bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Effusion Cooling Pattern Near the Dilution Hole for a Double-Walled Combustor Liner—Part 1: Overall Effectiveness Measurements
Authors: Shrager Adam C. , Thole Karen A. , Mongillo Dominic
Published: August 2018

The complex flow field in a gas turbine combustor makes cooling the liner walls a challenge. In particular, this paper is primarily focused on the region surrounding the dilution holes, which is especially challenging to cool due to the interaction between the effusion cooling jets and high-momentum dilution jets. This study presents overall effectiveness measurements for three different cooling hole patterns of a double-walled combustor liner. Only effusion hole patterns near the dilution holes were varied, which included: no effusion cooling; effusion holes pointed radially outward from the dilution hole; and effusion holes pointed radially inward toward the dilution hole. The double-walled liner contained both impingement and effusion plates as well as a row of dilution jets. Infrared thermography was used to measure the surface temperature of the combustor liners at multiple dilution jet momentum flux ratios and approaching freestream turbulence intensities of 0.5% and 13%. Results showed that the outward and inward geometries were able to more effectively cool the region surrounding the dilution hole compared to the closed case. A significant amount of the cooling enhancement in the outward and inward cases came from in-hole convection. Downstream of the dilution hole, the interactions between the inward effusion holes and the dilution jet led to lower levels of effectiveness compared to the other two geometries. High freestream turbulence caused a small decrease in overall effectiveness over the entire liner and was most impactful in the first three rows of effusion holes.
Importance of Surface Curvature in Modeling Droplet Impingement on Fan Blades
Authors: Burson-Thomas Charles B. , Wellman Richard , Harvey Terry J. , Wood Robert J. K.
Published: August 2018

When modeling a droplet impingement, it is reasonable to assume a surface is flat when the radius of curvature of the surface is significantly larger than the droplet radius. In other contexts where water droplet erosion (WDE) has been investigated, the typical droplet size has either been sufficiently small, or the radius of curvature of the surface sufficiently large, that it has been sensible to make this assumption. The equations describing the kinematics of an impinging water droplet on a flat surface were reformulated for a curved surface. The results suggest the relatively similar radii of curvature, of the leading-edge of a fan blade and the impinging water droplet, will significantly affect the application of the initial high-pressures, along with the onset of lateral outflow jetting. Jetting is predicted to commence substantially sooner and not in unison along the contact periphery, leading to an asymmetric flow stage. This is likely to have significant implications for the WDE that occurs, and thus, the engineering approaches to minimize the WDE of fan blades.
Effects of Effusion Cooling Pattern Near the Dilution Hole for a Double-Walled Combustor Liner—Part II: Flowfield Measurements
Authors: Shrager Adam C. , Thole Karen A. , Mongillo Dominic
Published: August 2018

The complex flowfield inside a gas turbine combustor creates a difficult challenge in cooling the combustor walls. Many modern combustors are designed with a double-wall that contain both impingement cooling on the backside of the wall and effusion cooling on the external side of the wall. Complicating matters is the fact that these double-walls also contain large dilution holes whereby the cooling film from the effusion holes is interrupted by the high-momentum dilution jets. Given the importance of cooling the entire panel, including the metal surrounding the dilution holes, the focus of this paper is understanding the flow in the region near the dilution holes. Near-wall flowfield measurements are presented for three different effusion cooling hole patterns near the dilution hole. The effusion cooling hole patterns were varied in the region near the dilution hole and include: no effusion holes; effusion holes pointed radially outward from the dilution hole; and effusion holes pointed radially inward toward the dilution hole. Particle image velocimetry (PIV) was used to capture the time-averaged flowfield at approaching freestream turbulence intensities of 0.5% and 13%. Results showed evidence of downward motion at the leading edge of the dilution hole for all three effusion hole patterns. In comparing the three geometries, the outward effusion holes showed significantly higher velocities toward the leading edge of the dilution jet relative to the other two geometries. Although the flowfield generated by the dilution jet dominated the flow downstream, each cooling hole pattern interacted with the flowfield uniquely. Approaching freestream turbulence did not have a significant effect on the flowfield.
Inflammasome SUMOylation
Authors: Williams Erin R.
Published: August 2018

NLRP3 inflammasome activity is inhibited by SUMOylation.
Glucan-Chitin Particles Enhance Th17 Response and Improve Protective Efficacy of a Multivalent Antigen (rCpa1) against Pulmonary Coccidioides posadasii Infection
Authors: Hung Chiung-Yu , Zhang Hao , Castro-Lopez Natalia , Ostroff Gary R. , Khoshlenar Payam , Abraham Ambily , Cole Garry T. , Negron Austin , Forsthuber Thomas , Peng Tao , Galgiani John N. , Ampel Neil M. , Yu Jieh-Juen
Published: August 2018

Developing an effective and safe recombinant vaccine requires microbe-specific antigens combined with an adjuvant/delivery system to strengthen protective immunity. In this study, we designed and expressed a multivalent recombinant
Coccidioides
polypeptide antigen (rCpa1) that consists of three previously identified antigens (i.e., Ag2/Pra, Cs-Ag, and Pmp1) and five pathogen-derived peptides with high affinity for human major histocompatibility complex class II (MHC-II) molecules.
The Intracellular Cyclophilin PpiB Contributes to the Virulence of Staphylococcus aureus Independently of Its Peptidyl-Prolyl
cis/trans
Isomerase Activity
Authors: Keogh Rebecca A. , Zapf Rachel L. , Wiemels Richard E. , Wittekind Marcus A. , Carroll Ronan K.
Published: August 2018

The
Staphylococcus aureus
cyclophilin PpiB is an intracellular peptidyl prolyl
cis/trans
isomerase (PPIase) that has previously been shown to contribute to secreted nuclease and hemolytic activity. In this study, we investigated the contribution of PpiB to
S. aureus
virulence.
In Vivo
Persistence of Chimeric Virus after Substitution of the Kaposi's Sarcoma-Associated Herpesvirus LANA DNA Binding Domain with That of Murid Herpesvirus 4
Authors: Pires de Miranda Marta , Quendera Ana Patrícia , McVey Colin E. , Kaye Kenneth M. , Simas J. Pedro
Published: August 2018

KSHV is a human oncogenic virus for which there is no tractable, immunocompetent animal model of infection. MuHV-4, a related rodent gammaherpesvirus, enables pathogenesis studies in mice. In latency, both viruses persist as extrachromosomal, circular genomes (episomes). LANA proteins encoded by KSHV (kLANA) and MuHV-4 (mLANA) contain a C-terminal DNA binding domain (DBD) that acts on the virus terminal repeats to enable episome persistence. mLANA is a smaller protein than kLANA. Their DBDs are structurally conserved but differ strikingly in the conformation of DNA binding. We report a recombinant, chimeric MuHV-4 which contains kLANA in place of mLANA, but in which the DBD is replaced with that of mLANA. Results showed that kLANA functionally accommodated mLANA's mode of DNA binding. In fact, the new chimeric virus established latency
in vivo
more efficiently than MuHV-4 expressing full-length kLANA.
Overdiagnosis in primary care: framing the problem and finding solutions
Authors: Kale Minal S , Korenstein Deborah
Published: August 2018

Overdiagnosis, is defined as the diagnosis of a condition that, if unrecognized, would not cause symptoms or harm a patient during his or her lifetime, and it is increasingly acknowledged as a consequence of screening for cancer and other conditions. Because preventive care is a crucial component of primary care, which is delivered to the broad population, overdiagnosis in primary care is an important problem from a public health perspective and has far reaching implications. The scope of overdiagnosis as a result of services delivered in primary care is unclear, though overdiagnosis of indolent breast, prostate, thyroid, and lung cancers is well described and overdiagnosis of chronic kidney disease, depression, and attention-deficit/hyperactivity disorder is also recognized. However, overdiagnosis is a known consequence of all screening and can be assumed to occur in many more clinical contexts. Overdiagnosis can harm patients by leading to overtreatment (with associated potential toxicities), diagnosis related anxiety or depression, and labeling, or through financial burden. Many entrenched factors facilitate overdiagnosis, including the growing use of advanced diagnostic technology, financial incentives, a medical culture that encourages greater use of tests and treatments, limitations in the evidence that obscure the understanding of diagnostic utility, use of non-beneficial screening tests, and the broadening of disease definitions. Efforts to reduce overdiagnosis are hindered by physicians’ and patients’ lack of awareness of the problem and by confusion about terminology, with overdiagnosis often conflated with related concepts. Clarity of terminology would facilitate physicians’ understanding of the problem and the growth in evidence regarding its prevalence and downstream consequences in primary care. It is hoped that international coordination regarding diagnostic standards for disease definitions will also help minimize overdiagnosis in the future.
CPR decision-making conversations in the UK: an integrative review
Authors: Hall Charlie C , Lugton Jean , Spiller Juliet Anne , Carduff Emma
Published: August 2018

Objectives

Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) discussions with patients and their caregivers have been subjected to intense ethical and legal debate in recent years. Legal cases and national guidelines have tried to clarify the best approach to DNACPR discussions; however, there is little evidence of how best to approach them from the patient, family or caregiver perspective. This paper describes published accounts of patient, family and caregiver experiences of discussions about advance cardiopulmonary resuscitation (CPR) decision making.

Methods

An integrative review of the UK literature between 2000 and 2016 including qualitative and quantitative studies was conducted. Worldwide, 773 abstracts were identified, and 20 papers from the UK were included in the final analysis.

Results

Patient, family and caregivers prefer discussions to be initiated by someone trusted, and wishes for family involvement vary depending on the context. Timing of discussions should be individualised, though discussions earlier in the illness are often preferable. Discussions held in the acute setting are suboptimal. CPR decisions should be part of a wider discussion about future care and adequate communication skills training is important.

Conclusions

The findings of this review are at odds with the current statutory framework and potentially challenging for medical professionals who are working in a stretched health service, with pressure to discuss DNACPR decisions at the earliest opportunity. With increasing focus on person-centred care and realistic medicine, patient narratives must be considered by doctors and policy makers alike, to minimise harm.
Revealing rangeomorph species characters using spatial analyses
Authors: Mitchell Emily G. , Kenchington Charlotte G. , Harris Simon , Wilby Philip R.
Published: August 2018

Rangeomorphs dominate the Ediacaran Avalonian macrofossil assemblages of Charnwood Forest, UK (∼562 Ma). However, their unfamiliar fractal architecture makes distinguishing phylogenetically reliable characters from intraspecific features difficult. Fortunately, spatial analysis of large in-situ populations offers an independent means of assessing their taxonomy. Populations of a single biological species are likely to exhibit similar spatial distributions due to their shared responses to the biological and ecological processes acting upon them. As such, spatial analyses can be used to interrogate which are the most taxonomically deductive characters in similar species. We used random labelling analyses to investigate the presence or absence of characters of Primocandelabrum boyntoni, P. aethelfalaedia, and P. aelfwynnia on the Bed ‘B’. The resultant spatial distributions were compared to observed characters using goodness-of-fit tests to determine which characters were associated with unique populations, and which were found across multiple populations. We found that P. boyntoni and P. aelfwynnia had statistically indistinguishable character distributions, suggesting that they represent a single biological species, and that they exhibited significantly different distributions to P. aethelfalaedia, suggesting that there are two (rather than three) species of Primocandelabrum present on the B surface. Furthermore, we found that the distribution of concealed versus unconcealed 1st order branches across all specimens exhibited significantly different density-dependant behaviour, with unconcealed branching occurring in areas of higher density populations and concealed branching occurring in the lower density areas of Primocandelabrum. We speculate that unconcealed branches may have been a response to the reduced availability of resources in higher density areas, implying rangeomorphs were capable of ecophenotypic responses.
Structure of Zhou Nil-clean Rings
Authors: Chen Huanyin , Sheibani Marjan
Published: August 2018

A ring R is Zhou nil-clean if every element in R is the sum of two tripotents and a nilpotent that commute. Homomorphic images of Zhou nil-clean rings are explored. We prove that a ring R is Zhou nil-clean if and only if 30 ϵ R is nilpotent and R/30R is Zhou nil-clean, if and only if R/BM(R) is 5-potent and BM(R) is nil, if and only if J(R) is nil and R/J(R) is isomorphic to a Boolean ring, a Yaqub ring, a Bell ring or a direct product of such rings. By means of homomorphic images, we completely determine when the generalized matrix ring is Zhou nil-clean. We prove that the generalized matrix ring Mn(R; s) is Zhou nil-clean if and only if R is Zhou nil-clean and s ϵ J(R).
Lie Triple Derivations of the Lie Algebra of Dominant Block Upper Triangular Matrices
Authors: Ghimire Prakash , Huang Huajun
Published: August 2018

Let [Formula: see text] be the Lie algebra of all n×n dominant block upper triangular matrices over a field 𝔽. In this paper, we explicitly describe all Lie triple derivations of [Formula: see text] when char(𝔽) ≠ 2. As an application, we characterize Lie derivations of [Formula: see text] when char(𝔽) ≠ 2.
Musculoskeletal disorder and pain associated with smartphone use: A systematic review of biomechanical evidence
Authors: Eitivipart Aitthanatt Chachris , Viriyarojanakul Sirinya , Redhead Lucy
Published: August 2018

The number of smartphone users is growing dramatically. Using the smartphone frequently forces the users to adopt an awkward posture leading to an increased risk of musculoskeletal disorders and pain. The objective of this study is to conduct a systematic review of studies that assess the effect of smartphone use on musculoskeletal disorders and pain. A systematic literature search of AMED, CINAHL, PubMed, Proquest, ScienceDirect using specific keywords relating to smartphone, musculoskeletal disorders and pain was conducted. Reference lists of related papers were searched for additional studies. Methodological quality was assessed by two independent reviewers using the modified Downs and Black checklist. From 639 reports identified from electronic databases, 11 were eligible to include in the review. One paper was found from the list of references and added to the review. The quality scores were rated as moderate. The results show that muscle activity of upper trapezius, erector spinae and the neck extensor muscles are increased as well as head flexion angle, head tilt angle and forward head shifting which increased during the smartphone use. Also, smartphone use in a sitting position seems to cause more shift in head–neck angle than in a standing position. Smartphone usage may contribute to musculoskeletal disorders. The findings of the included papers should be interpreted carefully in light of the issues highlighted by the moderate-quality assessment scores.
ASSESSING TECHNICAL EFFICIENCY OF INNOVATIONS IN CANADA: THE GLOBAL SNAPSHOT
Authors: NASIEROWSKI WOJCIECH
Published: August 2018

This paper presents the results of a comparison of the technical efficiency of innovation approach in Canada to approaches in 41 other countries. Data Envelopment Analysis was used to investigate this subject. Results of simulation experiments were used to anticipate possible general suggestions regarding policy measures that may be considered when exploring means to improve Canadian performance. Data from the World Competitiveness Yearbook and European Innovation Scoreboard were used. Oslo Manual definition of innovations was used. Enablers (context) — difficult to change country characteristics that may impact upon technical efficiency — were entered into the examination. A qualitative overview of the Canadian perspective to innovations supplements the quantitative portion of the presentation. It is observed that return to scale and congestion issues dominate considerations on technical efficiency of innovations. Wealthier countries seem to be less technically efficient in innovations than not so rich ones. Canada operates under Decreasing Returns to Scale. Congestions seem to be the main contributor to inefficiencies. Suggestions regarding the betterment of technical efficiency of innovations in Canada are presented here. Attention was drawn to several questions for further studies on the subject and their importance clarified.
Preexercise breakfast ingestion versus extended overnight fasting increases postprandial glucose flux after exercise in healthy men
Authors: Edinburgh Robert M. , Hengist Aaron , Smith Harry A. , Travers Rebecca L. , Koumanov Francoise , Betts James A. , Thompson Dylan , Walhin Jean-Philippe , Wallis Gareth A. , Hamilton D. Lee , Stevenson Emma J. , Tipton Kevin D. , Gonzalez Javier T.
Published: August 2018

The aim of this study was to characterize postprandial glucose flux after exercise in the fed versus overnight fasted state and to investigate the potential underlying mechanisms. In a randomized order, twelve men underwent breakfast-rest [(BR) 3 h semirecumbent], breakfast-exercise [(BE) 2 h semirecumbent before 60 min of cycling (50% peak power output)], and overnight fasted exercise [(FE) as per BE omitting breakfast] trials. An oral glucose tolerance test (OGTT) was completed after exercise (after rest on BR). Dual stable isotope tracers ([U-13C] glucose ingestion and [6,6-2H2] glucose infusion) and muscle biopsies were combined to assess postprandial plasma glucose kinetics and intramuscular signaling, respectively. Plasma intestinal fatty acid binding (I-FABP) concentrations were determined as a marker of intestinal damage. Breakfast before exercise increased postexercise plasma glucose disposal rates during the OGTT, from 44 g/120 min in FE {35 to 53 g/120 min [mean (normalized 95% confidence interval)] to 73 g/120 min in BE [55 to 90 g/120 min; P = 0.01]}. This higher plasma glucose disposal rate was, however, offset by increased plasma glucose appearance rates (principally OGTT-derived), resulting in a glycemic response that did not differ between BE and FE ( P = 0.11). Plasma I-FABP concentrations during exercise were 264 pg/ml (196 to 332 pg/ml) lower in BE versus FE ( P = 0.01). Breakfast before exercise increases postexercise postprandial plasma glucose disposal, which is offset (primarily) by increased appearance rates of orally ingested glucose. Therefore, metabolic responses to fed-state exercise cannot be readily inferred from studies conducted in a fasted state.
Endogenous glucose production after sequential meals in humans: evidence for more prolonged suppression after ingestion of a second meal
Authors: Ang Teddy , Kowalski Greg M. , Bruce Clinton R.
Published: August 2018

Single-meal studies have shown that carbohydrate ingestion causes rapid and persistent suppression of endogenous glucose production (EGP). However, little is known about the regulation of EGP under real-life eating patterns in which multiple carbohydrate-containing meals are consumed throughout the day. Therefore, we aimed to characterize the regulation of EGP in response to sequential meals, specifically during the breakfast-lunch transition. Nine healthy individuals (5 men, 4 women; 32 ± 2 yr; 25.0 ± 1.4 kg/m2) ingested two identical mixed meals, each containing 25 g of glucose, separated by 4 h, and EGP was determined by the variable infusion tracer-clamp approach. EGP was rapidly suppressed after both meals, with the pattern and magnitude of suppression being similar over the initial 75-min postmeal period. However, EGP suppression was more transient after breakfast compared with lunch, with EGP returning to basal rates 3 h after breakfast. In contrast, EGP remained in a suppressed state for the entire 4-h postlunch period. This occurred despite each meal eliciting similar plasma glucose and insulin responses. However, there was greater suppression of plasma glucagon levels after lunch, likely contributing to this response. These findings highlight the potential for distinct regulation of EGP with each meal of the day and suggest that EGP may be in a suppressed state for much of the day, since EGP did not return to basal rates even after a lunch meal containing a modest amount of carbohydrate.
Preliminary Study: Environmental Assessment of Perchloroethylene in Dry-Cleaning Facilities in the UAE
Authors: Habib Sedra , Ahmed Hafiz O. , Al-Muhairi Naema , Ziad Reem
Published: August 2018

Background. Perchloroethylene (PERC) is a widely spread cleaning solvent, used in nearly all dry-cleaning facilities. It has been declared as “probable human carcinogen” by the International Agency for Research on Cancer (IARC) due to its hazardous and toxic effects on human health. The study aimed at assessing the exposure of PERC among dry-cleaning workers at four different dry-cleaning facilities in the UAE. Methods. The four dry-cleaning facilities, using PERC in one of the cities of the UAE, were selected. Draeger perchloroethylene 10/b detector tubes along with a Draeger accuro pump were used to estimate the levels of PERC exposure in three main selected positions in each of the facilities. Results. The results showed that the second selected position had the highest amounts of PERC exposure above the international and local standards in 3 out of 4 selected facilities. The workers at position 2, who were not using any of the provided personal protective equipment, were at the highest risk of developing PERC-related health problems. Conclusion. It is important to install local exhaust ventilation systems and monitoring devices of PERC concentrations in these facilities, along with raising the awareness of workers about the health effects of PERC and the importance of using personal protective equipment (PPE) while performing their job.
Risk Transfer Mechanism for Agricultural Products Supply Chain Based on Weather Index Insurance
Authors: Fu Hongyong , Li Jiawen , Li Yujie , Huang Shengzhong , Sun Xiangkai
Published: August 2018

The risk management for agricultural products supply chain is more complex than that for typical manufacturing supply chain. Agricultural production is vulnerable to severe weather such as heavy rain, cyclones, and cold wave, which challenges the matching of random output with random demand for agricultural products supply chains. The goal of this paper is to design an effective risk transfer mechanism for managing severe weather risks so as to ensure the stable operation of the agricultural products supply chain. We study the coordination of two‐level agricultural products supply chain with a single company and a single farmer under the influence of severe weather. Taking rainstorm weather as an example, this paper designs a risk transfer mechanism based on weather index (rainfall) insurance: “rainfall index insurance + revenue sharing + risk transfer fee.” It is found that this risk transfer mechanism can overcome distortion of the farmer’s agricultural investment level under the influence of severe weather. When the contract parameters meet certain conditions, using the risk transfer mechanism can achieve the supply chain coordination and a win‐win situation. More importantly, weather change does not affect the Pareto improvement of the company and the farmer under the risk transfer mechanism. In addition, we also find that the company can incentivize the farmer to purchase weather index insurance and use the insurance market to shift the severe weather risk encountered during the agricultural production to protect the company’s and farmer’s income and the stable operation of the supply chain.
Impact of Obesity and Hyperglycemia on Placental Mitochondria
Authors: Mandò Chiara , Anelli Gaia Maria , Novielli Chiara , Panina-Bordignon Paola , Massari Maddalena , Mazzocco Martina Ilaria , Cetin Irene
Published: August 2018

A lipotoxic placental environment is recognized in maternal obesity, with increased inflammation and oxidative stress. These changes might alter mitochondrial function, with excessive production of reactive oxygen species, in a vicious cycle leading to placental dysfunction and impaired pregnancy outcomes. Here, we hypothesize that maternal pregestational body mass index (BMI) and glycemic levels can alter placental mitochondria. We measured mitochondrial DNA (mtDNA, real‐time PCR) and morphology (electron microscopy) in placentas of forty‐seven singleton pregnancies at elective cesarean section. Thirty‐seven women were normoglycemic: twenty‐one normal‐weight women, NW, and sixteen obese women, OB/GDM(−). Ten obese women had gestational diabetes mellitus, OB/GDM(+). OB/GDM(−) presented higher mtDNA levels versus NW, suggesting increased mitochondrial biogenesis in the normoglycemic obese group. These mitochondria showed similar morphology to NW. On the contrary, in OB/GDM(+), mtDNA was not significantly increased versus NW. Nevertheless, mitochondria showed morphological abnormalities, indicating impaired functionality. The metabolic response of the placenta to impairment in obese pregnancies can possibly vary depending on several parameters, resulting in opposite strains acting when insulin resistance of GDM occurs in the obese environment, characterized by inflammation and oxidative stress. Therefore, mitochondrial alterations represent a feature of obese pregnancies with changes in placental energetics that possibly can affect pregnancy outcomes.
NFVMon: Enabling Multioperator Flow Monitoring in 5G Mobile Edge Computing
Authors: Chirivella-Perez Enrique , Gutiérrez-Aguado Juan , Alcaraz-Calero Jose M. , Wang Qi
Published: August 2018

With the advances of new‐generation wireless and mobile communication systems such as the fifth‐generation (5G) mobile networks and Internet of Things (IoT) networks, demanding applications such as Ultra‐High‐Definition video applications is becoming ever popular. These applications require real‐time monitoring and processing to meet the mission‐critical quality of service requirements and are expected to be supported by the emerging fog or edge computing paradigms. This paper presents NFVMon, a novel monitoring architecture to enable flow monitoring capabilities of network traffic in a 5G multioperator mobile edge computing environment. The proposed NFVMon is integrated with the management plane of the Cloud Computing. NFVMon has been prototyped and a reference implementation is presented. It provides novel capabilities to provide disaggregated metrics related to the different 5G mobile operators sharing infrastructures and also about the different 5G subscribers of each of such mobile operators. Extensive experiments for evaluating the performance of the system have been conducted on a mid‐sized infrastructure testbed.
Giant Prolactinoma of Young Onset: A Clue to Diagnosis of MEN-1 Syndrome
Authors: Subasinghe Chandrika Jayakanthi , Somasundaram Noel , Sivatharshya Pathmanathan , Ranasinghe Lalana Devi , Korbonits Márta
Published: August 2018

Multiple endocrine neoplasia (MEN) type 1 syndrome is an autosomal dominant disorder caused by germline mutations in MEN1 gene, characterized by tumours in endocrine and nonendocrine organs. Giant prolactinoma is defined as tumours larger than 40mm with very high prolactin secretion. We report two unrelated Sri Lankan patients (8-year-old boy and a 20-year-old female) who presented with giant prolactinomas with mass effects of the tumours. The female patient showed complete response to medical therapy, while the boy developed recurrent resistant prolactinoma needing surgery and radiotherapy. During follow-up, both developed pancreatic neuroendocrine tumours. Genetic analysis revealed that one was heterozygous for a nonsense mutation and other for missense mutation in MEN1 gene. Screening confirmed familial MEN-1 syndrome in their families. High clinical suspicion upon unusual clinical presentation prompted genetic evaluation in these patients and detection of MEN1 gene mutation. Pituitary adenomas in children with MEN-1 syndrome are larger tumours with higher rates of treatment resistance. This report emphasizes importance of screening young patients with giant prolactinoma for MEN-1 syndrome and arranging long-term follow-up for them expecting variable treatment outcomes. Sri Lanka requires further studies to describe the genotypic-phenotypic variability of MEN-1 syndrome in this population.
Prevalence, Treatment, and Associated Factors of Hypertension in Spain: A Comparative Study between Populations
Authors: Corbatón-Anchuelo Arturo , Martínez-Larrad María Teresa , Prado-González Náyade del , Fernández-Pérez Cristina , Gabriel Rafael , Serrano-Ríos Manuel
Published: August 2018

The prevalence and related factors of hypertensive subjects according to the resident area (rural versus urban) were investigated in two population-based studies from Spain. Medical questionnaires were administered and anthropometrics were measured, using standardized protocols. Hypertension was diagnosed in pharmacology treated subjects or those with blood pressure (BP) ≥140/90 mm Hg. Regarding BP control, it was defined as under control if BP was <140/90 or <140/85 mm Hg in type 2 diabetic subjects. Information on educational status, social class, smoking habit, and alcohol intake was obtained. 3,816 subjects (54.38 % women) were included. Prevalence of diagnosed hypertension was higher in women and showed no differences according to the living area (men: urban 21.88 versus rural 21.92 %, p = 0.986; women: urban 28.73 versus rural 30.01 %, p = 0.540). Women living in rural areas and men with secondary or tertiary education levels had a lower probability of being BP uncontrolled (OR (95 % CI): 0.501 (0.258–0.970)/p=0.040, 0.245 (0.092–0.654)/p=0.005, and 0.156 (0.044–0.549)/p=0.004, respectively). Urban young men (31-45 years) and medium aged women (46-60 years) were less BP controlled than their rural counterparts (41.30 versus 65.79 %/p=0.025 and 35.24 versus 53.27 %/p=0.002, respectively).
Mass-Like Ground-Glass Opacities in Sarcoidosis: A Rare Presentation Not Previously Described
Authors: Tominna Marie , Al-Katib Sayf
Published: August 2018

Various typical and atypical imaging findings for pulmonary sarcoidosis have been described in the literature. Ground-glass opacities are one of the atypical manifestations, reported as diffuse or patchy ill-defined opacities frequently associated with additional findings and interstitial nodules. We performed a literature review to determine if our case had previously been described. The literature describes cases of mass-like consolidations, but there are no reports of mass-like ground-glass opacities. The appearance of the ground-glass opacities in our case is unique, appearing as discrete well-defined mass-like ground-glass opacities in a peribronchovascular distribution without additional parenchymal findings typically seen in sarcoidosis.
A 13-Year-Old with Coexistence of Gastric Volvulus and Leprosy: A Case Report of Two Rare Entities
Authors: Schneider Joanna , Mays Rhett
Published: August 2018

Leprosy, or Hansen’s disease, is caused by infection with Mycobacterium leprae. It is a rare diagnosis within the continental United States. We present the case of a 13-year-old immigrant from the Marshall Islands who presented with recurrent nausea, vomiting, and abdominal pain which are found to be due to intermittent gastric volvulus. Gastric volvulus is also exceedingly rare, with less than 8 pediatric cases on average per year. During her second hospitalization for recurrent acute gastrointestinal issues, nonspecific skin lesions were biopsied, revealing infection with M. leprae. The patient did not exhibit classic symptoms of leprosy but did have prominent skin changes including diffuse nodules. This case explores the pathophysiology connecting leprosy to volvulus, discussing the possible role of an inflammatory response to infection in causing gastric volvulus. The finding of lepromatous leprosy may have been unrelated but was fortuitous, as early intervention will result in avoidance of debilitating peripheral neuropathy and eventual disfiguration from Hansen’s disease. This case highlights the importance of considering rare causes of gastric outlet obstruction including gastric volvulus and of considering leprosy in the differential for patients with unusual skin lesions or paresthesias who have a history of living or traveling in endemic areas.
Effect of He’s Santong Needling Method on Dysphagia after Stroke: A Study Protocol for a Prospective Randomized Controlled Pilot Trial
Authors: Zhao Luopeng , Liu Lu , Zhang Claire Shuiqing , Zeng Lin , Zhao Jingxia , Wang Linpeng , Jing Xianghong , Wang Kelun , Li Bin
Published: August 2018

Background. Dysphagia is a common complication of stroke, affecting up to 78% of stroke patients. The existence of dysphagia after stroke has been associated with an increased risk for pulmonary complications and even mortality. Previous studies have shown that acupuncture could be potential therapeutic method for treatment of dysphagia after stroke. A prospective randomized controlled pilot trial is designed to evaluate the effect of He’s Santong needling method on dysphagia after stroke. Methods and Design. Sixty eligible participants will be recruited and randomly assigned into treatment group (He’s Santong needling method and swallowing rehabilitation training) and control group (swallowing rehabilitation training) in a 1:1 ratio. All treatments will be provided everyday on weekdays with a two‐day interval at the weekend, during a total treatment course of four weeks. The Penetration‐Aspiration Scale with Fiberoptic Endoscopic Examination of Swallowing will be assessed at baseline and endpoint (Week 4) as primary outcomes. The Saitoh’s classification score, Swallowing‐Related Quality of Life score, the Modified Mann Assessment of Swallowing Ability score, and Surface Electromyography will be evaluated at baseline and endpoint as secondary outcomes. Ethics and Dissemination. The trial protocol has been approved by the Research Ethical Committee of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University on 9 May 2017 (ethical batch number: 2017BL‐013‐02). Each participant will be notified regarding the study protocol. Written informed consent will be obtained from each participant. Trial Registration. ISRCTN registry: ISRCTN68981054; Registered on 25 September 2017.
Reuse of Waste Energy from Power Plants in Greenhouses through MAS‐Based Architecture
Authors: González-Briones Alfonso , Chamoso Pablo , Rodríguez Sara , Yoe Hyun , Corchado Juan M.
Published: August 2018

Today, most energy‐intensive processes have a high degree of optimization. However, in some of these processes large amounts of energy are inevitably released due to the way in which this energy is used. One of the most obvious examples is produced in the power plants during the process of obtaining electrical energy through the transformation of some kind of energy (chemical, kinetic, thermal, lighting, and nuclear or solar energy, among others). This released energy can be used in other processes that may need it so that no additional energy is needed. One of the possible uses of this energy is its use in greenhouses. Greenhouses need large amounts of energy to recreate the climatic conditions that crops need, which are not those of the weather station. To take advantage of the energy released from the power stations in greenhouses, a system based on agents has been developed that manages energy and allows it to be reused. This paper explains how the system allows us to reuse energy by a power plant and how the agents that integrate the system by means of communication with sensors and actuators and the use of data analysis algorithms allow us to use this energy in greenhouses, providing a reduction of the energy they need without the system. The system has been tested in several greenhouses with a pepper crop.
Transforaminal Epiduroscopic Basivertebral Nerve Laser Ablation for Chronic Low Back Pain Associated with Modic Changes: A Preliminary Open-Label Study
Authors: Kim Hyeun Sung , Adsul Nitin , Yudoyono Farid , Paudel Byapak , Kim Ki Joon , Choi Sung Ho , Kim Jeong Hoon , Chung Sung Kyun , Choi Jeong-Hoon , Jang Jee-Soo , Jang Il-Tae , Oh Seong-Hoon
Published: August 2018

Background. Chronic low back pain (CLBP) arising from degenerative disc disease continues to be a challenging clinical and diagnostic problem whether treated with nonsurgical, pain intervention, or motion-preserving stabilization and arthrodesis. Methods. Fourteen patients with CLBP, greater than 6 months, unresponsive to at least 4 months of conservative care were enrolled. All patients were treated successfully following screening using MRI findings of Modic type I or II changes and positive confirmatory provocative discography to determine the affected levels. All patients underwent ablation of the basivertebral nerve (BVN) using 1414 nm Nd:YAG laser-assisted energy guided in a transforaminal epiduroscopic approach. Macnab’s criteria and visual analog scale (VAS) score were collected retrospectively at each follow-up interval. Results. The mean age was 46 ± 9.95 years. The mean symptoms duration was 21.21 ± 21.87 months. The mean follow-up was 15.3 ± 2.67 months. The preoperative VAS score of 7.79 ± 0.97 changed to 1.92 ± 1.38, postoperatively (P<0.01). As per Macnab’s criteria, seven patients (50%) had excellent, six patients (42.85%) had good, and one patient (7.14%) had fair outcomes. Conclusion. The transforaminal epiduroscopic basivertebral nerve laser ablation (TEBLA) appears to be a promising option in carefully selected patients with CLBP associated with the Modic changes.
An Improved Robust Principal Component Analysis Model for Anomalies Detection of Subway Passenger Flow
Authors: Wang Xuehui , Zhang Yong , Liu Hao , Wang Yang , Wang Lichun , Yin Baocai
Published: August 2018

Subway is an important transportation means for residents, since it is always on schedule. However, some temporal management policies or unpredicted events may change passenger flow and then affect passengers requirement for punctuality. Thus, detecting anomaly event, mining its propagation law, and revealing its potential impact are important and helpful for improving management strategy; e.g., subway emergency management can predict flow change under the condition of knowing specific policy and estimate traffic impact brought by some big events such as vocal concerts and ball games. In this paper, we propose a novel anomalies detection method of subway passenger flow. In this method, an improved robust principal component analysis model is presented to detect anomalies; then ST-DBSCAN algorithm is used to group the station-level anomaly data on space-time dimensions to reveal the propagation law and potential impact of different anomaly events. The real flow data of Beijing subway are used for experiments. The experimental results show that the proposed method is effective for detecting anomalies of subway passenger flow in practices.
Low Cost and High Efficiency Hybrid Architecture Massive MIMO Systems Based on DFT Processing
Authors: Tan Weiqiang , Xu Guixian , De Carvalho Elisabeth , Zhou Mu , Fan Lisheng , Li Chunguo
Published: August 2018

Low cost and high efficiency, defined as energy efficiency (EE) and spectral efficiency (SE), have raised more and more attention in the fifth generation (5G) communication systems due to steadily rising hardware cost, energy consumption, and mobile traffic. This paper studies the hybrid architecture of multiuser massive MIMO systems, where the digital domain utilizes the zero‐forcing (ZF) precoding scheme and the analog domain uses discrete Fourier transform (DFT) processing that significantly reduces hardware cost and energy consumption. We derive analytical expressions on the total achievable SE and EE, as well as offering insight into some engineering parameters in the system performance. Our aim is to achieve low cost and high efficiency massive MIMO system, with constraints on the overall transmit power, the number of users, and the number of radio frequency (RF) chains. Results exhibit that the total achievable SE of the hybrid architectures with DFT precessing is inferior to the full digital architectures and hybrid architectures with the ideal phase shifters, but the performance attenuation can be compensated by providing the more input SNR and higher number of RF chains. Moreover, we find that the total achievable EE of hybrid architectures with DFT precessing outperforms other massive MIMO architectures that include a full digital implementation, ideal phase shifters, and a switched network.
Predictive Value of a Noninvasive Serological Hepatic Fibrosis Scoring System in Cirrhosis Combined with Oesophageal Varices
Authors: Zhang Feiyue , Liu Tong , Gao Pan , Fei Sujuan
Published: August 2018

Objective. In recent years, the noninvasive serological scoring system has become a research hotspot in predicting hepatic fibrosis and has achieved good results. However, it has rarely been applied to the prediction of oesophageal varices. The aim of the study was to evaluate the predictive value of the four following scoring systems in cirrhosis combined with oesophageal varices: aspartate and platelet ratio index (APRI), aspartate aminotransferase-alanine aminotransferase ratio (AAR), FIB-4, and S index. Methods. A total of 153 patients with cirrhosis were categorized into groups with or without oesophageal varices. In addition, cirrhosis patients with oesophageal varices were further divided into mild, moderate, and severe grades. The rank sum test was used to compare the significant differences of APRI, AAR, FIB-4, and S index between the two groups of cirrhosis patients with or without oesophageal varices. A ROC curve was generated to compare the area under the curve of the three groups and to obtain the corresponding optimal prediction value. Moreover, multivariate logistic regression analysis was employed to assess the predictive factors for cirrhosis combined with oesophageal varices. Results. 44 patients had no oesophageal varices and 108 patients had oesophageal varices. Of the 108 patients with oesophageal varices, 43 were mild, 32 were moderate, and 33 were severe. The rank sum test indicated that the APRI, FIB-4, and S index were statistically significant between two groups (P < 0.05), while no significant difference was detected in terms of AAR between the two groups (P > 0.05). In addition, all four scoring systems were statistically significant between nonoesophageal varices group and severe oesophageal varices group (P < 0.05). In the ROC curve of oesophageal varices, the AUC values of APRI, FIB-4, and S index for predicting oesophageal varices were 0.681, 0642, and 0.673, respectively. However, in the ROC curve of severe oesophageal varices, the AUC values of APRI, AAR, FIB-4, and S index were 0.729, 0.648, 0.673, and 0.695, respectively. Multivariate logistic regression analysis indicated that APRI and FIB-4 were predictors of disease progression (P < 0.05). Conclusion. AAR harboured a poor predictive value for oesophageal varices, APRI can be used as a reference index for the prediction of severe oesophageal varices, and the S index harboured potential value in predicting the degree of progression of cirrhosis.
Quaternionic Approach to Dual Magnetohydrodynamics of Dyonic Cold Plasma
Authors: Chanyal B. C. , Pathak Mayank
Published: August 2018

The dual magnetohydrodynamics of dyonic plasma describes the study of electrodynamics equations along with the transport equations in the presence of electrons and magnetic monopoles. In this paper, we formulate the quaternionic dual fields equations, namely, the hydroelectric and hydromagnetic fields equations which are an analogous to the generalized Lamb vector field and vorticity field equations of dyonic cold plasma fluid. Further, we derive the quaternionic Dirac-Maxwell equations for dual magnetohydrodynamics of dyonic cold plasma. We also obtain the quaternionic dual continuity equations that describe the transport of dyonic fluid. Finally, we establish an analogy of Alfven wave equation which may generate from the flow of magnetic monopoles in the dyonic field of cold plasma. The present quaternionic formulation for dyonic cold plasma is well invariant under the duality, Lorentz, and CPT transformations.
Global Dynamics of an SVEIR Model with Age-Dependent Vaccination, Infection, and Latency
Authors: M’pika Massoukou Rodrigue Yves , Oukouomi Noutchie Suares Clovis , Guiem Richard
Published: August 2018

Vaccine-induced protection is substantial to control, prevent, and reduce the spread of infectious diseases and to get rid of infectious diseases. In this paper, we propose an SVEIR epidemic model with age-dependent vaccination, latency, and infection. The model also considers that the waning vaccine-induced immunity depends on vaccination age and the vaccinated individuals fall back to the susceptible class after losing immunity. The model is a coupled system of (hyperbolic) partial differential equations with ordinary differential equations. The global dynamics of the model is established through construction of appropriate Lyapunov functionals and application of Lasalle’s invariance principle. As a result, the global stability of the infection-free equilibrium and endemic equilibrium is obtained and is fully determined by the basic reproduction number R0.