bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of the Efficiency of Hydroerosive Grinding Without Renewal of Abrasive Particles
Authors: Della Roverys Coseglio Mario Sergio , Portela Moreira Pâmela , Leonardo Procópio Henrique , Pintaude Giuseppe
Published: July 2015

Hydroerosive grinding is used as a finishing and inlet rounding operation of diesel nozzles to improve the engine performance. A mixture of hard particles suspended in a carrier fluid circulates through the injection holes to remove material until the required flow condition is achieved, although the time to reach this specification increases with time. The aim of this study is to analyze the process efficiency without renewal of solid particles. Results show that the removal efficiency decreased 20% after 150 hrs and this significant loss can be attributed to hydrodynamic interactions, particle size distribution change, and fluid viscosity reduction.
Synthesis of Quasi-Constant Transmission Ratio Planar Linkages
Authors: Figliolini Giorgio , Pennestrì Ettore
Published: July 2015

The present paper deals with the formulation of novel closed-form algorithms for the kinematic synthesis of quasi-constant transmission ratio planar four-bar and slider–crank linkages. The algorithms are specific for both infinitesimal and finite displacements. In the first case, the approach is based on the use of kinematic loci, such as centrodes, inflection circle, and cubic of stationary curvature, as well as Euler–Savary equation. In the second case, the design equations follow from the application of Chebyshev min–max optimality criterion. These algorithms are aimed to obtain, within a given range of motion, a quasi-constant transmission ratio between the driving and driven links. The numerical examples discussed allow a direct comparison of structural errors for mechanisms designed with different methodologies, such as infinitesimal Burmester theory and the Chebyshev optimality criterion.
Inexpensive Vision-Based System for the Direct Measurement of Ankle Stiffness During Quiet Standing
Authors: Chavez-Romero Raul , Cardenas Antonio , Manuel Rendon-Mancha Juan , Vernaza Karinna M. , Piovesan Davide
Published: July 2015

We created a sensor-fusion suite for the acquisition of biometric information that can be used for the estimation of human control strategy in a variety of everyday tasks. This work focuses on the experimental validation of the integrated motion capture subsystem based on raster images. Understanding human control strategies utilized in everyday activity requires measurement of several variables that can be grouped as kinematic, dynamic, and biological-feedback variables. Hence, there is a strong need for the acquisition, analysis, and synchronization of the information measured by a variety of transducers. Our system was able to capture the complex dynamics of a flexible robot by means of two inexpensive web cameras without compromising accuracy. After validating the vision system by means of the robotic device, a direct measure of the center of gravity (COG) position during the recovery from a fall was performed on two groups of human subjects separated by age. The instrumental setup was used to estimate how ankle operational stiffness changes as function of age. The results indicate a statistical increase of stiffness for the older group.
Modeling Viscous Oil Cavitating Flow in a Centrifugal Pump
Authors: Li Wen-Guang
Published: July 2015

Properly modeling cavitating flow in a centrifugal pump is a very important issue for prediction of cavitation performance in pump hydraulic design optimization and application. As a first trial, the issue is explored by using computational fluid dynamics (CFD) method plus the full cavitation model herein. To secure a smoothed head-net positive suction head available (NPSHa) curve, several critical techniques are adopted. The cavitation model is validated against the experimental data in literature. The predicted net positive suction head required (NPSHr) correction factor for viscosity oils is compared with the existing measured data and empirical correlation curve, and the factor is correlated to impeller Reynolds number quantitatively. A useful relation between the pump head coefficient and vapor plus noncondensable gas-to-liquid volume ratio in the impeller is obtained. Vapor and noncondensable gas concentration profiles are illustrated in the impeller, and a “pseudocavitation” effect is confirmed as NPSHa is reduced. The effects of exit blade angle on NPSHr are presented, and the contributions of liquid viscosity and noncondensable gas concentration to the increase of NPSHr at a higher viscosity are identified.
Alternative Environmental Contours for Marine Structural Design—A Comparison Study1
Authors: Vanem Erik , Bitner-Gregersen Elzbieta M.
Published: July 2015

A new approach to estimate environmental contours in the original physical space by direct Monte Carlo simulations rather than applying the Rosenblatt transformation has recently been proposed. In this paper, the new and the traditional approach to estimating the contours are presented and the assumptions on which they are based are discussed. The different results given by these two methods are then compared in a number of case studies. Simultaneous probability density functions are fitted to the joint distribution of significant wave height and wave period for selected ocean locations and environmental contours are estimated for both methods. Thus, the practical consequences of the choice of approach are assessed. Particular attention is given to mixed sea systems. In these situations, the two approaches to environmental contours may be very different while for other wave conditions the contours are similar.
Rolling at Small Scales
Authors: Nielsen Kim L. , Niordson Christian F. , Hutchinson John W.
Published: July 2015

The rolling process is widely used in the metal forming industry and has been so for many years. However, the process has attracted renewed interest as it recently has been adapted to very small scales where conventional plasticity theory cannot accurately predict the material response. It is well-established that gradient effects play a role at the micron scale, and the objective of this study is to demonstrate how strain gradient hardening affects the rolling process. Specifically, the paper addresses how the applied roll torque, roll forces, and the contact conditions are modified by strain gradient plasticity. Metals are known to be stronger when large strain gradients appear over a few microns; hence, the forces involved in the rolling process are expected to increase relatively at these smaller scales. In the present numerical analysis, a steady-state modeling technique that enables convergence without dealing with the transient response period is employed. This allows for a comprehensive parameter study. Coulomb friction, including a stick–slip condition, is used as a first approximation. It is found that length scale effects increase both the forces applied to the roll, the roll torque, and thus the power input to the process. The contact traction is also affected, particularly for sheet thicknesses on the order of 10 μm and below. The influences of the length parameter and the friction coefficient are emphasized, and the results are presented for multiple sheet reductions and roll sizes.
Build Direction Effects on Microchannel Tolerance and Surface Roughness
Authors: Snyder Jacob C. , Stimpson Curtis K. , Thole Karen A. , Mongillo Dominic J.
Published: July 2015

With the advance of additive manufacturing (AM) processes, complex designs can be created with engineering metals. One specific advantage of this greater design space is the ability to create small internal channels and passageways for cooling high heat flux or temperature applications such as electronics and gas turbine airfoils. These applications can have complex shapes, which when coupled with the required small channel sizes, make traditional finishing processes a challenge for additively manufactured parts. Therefore, it is desirable for designers to be able to use AM parts with small internal channels that are as-built. To achieve this goal, however, designers must know how the AM process affects internal channel tolerances and roughness levels, since both impact the amount of cooling that can be achieved in actual applications. In this study, the direct metal laser sintering (DMLS) process, more generically referred to as selective laser melting (SLM), was used to additively manufacture test coupons. The AM build direction was varied to study its effect on small microsized, circular channels. Specifically, X-ray computed tomography (CT-scan) was used to nondestructively inspect the interior of the test coupons. Using the data from the CT-scans, internal surface roughness, geometric tolerances, and deviations from the computer-aided design (CAD) model were calculated. In comparing the data, significant differences were seen between the three different build directions.
Exergy Prediction Model of a Double Pipe Heat Exchanger Using Metal Oxide Nanofluids and Twisted Tape Based on the Artificial Neural Network Approach and Experimental Results
Authors: Mmohammadiun Mohammad , Dashtestani Forough , Alizadeh Mostafa
Published: July 2015

In heat transfer area, researches have been carried out over several years for the development of convective heat transfer enhancement (HTE) techniques. For proper optimization of thermal engineering systems in terms of design and operation, not only the heat transfer has to be maximized but also the exegetic efficiency has to be minimized as well. Present study provides a theoretical, numerical, and experimental investigation of the exergy analysis in a double pipe heat exchanger. For this purpose, metal oxide-water nanofluids and twisted tapes (TTs) are considered as the model fluids and turbulators. Results are verified with well-known correlations. The results show that nanofluids and TTs can increase the exergetic efficiency by 30–100% compared to empty tube and water as a base fluid. In addition, the exergetic efficiency increases with increase in nanoparticles concentration and decreases in twist ratio. CuO nanofluid gives better enhancement in exergetic efficiency than others under the same condition. Since the prediction of exergetic efficiency from experimental process is complex and time-consuming process, an ant colony optimization–back propagation (ACOR–BP) artificial neural networks (ANN) model for identification of the relationship, which may exist between the thermal and flow parameters and exergetic efficiency, have been developed. The network input consists of 11 parameters (C,nf,Cbf,ρbf,ρnf,ϕ,kbf,knf,μbf,μnf,unf,ubf) that crucially dominate the heat transfer process. The results indicate that ACOR–BP ANN provides a high degree of accuracy and reliability. The proposed ANN model can be used to understand how key parameters affect exergetic efficiency without using extensive numerical modeling or experimental studies.
Effect of Oxidation Chemistry of Supercritical Water on Stress Corrosion Cracking of Austenitic Steels
Authors: Gong Bin , Huang Yanping , Jiang E. , Zhao Yongfu , Liu Weiwei , Zhou Zhiru
Published: July 2015

Austenitic steel is a candidate material for supercritical water-cooled reactor (SCWR). This study is to investigate the stress corrosion cracking (SCC) behavior of HR3C under the effect of supercritical water chemistry. A transition phenomenon of the water parameters was monitored during a pseudocritical region by water quality experiments at 650°C and 30 MPa. The stress–strain curves and fracture time of HR3C were obtained by slow strain rate tensile (SSRT) tests in the supercritical water at 620°C and 25 MPa. The concentration of the dissolved oxygen (DO) was 200–1000  μg/kg, and the strain rate was 7.5×10−7/s. The recent results showed that the failure mode was dominated by intergranular brittle fracture. The relations of the oxygen concentration and the fracture time were nonlinear. 200–500  μg/kg of oxygen accelerated the cracking, but a longer fracture time was measured when the oxygen concentration was increased to 1000  μg/kg. Chromium depletion occurred in the oxide layer at the tip of cracks. Grain size increased and chain-precipitated phases were observed in the fractured specimens. These characteristics were considered to contribute to the intergranular SCC.
Detection and analysis of spin signal in spin-labeled poly(l-lysine)
Authors: Naruszewicz Michal , Busiakiewicz Adam , Olejniczak Wielislaw , Pawlowski Slawomir , Gwozdzinski Krzysztof , Grabowski Grzegorz
Published: July 2015

In this paper, the authors present the study of spin-labeled poly(l-lysine) biological molecules (polypeptides) using electron paramagnetic resonance, atomic force microscopy, and electron spin noise-scanning tunneling microscopy. In the presented studies, the authors were able to obtain the information about the local distribution of the spin signal emission, and they registered the spectra for the selected area with nanometer resolution. The preparation method of spin-labeled biopolymer, experimental setup, and the procedure of calibration are also described in detail.
A computational method to predict and study underwater noise due to pile driving
Authors: Schecklman Scott , Laws Nathan , Zurk Lisa M. , Siderius Martin
Published: July 2015

A hybrid modeling approach that uses the parabolic equation (PE) with an empirical source model is presented to study and predict the underwater noise due to pile driving in shallow, inhomogeneous environments over long propagation ranges. The empirical source model uses a phased point source array to simulate the time-dependent pile source. The pile source is coupled with a broadband application of a PE wave propagation model that includes range dependent geoacoustic properties and bathymetry. Simulation results are shown to be in good agreement with several acoustic observations of pile driving in the Columbia River between Portland, OR and Vancouver, WA. The model is further applied to predict sound levels in the Columbia River and study the effects of variable bathymetry and sediment configurations on underwater sound levels.
Effects of subsampling of passive acoustic recordings on acoustic metrics
Authors: Thomisch Karolin , Boebel Olaf , Zitterbart Daniel P. , Samaran Flore , Van Parijs Sofie , Van Opzeeland Ilse
Published: July 2015

Passive acoustic monitoring is an important tool in marine mammal studies. However, logistics and finances frequently constrain the number and servicing schedules of acoustic recorders, requiring a trade-off between deployment periods and sampling continuity, i.e., the implementation of a subsampling scheme. Optimizing such schemes to each project's specific research questions is desirable. This study investigates the impact of subsampling on the accuracy of two common metrics, acoustic presence and call rate, for different vocalization patterns (regimes) of baleen whales: (1) variable vocal activity, (2) vocalizations organized in song bouts, and (3) vocal activity with diel patterns. To this end, above metrics are compared for continuous and subsampled data subject to different sampling strategies, covering duty cycles between 50% and 2%. The results show that a reduction of the duty cycle impacts negatively on the accuracy of both acoustic presence and call rate estimates. For a given duty cycle, frequent short listening periods improve accuracy of daily acoustic presence estimates over few long listening periods. Overall, subsampling effects are most pronounced for low and/or temporally clustered vocal activity. These findings illustrate the importance of informed decisions when applying subsampling strategies to passive acoustic recordings or analyses for a given target species.
Amplitude modulation reduces loudness adaptation to high-frequency tones
Authors: Wynne Dwight P. , George Sahara E. , Zeng Fan-Gang
Published: July 2015

Long-term loudness perception of a sound has been presumed to depend on the spatial distribution of activated auditory nerve fibers as well as their temporal firing pattern. The relative contributions of those two factors were investigated by measuring loudness adaptation to sinusoidally amplitude-modulated 12-kHz tones. The tones had a total duration of 180 s and were either unmodulated or 100%-modulated at one of three frequencies (4, 20, or 100 Hz), and additionally varied in modulation depth from 0% to 100% at the 4-Hz frequency only. Every 30 s, normal-hearing subjects estimated the loudness of one of the stimuli played at 15 dB above threshold in random order. Without any amplitude modulation, the loudness of the unmodulated tone after 180 s was only 20% of the loudness at the onset of the stimulus. Amplitude modulation systematically reduced the amount of loudness adaptation, with the 100%-modulated stimuli, regardless of modulation frequency, maintaining on average 55%–80% of the loudness at onset after 180 s. Because the present low-frequency amplitude modulation produced minimal changes in long-term spectral cues affecting the spatial distribution of excitation produced by a 12-kHz pure tone, the present result indicates that neural synchronization is critical to maintaining loudness perception over time.
A long-duration dihydroorotate dehydrogenase inhibitor (DSM265) for prevention and treatment of malaria
Authors: Phillips Margaret A. , Lotharius Julie , Marsh Kennan , White John , Dayan Anthony , White Karen L. , Njoroge Jacqueline W. , El Mazouni Farah , Lao Yanbin , Kokkonda Sreekanth , Tomchick Diana R. , Deng Xiaoyi , Laird Trevor , Bhatia Sangeeta N. , March Sandra , Ng Caroline L. , Fidock David A. , Wittlin Sergio , Lafuente-Monasterio Maria , Benito Francisco Javier Gamo , Alonso Laura Maria Sanz , Martinez Maria Santos , Jimenez-Diaz Maria Belen , Bazaga Santiago Ferrer , Angulo-Barturen Iñigo , Haselden John N. , Louttit James , Cui Yi , Sridhar Arun , Zeeman Anna-Marie , Kocken Clemens , Sauerwein Robert , Dechering Koen , Avery Vicky M. , Duffy Sandra , Delves Michael , Sinden Robert , Ruecker Andrea , Wickham Kristina S. , Rochford Rosemary , Gahagen Janet , Iyer Lalitha , Riccio Ed , Mirsalis Jon , Bathhurst Ian , Rueckle Thomas , Ding Xavier , Campo Brice , Leroy Didier , Rogers M. John , Rathod Pradipsinh K. , Burrows Jeremy N. , Charman Susan A.
Published: July 2015

The antimalarial drug DSM265 displays activity against blood and liver stages of
Plasmodium falciparum
and has a long predicted half-life in humans.
Plasticity of the human visual system after retinal gene therapy in patients with Leber’s congenital amaurosis
Authors: Ashtari Manzar , Zhang Hui , Cook Philip A. , Cyckowski Laura L. , Shindler Kenneth S. , Marshall Kathleen A. , Aravand Puya , Vossough Arastoo , Gee James C. , Maguire Albert M. , Baker Chris I. , Bennett Jean
Published: July 2015

Imaging reveals increased structural and functional plasticity in human visual pathways after retinal gene therapy.
HLA class II genes modulate vaccine-induced antibody responses to affect HIV-1 acquisition
Authors: Prentice Heather A. , Tomaras Georgia D. , Geraghty Daniel E. , Apps Richard , Fong Youyi , Ehrenberg Philip K. , Rolland Morgane , Kijak Gustavo H. , Krebs Shelly J. , Nelson Wyatt , DeCamp Allan , Shen Xiaoying , Yates Nicole L. , Zolla-Pazner Susan , Nitayaphan Sorachai , Rerks-Ngarm Supachai , Kaewkungwal Jaranit , Pitisuttithum Punnee , Ferrari Guido , McElrath M. Juliana , Montefiori David C. , Bailer Robert T. , Koup Richard A. , O’Connell Robert J. , Robb Merlin L. , Michael Nelson L. , Gilbert Peter B. , Kim Jerome H. , Thomas Rasmi
Published: July 2015

HLA class II modulated the quantity, quality, and efficacy of antibody responses in the RV144 HIV vaccine trial.
Delineating cancer evolution with single-cell sequencing
Authors: Navin Nicholas E.
Published: July 2015

Single-cell sequencing methods are revolutionizing cancer research and medicine by providing powerful tools to investigate intratumor heterogeneity and rare subpopulations.
The Endoplasmic Reticulum Stress Sensor Inositol-Requiring Enzyme 1α Augments Bacterial Killing through Sustained Oxidant Production
Authors: Abuaita Basel H. , Burkholder Kristin M. , Boles Blaise R. , O’Riordan Mary X.
Published: July 2015

Bacterial infection can trigger cellular stress programs, such as the unfolded protein response (UPR), which occurs when misfolded proteins accumulate within the endoplasmic reticulum (ER). Here, we used the human pathogen methicillin-resistant
Staphylococcus aureus
(MRSA) as an infection model to probe how ER stress promotes antimicrobial function. MRSA infection activated the most highly conserved unfolded protein response sensor, inositol-requiring enzyme 1α (IRE1α), which was necessary for robust bacterial killing
in vitro
and
in vivo
. The macrophage IRE1-dependent bactericidal activity required reactive oxygen species (ROS). Viable MRSA cells excluded ROS from the nascent phagosome and strongly triggered IRE1 activation, leading to sustained generation of ROS that were largely Nox2 independent. In contrast, dead MRSA showed early colocalization with ROS but was a poor activator of IRE1 and did not trigger sustained ROS generation. The global ROS stimulated by IRE1 signaling was necessary, but not sufficient, for MRSA killing, which also required the ER resident SNARE Sec22B for accumulation of ROS in the phagosomal compartment. Taken together, these results suggest that IRE1-mediated persistent ROS generation might act as a fail-safe mechanism to kill bacterial pathogens that evade the initial macrophage oxidative burst.

IMPORTANCE
Cellular stress programs have been implicated as important components of the innate immune response to infection. The role of the IRE1 pathway of the ER stress response in immune secretory functions, such as antibody production, is well established, but its contribution to innate immunity is less well defined. Here, we show that infection of macrophages with viable MRSA induces IRE1 activation, leading to bacterial killing. IRE1-dependent bactericidal activity required generation of reactive oxygen species in a sustained manner over hours of infection. The SNARE protein Sec22B, which was previously demonstrated to control ER-phagosome trafficking, was dispensable for IRE1-driven global ROS production but necessary for late ROS accumulation in bacteria-containing phagosomes. Our study highlights a key role for IRE1 in promoting macrophage bactericidal capacity and reveals a fail-safe mechanism that leads to the concentration of antimicrobial effector molecules in the macrophage phagosome.
Antibiotic-Induced Alterations of the Murine Gut Microbiota and Subsequent Effects on Colonization Resistance against Clostridium difficile
Authors: Schubert Alyxandria M. , Sinani Hamide , Schloss Patrick D.
Published: July 2015

Perturbations to the gut microbiota can result in a loss of colonization resistance against gastrointestinal pathogens such asClostridium difficile. AlthoughC. difficileinfection is commonly associated with antibiotic use, the precise alterations to the microbiota associated with this loss in function are unknown. We used a variety of antibiotic perturbations to generate a diverse array of gut microbiota structures, which were then challenged withC. difficilespores. Across these treatments we observed thatC. difficileresistance was never attributable to a single organism, but rather it was the result of multiple microbiota members interacting in a context-dependent manner. Using relative abundance data, we built a machine learning regression model to predict the levels ofC. difficilethat were found 24 h after challenging the perturbed communities. This model was able to explain 77.2% of the variation in the observed number ofC. difficileper gram of feces. This model revealed important bacterial populations within the microbiota, which correlation analysis alone did not detect. Specifically, we observed that populations associated with thePorphyromonadaceae,Lachnospiraceae,Lactobacillus, andAlistipeswere protective and populations associated withEscherichiaandStreptococcuswere associated with high levels of colonization. In addition, a population affiliated with theAkkermansiaindicated a strong context dependency on other members of the microbiota. Together, these results indicate that individual bacterial populations do not drive colonization resistance toC. difficile. Rather, multiple diverse assemblages act in concert to mediate colonization resistance.

IMPORTANCEThe gastrointestinal tract harbors a complex community of bacteria, known as the microbiota, which plays an integral role preventing its colonization by gut pathogens. This resistance has been shown to be crucial for protection againstClostridium difficileinfections (CDI), which are the leading source of hospital-acquired infections in the United States. Antibiotics are a major risk factor for acquiring CDI due to their effect on the normal structure of the indigenous gut microbiota. We found that diverse antibiotic perturbations gave rise to altered communities that varied in their susceptibility toC. difficilecolonization. We found that multiple coexisting populations, not one specific population of bacteria, conferred resistance. By understanding the relationships betweenC. difficileand members of the microbiota, it will be possible to better manage this important infection.
Marjolin's ulcer: a rare entity with a call for early diagnosis
Authors: Iqbal Fahad Mujtaba , Sinha Yashashwi , Jaffe Wayne
Published: July 2015

Marjolin's ulcer (MU) is an umbrella term covering squamous cell carcinoma (SCC), basal cell carcinoma and malignant melanoma that develop in chronic wounds, sinuses or scars. Cutaneous (non-MU) SCC is related to excessive sun-exposure, with Fitzpatrick skin types I and II being more susceptible. Radiation, genetic disorders (eg, Xeroderma pigmentosum) and immunosuppression, are other important risk factors often involved in the development of cutaneous malignancies and may also be involved in the development of MU. MU, first described by Jean-Nicholas Marjolin in 1828, is more aggressive than non-MU SCC, with a higher potential for early metastasis. A high index of suspicion and early histological diagnosis in chronic wounds and unstable scars with recent changes in characteristics offer the best prognosis with treatment. We present a case alongside a literature review contrasting the characteristics of MU and non-MU SCC, and suggest a management plan for early MU identification and prevention.
Subcutaneous fat necrosis causing neonatal hypercalcaemia
Authors: Tuddenham Emma , Kumar Arun , Tarn Anne
Published: July 2015

Hypercalcaemia in neonates is rare and often asymptomatic, but can have significant morbidity. If severe, it can cause symptoms including irritability, vomiting and seizures. We present the case of a baby girl, born at term after a traumatic delivery, who developed severe hypercalcaemia with nephrocalcinosis. She had several large areas of subcutaneous fat necrosis following delivery, with prolonged low-level elevation of C reactive protein. Subcutaneous fat necrosis of the newborn is a rare and underdiagnosed condition, often accompanied by high plasma calcium. Although self-limiting, it is important to recognise and treat this condition to minimise kidney damage, and to avoid unnecessary investigations or treatment with long courses of antibiotics. The infant recovered well, although a degree of nephrocalcinosis remains.
Pemphigus vegetans with coexistent herpes simplex infection and deep venous thrombosis of the lower extremities
Authors: Marchalik Rachel , Reserva Jeave , Plummer Malgorzata Anna , Braniecki Marylee
Published: July 2015

An elderly patient presented with a 4-month history of eroded hypertrophic condylomatous plaques with areas of vesiculation on the groin and lower extremities bilaterally, associated with swelling. Biopsy and immunofluorescence studies confirmed the diagnosis of pemphigus vegetans (PVeg). Further clinical evaluation revealed deep venous thrombosis of the lower extremities and septic shock from secondarily infected pemphigus lesions. Fluid obtained from vesicles was positive for herpes simplex virus (HSV) via PCR-based testing. The patient was therapeutically anticoagulated, treated with high-dose corticosteroid therapy, broad-spectrum intravenous antibiotics and acyclovir. This case represents a constellation of diagnoses not previously described. Although pemphigus vulgaris has been linked to thromboembolic events and has been associated with HSV, these associations have not been previously reported in PVeg. The coexistence of these diseases should encourage vigilance in the clinical work up of a patient with PVeg.
Early mobilisation versus plaster immobilisation of simple elbow dislocations: results of the FuncSiE multicentre randomised clinical trial
Authors: Iordens Gijs I T , Van Lieshout Esther M M , Schep Niels W L , De Haan Jeroen , Tuinebreijer Wim E , Eygendaal Denise , Van Beeck Ed , Patka Peter , Verhofstad Michael H J , Den Hartog Dennis
Published: July 2015

Background/aim

To compare outcome of early mobilisation and plaster immobilisation in patients with a simple elbow dislocation. We hypothesised that early mobilisation would result in earlier functional recovery.

Methods

From August 2009 to September 2012, 100 adult patients with a simple elbow dislocation were enrolled in this multicentre randomised controlled trial. Patients were randomised to early mobilisation (n=48) or 3 weeks plaster immobilisation (n=52). Primary outcome measure was theQuickDisabilities of the Arm, Shoulder, and Hand (Quick-DASH) score. Secondary outcomes were the Oxford Elbow Score, Mayo Elbow Performance Index, pain, range of motion, complications and activity resumption. Patients were followed for 1 year.

Results

Quick-DASH scores at 1 year were 4.0 (95% CI 0.9 to 7.1) points in the early mobilisation group versus 4.2 (95% CI 1.2 to 7.2) in the plaster immobilisation group. At 6 weeks, early mobilised patients reported less disability (Quick-DASH 12 (95% CI 9 to 15) points vs 19 (95% CI 16 to 22); p<0.05) and had a larger arc of flexion and extension (121° (95% CI 115° to 127°) vs 102° (95% CI 96° to 108°); p<0.05). Patients returned to work sooner after early mobilisation (10 vs 18 days; p=0.020). Complications occurred in 12 patients; this was unrelated to treatment. No recurrent dislocations occurred.

Conclusions

Early active mobilisation is a safe and effective treatment for simple elbow dislocations. Patients recovered faster and returned to work earlier without increasing the complication rate. No evidence was found supporting treatment benefit at 1 year.

Trial registration number

NTR 2025.
Proximal muscle rehabilitation is effective for patellofemoral pain: a systematic review with meta-analysis
Authors: Lack Simon , Barton Christian , Sohan Oliver , Crossley Kay , Morrissey Dylan
Published: July 2015

Background

Proximal muscle rehabilitation is commonly prescribed to address muscle strength and function deficits in individuals with patellofemoral pain (PFP). This review (1) evaluates the efficacy of proximal musculature rehabilitation for patients with PFP; (2) compares the efficacy of various rehabilitation protocols; and (3) identifies potential biomechanical mechanisms of effect in order to optimise outcomes from proximal rehabilitation in this problematic patient group.

Methods

Web of Knowledge, CINAHL, EMBASE and Medline databases were searched in December 2014 for randomised clinical trials and cohort studies evaluating proximal rehabilitation for PFP. Quality assessment was performed by two independent reviewers. Effect size calculations using standard mean differences and 95% CIs were calculated for each comparison.

Results

14 studies were identified, seven of high quality. Strong evidence indicated proximal combined with quadriceps rehabilitation decreased pain and improved function in the short term, with moderate evidence for medium-term outcomes. Moderate evidence indicated that proximal when compared with quadriceps rehabilitation decreased pain in the short-term and medium-term, and improved function in the medium term. Limited evidence indicated proximal combined with quadriceps rehabilitation decreased pain more than quadriceps rehabilitation in the long term. Very limited short-term mechanistic evidence indicated proximal rehabilitation compared with no intervention decreased pain, improved function, increased isometric hip strength and decreased knee valgum variability while running.

Conclusions

A robust body of work shows proximal rehabilitation for PFP should be included in conservative management. Importantly, greater pain reduction and improved function at 1 year highlight the long-term value of proximal combined with quadriceps rehabilitation for PFP.
Epidemiology of HEV in the Mediterranean basin: 10-year prevalence in Italy
Authors: Lanini Simone , Garbuglia Anna Rosa , Lapa Daniele , Puro Vincenzo , Navarra Assunta , Pergola Catia , Ippolito Giuseppe , Capobianchi Maria Rosaria
Published: July 2015

Objectives

The present study is aimed at describing the seroprevalence and exploring potential risk factor(s) for hepatitis E virus (HEV) in participants who voluntarily underwent anti-HIV antibody testing.

Study design

Seroprevalence study.

Setting

The HIV prevention unit at the National Institute for Infectious Diseases Lazzaro Spallanzani, serving as a referral centre for HIV infection in Lazio, an Italian Region with about 5.6 million inhabitants.

Participants

Participants are a random sample of all subjects who receive counselling and undergo serological tests for anti-HIV antibody (Ab) between 2002 and 2011.

Risk factors and outcome

A set of 16 epidemiological variables (risk factors) were assessed for association with positivity to anti-HEV IgG (outcome).

Results

Between 2002 and 2011, 27 351 serum specimens and related epidemiological information were collected; of these 1116 were randomly selected and analysed. The overall anti-HEV IgG prevalence was 5.38% (60 out of 1116) with evidence of potential heterogeneity between years of sampling (p=0.055). Multivariate analysis provided evidence that anti-HEV IgG prevalence increases by 4% per year of participants’ age (95% CI 1% to 7%, p=0.002). In addition, men who have sex with men and participants who were born outside Italy have an OR for past HEV infection that is about two times higher than in those who were not (p=0.040 and p=0.027, respectively). Analysis of temporal trend showed that variation of anti-HEV IgG can be well explained by a cubic logistic regression model, which describes the variation of prevalence over time as a fluctuation within a 3-year period (p=0.032).

Conclusions

This study provides new evidence that besides the orofecal and zoonotic routes, intimate contacts between males may be a significant mode of HEV transmission.
Barriers to uptake among high-risk individuals declining participation in lung cancer screening: a mixed methods analysis of the UK Lung Cancer Screening (UKLS) trial
Authors: Ali Noor , Lifford Kate J , Carter Ben , McRonald Fiona , Yadegarfar Ghasem , Baldwin David R , Weller David , Hansell David M , Duffy Stephen W , Field John K , Brain Kate
Published: July 2015

Objective

The current study aimed to identify the barriers to participation among high-risk individuals in the UK Lung Cancer Screening (UKLS) pilot trial.

Setting

The UKLS pilot trial is a randomised controlled trial of low-dose CT (LDCT) screening that has recruited high-risk people using a population approach in the Cambridge and Liverpool areas.

Participants

High-risk individuals aged 50–75 years were invited to participate in UKLS. Individuals were excluded if a LDCT scan was performed within the last year, if they were unable to provide consent, or if LDCT screening was unable to be carried out due to coexisting comorbidities.

Outcome measures

Statistical associations between individual characteristics and UKLS uptake were examined using multivariable regression modelling. In those who completed a non-participation questionnaire (NPQ), thematic analysis of free-text data was undertaken to identify reasons for not taking part, with subsequent exploratory linkage of key themes to risk factors for non-uptake.

Results

Comparative data were available from 4061 high-risk individuals who consented to participate in the trial and 2756 who declined participation. Of those declining participation, 748 (27.1%) completed a NPQ. Factors associated with non-uptake included: female gender (OR=0.64, p<0.001), older age (OR=0.73, p<0.001), current smoking (OR=0.70, p<0.001), lower socioeconomic group (OR=0.56, p<0.001) and higher affective risk perception (OR=0.52, p<0.001). Among non-participants who provided a reason, two main themes emerged reflecting practical and emotional barriers. Smokers were more likely to report emotional barriers to participation.

Conclusions

A profile of risk factors for non-participation in lung screening has emerged, with underlying reasons largely relating to practical and emotional barriers. Strategies for engaging high-risk, hard-to-reach groups are critical for the equitable uptake of a potential future lung cancer screening programme.

Trial registration number

The UKLS trial was registered with the International Standard Randomised Controlled Trial Register under the reference 78513845.
Improving the quality of handover by addressing handover culture and introducing a new, multi-disciplinary, team-based handover meeting
Authors: Walton Henry , Munro Wendy
Published: July 2015

Handover is a "major preventable cause of patient harm"[1] and this project aims to improve the quality of night handover within a teaching hospitals general medicine department, resulting in the safe transfer of patient care to the night team.

Quality of handover was assessed both qualitatively, via structured qualitative interviews with trainees and a baseline survey assessing doctor's opinions of night handover, and quantitatively through the collection of a data set during regular observation of night handover.

The initial intervention instituted a new handover meeting with a set time and new location and invited the night nurse practitioner to attend. A prompt card, standardised documentation, defined leadership, and an attendance register were also introduced. Successive PDSA cycles introduced technology to the intervention, enabled the nurse night practitioners to actually attend and re-branded the prompt card as an agenda.

Results show a sustained reduction in length of handover from 70 minutes (n=7) to 34 minutes (n=13) post-intervention as well as a reduction in the number of distractions occurring during each handover from a mean of 14 to a mean of 8.5. An improved quality of handover was also demonstrated with an overall increase in the percentage of task handovers containing hospital number, an admitting diagnosis, comorbidities and a time allocated for the task to be performed of at least 10%. When trainees were surveyed post-implementation they unanimously identified the new handover system as safer than the previous handover process (n=30).

This project demonstrates that replacing an ad-hoc system of handover with a multi-disciplinary, team based approach to handover improves handover quality. In addition it provides a useful guide to introducing a new handover meeting to a department and contains useful lessons on how to combat cultural barriers to change within a department.
Histone H3K4 trimethylation: dynamic interplay with pre-mRNA splicing
Authors: Davie James R. , Xu Wayne , Delcuve Genevieve P.
Published: July 2015

Histone H3 lysine 4 trimethylation (H3K4me3) is often stated as a mark of transcriptionally active promoters. However, closer study of the positioning of H3K4me3 shows the mark locating primarily after the first exon at the 5′ splice site and overlapping with a CpG island in mammalian cells. There are several enzyme complexes that are involved in the placement of the H3K4me3 mark, including multiple protein complexes containing SETD1A, SETD1B, and MLL1 enzymes (writers). CXXC1, which is associated with SETD1A and SETD1B, target these enzymes to unmethylated CpG islands. Lysine demethylases (KDM5 family members, erasers) demethylate H3K4me3. The H3K4me3 mark is recognized by several proteins (readers), including lysine acetyltransferase complexes, chromatin remodelers, and RNA bound proteins involved in pre-mRNA splicing. Interestingly, attenuation of H3K4me3 impacts pre-mRNA splicing, and inhibition of pre-mRNA splicing attenuates H3K4me3.
Screening of ligninolytic fungi for biological pretreatment of lignocellulosic biomass
Authors: Xu Chunyan , Singh Deepak , Dorgan Kathleen M. , Zhang Xiaoyu , Chen Shulin
Published: July 2015

To identify white rot fungi with high potential in biological pretreatment of lignocellulosic biomass, preliminary screening was carried out on plates by testing different strains for their ability to oxidize guaiacol and decolorize the dyes azure B and Poly R-478. Of the 86 strains screened, 16 were selected for secondary screening for their ligninolytic ability; however, low manganese peroxidase activity and no lignin peroxidase activity were detected. Strain BBEL0970 proved to be the most efficient in laccase production and was subsequently identified as Trametes versicolor by analysis of the ribosomal DNA internal transcribed spacer gene sequence. In combining laccase production with biological pretreatment, the replacement of glucose with barley straw significantly improved the laccase activity by up to 10.3 U/mL, which provided evidence toward potential utilization of barley straw in laccase production by BBEL0970. Simultaneously, comparison by thermogravimetric analysis of the untreated and pretreated barley straw in liquid fermentation of laccase also demonstrated the high potential of BBEL0970 in biological pretreatment of lignocellulosic biomass. This work sheds light on further exploration on the integrated process of low-cost laccase production and efficient biological pretreatment of barley straw by T. versicolor BBEL0970.
Existence of finite bases for quasi-equations of unary algebras with 0
Authors: Casperson D. , Hyndman J. , Mason J. , Nation J. B. , Schaan B.
Published: July 2015

A finite unary algebra of finite type with a constant function 0 that is a one-element subalgebra, and whose operations have range {0, 1}, is called a {0, 1}-valued unary algebra with 0. Such an algebra has a finite basis for its quasi-equations if and only if the relation defined by the rows of the nontrivial functions in the clone form an order ideal.
Bayesian Analysis for Burr-XII Masked System in Step-Stress Partially Accelerated Life Test Under Type-I Progressive Hybrid Censoring
Authors: Cai Jing , Shi Yimin , Liu Bin
Published: July 2015

This paper discusses the reliability analysis for a series system in step-stress partially accelerated lifetime test under Type-I progressive hybrid censoring, where independent Burr-XII distributed lifetimes are assumed for the components. In many cases, the exact component causing the system failure cannot be identified and the cause of failure is masked. Bayesian approach combined with auxiliary variables is applied for estimating the parameters of the model when the masking probability is dependent on the component. Further, the reliability and hazard rate functions of the system and components are estimated under use stress level. Simulation studies are performed to demonstrate the efficiency of the methods proposed in this paper under different masking probabilities and different progressive removal schemes.
Strong Separativity over Regular Rings
Authors: Chen Huanyin
Published: July 2015

An ideal I of a ring R is strongly separative provided that for all finitely generated projective R-modules A, B with A=AI and B=BI, if 2A ≅ A ⊕ B, then A ≅ B. We prove in this paper that a regular ideal I of a ring R is strongly separative if and only if each a ∈ 1+I satisfying (1-a)R ∝ r(a) is unit-regular, if and only if each a ∈ 1+I satisfying (1-a2)R ∝ r(a2) is unit-regular, if and only if each a ∈ 1+I satisfying R(1-a)R=R r(a) is unit-regular, if and only if each a ∈ 1+I satisfying R(1-a2)R=R r(a2) is unit-regular.
Gorenstein Injective and Injective Complete Cohomological Dimensions of Groups
Authors: Bahlekeh Abdolnaser
Published: July 2015

Using Nucinkis's injective complete cohomological functors, we assign a numerical invariant to each group Γ, called the injective complete cohomological dimension of Γ, denoted by iccd Γ. We study this dimension and investigate its properties. Also, we define the Gorenstein injective dimension of the group Γ, which is denoted by Gid Γ. We show that Gid Γ is related to iccd Γ, as well as to spli and silp invariants of Gedrich and Gruenberg. In particular, it is shown that iccd Γ is a refinement of Gid Γ. In addition, we show that silp Γ = spli Γ < ∞ if and only if the Shapiro lemma holds for injective complete cohomology.
The missing complexity in seismically imaged normal faults: what are the implications for geometry and production response?
Authors: Wood Alan M. , Paton Douglas A. , Collier Richard E. Ll.
Published: July 2015

The impact of geometric uncertainty on across-fault flow behaviour at the scale of individual intra-reservoir faults is investigated in this study. A high resolution digital elevation model (DEM) of a faulted outcrop is used to construct an outcrop-scale geocellular grid capturing high-resolution fault geometries (5 m scale). Seismic forward modelling of this grid allows generation of a 3D synthetic seismic cube, which reveals the corresponding seismically resolvable fault geometries (12.5 m scale). Construction of a second geocellular model, based upon the seismically resolvable fault geometries, allows comparison with the original outcrop geometries. Running fluid flow simulations across both models enables us to assess quantitatively the impact of outcrop resolution v. seismic resolution fault geometries upon across-fault flow. The results suggest that seismically resolvable fault geometries significantly underestimate the area of across-fault juxtaposition relative to realistic fault geometries. In turn this leads to overestimates in the sealing ability of faults, and inaccurate calculation of fault plane properties such as transmissibility multipliers (TMs).
Exercise training improves conduit vessel function in patients with coronary artery disease
Authors: Walsh Jennifer H. , Bilsborough William , Maiorana Andrew , Best Matthew , O'Driscoll Gerard J. , Taylor Roger R. , Green Daniel J.
Published: July 2015

It is well established that endothelial dysfunction is present in coronary artery disease (CAD), although few studies have determined the effect of training on peripheral conduit vessel function in patients with CAD. A randomized, crossover design determined the effect of 8 wk of predominantly lower limb, combined aerobic and resistance training, in 10 patients with treated CAD. Endothelium-dependent dilation of the brachial artery was determined, by using high-resolution vascular ultrasonography, from flow-mediated vasodilation (FMD) after ischemia. Endothelium-independent vasodilation was measured after administration of glyceryl trinitrate (GTN). Baseline function was compared with that of 10 control subjects. Compared with matched healthy control subjects, FMD and GTN responses were significantly impaired in the untrained CAD patients [3.0 ± 0.8 (SE) vs. 5.8 ± 0.8% and 14.5 ± 1.9 vs. 20.4 ± 1.5%, respectively; both P < 0.05]. Training significantly improved FMD in the CAD patients (from 3.0 ± 0.8 to 5.7 ± 1.1%; P < 0.05) but not responsiveness to GTN (14.5 ± 1.9 vs. 12.1 ± 1.4%; P = not significant). Exercise training improves endothelium-dependent conduit vessel dilation in subjects with CAD, and the effect, evident in the brachial artery, appears to be generalized rather than limited to vessels of exercising muscle beds. These results provide evidence for the benefit of exercise training, as an adjunct to routine therapy, in patients with a history of CAD.