bluuebunny/crossref_metadata_2025 huggingface dataset:
Liver stiffness does not affect ultrasound‐guided attenuation coefficient measurement in the evaluation of hepatic steatosis
Authors: Tada Toshifumi , Kumada Takashi , Toyoda Hidenori , Yasuda Satoshi , Sone Yasuhiro , Hashinokuchi Shinichi , Ogawa Sadanobu , Oguri Takuma , Kamiyama Naohisa , Chuma Makoto , Akita Tomoyuki , Tanaka Junko
Published: October 2019

Aim

Recently, a new method has been developed to diagnose hepatic steatosis with attenuation coefficients based on the ultrasound‐guided attenuation parameter (UGAP). We investigated whether fibrosis identified by hepatic stiffness measurements based on magnetic resonance elastography (MRE) affects attenuation coefficient measurement using UGAP for the evaluation of hepatic steatosis.

Methods

A total of 608 patients with chronic liver disease were analyzed. Correlations between magnetic resonance imaging‐determined proton density fat fraction (PDFF) or MRE value and attenuation coefficients were evaluated. In addition, the interaction between hepatic fibrosis and the attenuation coefficient was analyzed.

Results

The correlation coefficient (r) between PDFF values and attenuation coefficient values was 0.724, indicating a strong relationship. Conversely, the r between MRE values and attenuation coefficient values was −0.187, indicating almost no relationship. In the multiple regression assessment of the effect of PDFF and MRE on the attenuation coefficient based on UGAP, the P‐values for PDFF, MRE, and PDFF × MRE were < 0.001, 0.277, and 0.903, respectively. In patients with non‐alcoholic fatty liver disease (n = 169), the r between PDFF values and attenuation coefficient values was 0.695, indicating a moderate relationship. Conversely, the r between MRE values and attenuation coefficient values was −0.068, indicating almost no relationship. In the multiple regression assessment of the effect of PDFF and MRE on the attenuation coefficient based on UGAP, the P‐values for PDFF, MRE, and PDFF × MRE were <0.001, 0.948, and 0.706, respectively.

Conclusion

UGAP‐determined attenuation coefficient was weakly affected by liver stiffness, an indicator of hepatic fibrosis.
Hypovascular hepatic nodules as a predictive factor for transcatheter arterial chemoembolization refractoriness in hepatocellular carcinoma
Authors: Maesaka Kazuki , Sakamori Ryotaro , Yamada Ryoko , Tahata Yuki , Urabe Ayako , Shigekawa Minoru , Kodama Takahiro , Hikita Hayato , Tatsumi Tomohide , Takehara Tetsuo
Published: October 2019

Aim

Intermediate‐stage hepatocellular carcinoma (HCC) targeted for transcatheter arterial chemoembolization (TACE) corresponds to a highly heterogeneous population for whom the factors predicting TACE efficacy have not been established. This study aimed to evaluate the impact of hypovascular hepatic nodules coexisting with intermediate‐stage HCC as a significant predictive factor for TACE refractoriness.

Methods

A total of 66 patients with intermediate‐stage HCC who received initial TACE were retrospectively analyzed. Hypovascular hepatic nodules were detected by dynamic computed tomography or magnetic resonance imaging, as well as angiography, before all initial TACE. The time to TACE refractoriness (TTTR) was defined as the period from initial TACE until the diagnosis of TACE refractoriness.

Results

Hypovascular hepatic nodules were detected in 36 patients (54.5%), 15 (41.7%) of whom had a single nodule, whereas 21 (58.3%) had multiple nodules, and the median size of the maximum nodule was 10 mm (range 5–80 mm). The median TTTR was 17.4 months for all patients, and 7.3 and 33.1 months for patients with and without hypovascular hepatic nodules, respectively. The TTTR was significantly shorter for patients with hypovascular hepatic nodules than that for the other patients. In the multivariate analysis, the presence of hypovascular hepatic nodules (HR 7.016, 95% CI 3.534–13.930; P < 0.001) and being out of the up‐to‐seven criteria (HR 2.861, 95% CI 1.493–5.486; P = 0.002) were independent risk factors for a short TTTR.

Conclusions

The presence of hypovascular hepatic nodules with intermediate‐stage HCC represents a significant predictive risk factor for TACE refractoriness.
Biosafety risk assessment for production of candidate vaccine viruses to protect humans from zoonotic highly pathogenic avian influenza viruses
Authors: Chen Li‐Mei , Donis Ruben O. , Suarez David L. , Wentworth David E. , Webby Richard , Engelhardt Othmar G. , Swayne David E.
Published: October 2019

A major lesson learned from the public health response to the 2009 H1N1 pandemic was the need to shorten the vaccine delivery timeline to achieve the best pandemic mitigation results. A gap analysis of previous pre‐pandemic vaccine development activities identified possible changes in the Select Agent exclusion process that would maintain safety and shorten the timeline to develop candidate vaccine viruses (CVVs) for use in pandemic vaccine manufacture. Here, we review the biosafety characteristics of CVVs developed in the past 15 years to support a shortened preparedness timeline for A(H5) and A(H7) subtype highly pathogenic avian influenza (HPAI) CVVs. Extensive biosafety experimental evidence supported recent changes in the implementation of Select Agent regulations that eliminated the mandatory chicken pathotype testing requirements and expedited distribution of CVVs to shorten pre‐pandemic and pandemic vaccine manufacturing by up to 3 weeks.
Heparin reversal with protamine sulfate is not required in atrial fibrillation ablation with suture hemostasis
Authors: Yasar Senan J. , Bickel Trent , Zhang Shiyang , Akkaya Mehmet , Aznaurov Sam G. , Krishnan Kousik , Cuculich Phillip S. , Gautam Sandeep
Published: October 2019

Background

The utility of protamine sulfate for heparin reversal in catheter‐based atrial fibrillation (AF) ablation is unclear when using the suture closure technique for vascular hemostasis.

Objective

This study sought to address if protamine sulfate use for heparin reversal reduces vascular access complications in AF catheter ablation when suture techniques are used for postprocedural vascular hemostasis.

Methods

This is a retrospective multicenter observational study of 294 consecutive patients who underwent catheter ablation for AF with subsequent vascular access hemostasis by means of a figure‐of‐eight suture or stopcock technique. A total of 156 patients received protamine for heparin reversal before sheath removal while 138 patients did not receive protamine. The two groups were compared for procedural activated clotting time (ACT), access site complications, and duration of hospital stay.

Results

Baseline demographic characteristics were comparable in both groups. Despite higher ACT before venous sheath removal in patients not receiving protamine (288.0 ± 44.3 vs 153.9 ± 32.0 seconds; P < .001), there was no significant difference in groin complications, postoperative thromboembolic events, or duration of hospital stay between the two groups. Suture failure requiring manual compression was rarely observed in this cohort (0.34%).

Conclusion

With modern vascular access and sheath management techniques, for patients undergoing catheter ablation for AF, simple suture closure techniques can obviate the need for protamine administration to safely achieve hemostasis after removal of vascular sheaths.
Prognostic value of CRTC1‐MAML2 translocation in salivary mucoepidermoid carcinoma: Systematic review and meta‐analysis
Authors: Pérez‐de‐Oliveira Maria Eduarda , Wagner Vivian P. , Araújo Anna Luíza Damaceno , Martins Manoela D. , Santos‐Silva Alan Roger , Bingle Lynne , Vargas Pablo A.
Published: October 2019

The presence of the CRTC1‐MAML2 translocation has been described in mucoepidermoid carcinoma (MEC) as a predictor of better survival rates. However, the real prognostic value of the translocation has been debated due to recent controversial findings. The aim of this study was to perform a systematic review to understand the prognostic potential of the CRTC1‐MAML2 translocation in MEC. An electronic search was carried out using the MEDLINE/PubMed, EMBASE and Scopus databases. Articles that assessed the association between the CRTC1‐MAML2 translocation and survival of MEC patients were selected for the systematic review. Ten published articles were included in the qualitative synthesis. The prevalence of the translocation varied from 33.7% to 69.7%. Seven studies observed a significant association between the presence of the CRTC1‐MAML2 translocation and a favourable clinical outcome, which could improve disease‐free, disease‐specific or overall survival. Five studies were included in the quantitative synthesis. Fixed‐effects model confirmed that translocation‐positive patients have a decreased risk of death (combined odds ratio 0.08, 95% confidence interval – 0.03‐0.23, P < .00001). The detection of the CRTC1‐MAML2 translocation appears to be useful as a prognostic factor in MEC. However, the level of evidence is not as high as it could be once important limitations were found in the published studies.
Development and evaluation of a health‐related quality‐of‐life tool for dogs with Cushing's syndrome
Authors: Schofield Imogen , O'Neill Dan G. , Brodbelt Dave C. , Church David B. , Geddes Rebecca F. , Niessen Stijn J. M.
Published: October 2019

Background

Clinical signs and consequences of Cushing's syndrome are likely to impact upon a dog's life. Quantification of this impact on a dog's health‐related quality‐of‐life (HRQoL) could contribute to optimized disease management.

Hypothesis/objectives

To develop a novel HRQoL tool to aid assessment of dogs with Cushing's syndrome and to evaluate factors that impact upon dogs living with this disease.

Animals

Two hundred and ten dogs with Cushing's syndrome and 617 dogs without Cushing's syndrome.

Methods

Cross‐sectional study design. Dog owners answered questions relating to the HRQoL of their dogs which were refined to develop the final tool. The tool was analyzed for reliability, validity, and interpretability, including Cronbach's alpha and principal components analysis. Factors impacting upon the HRQoL of dogs with Cushing's syndrome were assessed using appropriate nonparametric tests.

Results

The tool was refined from 32 questions to 19 and showed good internal consistency (α = .83). Owners rated questions related to “owner impact” as more important and those related to demeanor as less important. There was a positive correlation between the tool score of dogs with Cushing's syndrome and owner's assessment of their dog's quality‐of‐life (r = .41, P < .001). Dogs currently on treatment with trilostane had a statistically better HRQoL (.33, interquartile range [IQR] .23–.44) than those not receiving trilostane (.36, IQR .33–.54, P = .04).

Conclusions and Clinical Importance

The developed tool quantifies the HRQoL of dogs with Cushing's syndrome and could assist clinicians in the clinical assessment of dogs with Cushing's syndrome.
Circulating neurohormone imbalances in canine sudden acquired retinal degeneration syndrome and canine pituitary‐dependent hypercortisolism
Authors: Oh Annie , Foster Melanie L. , Lunn Katharine F. , Mowat Freya M.
Published: October 2019

Background

Sudden acquired retinal degeneration syndrome (SARDS) has clinical similarity to pituitary‐dependent hypercortisolism (PDH) in dogs. Some studies have identified a greater frequency of SARDS in seasons with reduced daylight hours. Neurohormone imbalances contribute to retinal lesions in other species, warranting further study in dogs with SARDS.

Hypothesis

Dysregulation of circulating melatonin concentration is present in dogs with SARDS but not in dogs with PDH.

Animals

Fifteen client‐owned dogs with spontaneous SARDS (median time of vision loss 18 days), 14 normal dogs, and 13 dogs with confirmed PDH.

Procedures

Prospective case‐control study. ELISA on samples (obtained in the morning) for measurement of plasma melatonin and dopamine, serum serotonin, urine 6‐sulfatoxymelatonin (MT6s), and creatinine. Statistical analysis was performed using 1‐way ANOVA, Spearman correlation and receiver operator characteristic area under the curve analysis.

Results

There were no significant differences in circulating melatonin, serotonin or dopamine concentrations between the 3 groups, although the study was underpowered for detection of significant differences in serum serotonin. Urine MT6s:creatinine ratio was significantly higher in dogs with PDH (4.08 ± 2.15 urine [MT6s] ng/mL per mg of urine creatinine) compared with dogs with SARDS (2.37 ± .51,P < .01), but not compared with normal dogs.

Conclusions and Clinical Relevance

We have identified neurohormone differences between dogs with SARDS and PDH.
High‐dose posaconazole for azole‐resistant aspergillosis and other difficult‐to‐treat mould infections
Authors: Schauwvlieghe Alexander F. A. D. , Buil Jochem B. , Verweij Paul E. , Hoek Rogier A. S. , Cornelissen Jan J. , Blijlevens Nicole M .A. , Henriet Stefanie S. V. , Rijnders Bart J. A. , Brüggemann Roger J. M.
Published: October 2019

Background

Oral follow‐up therapy is problematic in moulds with reduced azole‐susceptibility, such as azole‐resistant Aspergillus fumigatus infection. Currently, only intravenous liposomal amphotericin B (L‐AmB) is advocated by guidelines for the treatment of azole‐resistant aspergillosis infections. Preclinical research indicates that high‐dose posaconazole (HD‐POS) might be a feasible option provided that high drug exposure (ie POS serum through levels >3 mg/L) can be achieved and is safe.

Objectives

To describe our experience with the use of oral HD‐POS as treatment strategies for patients infected with pathogens with a POS MIC close to the clinical breakpoint.

Patients/Methods

We review evidence supporting the use of HD‐POS and describe our experience on safety and efficacy in 16 patients. In addition, we describe the adverse events (AE) observed in 25 patients with POS concentrations at the higher end of the population distribution during treatment with the licensed dose.

Results

Sixteen patients were treated intentionally with HD‐POS for voriconazole‐resistant invasive aspergillosis (7/16), mucormycosis (4/16), salvage therapy for IA (4/16) and IA at a sanctuary site (spondylodiscitis) in 1. Grade 3‐4 AEs were observed in 6, and all of them were considered at least possibly related. Grade 3‐4 AEs were observed in 5 of the 25 patients with spontaneous high POS serum through levels considered at least possibly related using Naranjo scale.

Conclusions

High‐dose posaconazole is a treatment option if strict monitoring for both exposure and for AE is possible.
The effects of different positions on saturation and vital signs in patients
Authors: Alan Nurten , Khorshid Leyla
Published: October 2019

Background

Patient positioning is an independent nursing intervention and may increase peripheral oxygenation for patients with lung disease. Few studies have been conducted on the effect of body positions on oxygenation in patients with lung disease.

Aims and objectives

To investigate the effects of five different positions on peripheral oxygen saturation (SpO2) and vital signs in patients with lung disease.

Design

A semi‐experimental study was conducted.

Methods

Consecutive samples were recorded from critical care patients followed in the chest clinic of a university hospital. A total of 109 patients with lung disease were recruited. Patients who were able to lie in all positions, and who had unilateral or bilateral lung disease documented by a medical diagnosis by a physician were included in this study. The SpO2 and vital signs were measured at each position three times.

Results

For patients with right, left, and bilateral lung disease, lying on the right side of the body at 45 in bed, the SpO2 was higher, but this difference was not statistically significant. There was a significant difference at 40 minutes between the pulse rate in patients with left and bilateral lung disease, but not in patients with right lung disease. No significant differences were found between respiratory rates and body temperature in patients in any of the three groups at 10, 25, and 40 minutes.

Conclusions

Although this difference was not statistically significant, lying on the right side of the body at 45 in bed can be an effective position for improving oxygenation in all patients with lung disease.

Relevance to Clinical Practice

As there is insufficient evidence to suggest a specific position, further studies are needed. This study provides evidence that the best oxygenation in patients with unilateral and bilateral lung disease can be obtained by determining the appropriate position for critical care nurses.
A membrane‐associated NAC domain transcription factor XVP interacts with TDIF co‐receptor and regulates vascular meristem activity
Authors: Yang Jung Hyun , Lee Kwang‐Hee , Du Qian , Yang Shuo , Yuan Bingjian , Qi Liying , Wang Huanzhong
Published: October 2019

Vascular stem cell maintenance is regulated by a peptide signaling involving Tracheary Element Differentiation Inhibitory Factor (TDIF) and Receptor TDR/PXY (Phloem intercalated with Xylem) and co‐receptor BAK1 (BRI1‐associated receptor kinase1). The regulatory mechanism of this signaling pathway is largely unknown despite its importance in stem cell maintenance in the vascular meristem.

We report that activation of a NAC domain transcription factor XVP leads to precocious Xylem differentiation, disruption of Vascular Patterning, and reduced cell numbers in vascular bundles. We combined molecular and genetic studies to elucidate the biological functions of XVP.

XVP is expressed in the cambium, localized on the plasma membrane and forms a complex with TDIF co‐receptors PXY‐BAK1. Simultaneous mutation of XVP and its close homologous NAC048 enhances TDIF signaling. In addition, genetics analysis indicated that XVP promotes xylem differentiation through a known master regulator VASCULAR‐RELATED NAC‐DOMAIN6 (VND6). Expression analyses indicate that XVP activates CLAVATA3/ESR (CLE)‐related protein 44 (CLE44), the coding gene of TDIF, whereas TDIF represses XVP expression, suggesting a feedback mechanism.

Therefore, XVP functions as a negative regulator of the TDIF‐PXY module and fine‐tunes TDIF signaling in vascular development. These results shed new light on the mechanism of vascular stem cell maintenance.
Recommendations for reducing harm and improving quality of care for older people in residential respite care
Authors: Willoughby Melissa , Woolford Marta H. , Young Carmel , Ibrahim Joseph E.
Published: October 2019

Objectives

Residential respite care (RRC) is a vital service that supports older people and their informal caregivers to continue to live in the community. Older people in RRC have an increased risk of injury‐related harm, such as choking and suicide, compared to permanent nursing home residents. However, the opportunities for the prevention of harm during a RRC admission are largely unknown. This study developed recommendations to reduce harm and improve quality of care for older people in RRC.

Methods

Experts developed, refined and prioritised recommendations through two consultation forums applying the modified nominal group technique and a follow‐up online survey. Participants were purposively sampled from an existing network and were selected based on their expertise in aged care practice, nursing, policy, research, caregiver advocacy and quality improvement in the aged and healthcare sectors. Haddon's Matrix, an injury prevention framework, was applied to the recommendations. Final recommendations were released to over 300 organisations for validation and feedback.

Results

Five experts were involved in forum one, seven attended forum two, and a further seven completed the survey. Seventeen draft recommendations were developed and refined to 11 final recommendations, four of which were prioritised as most important for implementation. These included the following: (a) a planned preventative care model of RRC; (b) facilities that specialised in RRC; (c) optimising information gathered on RRC residents; and (d) a standardised procedure for admission, handover and discharge from RRC. We received limited feedback from the organisations, which did not alter the recommendations.

Implications for practice

The recommendations developed in this study provide a valuable basis for the development of strategies to reduce harm and improve care in RRC and are a valuable first step towards improving practice. The next step is to empirically test the suggested recommendations to determine their effectiveness.
Shape variability in tridactyl dinosaur footprints: the significance of size and function
Authors: Lallensack Jens N. , Engler Thomas , Barthel H. JONAS
Published: October 2019

The functional anatomy of the hindlimb of bipedal dinosaurs has been intensively studied. Yet, surprisingly little work has been done concerning functional adaptation of digits for terrestrial locomotion. While complete and articulated pes skeletons are scarce, pes shape is abundantly recorded by fossil footprints. We elucidate the significance of footprint shape and size for locomotion using a large sample (n = 303) of tridactyl dinosaur footprints from a broad range of geographical localities and time slots. Size and shape variation are characterized separately for theropods and ornithischians, the two principal trackmaker taxa. At smaller sizes, theropod footprints are best discriminated from ornithischian footprints by their smaller interdigital angle and larger projection of digit III; at larger sizes digital widths are effective discriminants. Ornithischian footprints increase in size from the Early Jurassic to the Late Cretaceous, a trend not observed in theropod footprints. Size and function are argued to be important determinants of footprint shape, and an attempt made to infer function from shape. Digit III projection and length‐to‐width ratio of the footprints are negatively correlated with size in both groups; digit impression width is positively correlated with size only in ornithischians. Digit III projection appears to be positively correlated with cursorial ability. Increased interdigital angles are associated with a decrease in digital width, possibly an adaptation for stability. Weak digit III projection and increased digital width are interpreted as adaptations for graviportality. Footprints yield great potential for the understanding of the functional morphology of dinosaur feet.
Development and validation of a robust KASP marker for zt2 locus in faba bean (Vicia faba)
Authors: Zanotto Stefano , Vandenberg Albert , Khazaei Hamid
Published: October 2019

Faba bean has the potential to become a key food and feed protein crop in many areas of the world. The presence of tannins in its seed coat has limited the deployment of this crop as feed and food. The expression of either of the two recessive genes, zt1 and zt2, causes a great reduction of tannins from the seed coat and results in a white flower phenotype. Molecular markers linked to these loci are fundamental tools for speeding up the breeding of low‐tannin varieties. The main aim of this study was to develop and validate a robust molecular marker linked to the zt2 locus. We used 176 recombinant inbred lines of the Disco/2 × ILB 938/2 cross at F6 and genotyped those using 257 SNP (single nucleotide polymorphism) markers. An SNP marker associated with zt2 locus was found on faba bean chromosome 3 and was used to develop a high‐throughput low‐cost KASP (kompetitive allele‐specific PCR) marker. The KASP marker can successfully discriminate low‐tannin faba beans carrying zt2 from those carrying zt1 and wild‐type alleles.
The historical argument in early Reformation controversy revisited: the Council of Constance in the writings of Eck and Cochlaeus
Authors: Bagchi David V. N.
Published: October 2019

Pontianus Polman, in his classic study L'élément historique dans la controverse religieuse du XVIe siècle, was critical of the historical abilities of the earliest Catholic opponents of the Reformation, regarding the efforts of the likes of Johann Eck and Johann Cochlaeus as mediocre and superficial. His verdict, that the use of history in religious controversy achieved maturity only much later in the sixteenth century, has proved influential. But a review of Reformation‐era treatments of the Council of Constance (1414–18) shows that Polman underestimated the work of the early Catholic controversialists in this regard. Writing against Luther after the Leipzig Disputation of 1519, Eck emphasized the importance of using primary sources when discussing the decrees of church councils. Cochlaeus, in a series of writings on Constance and the execution of Jan Hus, showed a similar concern for the importance of consulting original documents, of citing them correctly and of quoting them accurately. While one looks in vain to the early controversialists for a recognizably modern, critical approach to history‐writing, we do see a nascent interest in the importance of primary sources, of accurate citation, and a relative openness to new interpretations – the building blocks of history as a critical discipline.
Deprivation of Women and Men Living in a Couple: Sharing or Unequal Division?
Authors: Guio Anne-Cathérine , Van den Bosch Karel
Published: October 2019

In standard poverty analyses, all household members are assumed to share equal living conditions. Though a few national studies exist, this paper is the first to present empirical evidence on this issue for the EU, using the 2015 wave of the EU Statistics on Income and Living Conditions. We map the extent of intra‐couple inequality in deprivation, and analyze its determinants. We find that for most items, the gender difference in lack between partners, though generally small, is significant and at the disadvantage of women. When aggregating the individual items into a deprivation scale, couples where the number of enforced lacks is higher for the woman (9.2 percent) are (significantly) more numerous than couples where the man is disadvantaged (6.5 percent), at the EU level. Econometric analysis shows that the work status of the partners and their relative contribution to the joint income are important determinants of the intra‐couple gender deprivation gap.
Talon cusp in the temporary dentition of a patient with Kabuki syndrome: Case report with a two‐year follow‐up
Authors: Santos Catielma Nascimento , Cardoso Mônica Christine Alves Cabral , Turrioni Ana Paula , Santo Aline Soares Monte , Paranhos Luiz Renato
Published: October 2019

The presence of dental abnormalities in the same individual may be related to syndromic cases and occur through associated systemic changes. Kabuki syndrome presents well‐defined systemic changes, but its clinical characteristics related to the oral cavity have not been fully explained. This study aimed to report the dental changes in a child diagnosed with Kabuki syndrome. A male brown patient aged 2 years and 7 months, accompanied by his mother to the dental visit, they main complaint was the presented of an additional tooth behind upper right central incisor. Anamnesis, intra‐ and extraoral examinations, and dental X‐rays were performed, revealing a talon cusp. Considering the dental clinical findings, the patient was referred to a medical geneticist who additionally requested cardiological and genetic examinations, which established the Kabuki syndrome. The caregivers were advised that the talon cusp would not cause any injury to the natural exfoliation of the tooth and that oral hygiene should be performed carefully. Abnormalities in the oral cavity and developmental delay may be associated with a potential undiagnosed syndrome. The medical evaluation becomes decisive for investigation, diagnosis, and final conduct of the case.
A New, Noninvasive Accelerometric Method for Diagnosing Acid andNon-Acid Gastroesophageal Reflux in Premature Infants: Proof of Concept
Authors: Gewolb Ira H. , Vice Frank L.
Published: October 2019

Non-acid reflux is common in premature neonates. Current methods of diagnosing gastroesophageal reflux (GER) such as pH probes, multichannel impedance monitoring, X-rays, or endoscopy are either invasive or unable to diagnose non-acid reflux. Passage of a naso-esophageal tube is uncomfortable. Imaging studies are of short duration and may miss reflux entirely. Herein, we present proof of concept of a noninvasive accelerometric device that detects acid and non-acid reflux in premature infants. An accelerometer was taped over the subxiphoid process in patients suspected of having GER who were already scheduled for pH probe or multichannel impedance monitoring. The largest cohort was preterm infants, but term infants and toddlers were also studied. Low-frequency subaudible signals were obtained on a digital recorder (sampling rate 200 Hz) signals. Fast Fourier transforms graphically displayed the frequency and amplitude of signals. Data were then resampled at a rate of 60 Hz to create a spectrogram with a focused range of 0–30 Hz representing reflux-associated events. Proof of concept was attained through successful comparison with results from concurrent pH probes, multichannel impedance recordings, and ultrasound studies. We have thus validated accelerometry as a noninvasive method for assessing both acid and non-acid GER. The noninvasiveness of this diagnostic modality allows for repeated testing to assess the efficacy of anti-reflux medications, even when patients remain on antacids. This technology allows for more rational management of patients with GER and represents a major advance in the diagnosis and treatment of GER.
Measured and Simulated Forced Response of a Rotating Turbine Disk With Asymmetric and Cylindrical Underplatform Dampers
Authors: Hoffmann Thomas , Panning-von Scheidt Lars , Wallaschek Jörg
Published: October 2019

The dynamics of turbine blades with underplatform dampers (UPDs) is often experimentally explored by using small test rigs like two-blade models for cost and complexity reasons. In this paper, the dynamics of a large-scale academic turbine disk is measured on a special rotation test rig. Such measurements have rarely been published so far. The test rig supports speeds up to 3600 rpm and turbine disks up to a diameter of 1.2 m. The turbine disk is tested linearly as well as with asymmetric and cylindrical UPDs. The excitation forces and the excitation order are varied. The results prove the damper effectiveness by lowering resonance amplitudes. Additionally, the mistuning influence on the result depiction is discussed. The measurements are compared to simulations of the nonlinear frequency response functions (FRFs), showing good agreement.
Flow Dynamics in a Multiswirler Model Combustor Based on Large Eddy Simulation and Proper Orthogonal Decomposition Analysis
Authors: Liu Weijie , Wang Huiru , Yang Qian , Xue Ranran , Ge Bing , Ji Yongbin
Published: October 2019

Swirling flow is often employed in gas turbine combustion chambers for the sake of improving flame stability. Swirling flow induces not only recirculation zones but also large coherent structures, which show close relationship with flow dynamics and combustion instability. The flow dynamics including precessing vortex core (PVC) in simple swirlers is extensively studied, while the flow instability characteristics in a multiswirler combustor are not fully reported. In this paper, large eddy simulation (LES) of nonreacting turbulent swirling flow is conducted in a multiswirler burner, which comprises a pilot stage and a main stage. Flow dynamics in the multiswirler combustor are analyzed based on phase-averaged evolution of instantaneous flowfield. LES results are compared with particle image velocimetry (PIV) data in terms of mean and root mean square (RMS) velocities. Proper orthogonal decomposition (POD) is employed to identify the coherent structures in the multiswirling flow. Results show that LES results are in good agreement with particle image velocimetry (PIV) data. Main stage and pilot stage flow interact with each other generating highly turbulent swirling flow. PVC is successfully captured at the boundary of main recirculation zone (MRZ) in the pilot stage with a dominant frequency of 1915 Hz. The PVC leads to periodic azimuthal flow instability. POD analyses for the velocity fields show dominant high-frequency modes (modes 1 and 2) in the pilot stage. However, the dominant energetic flow is damped rapidly downstream of the pilot stage that it has little effect on the main stage flow.
Non-Invasive Temperature Measurement for Polyimid-Based Microstructured Devices
Authors: Bobers Jens , Reichmann Felix , Zimmermann Jakob , Kockmann Norbert
Published: October 2019

Besides the common benefits of micro-structured reactors such as enhanced mass and heat transfer caused by a high specific surface and enhanced mixing, they have also drawbacks due to their tiny dimensions. Non-invasive temperature measurement is an important issue for micro process engineering regarding to process control and safety issues. High resolution and robustness are requirements which should be met by the temperature measuring method. Thin film technology combines the possibility to manufacture micro scaled structures with great flexibility in choosing material and geometry of the structures. Layers of aluminum with a thickness in nanometer range are deposited on flexible polyimide foil and structured lithographically to obtain electrical conductor tracks which are used as temperature sensors based on their electrical resistance. The produced temperature sensors were calibrated in the range from 20 to 70 °C and the accuracy of the sensors was checked.
Development of a Manufacturing Process for Polyimide-Based Microstructured Devices Using Reactive Ion Etching
Authors: Bobers Jens , Hesselmann Maurice , Schneider Arndt-Christian , Zimmermann Jakob , Kockmann Norbert
Published: October 2019

Miniaturization and modularization are fast growing fields in chemical engineering in recent years. Fast and flexible production processes for microstructured devices are desirable to meet the requirements of rapid prototyping and flexible chip manufacturing. Reactive ion etching provides a structuring process which leads to a highly precise and anisotropic etching behavior. A new manufacturing process for polyimide-based microstructured devices with low surface roughness was developed and applied on reactor geometry for liquid-liquid two-phase-flow. The fabricated chip geometry is designed for creating droplets via flow focusing as the dispersed phase is incised by two continuous phase inlet streams. The droplets are created in the widening channel. In order to keep the pressure loss for the developed reactor geometry and the production time as small as possible, the manufacturing process was optimized with a view to minimize surface roughness and maximizing the etching rate by using Design of Experiments. The corresponding pressure drop was measured for flow rates from 0.05 ml min−1 to 0.5 ml min−1.
Pressure Drop of Liquid-Liquid Taylor Flow in Mini-Scale Coiled and Curved Tubing
Authors: Adrugi W. , Muzychka Y. S. , Pope K.
Published: October 2019

This paper presents an experimental study on pressure drop using non-boiling liquid-liquid Taylor flow in mini scale coiled and curved tubing. Experiments were carried out to measure the pressure drop characteristics by varying the numbers of turns in coiled tubes and the lengths of curved tubes of less than one turn, such that Dean number, Reynolds number, radius of curvature, and coil pitch were considered. A set of narrow coiled tubes (ID = 1.59 mm, 1.27 mm, 1.016 mm) was used as test sections with different radii of curvature and overall lengths, and thus a different quantity of turns. Water and 1 cSt low viscosity silicone oil were used to create a segmented slug flow. An asymptotic model is developed based on the experimental results and previous models to predict the pressure drop, based on Dean number and dimensionless slug length. The effects of varying tube curvature and tube diameter are also studied. The results provide new insights into the effect of coiling and secondary flow on pressure drop for a liquid-liquid Taylor flow in mini scale systems.
Parametric Study of Vortex Generator Effects in an Additive Manufactured Minichannel Heat Exchanger
Authors: Rastan Hamidreza , Ameel Tim , Palm Björn
Published: October 2019

Heat exchangers with mini- and micro-channel components are capable of high energy exchange due to their incumbent large surface area to volume ratio. Concurrently, recent advances in additive manufacturing simplify the creation of metallic minichannels that incorporate turbulators for heat transfer enhancement. As part of the development of a minichannel heat exchanger with turbulators, this study analyzes the three-dimensional conjugate heat transfer and laminar flow in a minichannel heat exchanger equipped with rectangular winglet vortex generators (VGs) through numerical simulation. The minichannels have a hydraulic diameter of 2.86 mm and are assumed to be made from aluminum alloy AlSi10Mg. This material is one of the popular alloys in the additive manufacturing industry (three-dimensional (3D) printing) because of its light weight and beneficial mechanical and thermal properties. The working fluid is distilled water with temperature-dependent thermal properties. The minichannel is heated by a constant heat flux of 5 W cm−2 and the Reynolds number is varied from 230 to 950. The simulations are performed using the COMSOL® platform, which solves the governing mass, momentum, and energy equations based on the finite element method. The effect of the VG design parameters, which include VG angle of attack, height, length, thickness, longitudinal pitch, and distance from the sidewalls, is investigated. It is found that the generation of three-dimensional vortices caused by the presence of the vortex generators can notably boost the convective heat transfer, at the cost of increased pressure drop, potentially reducing the heat exchanger size for a given heat duty. A sensitivity analysis indicates that the angle of attack, VG height, VG length, and longitudinal pitch have the most significant effects on the heat transfer and flow friction characteristics. In contrast, the VG thickness and distance from the sidewalls only had minor influences on the heat exchanger performance over the studied range of design parameters.
Design and Scale-up of Modular Capillary Helical Flow Inverter Reactors With Narrow Residence Time Distribution
Authors: Kockmann Norbert , Krieger Waldemar , Schmalenberg Mira
Published: October 2019

Lab-on-chip processes often require long dwelling times leading to coiled capillary reactors with laminar flow. These tubular reactors are designed for a reaction time, unfortunately with a wide residence time distribution. This contribution presents a modular concept based on coiled flow inverters (CFI), which achieve high radial mixing with narrow residence time distribution at low Reynolds numbers [1]. The modular design enables quick adaptation to changing residence times and flow rates with low pressure loss. The tube diameters range from capillaries with a few 100 μm to several millimeters for high throughput and long residence time.

With the aid of a design space diagram, the required pipe diameters and lengths can be quickly determined based on standardized coil diameters [2]. The modular concept enables various arrangements for different residence time and flow rate requirements with minimum pressure loss. In the laboratory, for example, a chemical process in the throughput range of a few grams per hour can be developed and processed in the simple device. The results can be scaled via the platform concept to higher production rates with constant residence time characteristics. The scale-up concept can easily be displayed and designed graphically in the reactor performance diagram.
Development of a Hybrid Heat Sink for Thermal Management of Photovoltaic Cells
Authors: Rahman Danish , Almomani Ahmad , Hassan Ibrahim , Al-Hamidi Yasser , Rahman Aziz
Published: October 2019

The objective of this paper is to study the effect of multiple jet impingements on one another in a heat sink under adiabatic conditions. The jet impingement is a unique design which aimed to optimize the cooling performance of a concentrated photovoltaic cell. The paper is based on the design and fabrication of a new 9-celled test section. Initially, to set a baseline, individual cells in the 9-celled test section were tested alone in order to observe their flow regimes. These tests were completed by applying varying water cross flow rates to a set air-water mass flow rate exiting the jet impingement. Afterwards, two cells were tested in conjunction with one another under similar conditions. The location of the cells tested had been varied in order to observe how different cells interact with another. Plug flow and bubbly flow were consistently found through the various experiments. In general, it was noticed at higher crossflow rates the bubble sizes and quantity would decrease drastically.
Performance Analysis of Concentrator Photovoltaic/Microchannel Heat Sink System Using Nanofluid
Authors: Radwan Ali , Awad Mohamed M. , Ookawara Shinichi , Ahmed Mahmoud
Published: October 2019

In this study, the performance of concentrator photovoltaic (CPV) cell enhanced by using double layer microchannel heat sink (DL-MCHS) with nanofluid is investigated. Pure ethanol and 0.2 % Vol. Al2O3-ethanol are utilized to reduce the solar cell temperature under indoor solar concentration ratio of 5.7 Suns. The designed DL-MCHS is monolithically fabricated from Maraging steel using 3D metal printer. The experimental results showed that using parallel flow (PF) operation mode of the designed DL-MCHS is favourable for cooling the CPV system compared with the counter flow (CF) operation mode. In the cooled CPV using PF mode, the open circuit voltage enhancement is about 12.7% in comparison to the uncooled case. The nanofluid results also showed a reduction in the solar cell temperature in comparison with the pure coolant. The current results can be used as a validation step for accurate numerical modelling of nanofluid applications in CPV system cooling.
Zika Virus NS2A-Mediated Virion Assembly
Authors: Zhang Xianwen , Xie Xuping , Xia Hongjie , Zou Jing , Huang Linfen , Popov Vsevolod L. , Chen Xinwen , Shi Pei-Yong
Published: October 2019

ZIKV is a recently emerged mosquito-borne flavivirus that can cause devastating congenital Zika syndrome in pregnant women and Guillain-Barré syndrome in adults. The molecular mechanism of ZIKV virion assembly is largely unknown. Here, we report that ZIKV NS2A plays a central role in recruiting viral RNA, structural protein prM/E, and viral NS2B/NS3 protease to the virion assembly site and orchestrating virion morphogenesis. One mutation that impairs these interactions does not significantly affect viral RNA replication but selectively abolishes virion assembly, demonstrating the specific role of these interactions in virus morphogenesis. We also show that the 3ʹ UTR of ZIKV RNA may serve as a “recruitment signal” through binding to NS2A to enter the virion assembly site. Following a coordinated cleavage of C-prM-E at the virion assembly site, NS2A may present the viral RNA to C protein for nucleocapsid formation followed by envelopment with prM/E proteins. The results have provided new insights into flavivirus virion assembly.
Shielding the Next Generation: Symbiotic Bacteria from a Reproductive Organ Protect Bobtail Squid Eggs from Fungal Fouling
Authors: Kerwin Allison H. , Gromek Samantha M. , Suria Andrea M. , Samples Robert M. , Deoss Dister J. , O’Donnell Kerry , Frasca Salvatore , Sutton Deanna A. , Wiederhold Nathan P. , Balunas Marcy J. , Nyholm Spencer V.
Published: October 2019

Organisms must have strategies to ensure successful reproduction. Some animals that deposit eggs protect their embryos from fouling/disease with the help of microorganisms. Although beneficial bacteria are hypothesized to contribute to egg defense in some organisms, the mechanisms of this protection remain largely unknown, with the exception of a few recently described systems. Using both experimental and analytical approaches, we demonstrate that symbiotic bacteria associated with a cephalopod reproductive gland and eggs inhibit fungi. Chemical analyses suggest that these bacteria produce antimicrobial compounds that may prevent overgrowth from fungi and other microorganisms. Given the distribution of these symbiotic glands among many cephalopods, similar defensive relationships may be more common in aquatic environments than previously realized. Such defensive symbioses may also be a rich source for the discovery of new antimicrobial compounds.
A Bumpy Pathway to Stationary-Phase Survival in Bacillus subtilis
Authors: Nicholson Wayne L.
Published: October 2019

Bacillus subtilis
cells can mount a number of responses to nutritional deprivation but ultimately either form dormant spores or enter a metabolically quiescent state. In a recent article (mBio 10:e01414-19,
https://doi.org/10.1128/mBio.01414-19
, 2019), R. Hashuel and S.
Genome-Wide Transposon Screen of a
Pseudomonas syringae mexB
Mutant Reveals the Substrates of Efflux Transporters
Authors: Helmann Tyler C. , Ongsarte Caitlin L. , Lam Jennifer , Deutschbauer Adam M. , Lindow Steven E.
Published: October 2019

Bacteria use protein pumps to remove toxic compounds from the cell interior, enabling survival in diverse environments. These protein pumps can be highly redundant, making their targeted examination difficult. In this study, we exposed mutant populations of
Pseudomonas syringae
to diverse toxicants to identify pumps that contributed to survival in those conditions. In parallel, we examined pump redundancy by testing mutants of a population lacking the primary efflux transporter responsible for toxin tolerance. We identified partial substrate overlap for redundant transporters, as well as several pumps that appeared more substrate specific. For bacteria that are found in diverse environments, having multiple, partially redundant efflux pumps likely allows flexibility in habitat colonization.
Pharmacologically Aware Phage Therapy: Pharmacodynamic and Pharmacokinetic Obstacles to Phage Antibacterial Action in Animal and Human Bodies
Authors: Dąbrowska Krystyna , Abedon Stephen T.
Published: October 2019

The use of viruses infecting bacteria (bacteriophages or phages) to treat bacterial infections has been ongoing clinically for approximately 100 years. Despite that long history, the growing international crisis of resistance to standard antibiotics, abundant anecdotal evidence of efficacy, and one successful modern clinical trial of efficacy, this phage therapy is not yet a mainstream approach in medicine.
Dectin-2-Targeted Antifungal Liposomes Exhibit Enhanced Efficacy
Authors: Ambati Suresh , Ellis Emma C. , Lin Jianfeng , Lin Xiaorong , Lewis Zachary A. , Meagher Richard B.
Published: October 2019

Invasive fungal diseases caused by
Candida albicans
,
Cryptococcus neoformans
, and
Aspergillus fumigatus
have mortality rates ranging from 10 to 95%. Individual patient costs may exceed $100,000 in the United States. All antifungals in current use have serious limitations due to host toxicity and/or insufficient fungal cell killing that results in recurrent infections. Few new antifungal drugs have been introduced in the last 2 decades. Hence, there is a critical need for improved antifungal therapeutics. By targeting antifungal-loaded liposomes to α-mannans in the extracellular matrices secreted by these fungi, we dramatically reduced the effective dose of drug. Dectin-2-coated liposomes loaded with amphotericin B bound 50- to 150-fold more strongly to
C. albicans
,
C. neoformans
, and
A. fumigatus
than untargeted liposomes and killed these fungi more than an order of magnitude more efficiently. Targeting drug-loaded liposomes specifically to fungal cells has the potential to greatly enhance the efficacy of most antifungal drugs.