating in all fields of engineering, science, marketing, and business. One of the fallouts is that an explosion has been taking place in the publication of the resulting information and data. It is estimated that the volume of published information is doubling roughly every eight to ten years. Clearly, there exists a wealth of knowledge waiting to be tapped. In looking to the future, Breton notes that, “knowledge will replace capital as society’s most important resource.” (Reinventing the Wheel; Breton, Ernest J., Mechanical Engineering, 54, March 1981).

Paper published with permission.
Microcomputers in Citrus Plants
Authors: Westmoreland Richard L.
Published: January 2018

How would you like to have that perfect assistant who would do just exactly what you asked? No more, no less, no questions, no arguments, no better ways, no tomorrows. Such an assistant would be beyond the fondest dreams of most of us, but is the dream so remote?

Paper published with permission.
The Schmidt SigmaStar™ Evaporator: An Improved Evaporator Type for the Fruit Juice Industry
Authors: Aust Richard A.
Published: January 2018

Figure 1. Over the years, Schmidt has paid special attention to improvements in processes for concentration and aroma recovery of fruit and vegetable juices.

Our new technology was introduced in a symposium on the 26th of January 1983 in Bretten, West Germany, namely:

- the new SigmaStar™ evaporator (for which we received a US patent in 1986)

- new techniques for aroma recovery

- new energy saving methods for multi-effect evaporation in combination with aroma recovery.

We will describe and explain the new SigmaStar™ evaporator, the new aroma recovery plant as well as the integrated plant. Thereafter we will report our experiences, the quality of the final products, both aroma and concentrate, and improvements that have been developed over the years.

Paper published with permission.
Aseptic Bulk Handling of Citrus Juices and Concentrates
Authors: Mathews Glenna
Published: January 2018

This presentation is based upon FR MFG Corporation’s extensive experience in bulk storage of tomato products and the application of its knowledge to citrus in a current Fran Rica installation in Morocco.

Paper published with permission.
A Commercial Citrus Debittering System
Authors: Norman Seth I. , Kimball Dan A.
Published: January 2018

Excessive bitterness in citrus juices has been extensively studied in the past due to a reduction in juice quality. In the late 1970’s, Australia began to commercially debitter citrus juices using cellulose acetate beads. However, due to operational problems, this plant was shutdown. Continued research has led to the first commercial debittering installation in the United States. Using a proprietary styrene/divinylbenzene hydrophylic adsorbent, a citrus debittering system was started in 1988 to debitter navel orange juice. The automatic citrus debittering system was designed for continuous operation at an operator’s selectable flow rate from between 20 to 55 gallons per minute. The determination of the economics, compositional analysis and taste of the treated products was the focus of this study.

Paper published with permission.
Corrosion
Authors: Raasch Jeffrey
Published: January 2018

On behalf of ENERFAB, I’d like to thank you for the opportunity to participate in your technical session. As fabricators we use many types of material to produce our products. The material of choice in the Citrus Industry is stainless steel.

Paper published with permission.
Radar Liquid Level Measurement
Authors: England Mark D.
Published: January 2018

Microwave radar level technology has been available to industry since World War II, but only recently has it found its way into the wider commercial mainstream. Through extensive use of radar technology by government and large industrial users, and advance in modern electronic components, microwave instruments are now affordable for use in smaller, more general applications. There are a number of distinct advantages this technology has over conventional, mechanical level devices including longer mean time between failure (MTBF), fewer effects from changing process or ullage (the are above the process liquid) conditions, less instrument maintenance, isolation of the instrumentation from the process liquid, and instantaneous monitoring of conditions inside a process or storage vessel. Factors that affect accurate level measurement using radar are the dielectric of the process material, location and alignment of the radar sensor, obstructions in the vessel, surface conditions of the process liquid, and calibration of the system’s electronics. Microwave radar level technology also offers the potential for the ability to anticipate and diagnose problem areas remotely.

Paper published with permission.
Citrus Juice Processing in Brazil
Authors: Marques Daniel S.
Published: January 2018

The evolution of the Brazilian citrus processing industry is revised and the new trends are discussed. The production of Frozen Concentrated Orange Juice (FCOJ) in Brazil, mainly in the State of São Paulo is outlined.

Comments on the technology and management strategies that have been used to keep the competitive position of the Brazilian citrus industry will be addressed.

Special attention is dedicated to the constraints and the new opportunities that this important sector of the Brazilian industry will face in the near future.

Paper published with permission.
Best Practices for Fresh Juice Production
Authors: Schrader Greg W. , Kane Lisamarie
Published: January 2018

In late 1995 an outbreak of Salmonella was traced to unpasteurized orange juice. In response to the outbreak, the Florida Citrus Commission has recommended several amendments to the Department of Citrus Rules. Regardless of the outcome of these amendments, there exists a series of “best practices” to help insure the production of a consistent product of sound nature. This paper focuses on best practices in process design, equipment and facility design. A brief overview of microbiology is given with attention to source of contamination and environmental conditions for microbial growth.

Paper published with permission.
d-Limonene Recovery
Authors: Odio Carlos
Published: January 2018

Oils have become an increasingly important by-product of the citrus processing industry. At the high prices reached last year and with good rates of recovery, one could get a dollar’s worth of oil out of a box of Valencia oranges, as shown in Table 1. No other commercially produced by-product of citrus processing comes close to these figures.

Paper published with permission.
Pumping Power Requirements and Role of Viscosity During Agitation of Concentrated Orange Juice
Authors: Rao M. A.
Published: January 2018

The rheological behavior of concentrated orange juice (FCOJ) has been shown to be shear-thinning in several recent studies. Concentric cylinder viscometers have been used to obtain the rheological data in these studies. The effect of temperature, soluble solids, and pulp content has been described quantitatively. To estimate the pumping power requirements of FCOJ, the mechanical energy balance equation is used together with the necessary estimates of pressure drop due to friction in pipes and fittings estimated from empirical equations. Empirical equations are available to calculate power consumption during agitation of concentrated orange juice in terms of the dimensionless groups: power and agitator Reynolds numbers for several types of agitators.

Paper published with permission.
The Internet and the Citrus Industry
Authors: Montanari Tony
Published: January 2018

The Internet is a worldwide connection of thousands of computer networks. All of them speak the same language, TCP/IP, the standard protocol. The Internet allows people with access to these networks to share information and knowledge. Resources available on the Internet are chat groups, e-mail, newsgroups, file transfers, and the World Wide Web. The Internet has no centralized authority and it is uncensored. The Internet belongs to everyone and to no one.

Paper published with permission.
“HACCP” for Citrus Processing
Authors: Newslow Debby
Published: January 2018

“HACCP” for Citrus Processing is a topic that I have presented five different times in five years and each time the urgency of this topic becomes more critical. Five years ago when one spoke of HACCP, concern in the citrus industry other than foreign material, was a mute point. No one ever believed that pathogens could survive at such a low pH. But after several reported food safety instances that related to microbes and juice, the time has come for citrus processors to seriously evaluate their process and establish and maintain a HACCP Plan that will control existing and potential food safety hazards as defined by present day standards and concerns.

Paper published with permission.
Multimodal imaging technology by integrated scanning electron, force, and microwave microscopy and its application to study microscaled capacitors
Authors: Haenssler Olaf C. , Fatikow Sergej , Theron Didier
Published: January 2018

Extracting simultaneously multimodal nanoscale specimen information, by an integrated microscopy technology, is in the focus of this report. The combination of multiple imaging techniques allows for obtaining complementary and often unique datasets of samples under test. An instrumental setup operating under high-vacuum conditions inside the chamber of a scanning electron microscope (SEM), as a platform fusing various microscopy methods, techniques and processes, illustrates the potential of such multimodal technology. An atomic force microscope based on a compact optical interferometer performs imaging of surface topographies and a scanning microwave microscope records electromagnetic properties in the microwave frequency domain at the same time and spot. An open-source software framework, tailored for vision-based automation by nanorobotics, controls the instrument. The setup allows for simultaneously observing the region-of-interest with SEM resolution, while imaging and characterizing with evanescent microwaves and atomic forces. To validate the approach an analysis of microscale capacitors is included.
Training candidate selection for effective out-of-set rejection in robust open-set language identification
Authors: Zhang Qian , Hansen John H. L.
Published: January 2018

Research in open-set language identification (LID) generally focuses on in-set language modeling versus out-of-set (OOS) language rejection. However, unknown/OOS language rejection is essential for effective speech and language pre-processing. To address this, an approach for OOS language selection is proposed. Using probe OOS data, three effective OOS candidate selection methods are developed for universal OOS language coverage. The selected OOS candidates are expected to reflect the entire OOS language space for the state-of-the-art i-vector LID system followed by a Gaussian back-end. Two front-end feature selection strategies are proposed: (i) unsupervised k-means clustering and (ii) complementary candidate selection. Also, (iii) general candidate selection is proposed according to language relationship explored at the score level. All methods are evaluated on a large-scale corpus (LRE-09) containing 40 languages. The proposed selection methods reduce OOS training data diversity by 86% while achieving performance similar to closed-set using all probe OOS for training. The proposed methods also show clear benefits versus random candidate selection (i.e., the proposed solutions achieve sustained performance while employing a minimum number of effective OOS language candidates). To the best of our knowledge, this is the first major effort on effective OOS language selection and enhancement for improved OOS rejection in open-set LID.
Estimating drift of directional sonobuoys from acoustic bearings
Authors: Miller Brian S. , Wotherspoon Simon , Rankin Shannon , Calderan Susannah , Leaper Russell , Keating Jennifer L.
Published: January 2018

A maximum likelihood method is presented for estimating drift direction and speed of a directional sonobuoy given the deployment location and a time series of acoustic bearings to a sound source at known position. The viability of this method is demonstrated by applying it to two real-world scenarios: (1) during a calibration trial where buoys were independently tracked via satellite, and (2) by applying the technique to sonobuoy recordings of a vocalising Antarctic blue whale that was simultaneously tracked by photogrammetric methods. In both test cases, correcting for sonobuoy drift substantially increased the accuracy of acoustic locations.
Assessing the shielding of engine noise by the wings for current aircraft using model predictions and measurements
Authors: Vieira Ana , Snellen Mirjam , Simons Dick G.
Published: January 2018

Reducing aircraft noise is a major issue to be dealt with by the aerospace industry. In addition to lowering noise emissions from the engine and airframe, also the shielding of engine noise by the aircraft is considered as a promising means for reducing the perceived noise on the ground. In literature, noise shielding predictions indicate significant reductions in received noise levels for blended wing body configurations, but also for conventional aircraft with the engines placed above the wings. Little work has been done in assessing these potential shielding effects for full aircraft under real operational conditions. Therefore, in this work, noise shielding for current aircraft is investigated using both measurements and model predictions. The predictions are based on the Kirchhoff integral theory and the Modified Theory of Physical Optics. For the comparison between the predictions and measurements, Twenty Fokker 70 flyovers are considered. The data analysis approach for the extraction of shielding levels for aircraft under these operational conditions is presented. Directly under the flight path, the simulations predict an engine noise shielding of 6 dB overall sound pressure level. This is confirmed by some of the flyover data. On average, the measurements show somewhat lower shielding levels.
Auditory stream segregation of iterated rippled noises by normal-hearing and hearing-impaired listeners
Authors: Shearer Daniel E. , Molis Michelle R. , Bennett Keri O. , Leek Marjorie R.
Published: January 2018

Individuals with hearing loss are thought to be less sensitive to the often subtle variations of acoustic information that support auditory stream segregation. Perceptual segregation can be influenced by differences in both the spectral and temporal characteristics of interleaved stimuli. The purpose of this study was to determine what stimulus characteristics support sequential stream segregation by normal-hearing and hearing-impaired listeners. Iterated rippled noises (IRNs) were used to assess the effects of tonality, spectral resolvability, and hearing loss on the perception of auditory streams in two pitch regions, corresponding to 250 and 1000 Hz. Overall, listeners with hearing loss were significantly less likely to segregate alternating IRNs into two auditory streams than were normally hearing listeners. Low pitched IRNs were generally less likely to segregate into two streams than were higher pitched IRNs. High-pass filtering was a strong contributor to reduced segregation for both groups. The tonality, or pitch strength, of the IRNs had a significant effect on streaming, but the effect was similar for both groups of subjects. These data demonstrate that stream segregation is influenced by many factors including pitch differences, pitch region, spectral resolution, and degree of stimulus tonality, in addition to the loss of auditory sensitivity.
Organelle luminal dependence of (+)strand RNA virus replication reveals a hidden druggable target
Authors: Nishikiori Masaki , Ahlquist Paul
Published: January 2018

New results link redox modulation, viroporin formation, and genome replication by (+)RNA viruses.
Critics see only risks, no benefits in horsepox paper
Authors: Kupferschmidt Kai
Published: January 2018

Scientists say their labmade virus could make a new smallpox vaccine. Others call it a “mistake” and a “stunt.”
Heavy-lift rocket poised to boost space science
Authors: Mann Adam
Published: January 2018

Falcon Heavy could enable faster, heavier, cheaper missions.
Crackdown threatens science in Turkey
Authors: McTighe Kristen
Published: January 2018

Verdict expected soon in trial of dual-nationality scientist accused of terrorism.
Australian state forecasts deadly thunderstorm asthma
Authors: Kornei Katherine
Published: January 2018

Scientists probe ways that storms weaponize pollen.
Nanoscale chiral valley-photon interface through optical spin-orbit coupling
Authors: Gong Su-Hyun , Alpeggiani Filippo , Sciacca Beniamino , Garnett Erik C. , Kuipers L.
Published: January 2018

Nanoscale chiral valley-photon interface

Occupation of different valleys within the band structure of some materials can be used to encode information. That information is typically encoded in terms of the chirality or polarization of emitted photons. Gong
et al.
combined a plasmonic silver nanowire with a flake of the transition metal dichalcogenide WS
2
to form a nanophotonic platform for the transfer of solid-state spin into optical information over mesoscopic distances. The direction of light emission from the nanowire was strongly dependent on the spin-orbit coupling of light and the WS2 layer. Such a highly efficient interface should prove useful for developing valleytronics into a practical on-chip technology.

Science
, this issue p.
443
Synthesis of partially and fully fused polyaromatics by annulative chlorophenylene dimerization
Authors: Koga Yoshito , Kaneda Takeshi , Saito Yutaro , Murakami Kei , Itami Kenichiro
Published: January 2018

How to get two bonds for the price of one

For more than a century, we have known how to couple aryl chlorides at the sites of their C-Cl bonds to form a single C-C bond. Koga
et al.
found that palladium catalysis can instead activate these C-Cl bonds to attack nearby aromatic C-H bonds in a terphenyl molecular framework. The reaction thereby produces a new ring, fused to the original rings on either side. Polycyclic compounds of this sort are of particular interest in optoelectronics research because of their expansive electron delocalization.

Science
, this issue p.
435
Molecular structure of human P-glycoprotein in the ATP-bound, outward-facing conformation
Authors: Kim Youngjin , Chen Jue
Published: January 2018

A path to multidrug resistance

Permeability glycoprotein (PgP) uses the energy from adenosine triphosphate (ATP) hydrolysis to transport substrates out of the cell. Many of its substrates are drugs, so it plays an important role in drug resistance. Structures in the inward-facing conformation have been determined for mouse, yeast, and algal PgP. Kim and Chen present the cryo–electron microscopy structure of human PgP in an outward-facing conformation. Two ATP molecules are bound between two nucleotide-binding domains. The substrate-binding site, located in the transmembrane domain, is open to the outside of the cell, but compressed, and no substrate is bound. This suggests that ATP binding, rather than ATP hydrolysis, promotes the transition to the outward-facing conformation and substrate release.

Science
, this issue p.
915
When did modern humans leave Africa?
Authors: Stringer Chris , Galway-Witham Julia
Published: January 2018

A ∼180,000-year-old fossil from Israel provides evidence for early forays of
Homo sapiens
into western Asia
A tale of two cultures
Authors: Holt Rush
Published: January 2018

It is the best of times. It is the worst of times. We are witnessing major advances in almost every field of science, leading to a better understanding of the world and improvements in the quality of people's lives. Yet, scattered distrust of science, neglect of science by public officials, and frequent denial of scientific thinking in many quarters seem to call into question that rosy view of scientific progress. The inconsistency indicates widespread misunderstanding of what science is and how it works. It is up to scientists to fix this.
Functional Expression of the Clostridium ljungdahlii Acetyl-Coenzyme A Synthase in Clostridium acetobutylicum as Demonstrated by a NovelIn VivoCO Exchange Activity En Route to Heterologous Installation of a Functional Wood-Ljungdahl Pathway
Authors: Fast Alan G. , Papoutsakis Eleftherios T.
Published: January 2018

Engineering the Wood-Ljungdahl pathway (WLP) in the established industrial organismClostridium acetobutylicumwould allow for the conversion of carbohydrates into butanol, acetone, and other metabolites at higher yields than are currently possible, while minimizing CO2and H2release. To this effect, we expressed 11Clostridium ljungdahliicore genes coding for enzymes and accessory proteins of the WLP inClostridium acetobutylicum. The engineered WLP inC. acetobutylicumshowed functionality of the eastern branch of the pathway based on the formation of labeled 5,10-methylenetetrahydrofolate from13C-labeled formate, as well as functionality of the western branch as evidenced by the formation of CO from CO2. However, the lack of labeling in acetate and butyrate pools indicated that the connection between the two branches is not functional. The focus of our investigation then centered on the functional expression of the acetyl-coenzyme A (CoA) synthase (ACS), which forms a complex with the CO dehydrogenase (CODH) and serves to link the two branches of the WLP. The CODH/ACS complex catalyzes the reduction of CO2to CO and the condensation of CO with a methyl group to form acetyl-CoA, respectively. Here, we show the simultaneous activities of the two recombinant enzymes. We demonstratein vivothe classicalin vitroACS carbonyl carbon exchange assay, whereby the carbonyl carbon of acetyl-CoA is exchanged with the CO carbon. Our data suggest that the low heterologous expression of ACS may limit the functionality of the heterologous WLP inC. acetobutylicum.

IMPORTANCEThe bifunctional carbon monoxide dehydrogenase/acetyl-CoA synthase (CODH/ACS) fromC. ljungdahliiwas heterologously expressed in the obligate heterotrophC. acetobutylicum. The functional activity of the CODH was confirmed through both the oxidation and reduction of CO, as had previously been shown for the heterologous CODH fromClostridium carboxidivorans. Significantly, a novelin vivoassay for ACS exchange activity using13C-tracers was developed and used to confirm functional ACS expression.
Whole-Genome Sequencing and Genetic Analysis Reveal Novel Stress Responses to Individual Constituents of Essential Oils in Escherichia coli
Authors: Chueca Beatriz , Renzoni Adriana , Berdejo Daniel , Pagán Rafael , Kelley William L. , García-Gonzalo Diego
Published: January 2018

Food preservation by the use of essential oils (EOs) is being extensively studied because of the antimicrobial properties of their individual constituents (ICs). Three resistant mutants (termed CAR, CIT, and LIM) of
Escherichia coli
MG1655 were selected by subculturing with the ICs carvacrol, citral, and (+)-limonene oxide, respectively. These derivative strains showed increased MIC values of ICs and concomitantly enhanced resistance to various antibiotics (ampicillin, trimethoprim, chloramphenicol, tetracycline, kanamycin, novobiocin, norfloxacin, cephalexin, and nalidixic acid) compared to those for the parental strain (wild type [WT]). Whole-genome sequencing (WGS) of these hyperresistant strains permitted the identification of single nucleotide polymorphisms (SNPs) and deletions in comparison to the WT. In order to analyze the contribution of these mutations to the increased antimicrobial resistance detected in hyperresistant strains, derivative strains were constructed by allelic reversion. A role of the SoxR D137Y missense mutation in CAR was confirmed by growth in the presence of some ICs and antibiotics and by its tolerance to ICs but not to lethal heat treatments. In CIT, increased resistance relied on contributions by several detected SNPs, resulting in a frameshift in MarR and an in-frame GyrB ΔG157 mutation. Finally, both the insertion resulting in an AcrR frameshift and large chromosomal deletions found in LIM were correlated with the hyperresistant phenotype of this strain. The nature of the obtained mutants suggests intriguing links to cellular defense mechanisms previously implicated in antibiotic resistance.

IMPORTANCE
The antimicrobial efficacy of ICs has been proven over the years, together with their potential to improve traditional heat treatments by reducing treatment intensity and, consequently, adverse effects on food quality. However, the mechanisms of bacterial inactivation by ICs are still not well understood, in contrast to antibiotics. We performed WGS of three
E. coli
strains that are hyperresistant to ICs. The information provided detailed insight into the mechanisms of bacterial resistance arising from exposure to carvacrol, citral, and (+)-limonene oxide. Future experiments will undoubtedly yield additional insights into genes and pathways contributing to the acquisition of endogenous resistance to ICs.
Use of 3D printing to create a bespoke repair of a Percutaneous Endoscopic Gastrostomy (PEG) tube in patient unfit for surgical replacement
Authors: O’Sullivan Kevin J , O’Sullivan Aidan G , Power Noelle , Gillick John , Dunne Colum P , O’Sullivan Leonard , Linnane Barry
Published: January 2018

We report a case of three-dimensional (3D) printing being used to solve a difficult bedside clinical problem and avoidance of substantial risk associated with alternative solutions. A 15-year-old male with advanced cystic fibrosis developed a small (~1mm) linear tear in his Percutaneous Endoscopic Gastrostomy (PEG) tube, approximately 40 mm from the skin surface. The patient’s advanced condition precluded replacement of the PEG tube under general anaesthetic. Attempts to manage the tear with adhesive tapes yielded limited success. 3D printing was used to create a bespoke sealing device overnight, rectifying the leak and allowing enteral feeding to recommence unimpeded. The device is functioning well, several months post-discharge of the patient.
Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial
Authors: Roets-Merken Lieve M , Zuidema Sytse U , Vernooij-Dassen Myrra J F J , Teerenstra Steven , Hermsen Pieter G J M , Kempen Gertrudis I J M , Graff Maud J L
Published: January 2018

Objective

To evaluate the effectiveness of a nurse-supported self-management programme to improve social participation of dual sensory impaired older adults in long-term care homes.

Design

Cluster randomised controlled trial.

Setting

Thirty long-term care homes across the Netherlands.

Participants

Long-term care homes were randomised into intervention clusters (n=17) and control clusters (n=13), involving 89 dual sensory impaired older adults and 56 licensed practical nurses.

Intervention

Nurse-supported self-management programme.

Measurements

Effectiveness was evaluated by the primary outcome social participation using a participation scale adapted for visually impaired older adults distinguishing four domains: instrumental activities of daily living, social-cultural activities, high-physical-demand and low-physical-demand leisure activities. A questionnaire assessing hearing-related participation problems was added as supportive outcome. Secondary outcomes were autonomy, control, mood and quality of life and nurses’ job satisfaction. For effectiveness analyses, linear mixed models were used. Sampling and intervention quality were analysed using descriptive statistics.

Results

Self-management did not affect all four domains of social participation; however. the domain ‘instrumental activities of daily living’ had a significant effect in favour of the intervention group (P=0.04; 95% CI 0.12 to 8.5). Sampling and intervention quality was adequate.

Conclusions

A nurse-supported self-management programme was effective in empowering the dual sensory impaired older adults to address the domain ‘instrumental activities of daily living’, but no differences were found in addressing the other three participation domains. Self-management showed to be beneficial for managing practical problems, but not for those problems requiring behavioural adaptations of other persons.

Trial registration number

NCT01217502; Results.
Attitudes and barriers to exercise in adults with a recent diagnosis of type 1 diabetes: a qualitative study of participants in the Exercise for Type 1 Diabetes (EXTOD) study
Authors: Kennedy Amy , Narendran Parth , Andrews Robert C , Daley Amanda , Greenfield Sheila M
Published: January 2018

Objectives

To explore attitudes and barriers to exercise in adults with new-onset type 1 diabetes mellitus (T1DM).

Design

Qualitative methodology using focus group (n=1), individual face-to-face (n=4) and telephone interviews (n=8). Thematic analysis using the Framework Method.

Setting

Nineteen UK hospital sites.

Participants

Fifteen participants in the Exercise for Type 1 Diabetes study. We explored current and past levels of exercise, understanding of exercise and exercise guidelines, barriers to increasing exercise levels and preferences for monitoring of activity in a trial.

Results

Five main themes were identified: existing attitudes to exercise, feelings about diagnosis, perceptions about exercise consequences, barriers to increasing exercise and confidence in managing blood glucose. An important finding was that around half the participants reported a reduction in activity levels around diagnosis. Although exercise was felt to positively impact on health, some participants were not sure about the benefits or concerned about potential harms such as hypoglycaemia. Some participants reported being advised by healthcare practitioners (HCPs) not to exercise.

Conclusions

Exercise should be encouraged (not discouraged) from diagnosis, as patients may be more amenable to lifestyle change. Standard advice on exercise and T1DM needs to be made available to HCPs and patients with T1DM to improve patients’ confidence in managing their diabetes around exercise.

Trial registration number

ISRCTN91388505; Results
Quality of life of elderly patients with solid tumours undergoing adjuvant cancer therapy: a systematic review
Authors: Cheng Karis Kin-Fong , Lim Ethel Yee-Ting , Kanesvaran Ravindran
Published: January 2018

Objectives

The measurement of quality of life (QoL) in elderly cancer population is increasingly being recognised as an important element of clinical decision-making and the evaluation of treatment outcome. This systematic review aimed to summarise the evidence of QoL during and after adjuvant therapy in elderly patients with cancer.

Methods

A systematic search was conducted of studies published in CINAHL plus, CENTRAL, PubMed, PsycINFO and Web of Science from the inception of these databases to December 2016. Eligible studies included RCTs and non-RCTs in which QoL was measured in elderly patients (aged 65 years or above) with stage I–III solid tumours who were undergoing adjuvant chemotherapy and/or radiotherapy. Because of the heterogeneity and the insufficient data among the included studies, the results were synthesised narratively.

Results

We included 4 RCTs and 14 non-RCTs on 1785 participants. In all four RCTs, the risk of bias was low or unclear for most items but high for detection. Of the 14 non-RCTs, 5 studies were judged to have a low or moderate risk of bias for all domains, and the other 9 studies had a serious risk of bias in at least one domain. The bias was observed mainly in the confounding and in the selection of participants for the study. For most elderly patients with breast cancer, the non-significant negative change in the QoL was transient. A significant increase in the QoL during the course of temozolomide in elderly patients with glioblastoma but a decreasing trend in QoL after radiotherapy was shown. This review also shows a uniform trend of stable or improved QoL during adjuvant therapy and at follow-up evaluations across the studies with prostate, colon or cervical cancer population.

Conclusions

This review suggests that adjuvant chemotherapy and radiotherapy may not have detrimental effects on QoL in most elderly patients with solid tumours.
Association of chronic kidney disease with mortality risk in patients with lung cancer: a nationwide Taiwan population-based cohort study
Authors: Wei Yu-Feng , Chen Jung-Yueh , Lee Ho-Shen , Wu Jiun-Ting , Hsu Chi-Kuei , Hsu Yao-Chun
Published: January 2018

Objective

Our population-based research aimed to clarify the association between chronic kidney disease (CKD) and mortality risk in patients with lung cancer.

Design

Retrospective cohort study

Setting

National health insurance research database in Taiwan

Participants

All (n=1 37 077) Taiwanese residents who were diagnosed with lung cancer between 1997 and 2012 were identified. Eligible patients with baseline CKD (n=2269) were matched with controls (1:4, n=9076) without renal disease according to age, sex and the index day of lung cancer diagnosis.

Methods

The cumulative incidence of death was calculated by the Kaplan-Meier method, and the risk determinants were explored by the Cox proportional hazards model.

Results

Mortality occurred in 1866 (82.24%) and 7135 (78.61%) patients with and without CKD, respectively (P=0.0001). The cumulative incidences of mortality in patients with and without chronic renal disease were 72.8% vs 61.6% at 1 year, 82.0% vs 76.6% at 2 years and 88.9% vs 87.2% at 5 years, respectively. After adjusting for multiple confounding factors including age and comorbidities, Cox regression analysis revealed that CKD was associated with an increased risk of mortality (adjusted HR 1.38; 95% CI 1.29 to 1.47). Stratified analysis further showed that the association was consistent across patient subgroups.

Conclusion

Comorbidity associated with CKD is a risk factor for mortality in patients with lung cancer.
Acetazolamide reduces exercise capacity following a 5-day ascent to 4559 m in a randomised study
Authors: Bradwell Arthur R , Ashdown Kimberley , Rue Carla , Delamere John , Thomas Owen D , Lucas Samuel J E , Wright Alex D , Harris Stephen J , Myers Stephen D
Published: January 2018

Objective

To assess whether acetazolamide (Az), used prophylactically for acute mountain sickness (AMS), alters exercise capacity at high altitude.

Methods

Az (500 mg daily) or placebo was administered to 20 healthy adults (aged 36±20 years, range 21–77), who were paired for age, sex, AMS susceptibility and weight, in a double-blind, randomised manner. Participants ascended over 5 days to 4559 m, then exercised to exhaustion on a bicycle ergometer, while recording breath-by-breath gas measurements. Comparisons between groups and matched pairs were done via Mann-Whitney U and Pearson’s χ2tests, respectively.

Results

Comparing paired individuals at altitude, those on Az had greater reductions in maximum power output (Pmax) as a percentage of sea-level values (65±14.1 vs 76.6±7.4 (placebo); P=0.007), lower VO2max(20.7±5.2 vs 24.6±5.1 mL/kg/min; P<0.01), smaller changes from rest to Pmaxfor VO2(9.8±6.2 vs 13.8±4.9 mL/kg/min; P=0.04) and lower heart rate at Pmax(154±25 vs 167±16, P<0.01) compared with their placebo-treated partners. Correlational analysis (Pearson’s) indicated that with increasing age Pmax(r=−0.83: P<0.005) and heart rate at Pmax(r=−0.71, P=0.01) reduced more in those taking Az.

Conclusion

Maximum exercise performance at altitude was reduced more in subjects taking Az compared with placebo, particularly in older individuals. The age-related effect may reflect higher tissue concentrations of Az due to reduced renal excretion. Future studies should explore the effectiveness of smaller Az doses (eg, 250 mg daily or less) in older individuals to optimise the altitude–Az–exercise relationships.
Chief physicians’ perceived need for improvement of morbidity and mortality conferences: the role of structural and procedural characteristics
Authors: Schwappach David L B , Häsler Lynn , Pfeiffer Yvonne
Published: January 2018

Background

Mortality and morbidity conferences (M&MCs) are used to retrospectively discuss adverse events. Recently, the focus of the M&MC shifted from a clinical learning tool to a forum for analysing events using systems-based approaches. The aim of this study was to explore the M&MC characteristics that are associated with perceived improvement needs reported by chief physicians.

Methods

A cross-sectional survey among chief physicians assessed characteristics of currently implemented M&MCs in Switzerland (44 items). A summative score was developed covering information on procedural and structural characteristics commonly recommended for design of M&MCs.

Results

Of 223 participants, 145 (65%) indicated that their M&MC could be improved. Regression analysis revealed that the score (ie, the sum of structural and procedural features of the M&MC) was associated with self-perceived need for improvement of M&MCs (OR=0.73, CI 0.62 to 0.85, P<0.001). Chief physicians who explicitly select cases for M&MC discussion which involve problems in cooperation had twice the odds of reporting a need for improvement (OR=1.99, CI 1.05 to 3.74, P=0.034).

Conclusion

Our study provides important insights into the factors contributing to chief physicians’ evaluation of M&MCs. Offering support for addressing the procedural and structural features of the M&MCs may be a good lever to improve them.
Endovascular revascularisation of acute tandem vertebrobasilar artery occlusion: seven case series with literature reviews
Authors: Yang Haihua , Ma Ning , Zhang Shiyong , Huo Xiaochuan , Gao Feng , Sun Xuan , Mo Dapeng , Miao Zhongrong
Published: January 2018

Background

The outcome of acute ischaemic stroke due to tandem vertebrobasilar artery occlusion was poor. Endovascular revascularisation may be a positive approach for acute basilar artery occlusion combined with vertebral ostium stenosis or occlusion. We reported seven patients with acute vertebrobasilar tandem occlusion by using angioplasty or stenting for proximal lesion and thrombectomy for distal occlusion.

Materials and methods

Consecutive patients with acute tandem vertebrobasilar artery occlusion at two centres were included in this study. We retrospectively analysed the clinical, technical and functional outcomes of the patients.

Results

From March 2016 to March 2017, seven patients were included. The mean age and National Institute of Health Stroke Scale score at admission was 57 years and 22, respectively. A reverse approach was used in five patients. The Thrombolysis in Cerebral Infarction score 2b-3 was acquired in all patients. There were no procedural complications. The modified Rankin Scale score was 1–2 for three patients and 4 for one patient at 3 months. Three patients died at 3 months of follow-up.

Conclusions

Endovascular revascularisation may be feasible for acute tandem vertebrobasilar artery occlusion, and more researches are needed.
Resuscitative endovascular balloon occlusion of the aorta: rupture risk and implications for blind inflation
Authors: Wasicek Philip J , Teeter William A , Brenner Megan L , Hoehn Melanie R , Scalea Thomas M , Morrison Jonathan J
Published: January 2018

Background

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a torso hemorrhage control technique. To expedite deployment, inflation is frequently performed as a blind technique with minimal imaging, which carries a theoretical risk of aortic injury. The objective of this study was to examine the relationship between balloon inflation, deformation and the risk of aortic rupture.

Methods

Compliant balloon catheters were incrementally inflated in segments of cadaveric swine aorta. Serial longitudinal and circumferential measurements were recorded, along with the incidence of aortic rupture.

Results

Fourteen cadaveric swine aorta segments were tested with mean (±SD) baseline aortic diameter (mm) of 14.2±3.4. Rupture occurred in three aortas. The mean baseline diameters (mm) of the aortic segments that were ruptured were significantly smaller than those that did not rupture (8.9±1.2 vs 15.6±1.9; P<0.001). The maximal circumferential stretch ratios were significantly higher in the aorta segments that ruptured compared with those that did not (1.9±0.1 vs 1.5±0.1; P<0.001). The maximal amount of balloon longitudinal deformation was 80 mm (116% longer than the intended working length).

Conclusions

Inflation of aortic balloon catheters carries an inherent risk of aortic injury, which may be minimized through an understanding of the intrinsic characteristics of the aorta and compliant balloons. Smaller diameter aortic segments undergoing overinflation, particularly beyond a circumferential stretch ratio of 1.8, are at risk of aortic rupture.

Level of evidence

Level II.