bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring Exchange Rate, Price, and Output Dynamics at the Effective Lower Bound
Authors: Bäurle Gregor , Kaufmann Daniel
Published: October 2018

New Keynesian models with sticky prices make stark predictions about how the economy responds to shocks under different monetary policy regimes when short‐term interest rates are constrained by an effective lower bound. We use the Swiss case as a laboratory to find evidence in favour of these predictions. We propose a Bayesian VAR to estimate impulse responses to risk shocks for short periods with a binding effective lower bound and with a publicly announced minimum exchange rate. In line with predictions from theory, we find that with a binding effective lower bound, the responses of the exchange rate, prices, and output become more persistent. However, the minimum exchange rate attenuates this adverse impact.
Perioperative respiratory adverse event risk assessment in children with upper respiratory tract infection: Validation of the COLDS score
Authors: Lee Lisa K. , Bernardo Marsha Kristel L. , Grogan Tristan R. , Elashoff David A. , Ren Wendy H. P.
Published: October 2018

Background

The decision to proceed with anesthesia and surgery has been controversial in pediatric patients with an upper respiratory tract infection. The COLDS score was proposed by Lee and August as a potential risk stratification scheme, but no validation has been performed on this scale.

Aims

The aim of this study was to evaluate the utility of the COLDS score in predicting perioperative respiratory adverse events and optimize its predictive ability.

Methods

COLDS scores, incidence of perioperative respiratory adverse events, surgical procedure type, and age were prospectively collected for 536 patients who met inclusion criteria. Area under the receiver operating characteristic curves was computed for total COLDS score and individual COLDS score categories. Multivariable regression was used create an optimized score. To quantify the decrease in risk associated with case cancelation due to illness, the other risk factors in COLDS were assessed separately from upper respiratory infection status and a risk model was created.

Results

The area under the receiver operating characteristic curve for the total COLDS score was 0.69, suggesting that the COLDS score has a moderate predictive ability for perioperative respiratory adverse events. When split into individual component scores, the area under the receiver operating characteristic curve ranged from 0.55 to 0.63. We also found that the area under the receiver operating characteristic curve for the scoring system was higher in younger children than for children aged 4‐6 (area under receiver operating characteristic curve of 0.70‐0.71 vs 0.66). The area under the receiver operating characteristic curve for the optimized scoring system was 0.71.

Conclusion

The COLDS score has the potential to be a valuable risk assessment tool for prediction of perioperative respiratory adverse events and appears to have a better predictive value in certain subpopulations.
A retrospective cohort study of children with spinal muscular atrophy type 2 receiving anesthesia for intrathecal administration of nusinersen
Authors: Bielsky Alan R. , Fuhr Peter G. , Parsons Julie A. , Yaster Myron
Published: October 2018

Introduction

Spinal muscular atrophy is characterized by loss of motor neurons in the anterior horn of the spinal cord with resultant proximal muscle weakness. Intrathecal nusinersen has revolutionized the treatment of spinal muscular atrophy. We reviewed the perioperative care of 61 anesthetics performed on eight patients with spinal muscular atrophy type 2 who received nusinersen over 30 months in conjunction with nusinersen's phase 3 clinical trials.

Methods

Anesthesia was induced in all patients with sevoflurane, nitrous oxide, and oxygen (30%) via facemask. A peripheral intravenous line was placed after the loss of consciousness in all but three procedures. General anesthesia was maintained in 58 anesthetics with a propofol infusion at 250‐300 μg/kg/min, while the remainder was maintained with inhalational anesthetics. The airway was managed via facemask or nasal cannula in all but two procedures, in whom a laryngeal mask airway was placed. We analyzed patient demographics, duration of anesthesia and of postanesthesia care unit stay, discharge destination, preprocedure oxygen saturation (SaO2), postanesthesia care unit discharge oxygen saturation, and occurrence of unanticipated admission or postdischarge hospitalization.

Results

Eight American Society of Anesthesiologists physical status three patients (3 male: 5 female) with a median age of 4.1 (2.1‐7.8) years and median weight of 13.2 (10‐24.7) kg, underwent 61 anesthetics for nusinersen administration or sham procedure. There were no intraoperative anesthetic complications of unanticipated cardiovascular instability, major neurologic events, respiratory failure, or death. Anesthesiologists performed 83% of the procedures.

Conclusion

Nusinersen has revolutionized the care of patients with spinal muscular atrophy type 2 and anesthesiologists will be involved in its administration. We found that routine anesthetic care was safe and effective.
Determination of the minimal alveolar concentration of sevoflurane associated with isoelectric electroencephalogram in children: A prospective, randomized, double‐blind study
Authors: He Lin , Wang Xuan , Zheng Shan
Published: October 2018

Objective

We investigated the minimal alveolar concentration (MAC) of sevoflurane associated with the occurrence of isoelectric electroencephalogram in 50% of children under steady‐state conditions (MAC IE). The MAC IE was determined in 100% oxygen and with the addition of 50% nitrous oxide or after the injection of fentanyl.

Methods

Seventy‐two children (ASA I or II, age 3‐8 years) undergoing elective surgery were allocated to one of three groups: in 100% oxygen (group O2), in 50% oxygen and 50% nitrous oxide (group N2O), or in 100% oxygen with a bolus of 3 μg/kg fentanyl (group FENTANYL). The state of isoelectric EEG was considered as significant when a burst suppression ratio of 100% lasted for >1 minute. The MAC IE was determined by the Dixon's up‐and‐down method after a 15‐minute period with a stable endtidal concentration of sevoflurane. The concentration of sevoflurane was determined by the electroencephalogram of the previous patient: increase of 0.2% if isoelectric EEG were absent or decrease of 0.2% if isoelectric EEG were present.

Results

The MAC IE in group O2 (MAC IEO2) was 5.30 (5.12‐5.48)% (median [95% CI]). The MAC IE in group N2O (MAC IEN2O) was 5.83 (5.67‐5.99)%. The MAC IE in group FENTANYL (MAC IEFENTANYL) was 5.37 (5.21‐5.53)%, which was close to MAC IEO2.

Conclusion

The MAC IE of sevoflurane calculated in 100% O2 was 5.30% in children. Addition of 50% N2O modestly increased MAC IE of sevoflurane, while 3 μg/kg fentanyl had no effect on MAC IE of sevoflurane.
Virtual reality for lumbar puncture in a morbidly obese patient with leukemia
Authors: Thomas James J. , Albietz Joseph , Polaner David
Published: October 2018

Virtual reality is an immersive technology that can provide distraction and anxiolysis during painful procedures. While it has been shown to be effective in less invasive procedures, it is underutilized in more invasive procedures. We describe using virtual reality for a morbidly obese patient with leukemia undergoing lumbar puncture. The use of virtual reality reduced the amount of analgesics and anxiolytics and the procedure and recovery times compared with no virtual reality.
Identification and characterization of a new class of Tomato spotted wilt virus isolates that break Tsw‐based resistance in a temperature‐dependent manner
Authors: de Ronde D. , Lohuis D. , Kormelink R.
Published: October 2018

The single dominant Tsw resistance gene from Capsicum chinense against the Tomato spotted wilt orthotospovirus (TSWV) is temperature sensitive, i.e. the resistance fails to function at or above 32 °C. This study describes a new class of temperature‐sensitive resistance‐breaking TSWV isolates that induce Tsw‐mediated resistance at T < 28 °C but at T ≥ 28 °C break this resistance. The NSs genes from these isolates were cloned and expressed to be analysed for RNA silencing suppressor (RSS) activity and the ability to induce a Tsw‐mediated hypersensitive response (HR) in C. chinense and Capsicum annuum (Tsw+). Unlike in viral infection, transient expression of some of the NSs proteins at standard temperatures (22 °C) did not induce Tsw‐mediated HR, although varying degrees of RSS activity were observed. Attempts to express and test the NSs proteins for functionality at an elevated temperature through agroinfiltration remained unsuccessful. The NSs proteins of some TSWV resistance‐breaking (RB) isolates were analysed and found to lack amino acid residues that were previously shown to be important for RNA silencing suppression and avirulence. This study describes a new class of resistance‐breaking TSWV isolates that may be of importance for breeders and growers and for which the underlying mechanism still remains unknown.
The contribution of respiratory microbiome analysis to a treatable traits model of care
Authors: Taylor Steven L. , O'Farrell Hannah E. , Simpson Jodie L. , Yang Ian A. , Rogers Geraint B.
Published: October 2018

The composition of the airway microbiome in patients with chronic airway diseases, such as severe asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and cystic fibrosis (CF), has the potential to inform a precision model of clinical care. Patients with these conditions share overlapping disease characteristics, including airway inflammation and airflow limitation. The clinical management of chronic respiratory conditions is increasingly moving away from a one‐size‐fits‐all model based on primary diagnosis, towards care targeting individual disease traits, and is particularly useful for subgroups of patients who respond poorly to conventional therapies. Respiratory microbiome analysis is an important potential contributor to such a ‘treatable traits’ approach, providing insight into both microbial drivers of airways disease, and the selective characteristics of the changing lower airway environment. We explore the potential to integrate respiratory microbiome analysis into a treatable traits model of clinical care and provide a practical guide to the application and clinical interpretation of respiratory microbiome analysis.
Paradoxical Thinking Interventions: A Paradigm for Societal Change
Authors: Hameiri Boaz , Bar‐Tal Daniel , Halperin Eran
Published: October 2018

Social problems such as intergroup conflicts, prejudice, and discrimination have a significant effect on the world's population. Often, to facilitate constructive solutions to these problems, fundamental attitude change is needed. However, changing the beliefs and attitudes to which people strongly adhere has proven to be difficult, as these individuals resist change. In this article, we offer a new and unconventional approach, termed paradoxical thinking, to promote the change of attitudes relevant to social realities. Paradoxical thinking refers to a process of exposing individuals to amplified, exaggerated, or even absurd messages that are still congruent with their held societal beliefs. In our research program, we focused on the Israeli–Palestinian conflict and found that paradoxical thinking interventions led to attitude moderation among those who were the most adamant in their held attitudes and beliefs, even in the challenging context of a harsh and prolonged intergroup conflict. We then discuss how paradoxical thinking can be utilized to facilitate attitude change in this context and provide two brief examples as preliminary evidence that this approach might work in other important societal contexts, (i.e., attitudes toward refugees and asylum seekers, and gender‐based discrimination), and conclude with policy recommendations.
The retrenchment of public pension provision in the liberal world of welfare during the age of austerity—and its unexpected reversal, 1980–2017
Authors: Bridgen Paul
Published: October 2018

Pension system adaption during the “age of austerity” since 1980 is expected to vary between industrialized countries broadly in line with their membership of conservative, liberal, or social democratic worlds of welfare. Empirical testing on the liberal world focuses on the later period and differs in its conclusions. This paper is based on a systematic study of the scale, nature, and trajectory of change in six liberal pension systems between 1980 and 2017 using expenditure, economic, demographic, and social rights data. These data are analysed using a framework developed through critical engagement with Pierson's three welfare state change criteria and the welfare state “dependent variable problem.” The paper finds a significant retrenchment of public pension provision in most liberal welfare states after 1980 but largely during the first half of the period. This has been partly reversed in most countries since the mid‐1990s, though the scale of this reversal varies between countries. The recent rise of the state in liberal systems has been noted by some commentators, but to be properly understood, the paper argues, it must be considered in the context of the significant retrenchment, which preceded it. There is a scope especially for research on the broader social context of recent reforms, particularly how middle‐income groups were affected by retrenchment and how recent reforms have mitigated this.
Linkage to care and antiretroviral therapy initiation by testing modality among individuals newly diagnosed with HIV in Tanzania, 2014–2017
Authors: Rentsch Christopher T. , Wringe Alison , Machemba Richard , Michael Denna , Urassa Mark , Todd Jim , Reniers Georges , Zaba Basia
Published: October 2018

Objective

To measure linkage to care and antiretroviral therapy (ART) initiation among newly diagnosed individuals with HIV in a rural Tanzanian community.

Methods

We included all new HIV diagnoses of adults made between 2014 and 2017 during community‐ or facility‐based HIV testing and counselling (HTC) in a rural ward in northwest Tanzania. Community‐based HTC included population‐level HIV serological testing (sero‐survey), and facility‐based HTC included a stationary, voluntary HTC clinic (VCT) and an antenatal clinic (ANC) offering provider‐initiated HTC (ANC‐PITC). Cox regression models were used to compare linkage to care rates by testing modality and identify associated factors. Among those in care, we compared initial CD4 cell counts and ART initiation rates by testing modality.

Results

A total of 411 adults were newly diagnosed, of whom 10% (27/265 sero‐survey), 18% (3/14 facility‐based ANC‐PITC) and 53% (68/129 facility‐based VCT) linked to care within 90 days. Individuals diagnosed using facility‐based VCT were seven times (95% CI: 4.5–11.0) more likely to link to care than those diagnosed in the sero‐survey. We found no difference in linkage rates between those diagnosed using facility‐based ANC‐PITC and sero‐survey (P = 0.26). Among individuals in care, 63% of those in the sero‐survey had an initial CD4 count >350 cells/mm3 vs. 29% of those using facility‐based VCT (P = 0.02). The proportion who initiated ART within 1 year of linkage to care was similar for both groups (94% sero‐survey vs. 85% facility‐based VCT; P = 0.16).

Conclusions

Community‐based sero‐surveys are important for earlier diagnosis of HIV‐positive individuals; however, interventions are essential to facilitate linkage to care.
Comparison between the traditional (1997) and revised (2009) WHO classifications of dengue disease: a retrospective study of 30 670 patients
Authors: da Silva Natal Santos , Undurraga Eduardo A. , Verro Alice Tobal , Nogueira Maurício Lacerda
Published: October 2018

Objective

To compare WHO's traditional (1997) and revised (2009) guidelines for dengue classification, using a large sample of patients of all ages with varying clinical conditions from a dengue‐endemic area in Brazil.

Methods

We compared 30 670 laboratory‐confirmed dengue cases (1998–2012) using both WHO's dengue classification guidelines. Stereotype ordinal logistic regressions were used to analyse the association between patients’ demographics and signs and symptoms related to dengue infection severity, as defined in the 1997 and 2009 guidelines. We then compared the degree of agreement in dengue classification of both guidelines.

Results

Dengue signs and symptoms in patients were poorly correlated to disease severity as defined by both guidelines (Cramer's V test <0.2). Hypotensive shock was the exception for both classifications, presenting dependence (Z = 56.42; P < 0.001, and Z = 55.24; P < 0.001) and high agreement (Cramers's V = 1; P < 0.001, and Cramers's V = 0.97; P < 0.001) for WHO 1997 and 2009, respectively. Last, we also found substantial agreement in disease classification between both guidelines (Kendall tau‐b = 0.79; P < 0.001), although 2009 guidelines were more sensitive in the detection of severe cases.

Conclusions

We hope our results will inform the debate about dengue classification guidelines, particularly concerning clinical value, study comparability, and ways in which future guidelines can support the clinical management of dengue. Our results suggest that caution should be taken when using WHO guidelines to assess dengue severity to improve clinical management of patients.
Autoimmune heparin‐induced thrombocytopenia of delayed onset: a clinical challenge
Authors: Kuitunen Anne , Sinisalo Marjatta , Vahtera Annukka , Hiltunen Leena , Javela Kaija , Laine Outi
Published: October 2018

BACKGROUND

Heparin‐induced thrombocytopenia (HIT) usually appears at 5 to 10 days after initiation of heparin. Autoimmune HIT can arise after discontinuation of heparin treatment (delayed‐onset HIT) or without any preceding heparin exposure (spontaneous HIT syndrome).

CASE REPORT

This case presents a course of autoimmune HIT with delayed onset. The patient was hospitalized due to influenza pneumonia and received low‐molecular‐weight heparin thromboprophylaxis for 9 days. Seven days after discharge, she was readmitted because of a cerebral sinus vein thrombosis and severe thrombocytopenia. Intracranial bleeding and brain infarction caused her death.

DISCUSSION

Autoimmune HIT was confirmed by functional heparin‐induced platelet (PLT) activation test. Intracranial bleeding prevented continuous and effective anticoagulation. PLT transfusions were given, although they are generally advised against in HIT patients due to potential risk of thromboembolic events.

CONCLUSION

This case presents that testing PLT‐activating antibodies both in the presence and in the absence of current heparin treatment helps to diagnose patients with autoimmune HIT. There is conflicting evidence to refuse PLT transfusion when HIT is complicated with life‐threatening bleeding.
A variant RhAG protein encoded by the RHAG*572A allele causes serological weak D expression while maintaining normal RhCE phenotypes
Authors: Wen Jizhi , Verhagen Onno J.H.M. , Jia Shuangshuang , Liang Qianni , Wang Zhen , Wei Ling , Luo Hong , Luo Guangping , Vidarsson Gestur , van den Akker Emile , Ji Yanli , van der Schoot C. Ellen
Published: October 2018

BACKGROUND

The molecular events resulting in a weak D phenotype include missense mutations, in‐frame insertion, or deletion mutations of the RHD gene and hybrid RHD‐CE‐D hybrid alleles. Mutations in genes encoding the proteins that are required for proper membrane expression of Rh proteins, such as RhAG and ankyrin 1, can lead to absent or weakened expression of Rh antigens.

STUDY DESIGN AND METHODS

Blood sample from a Chinese blood donor with a serological weak D phenotype was collected. RhAG antigen expression, RhD, and RhCE phenotypes were determined. Analysis of the RHD and RHCE genotypes by RH multiplex ligation‐dependent probe amplification (MLPA), Sanger sequencing of the RHD exons, and next‐generation sequencing (NGS) of the RHAG and ANK1 exons were performed. Expression studies in vitro were conducted by lentivirally transducing the mutant RHAG*572A or wild‐type RHAG, in combination with either RHD or RHCE constructs, into HEK 293 T cells. The expression of RhAG, RhD, and RhCE antigens was analyzed by flow cytometry.

RESULTS

Serological weak D and normal C + c‐ E– e + phenotypes, normal CCDDee genotype determined by RH‐MLPA, and normal sequence of the RHD gene by Sanger sequencing were demonstrated. A homozygous variant (c.572G > A, p.Arg191Gln) of the RHAG gene was revealed by NGS analysis. Normal RhAG, weak RhD, and normal RhCE antigens were detected in cells transduced with the mutant RHAG*572A, the mutant RHAG*572A and RHD, and the mutant RHAG*572A and RHCE constructs, respectively.

CONCLUSION

The homozygous presence of RHAG*572A allele results in weak D expression. It does not affect RhCE expression.
Elevation of extracellular osmolarity improves signs of myotonia congenita in vitro: a preclinical animal study
Authors: Hoppe Kerstin , Chaiklieng Sunisa , Lehmann‐Horn Frank , Jurkat‐Rott Karin , Wearing Scott , Klingler Werner
Published: October 2018

Key points

During myotonia congenita, reduced chloride (Cl−) conductance results in impaired muscle relaxation and increased muscle stiffness after forceful voluntary contraction.

Repetitive contraction of myotonic muscle decreases or even abolishes myotonic muscle stiffness, a phenomenon called ‘warm up’.

Pharmacological inhibition of low Cl− channels by anthracene‐9‐carboxylic acid in muscle from mice and ADR (‘arrested development of righting response’) muscle from mice showed a relaxation deficit under physiological conditions compared to wild‐type muscle.

At increased osmolarity up to 400 mosmol L–1, the relaxation deficit of myotonic muscle almost reached that of control muscle.

These effects were mediated by the cation and anion cotransporter, NKCC1, and anti‐myotonic effects of hypertonicity were at least partly antagonized by the application of bumetanide.

Low chloride‐conductance myotonia is caused by mutations in the skeletal muscle chloride (Cl−) channel gene type 1 (CLCN1). Reduced Cl− conductance of the mutated channels results in impaired muscle relaxation and increased muscle stiffness after forceful voluntary contraction. Exercise decreases muscle stiffness, a phenomena called ‘warm up’. To gain further insight into the patho‐mechanism of impaired muscle stiffness and the warm‐up phenomenon, we characterized the effects of increased osmolarity on myotonic function. Functional force and membrane potential measurements were performed on muscle specimens of ADR (‘arrested development of righting response’) mice (an animal model for low gCl– conductance myotonia) and pharmacologically‐induced myotonia. Specimens were exposed to solutions of increasing osmolarity at the same time as force and membrane potentials were monitored. In the second set of experiments, ADR muscle and pharmacologically‐induced myotonic muscle were exposed to an antagonist of NKCC1. Upon osmotic stress, ADR muscle was depolarized to a lesser extent than control wild‐type muscle. High osmolarity diminished myotonia and facilitated the warm‐up phenomenon as depicted by a faster muscle relaxation time (T90/10). Osmotic stress primarily resulted in the activation of the NKCC1. The inhibition of NKCC1 with bumetanide prevented the depolarization and reversed the anti‐myotonic effect of high osmolarity. Increased osmolarity decreased signs of myotonia and facilitated the warm‐up phenomenon in different in vitro models of myotonia. Activation of NKCC1 activity promotes warm‐up and reduces the number of contractions required to achieve normal relaxation kinetics.
The central amygdala to periaqueductal gray pathway comprises intrinsically distinct neurons differentially affected in a model of inflammatory pain
Authors: Li Jun‐Nan , Sheets Patrick L.
Published: October 2018

Key points

The central nucleus of the amygdala (CeA) encompasses the main output pathways of the amygdala, a temporal lobe structure essential in affective and cognitive dimensions of pain.

A major population of neurons in the CeA send projections to the periaqueductal gray (PAG), a key midbrain structure that mediates coping strategies in response to threat or stress.

CeA‐PAG neurons are topographically organized based on their targeted subregion within the PAG.

PAG‐projecting neurons in the central medial (CeM) and central lateral (CeL) regions of CeA are intrinsically distinct.

CeL‐PAG neurons are a homogeneous population of intrinsically distinct neurons while CeM‐PAG neurons are intrinsically heterogeneous.

Membrane properties of distinct CeM‐PAG subtypes are altered in the complete Freund's adjuvant model of inflammatory pain.

A major population of neurons in the central nucleus of amygdala (CeA) send projections to the periaqueductal gray (PAG), a key midbrain structure that mediates coping strategies in response to threat or stress. While the CeA‐PAG pathway has proved to be a component of descending anti‐nociceptive circuitry, the functional organization of CeA‐PAG neurons remains unclear. We identified CeA‐PAG neurons in C57BL/6 mice of both sexes using intracranial injection of a fluorescent retrograde tracer into the PAG. In acute brain slices, we investigated the topographical and intrinsic characteristics of retrogradely labelled CeA‐PAG neurons using epifluorescence and whole‐cell electrophysiology. We also measured changes to CeA‐PAG neurons in the complete Freund's adjuvant (CFA) model of inflammatory pain. Neurons in the central lateral (CeL) and central medial (CeM) amygdala project primarily to different regions of the PAG. CeL‐PAG neurons consist of a relatively homogeneous population of intrinsically distinct neurons while CeM‐PAG neurons are intrinsically heterogeneous. Membrane properties of distinct CeM‐PAG subtypes are altered 1 day after induction of the CFA inflammatory pain model. Collectively, our results provide insight into pain‐induced changes to a specific population of CeA neurons that probably play a key role in the integration of noxious input with endogenous analgesia and behavioural coping response.
Analytical Prediction of Large Radius Bending by Circular Approximation
Authors: Vorkov Vitalii , Aerens Richard , Vandepitte Dirk , Duflou Joost R.
Published: October 2018

An accurate analytical method is normally the preferred choice in engineering practice since this approach usually does not require additional software and can be applied for different situations. A number of analytical methods have been proposed for the air bending process, however, none of them has the capacity to deal with large radius bending. Large radius bending is characterized by a high ratio of the punch radius to the die opening and it is often applied for high-strength steels because of their limited bendability. This bending mode is used to fulfill the imposed level of maximum strain during the forming process. This contribution develops an analytical solution based on the assumption that the bent plate profile can be represented by two straight lines and a circular segment. Three different hardening laws—linear, Swift, and Aerens—are used for the bending moment calculation. Unit moment measurements are used in order to avoid extrapolation of hardening curves obtained by tensile testing. The model is compared with a wide range of experiments using the coefficient of determination, relative and absolute average errors, in addition to the mean standard error. The analytical prediction based on the circular approximation is found to be an accurate and robust tool for the calculation of the major bending characteristics for large radius air bending of high-strength steels.
Experimental Evaluations of the Relative Contributions to Overall Effectiveness in Turbine Blade Leading Edge Cooling
Authors: Bryant Carol E. , Wiese Connor J. , Rutledge James L. , Polanka Marc D.
Published: October 2018

Gas turbine components are protected through a combination of internal cooling and external film cooling. Efforts aimed at improving cooling are often focused on either the internal cooling or the film cooling; however, the common coolant flow means the internal and external cooling schemes are linked and the coolant holes themselves provide another convective path for heat transfer to the coolant. Measurements of overall cooling effectiveness, ϕ, using matched Biot number models allow evaluation of fully cooled components; however, the relative contributions of internal cooling, external cooling, and convection within the film cooling holes are not well understood. Matched Biot number experiments, complemented by computational fluid dynamics (CFD) simulations, were performed on a fully film cooled cylindrical leading edge model to quantify the effects of alterations in the cooling design. The relative influence of film cooling and cooling within the holes was evaluated by selectively disabling individual holes and quantifying how ϕ changed. Testing of several impingement cooling schemes revealed that impingement has a negligible influence on ϕ in the showerhead region. This indicates that the pressure drop penalties with impingement may not always be compensated by an increase in ϕ. Instead, internal cooling from convection within the holes and film cooling were shown to be the dominant contributors to ϕ. Indeed, the numerous holes within the showerhead region impede the ability of internal surface cooling schemes to influence the outside surface temperature. These results may allow improved focus of efforts on the forms of cooling with the greatest potential to improve performance.
Numerical Analysis of Equivalence Ratio Fluctuations in a Partially Premixed Gas Turbine Combustor Using Large Eddy Simulations
Authors: Wang Ping , Yu Qian , Shrotriya Prashant , Chen Mingmin
Published: October 2018

In the present work, the fluctuations of equivalence ratio in the PRECCINSTA combustor are investigated via large eddy simulations (LES). Four isothermal flow cases with different combinations of global equivalence ratios (0.7 or 0.83) and grids (1.2 or 1.8 million cells) are simulated to study the mixing process of air with methane, which is injected into the inlet channel through small holes. It is shown that the fluctuations of equivalence ratio are very large, and their ranges are [0.4, 1.3] and [0.3, 1.2] for cases 0.83 and 0.7, respectively. For simulating turbulent partially premixed flames in this burner with the well-known dynamically thickened flame (DTF) combustion model, a suitable multistep reaction mechanism should be chosen aforehand. To do that, laminar premixed flames of 15 different equivalence ratios are calculated using three different methane/air reaction mechanisms: 2S_CH4_BFER, 2sCM2 reduced mechanisms and GRI-Mech 3.0 detailed reaction mechanism. The variations of flame temperature, flame speed and thickness of the laminar flames with the equivalence ratios are compared in detail. It is demonstrated that the applicative equivalence ratio range for the 2S_CH4_BFER mechanism is [0.5, 1.3], which is larger than that of the 2sCM2 mechanism [0.5, 1.2]. Therefore, it is recommended to use the 2S_CH4_BFER scheme to simulate the partially premixed flames in the PRECCINSTA combustion chamber.
Foreign Object Damage Behavior of a Silicon Carbide Fibrous Ceramic Composite
Authors: Kedir Nesredin , Calvin Faucett D. , Sanchez Luis , Choi Sung R.
Published: October 2018

The response of a silicon carbide (SiC) fibrous ceramic composite to foreign object damage (FOD) was determined at ambient temperature and velocities ranging from 40 to 150 m/s. Target specimens were impacted, at a normal incidence angle and in a partially supported configuration, using 1.59 mm diameter hardened steel ball projectiles. Qualitative analysis of the damage morphologies of targets and projectiles was made via scanning electron microscopy (SEM). In addition, the extent of impact damage was characterized by determining the post-impact strength of each target specimen as a function of impact velocity. Relative to the as-received (As-R) strength, the fibrous composite showed limited strength degradation due to impact with the maximum reduction of 17% occurring at 150 m/s. A quasi-static analysis of the impact force prediction was also made based on the principle of energy conservation and the results were verified via experimental data.
Airway brush cells: Not as “tuft” as you might think
Authors: Bouchery Tiffany , Marsland Benjamin J.
Published: October 2018

CysLT
3
R regulates expansion of chemosensory brush cells and production of IL-25 in the airways. See related Research Article by

Bankova
et al
.
Amixicile Reduces Severity of Cryptosporidiosis but Does Not Have
In Vitro
Activity against Cryptosporidium
Authors: Bartelt Luther A. , Bolick David T. , Kolling Glynis L. , Stebbins Erin , Huston Christopher D. , Guerrant Richard L. , Hoffman Paul S.
Published: October 2018

Cryptosporidium
species cause significant morbidity in malnourished children. Nitazoxanide (NTZ) is the only approved treatment for cryptosporidiosis, but NTZ has diminished effectiveness during malnutrition.
Role of Capsule in Resistance to Disinfectants, Host Antimicrobials, and Desiccation in Acinetobacter baumannii
Authors: Tipton Kyle A. , Chin Chui-Yoke , Farokhyfar Marjan , Weiss David S. , Rather Philip N.
Published: October 2018

Acinetobacter baumannii
strain AB5075 forms two cell types distinguished by their opaque (VIR-O) or translucent (AV-T) colonies. VIR-O cells possess a thicker capsule and are more resistant to a variety of stressors than AV-T cells.
Prevalence of cystoid macular oedema, epiretinal membrane and cataract in retinitis pigmentosa
Authors: Liew Gerald , Strong Stacey , Bradley Patrick , Severn Philip , Moore Anthony T , Webster Andrew R , Mitchell Paul , Kifley Annette , Michaelides Michel
Published: October 2018

Background/Aims

To report the prevalence of treatable complications (cystoid macular oedema, CME; epiretinal membrane, ERM and cataract) in patients with retinitis pigmentosa (RP).

Methods

Consecutive patients with RP attending a tertiary eye clinic in 2012. Spectral domain-optical coherence tomography was used to determine presence of CME and ERM. Clinic records were reviewed to identify cataract and pseudophakia. Multivariable analyses adjusted for age, gender and other confounders.

Results

Data are presented for 338 eyes from 169 patients. CME was present in 58.6% of patients and 50.9% of eyes and was bilateral in 73.7%. ERM, cataract and pseudophakia were present in 22.8%, 23.4% and 11.2% eyes, respectively. In multivariable analyses, CME was associated with younger age (OR 0.81, 95% CI 0.67 to 0.98) but not with gender. Patients with ERM and cataract/pseudophakia were less likely to also have CME (OR 0.19, 95% CI 0.09 to 0.40 and OR 0.37, 95% CI 0.16 to 0.84, respectively). CME was most prevalent in patients with autosomal-dominant inheritance (71.4%), followed by autosomal recessive/sporadic inheritance (58.9%) and least likely in persons with X linked inheritance (12.5%, p<0.001).

Conclusions

The prevalence of treatable RP complications is high and suggests it may be clinically beneficial to screen patients with RP to identify those who may benefit from current or future interventions.
Virtual outpatient clinic as an alternative to an actual clinic visit after surgical discharge: a randomised controlled trial
Authors: Healy Paul , McCrone Liam , Tully Roisin , Flannery Emer , Flynn Aoife , Cahir Caitriona , Arumugasamy Mayilone , Walsh Thomas
Published: October 2018

Background

It is standard practice to review all patients following discharge at a follow-up clinic but demands on all health services outweigh resources and unnecessary review appointments may delay or deny access to patients with greater needs.

Aims

This randomised trial aimed to establish whether a virtual outpatient clinic (VOPC) was an acceptable alternative to an actual outpatient clinic (OPC) attendance for a broad range of general surgical patients following a hospital admission.

Patients and methods

All patients admitted under one general surgical service over the study period were assessed. If eligible for inclusion the rationale, randomisation and follow-up methods were explained, consent was sought and patients randomised to receive either a VOPC or an OPC appointment.

Results

Two-hundred and nine patients consented to study inclusion, of which 98/107 (91.6%) in the VOPC group and 83/102 (81.4%) in the OPC group were successfully contacted. Only 6 patients in the OPC group and 10 in the VOPC group reported ongoing issues. A further follow-up indicated 78 of 82 (95%) VOPC patients were very happy with their overall experience compared with 34/61 (56%) in the actual OPC group (p<0.001). A significant proportion of both cohorts—68/82 (83%) in VOPC group and 41/61 (67%) in OPC group (p = 0.029)—preferred a VOPC appointment as their future follow-up of choice.

Conclusions

The majority of patients discharged from a surgical service could be better followed up by a virtual clinic with a significant proportion of patients reporting a preference for and a greater satisfaction with such a service.
Ultrasonography of the abdomen in foals
Authors: Magri Massimo
Published: October 2018

Abdominal pathologies in equids are a source of major concern for both owners and veterinary practitioners. When a foal is involved, the situation is more complex because rectal examination is not possible. Abdominal ultrasonography can assist the diagnosis of a wide variety of abdominal disorders from uroperitoneum to colic. This article describes the normal ultrasonographic appearance of structures within the abdominal cavity and some of the pathologies that may arise.
Differential diagnosis and management of haematochezia in dogs and cats
Authors: Keyte Sophie
Published: October 2018

Haematochezia is defined as the passing of fresh blood in the stools, and is a commonly encountered problem in dogs and, more rarely, in cats seen in first‐opinion veterinary practice. This clinical sign causes anxiety to owners and can also indicate a more severe underlying disease, although this is often benign. Thorough history taking is key to narrowing down an extensive list of differential diagnoses; this should include dietary exposure and a thorough clinical examination, including digital rectal examination. This article gives guidelines on the approach to haematochezia as well as on the diagnosis and treatment of the most commonly encountered conditions for which it is a clinical sign.
Comments on the dilemma in the September issue: Pleural effusion in a geriatric cat
Authors: Smith Ben
Published: October 2018

In the dilemma discussed in the September issue of In Practice, Elizabeth Hele described a scenario where you were presented with Ralph, a geriatric cat with a palpable mass and pleural effusion shown on radiographs. He becomes increasingly dyspnoeic and, as his prognosis is poor and he is suffering, you advise immediate euthanasia. Ralph's owner refuses immediate euthanasia stating she wishes for her daughter to be present at the practice when it is carried out. It will take the daughter two to three hours to reach the practice (IP, September 2018, vol 40, pp 310‐311). What do you do?
Cell-based therapy for bronchopulmonary dysplasia in preterm infants
Authors: Guillot Mireille , Offringa Martin , Lacaze-Masmonteil Thierry , Thébaud Bernard
Published: October 2018

Bronchopulmonary dysplasia (BPD) is the most common complication of extreme prematurity. Currently, there is no specific treatment available. Preclinical studies support cell therapy as a promising therapy for BPD in preterm infants. A successful translation to a safe and effective clinical intervention depends on multiple factors including the perspective of neonatal health care providers. A 2-hour workshop with 40 Canadian neonatologists was held to enhance the design of a phase II trial of stem cells for babies at risk for BPD, with a focus on the population to target and the outcomes to measure in such a trial. The consensus was that infants recruited in an early trial of stem cells should be the ones with the highest risk of developing severe BPD. This risk should be established based on known antenatal, perinatal, and postnatal risk factors. The primary outcome in a phase II trial will be focussed on a non-clinical outcome (e.g., a dose-finding study or a safety study). With other aspects of a translational study discussed, this workshop contributed to accelerate the design of a first Canadian clinical cell-therapy study for BPD in preterm infants.
Tricotyledenous giant ragweed (Ambrosia trifida L.)
Authors: Page Eric R. , Meloche Sydney , Bae Jichul , Larsen R. James , Laforest Martin , Nurse Robert E.
Published: October 2018

In this short communication, we report the observation of a tricotyledenous giant ragweed (Ambrosia trifida L.) individual. In contrast to the normal dicotyledenous pattern of phyllotaxy, this individual was observed to express three axillary meristems at each node that intersected the main stem at angles of 120°.
Alternative scenarios for the future of the Canadian boreal zone1
Authors: Steenberg James W.N. , Duinker Peter N. , Creed Irena F. , Serran Jacqueline N. , Ouellet Dallaire Camille
Published: October 2018

In response to global climate change, Canada is transitioning towards a low-carbon economy and the need for policy approaches that are effective, equitable, coordinated, and both administratively and politically feasible is high. One point is clear; the transition is intimately tied to the vast supply of ecosystem services in the boreal zone of Canada. This paper describes four contrasting futures for the boreal zone using scenario analysis, which is a transdisciplinary, participatory approach that considers alternative futures and policy implications under conditions of high uncertainty and complexity. The two critical forces shaping the four scenarios are the global economy’s energy and society’s capacity to adapt. The six drivers of change are atmospheric change, the demand for provisioning ecosystem services, the demand for nonprovisioning ecosystem services, demographics, and social values, governance and geopolitics, and industrial innovation and infrastructure. The four scenarios include: (i) the Green Path, where a low-carbon economy is coupled with high adaptive capacity; (ii) the Uphill Climb, where a low-carbon economy is instead coupled with low adaptive capacity; (iii) the Carpool Lane, where society has a strong capacity to adapt but a reliance on fossil fuels; and (iv) the Slippery Slope, where there is both a high-carbon economy and a society with low adaptive capacity. The scenarios illustrate the importance of transitioning to a low-carbon economy and the role of society’s adaptive capacity in doing so. However, they also emphasize themes like social inequality and adverse environmental outcomes arising from the push towards climate change mitigation.
An Efficient Algorithm for the Construction of the Equation Tree Automaton
Authors: Mignot Ludovic , Ouali-Sebti Nadia , Ziadi Djelloul
Published: October 2018

Champarnaud et al., and Khorsi et al. show how to compute the equation automaton of a word regular expression [Formula: see text] via the C-continuations. Kuske and Meinecke extend the computation of the equation automaton to a regular tree expression [Formula: see text] over a ranked alphabet [Formula: see text] and produce a [Formula: see text] time and space complexity algorithm, where [Formula: see text] is the maximal rank of a symbol occurring in [Formula: see text] and [Formula: see text] is the size of the syntax tree of [Formula: see text]. In this paper, we give a full description of an algorithm based on the acyclic minimization of Revuz in order to compute the pseudo-continuations from the C-continuations. Our algorithm, which is performed in [Formula: see text] time and space complexity, where [Formula: see text] is the number of states of the produced automaton, is more efficient than the one obtained by Kuske and Meinecke since [Formula: see text]. Moreover, our algorithm is an output-sensitive algorithm, i.e. the complexity of which is based on the size of the produced automaton.
From Tree Automata to Rational Tree Expressions
Authors: Guellouma Younes , Cherroun Hadda
Published: October 2018

We propose a construction of rational tree expression from finite tree automata. First, we define rational expression equation systems and we propose a substitution based method to find the unique solution. Furthermore, we discuss the case of recursion being present in an equation system, and then show under which restrictions such systems can effectively be solved. Secondly, we show that any finite tree automaton can be associated to a rational tree equation system, and that the latter can in turn be resolved. Finally, using the previous steps, a rational tree expression equivalent to the underlying automaton is extracted.
DOES INNOVATION ENHANCE PRODUCTIVITY IN CASE OF SELECTED INDIAN MANUFACTURING FIRMS?
Authors: KALE SEENAIAH , RATH BADRI NARAYAN
Published: October 2018

This study examines the effects of innovation on productivity of Indian Manufacturing firms. Despite the voluminous literature on this area, the demanding line, i.e., various types of innovation effects on productivity growth, received little attention particularly in the Indian context; hence, our study fills the gap by employing firm-level data from Hyderabad and Bengaluru cities of India from 2011 to 2013. The estimated results confirm the significant impact of innovation on productivity upsurge in Indian manufacturing firms. Further, we investigate the spatial aspects of innovation considering the two cities separately. However, such city-based analysis does not produce any different findings.
Plasticity of spacetime as an alternative to dark matter
Authors: Feoli Antonio
Published: October 2018

We propose an alternative to the dark matter hypothesis that would explain why the effects of a curvature of spacetime are measured in regions where no electromagnetic radiation is observed. The problem could be solved, assuming a plasticity of spacetime that, in some conditions, can allow a region to remain locally curved even when the mass density has gone away from that region. This way we can observe curvature also in the absence of a local mass density. We apply this idea in a very simple way to the rotation curve of Milky Way showing an agreement between the prediction of the theory and the experimental data. We propose also a different scenario that gives as a result a flat rotation curve. At this stage, our approach is just an idea, not an already complete theory, so many problems remain still unsolved.
Non-minimal torsion-matter coupling and wormhole solutions
Authors: Jawad Abdul , Moradpour H.
Published: October 2018

Taking into account various energy density models in the framework of torsion-based modified theory, some wormhole solutions are derived and studied. We use a non-minimal coupling between matter and torsion in order to construct the wormhole geometry for constant, exponential and Lorentzian energy density models. Two sets of torsion dependent models, including (i) teleparalell case with linear forms of torsion scalar and (ii) a [Formula: see text] gravity with quadratic form of torsion scalar, have been considered throughout this paper. Our study shows that additional terms to the Einstein field equations, due to consider modified gravity, give us the opportunity of obtaining wormhole solutions which may be supported by baryonic sources. We also check the equilibrium phase of the wormhole solutions using anisotropic and hydrostatic forces. The details of the obtained results depend on the numerical values of the free parameters that the function [Formula: see text] holds.