bluuebunny/crossref_metadata_2025 huggingface dataset:
Severity strata for five patient-reported outcomes in adults with atopic dermatitis
Authors: Vakharia P.P. , Chopra R. , Sacotte R. , Patel N. , Immaneni S. , White T. , Kantor R. , Hsu D.Y. , Simpson E.L. , Silverberg J.I.
Published: October 2017

Background

Several patient-reported outcomes have been used to assess the burden of atopic dermatitis (AD). Some are disease specific, such as the Patient-Oriented Eczema Measure (POEM), while others pertain to itch, for example the numerical rating scale (NRS)-itch, ItchyQoL and 5-D itch, or dermatological disease in general, for example the Dermatology Life Quality Index (DLQI). Development of severity strata is essential for proper interpretability of these assessments.

Objectives

To confirm previously developed strata for POEM, DLQI and raw ItchyQoL, and develop strata for the NRS-itch, mean ItchyQoL and 5-D itch scale for use in adults with AD.

Methods

Self-administered questionnaires were completed by 210 adults with AD in a dermatology practice setting. Strata were selected using an anchoring approach based on patient-reported disease severity.

Results

We confirmed the existing strata for POEM (mild 0–7, moderate 8–16, severe 17–28; κ = 0·440), DLQI (mild 0–5, moderate 6–10, severe 11–30; κ = 0·398) and NRS-itch (mild 0–3, moderate 4–6, severe 7–10; κ = 0·499). However, the preferred band for raw ItchyQoL was mild 22–58, moderate 59–74 and severe 75–110 (κ = 0·379) and for mean ItchyQoL, mild 1–2·9, moderate 3·0–3·9, severe 4·0–5·0 (κ = 0·374). The preferred band for 5-D itch scale was mild 0–11, moderate 12–17 and severe 18–25 (κ = 0·331).

Conclusions

Existing strata for POEM and DLQI performed well in adult AD. Previously reported strata for visual analogue scale-itch performed best for NRS-itch. We identified banding for the raw ItchyQoL for our AD population that varies slightly from the banding published for a more heterogeneous population. Finally, we proposed strata for mean ItchyQoL and 5-D itch scale in adult AD.
How I manage relapse of chronic myeloid leukaemia after stopping tyrosine kinase inhibitor therapy
Authors: Rea Delphine , Mahon François‐Xavier
Published: October 2017

During the last 10 years, clinical trials formally demonstrated that about 50% of patients with chronic phase (CP) chronic myeloid leukaemia (CML) who achieve and maintain deep molecular responses for a prolonged period of time during treatment with imatinib or new generation tyrosine kinase inhibitors (TKIs) may successfully stop their anti‐leukaemic therapy. Based on the accumulated knowledge from abundant clinical trial experience, TKI discontinuation is becoming an important goal to achieve and is about to enter clinical practice. This review focuses on relapse definition, laboratory tests to identify relapse and relapse management after TKI discontinuation.
Brief workshops to teach drug and alcohol first aid: A pilot evaluation study
Authors: Kostadinov Victoria R. , Roche Ann M. , McEntee Alice , Allan Julaine M. , Meumann Nicholas R. , McLaughlin Lara L.
Published: October 2017

Introduction and Aims

Health and community service workers frequently encounter people with alcohol and other drug (AOD) problems in the course of their work, yet few have had training on how to respond effectively. A Drug and Alcohol First Aid workshop was developed by Lyndon, a non‐government organisation treatment provider, and delivered to community and health sector workers and the general public. It presented evidence‐based information regarding AOD use and harm reduction and treatment options. A pilot evaluation of the workshop was conducted to assess changes in participants’ knowledge about AOD, methods of responding to use and attitudes towards individuals who use AOD, over a 3 month period.

Design and Methods

A self‐report evaluation survey was developed and administered to workshop participants at three time points: before (T1), immediately after (T2) and 3 months after the workshop (T3). Paired samples t‐tests examined changes in knowledge, role adequacy, motivation and personal views.

Results

A total of 142 participants completed the T1 survey, 184 completed the T2 survey and 98 completed the T3 survey. Between T1 and T2, there were significant increases in scores for knowledge and role adequacy, indicating significant improvements in these areas. No significant differences were found for motivation and personal views. At T3, knowledge and role adequacy scores remained significantly higher than at baseline.

Discussion and Conclusions

Drug and Alcohol First Aid appears to be a viable initiative to improve AOD‐related knowledge and role adequacy. However, alternative strategies may be required to shift negative attitudes towards individuals who use AOD. [Kostadinov VR, Roche AM, McEntee A, Allan JM, Meumann NR, McLaughlin LL. Brief workshops to teach drug and alcohol first aid: A pilot evaluation study. Drug Alcohol Rev 2018;37:23–27]
TO DETER OR TO MODERATE? ALLIANCE FORMATION IN CONTESTS WITH INCOMPLETE INFORMATION
Authors: Konrad Kai A. , Morath Florian
Published: October 2017

We consider two players' choice about the formation of an alliance ahead of conflict in a framework with incomplete information about the strength of the potential ally. When deciding on alliance formation, players anticipate the self‐selection of other players and the informational value of own and other players' choices. In the absence of these signaling effects, strong players have an incentive to stand alone, which leads to a separating equilibrium. This separating equilibrium can be destabilized by deception incentives if beliefs are updated on the basis of endogenous alliance formation choices. Weak players may find it attractive to appear strong in order to deter competitors from positive effort choices. Strong players may find it attractive to appear weak in order to give their competitors a false sense of security and then beat them with little effort. Moreover, appearing weak allows players to free‐ride when alliances are formed. (JEL D72, D74)
The evolution of the political criteria for accession to the European Community, 1957–1973
Authors: Janse Ronald
Published: October 2017

This article describes the evolution of political conditions for accession to the European Community from 1957 to 1973 on the basis of the responses of the Community and national parliaments to applications for association (Article 238 EC Treaty) and membership (Article 237 EC Treaty) and to a US foreign policy initiative. It challenges the thesis that the European Community was originally uninterested in the political nature of its members as long as they were non‐communist and that the Community made a volte face in 1962 in reaction to a request for an association agreement by Franco's Spain. It argues that the Copenhagen political criteria, except minority protection, were firmly established by 1973 after a series of pronouncements and decisions by the European Parliament, national parliaments (both 1962), the Commission (1967) and the Council (1973). The article aims to contribute to the early history of the constitutionalization of the Union and discusses how demands from outsiders prompted the Six to define the constitutional requirements for (candidate) members. It is partly based on new archival research.
Efficacy and safety of Nuwiq® (human‐cl rhFVIII) in patients with severe haemophilia A undergoing surgical procedures
Authors: Zozulya N. , Kessler C. M. , Klukowska A. , von Depka M. , Hampton K. , Hay C. R. M. , Jansen M. , Bichler J. , Knaub S. , Rangarajan S.
Published: October 2017

Introduction

Haemophilia A patients are at a high risk of excess bleeding during surgeries. The aim of haemostatic therapy during the perioperative period is to normalize FVIII level perioperatively and postoperatively to maintain normal haemostasis until wound healing is complete.

Aims/Methods

To examine the efficacy of Nuwiq® (simoctocog alfa, human‐cl rhFVIII), a 4th generation recombinant FVIII produced in a human cell line, for surgical prophylaxis in patients with severe haemophilia A. This analysis assessed the efficacy of Nuwiq® during surgical procedures and in the postoperative period in seven clinical studies of previously treated patients (PTPs) with severe haemophilia A.

Results

Thirty‐six patients, aged 3‐55 years, received surgical prophylaxis with Nuwiq® for 60 surgeries (28 major and 32 minor). Efficacy was evaluated for 52 surgeries (25 major and 27 minor). The success rate of Nuwiq® treatment was 98.1% (51 of 52 evaluated surgeries); haemostatic efficacy was assessed as “excellent” or “good” in all but one major surgery (assessed as “moderate”). The number of infusions ranged from 1 to 19 for minor surgeries and from 3 to 76 for major surgeries. The median (range) daily doses were 42.0 (28.2‐100.9) IU kg−1 for minor surgeries and 69.3 (43.3‐135.6) IU kg−1 for major surgeries. There were no serious treatment‐related adverse events, and none of the patients developed FVIII inhibitors.

Conclusions

The results of this pooled analysis show that Nuwiq® was efficacious in maintaining haemostasis during and after major and minor surgical procedures in PTPs with severe haemophilia A.
Associations Between Depression/Anxiety and Headache Frequency in Migraineurs: A Cross‐Sectional Study
Authors: Chu Hsuan‐Te , Liang Chih‐Sung , Lee Jiunn‐Tay , Yeh Ta‐Chuan , Lee Meei‐Shyuan , Sung Yueh‐Feng , Yang Fu‐Chi
Published: October 2017

Background

While migraines have been associated with emotional disturbances, it remains unknown whether the intensity of emotional expression is directly related to migraine frequency.

Objective

The present study investigated depression/anxiety among migraineurs.

Methods

This cross‐sectional study included 588 clinical outpatients in Taiwan. Migraines were stratified by attack frequency, with and without auras, and with well‐controlled confounding variables. Demographic and clinical data, including sleep characteristics, were collected. Multivariable linear regressions were employed to examine whether migraine frequency (1‐4 headache days per month, 5‐8 headache days per month, 9‐14 headache days per month, or >14 headache days per month) was associated with depression/anxiety symptoms, as indicated by the Beck's Depression Inventory (BDI) and Hospital Anxiety and Depression Subscales (HADS).

Results

BDI total scores were highest in patients with chronic migraines (mean ± SD: 13.2 ± 8.5), followed by those with high frequency (12.1 ± 8.5), medium frequency (10.6 ± 8.0), low frequency (9.1 ± 7.1), and lowest in nonmigraine controls (6.6 ± 5.9), with a significant trend in frequency (P trend < .001); similar results were obtained for HADS scores. BDI and HADS scores were independently related to high‐frequency episodic and chronic migraine frequency and to poor sleep quality. The relationship between BDI score and migraine frequency was present in both aura‐present (P trend = .001) and aura‐absent subgroups (P trend = .029).

Conclusion

Higher migraine frequency, either with or without auras, correlated with higher symptom scores of anxiety and depression.
Melting behavior and superheating capacity of REBa2Cu3Oy films with nano‐layer buffered structures
Authors: Wang Wei , Xiang Hui , Hussain Ghulam , Yu Dejing , Zhu Yisha , Zhang Letian , Samoilenkov Sergey V. , Kaul Andrey R. , Yao Xin
Published: October 2017

Using high temperature‐optical microscopy, in situ investigations were conducted on melting and superheating behaviors of REBa2Cu3O7−δ (RE123, RE = Nd, Gd) films, which were grown on nano‐layer buffered substrates. The results demonstrate that all buffered RE123 films have improved crystallinity and in‐plane alignments, leading to the higher superheating capability. In the first case, due to its good lattice match with the buffer material of Y123, the Nd123 film with the minimal extrinsic property grew from the superior interface. In the second circumstance, because of its stronger chemical bonding with the buffer layer of Gd2O3, the pure c‐axis oriented Gd123 film was fabricated. Moreover, the optimized thickness of buffer layer plays an important role in reducing interface energy of RE123 films and enhancing its superheating capacity.
From job stress to intention to leave among hospital nurses: A structural equation modelling approach
Authors: Lo Wen‐Yen , Chien Li‐Yin , Hwang Fang‐Ming , Huang Nicole , Chiou Shu‐Ti
Published: October 2017

Aims

The aim of this study was to examine the structural relationships linking job stress to leaving intentions through job satisfaction, depressed mood and stress adaptation among hospital nurses.

Background

High turnover among nurses is a global concern. Structural relationships linking job stress to leaving intentions have not been thoroughly examined.

Design

Two nationwide cross‐sectional surveys of full‐time hospital staff in 2011 and 2014.

Methods

The study participants were 26,945 and 19,386 full‐time clinical nurses in 2011 and 2014 respectively. Structural equation modelling was used to examine the interrelationships among the study variables based on the hypothesized model. We used cross‐validation procedures to ensure the stability and validity of the model in the two samples.

Results

There were five main paths from job stress to intention to leave the hospital. In addition to the direct path, job stress directly affected job satisfaction and depressed mood, which in turn affected intention to leave the hospital. Stress adaptation mitigated the effects of job stress on job satisfaction and depressed mood, which led to intention to leave the hospital. Intention to leave the hospital preceded intention to leave the profession. Those variables explained about 55% of the variance in intention to leave the profession in both years.

Conclusion

The model fit was good for both samples, suggesting validity of the model. Strategies to decrease turnover intentions among nurses could focus on creating a less stressful work environment, increasing job satisfaction and stress adaptation and decreasing depressed mood. Hospitals should cooperate in this issue to decrease nurse turnover.
Clinical factors associated with the symptoms of constipation in patients with diabetes mellitus: A multicenter study
Authors: Yamada Eiji , Namiki Yulia , Takano Yuya , Takamine Hikaru , Inazumi Koji , Sasaki Hiroto , Yamada Masayo , Ito Satoshi , Iwasaki Tomoyuki , Mantani Naoki , Minami Taichi , Osada Uru Nezu , Terauchi Yasuo , Nakajima Atsushi
Published: October 2017

Background and Aim

Changes in treatment protocols for patients with diabetes mellitus (DM) may influence the functions of the digestive tract. This study examined possible clinical factors associated with the symptoms of constipation in patients with DM.

Methods

This was a multicenter study. Participants were consecutive Japanese patients undergoing treatment for type 1 or type 2 DM. Constipation was evaluated using the gastrointestinal symptom rating scale. Diabetic neuropathy was evaluated by the presence or absence of peripheral neuropathy of the lower limbs.

Results

Of 419 participants, 258 were men and 161 women (ratio: 1.6:1), with a mean age of 63.6 ± 12.5 years. In multivariate analysis, symptoms of constipation were significantly associated with age (odds ratio [OR] = 1.02, 95% confidence interval [CI]: 1.01–1.04, P = 0.032), lower mental component summary (OR = 3.31, 95% CI: 1.69–6.48, P < 0.001), diabetic retinopathy (OR = 1.99, 95% CI: 1.14–3.45, P = 0.015), and diabetic neuropathy (OR = 1.86, 95% CI: 1.10–3.16, P = 0.021). In patients with peripheral neuropathy of the lower limbs, regardless of the presence of other complications (diabetic nephropathy and diabetic retinopathy), the prevalence of symptoms of constipation was twice that of patients without peripheral neuropathy (40.0–49.1% vs 22.0%). Diabetic drugs were not associated with symptoms of constipation.

Conclusions

Diabetic neuropathy, defined as peripheral neuropathy of the lower limbs, was significantly associated with symptoms of constipation. Peripheral neuropathy of the lower limbs is not a direct risk factor for constipation but may be a useful criterion when assessing whether constipation is associated with DM.
Meeting the support needs of persons with mild intellectual disability or borderline intellectual functioning: still a long way to go
Authors: Nouwens P. J. G. , Smulders N. B. M. , Embregts P. J. C. M. , van Nieuwenhuizen C.
Published: October 2017

Background

Among persons with a mild intellectual disability or borderline intellectual functioning, differences in their characteristics imply that a differentiated approach is required to meet their needs. This retrospective study examined whether the history of support/treatment programs and the type of healthcare providers involved matched the specific support needs of persons with a mild intellectual disability or borderline intellectual functioning.

Method

Five (previously identified) profiles of persons with a mild intellectual disability or borderline intellectual functioning were used to investigate to what extent the support needs of this group had been met. For the 250 persons with mild intellectual disability or borderline intellectual functioning who matched these five profiles, data were collected retrospectively from their case files.

Results

Persons with mild intellectual disability or borderline intellectual functioning received a very similar amount and type of support/treatment programs. Differences between the profiles were found for non‐verbal therapy, residential treatment and contacts with social work. Regarding the type of healthcare providers involved, differences between the profiles emerged for specialised intellectual disability services, youth services and specialised addiction services.

Conclusions

The support programs for a heterogeneous population of persons with mild intellectual disability or borderline intellectual functioning seem to be suboptimal, indicating that more differentiation is required in the services offered to these individuals.
Do men and women with intellectual disabilities understand death?
Authors: Chow A. Y. M. , McEvoy J. , Chan I. K. N. , Borschel M. , Yuen J. H. L. , Lo J. Y. M.
Published: October 2017

Background

Individuals with ID are often withheld information about the death of their loved ones as it has often been thought that they do not understand death or cannot grieve. This grief exacerbates the stress of individuals with ID as they often encounter secondary losses such as transitioning to a care facility. The aim of this study is to investigate men and women with ID understanding death concepts and to what extent.

Method

Adopting a stratified random sampling method, 156 Chinese people with ID were invited to join the study. One hundred and ten participants were interviewed using simple death related vignettes expanding upon and replicating a published study carried out in Ireland. The understanding of the five death concepts: causality, irreversibility, nonfunctionality, universality and inevitability was examined. The correlates of demographics, bereavement experiences and comprehension were explored.

Results

The majority of the participants did understand concepts such as death is irreversible and that the deceased no longer function. One third of the participants understood causality and the universality of death. One fifth understood the inevitability of death. Previous bereavement experiences were correlated with higher understanding. Communication and community skills were correlated with all concepts of death except universality.

Conclusion

The results indicate that individuals with ID do have a partial to full understanding of the concepts of death. The culture of Hong Kong is one that considers death to be a taboo or unlucky subject. Therefore, the results mirror the the lack of understanding of universality and inevitability concepts as it is forbidden to speak of these concepts. An open and honest environment is encouraged to educate individuals with ID about death and bereavement.
Nursing documentation in inpatient psychiatry: The relevance of nurse–patient interactions in progress notes—A focus group study with mental health staff
Authors: Myklebust Kjellaug K. , Bjørkly Stål , Råheim Målfrid
Published: October 2017

Aims and objectives

To gain insight into mental health staff's perception of writing progress notes in an acute and subacute psychiatric ward context.

Background

The nursing process structures nursing documentation. Progress notes are intended to be an evaluation of a patient's nursing diagnoses, interventions and outcomes. Within this template, a patient's status and the care provided are to be recorded. The therapeutic nurse–patient relationship is recognised as a key component of psychiatric care today. At the same time, the biomedical model remains strong. Research literature exploring nursing staff's experiences with writing progress notes in psychiatric contexts, and especially the space given to staff–patient relations, is sparse.

Design

Qualitative design.

Methods

Focus group interviews with mental health staff working in one acute and one subacute psychiatric ward were conducted. Systematic text condensation, a method for transverse thematic analysis, was used.

Results

Two main categories emerged from the analysis: the position of the professional as an expert and distant observer in the progress notes, and the weak position of professional–patient interactions in progress notes.

Conclusions

The participants did not perceive that the current recording model, which is based on the nursing process, supported a focus on patients’ resources or reporting professional–patient interactions. This model appeared to put ward staff in an expert position in relation to patients, which made it challenging to involve patients in the recording process. Essential aspects of nursing care related to recovery and person‐centred care were not prioritised for documentation.

Relevance to clinical practice

This study contributes to the critical examination of the documentation praxis, as well as to the critical examination of the documentation tool as to what is considered important to document.
Effectiveness and side‐effect profile of stimulant therapy as monotherapy and in combination in the central hypersomnias in clinical practice
Authors: Thakrar Chiraag , Patel Kishankumar , D'ancona Grainne , Kent Brian D. , Nesbitt Alexander , Selsick Hugh , Steier Joerg , Rosenzweig Ivana , Williams Adrian J. , Leschziner Guy D. , Drakatos Panagis
Published: October 2017

Effectiveness and side‐effect profile data on pharmacotherapy for daytime sleepiness in central hypersomnias are based largely upon randomized controlled trials. Evidence regarding the use of combination therapy is scant. The aim of this study was to examine the effectiveness and occurrence of drug‐related side effects of these drugs in routine clinical practice. Adult patients diagnosed with a central hypersomnia during a 54‐month period at a tertiary sleep disorders centre were identified retrospectively. Side effects were recorded at every follow‐up visit. A total of 126 patients, with 3275 patient‐months of drug exposure, were categorized into narcolepsy type 1 (n = 70), narcolepsy type 2 (n = 47) and idiopathic hypersomnia (n = 9). Modafinil was the most common drug used as a first‐line treatment (93%) and in combination therapy (70%). Thirty‐nine per cent of the patients demonstrated a complete, 25% partial and 36% a poor response to treatment. Combination treatment improved daytime sleepiness in 55% of the patients with residual symptoms despite monotherapy. Sixty per cent of patients reported side effects, and 30% reported treatment‐limiting side effects. Drugs had similar side‐effect incidence (P = 0.363) and their side‐effect profile met those reported in the literature. Twenty‐seven per cent of the patients received combination treatment and had fewer side effects compared to monotherapy (29.4% versus 60%, respectively, P = 0.001). Monotherapy appears to achieve satisfactory symptom control in most patients with central hypersomnia, but significant side effects are common. Combination therapy appears to be a useful and safe option in patients with refractory symptoms.
Hepatic transudation barrier properties
Authors: Dongaonkar Ranjeet M. , Stewart Randolph H. , Quick Christopher M. , Uray Karen L. , Cox Charles S. , Laine Glen A.
Published: October 2017

Objective

Fluid and protein continuously transude from the surface of the liver. Despite a common understanding that transudation plays a critical role in hepatic interstitial and peritoneal fluid balance, transudation from the entire liver has not been studied. Therefore, the goal of the present work was to provide the first direct measurement of the hepatic transudation rate and transudation barrier properties.

Methods

Transudation rates were determined by collecting transudate from the entire liver. Hydraulic conductivity, and fluid transudation and protein reflection coefficients of the transudation barrier (formed by the subscapular interstitial matrix, capsule, and peritoneum) were determined from changes in fluid and protein transudation rates in response to hepatic venous pressure elevation.

Results

Following hepatic venous pressure elevation from 6.1 ± 0.9 to 11.1 ± 0.6 mm Hg, transudation rate increased from 0.13 ± 0.03 to 0.37 ± 0.03 mL/min·100 g. Transudation barrier hydraulic conductivity, fluid transudation and protein reflection coefficients (3.9 × 10−4 ± 5.7 × 10−5 mL/min·mm Hg·cm2, 0.36 ± 0.04 mL/min·mm Hg, and 0.09 ± 0.03, respectively) were comparable to those reported for hepatic sinusoids.

Conclusions

Taken together, these findings suggest that the hepatic transudation barrier is highly permeable at elevated sinusoidal pressures. These fundamental studies provide a better understanding of the hepatic transudation barrier properties and transudation under conditions that are physiologically and clinically relevant to ascites formation.
A review of wheat diseases—a field perspective
Authors: Figueroa Melania , Hammond‐Kosack Kim E. , Solomon Peter S.
Published: October 2017

Wheat is one of the primary staple foods throughout the planet. Significant yield gains in wheat production over the past 40 years have resulted in a steady balance of supply versus demand. However, predicted global population growth rates and dietary changes mean that substantial yield gains over the next several decades will be needed to meet this escalating demand. A key component to meeting this challenge is better management of fungal incited diseases, which can be responsible for 15%–20% yield losses per annum. Prominent diseases of wheat that currently contribute to these losses include the rusts, blotches and head blight/scab. Other recently emerged or relatively unnoticed diseases, such as wheat blast and spot blotch, respectively, also threaten grain production. This review seeks to provide an overview of the impact, distribution and management strategies of these diseases. In addition, the biology of the pathogens and the molecular basis of their interaction with wheat are discussed.
Pediatric allergy and immunology in China
Authors: Wong Gary W. K. , Li Jing , Bao Yi‐Xiao , Wang Jiu‐Yao , Leung Ting Fan , Li Luan‐Luan , Shao Jie , Huang Xin‐Yuan , Liu En‐Mei , Shen Kun‐Ling , Chen Yu‐Zhi
Published: October 2017

Over the past 30 years, China has enjoyed rapid economic development along with urbanization at a massive scale that the world has not experienced before. Such development has also been associated with a rapid rise in the prevalence of allergic disorders. Because of the large childhood population in the country, the burden of childhood allergic disorders has become one of the major challenges in the healthcare system. Among the Chinese centers participating in the International Study of Asthma and Allergies in Childhood, the data clearly showed a continuing rise in the prevalence of asthma, allergic rhinitis, and atopic eczema. However, the discipline of pediatric allergy in mainland China is still in its infancy due to the lack of formal training program and subspecialty certification. Clinicians and researchers are increasingly interested in providing better care for patients with allergies by establishing pediatric allergy centers in different regions of the country. Many of them have also participated in national or international collaborative projects hoping to answer the various research questions related to the discipline of pediatric allergy and immunology. It is our hope that the research findings from China will not only improve the quality of care of affected children within this country but also the millions of patients with allergies worldwide.
Telomerase reverse transcriptase (TERT) promoter mutations are rare in urachal cancer
Authors: Thiem Sebastian , Herold Thomas , Krafft Ulrich , Bremmer Felix , Tolkach Yuri , Szász Attila M. , Kriegsmann Joerg , Gaisa Nadine T. , Niedworok Christian , Szarvas Tibor , Reis Henning
Published: October 2017

High rates of telomerase reverse transcriptase (TERT) promoter mutations have recently been described in urothelial carcinoma (UC). Unlike UC in the bladder, adenocarcinomas account for the majority of urachal cancer (UrC) cases. As data in UrC is unclear, we analyzed TERT promoter mutations in a large cohort of UrC for its differential diagnostic, clinicopathological and prognostic significance. UrC cases from six academic centers were analyzed for c.‐146C>T (C250T) and c.‐124C>T (C228T) TERT promoter mutations by PCR and Sanger sequencing. Clinicopathological and survival data were collected. The cohort consisted of 15 men (56%) and 12 women (44%) with a median age of 50 years including 23 adenocarcinomas, two squamous cell carcinomas (SCC), one UC and one undifferentiated carcinoma. In one case of (mucinous) urachal adenocarcinoma a C228T mutation was detected (1/23; 4%), like in a case of SCC in addition to one C250T mutation in the UC case. TERT promoter mutations are very rare in urachal adenocarcinomas (unlike in UC) with differential diagnostic implications. Additionally, the low TERT promoter mutation rate in urachal adenocarcinomas is more comparable to colorectal adenocarcinomas than to UC, giving further support to recent genetic findings and therapeutic considerations.
Political Accountability in the Republic of Kosovo
Authors: Jashari Murat
Published: October 2017

Political accountability is the most specific type of social accountability for the fact that it lacks a normative legal aspect and that it derives mainly from the behavior, not from an opportunistic attitude or disclosure of specific subject in relation to the expectations of the body or institution or the relevant electoral body. Political accountability is the conditio sine quo non (indispensable condition) to a democratic system of government. Hence the Kosovo Government on the merits of the constitutional aspect has accepted this institute. It is precisely this institute of political accountability that will be the topic of this paper taking into account the responsibilities of the executive government in relation to the legislative, as well as the political accountability of those elected in relation to the voters. The accountability of the President will be treated in the framework of constitutional accountability, and that of the Government in the framework of parliamentary accountability.
Monte Carlo Simulation for Radiative Transfer in a High-Pressure Industrial Gas Turbine Combustion Chamber
Authors: Ren Tao , Modest Michael F. , Roy Somesh
Published: October 2017

Radiative heat transfer is studied numerically for reacting swirling flow in an industrial gas turbine burner operating at a pressure of 15 bar. The reacting field characteristics are computed by Reynolds-averaged Navier–Stokes (RANS) equations using the k-ϵ model with the partially stirred reactor (PaSR) combustion model. The GRI-Mech 2.11 mechanism, which includes nitrogen chemistry, is used to demonstrate the ability of reducing NOx emissions of the combustion system. A photon Monte Carlo (PMC) method coupled with a line-by-line (LBL) spectral model is employed to accurately account for the radiation effects. Optically thin (OT) and PMC–gray models are also employed to show the differences between the simplest radiative calculation models and the most accurate radiative calculation model, i.e., PMC–LBL, for the gas turbine burner. It was found that radiation does not significantly alter the temperature level as well as CO2 and H2O concentrations. However, it has significant impacts on the NOx levels at downstream locations.
Contributions of Kinetic Energy and Viscous Dissipation to Airway Resistance in Pulmonary Inspiratory and Expiratory Airflows in Successive Symmetric Airway Models With Various Bifurcation Angles
Authors: Choi Sanghun , Choi Jiwoong , Lin Ching-Long
Published: October 2017

The aim of this study was to investigate and quantify contributions of kinetic energy and viscous dissipation to airway resistance during inspiration and expiration at various flow rates in airway models of different bifurcation angles. We employed symmetric airway models up to the 20th generation with the following five different bifurcation angles at a tracheal flow rate of 20 L/min: 15 deg, 25 deg, 35 deg, 45 deg, and 55 deg. Thus, a total of ten computational fluid dynamics (CFD) simulations for both inspiration and expiration were conducted. Furthermore, we performed additional four simulations with tracheal flow rate values of 10 and 40 L/min for a bifurcation angle of 35 deg to study the effect of flow rate on inspiration and expiration. Using an energy balance equation, we quantified contributions of the pressure drop associated with kinetic energy and viscous dissipation. Kinetic energy was found to be a key variable that explained the differences in airway resistance on inspiration and expiration. The total pressure drop and airway resistance were larger during expiration than inspiration, whereas wall shear stress and viscous dissipation were larger during inspiration than expiration. The dimensional analysis demonstrated that the coefficients of kinetic energy and viscous dissipation were strongly correlated with generation number. In addition, the viscous dissipation coefficient was significantly correlated with bifurcation angle and tracheal flow rate. We performed multiple linear regressions to determine the coefficients of kinetic energy and viscous dissipation, which could be utilized to better estimate the pressure drop in broader ranges of successive bifurcation structures.
Robust Stability of Switched Interconnected Systems With Time-Varying Delays
Authors: Xue Huanbin , Zhang Jiye , Wang Hong , Jiang Baoshan
Published: October 2017

The problem of robust exponential stability for a class of switched nonlinear dynamical systems with uncertainties and time-varying delays is investigated. On the assumption that each isolated subsystem of the interconnected system can be exponentially stabilized and the corresponding Lyapunov functions are available, using M-matrix property, the differential inequalities with time-varying delays are constructed. By the stability analysis of the differential inequalities, the sufficient conditions to ensure the robust exponential stability of the switched interconnected systems (SIS) under arbitrary switching are obtained. The proposed method, which neither requires the individual subsystems to share a common Lyapunov function (CLF), nor needs to know the values of individual Lyapunov functions at each switching time, would provide a new mentality for studying stability of arbitrary switching. In addition, by resorting to average dwell time approach, conditions for guaranteeing the robust exponential stability of SIS under constrained switching are derived. The proposed criteria are explicit, and they are convenient for practical applications. Finally, two numerical examples are given to illustrate the validity and correctness of the proposed theories.
An Optimum Design Method for a Thermal-Fluid Device Incorporating Multiobjective Topology Optimization With an Adaptive Weighting Scheme
Authors: Sato Yuki , Yaji Kentaro , Izui Kazuhiro , Yamada Takayuki , Nishiwaki Shinji
Published: October 2017

This paper proposes an optimum design method for a two-dimensional microchannel heat sink under a laminar flow assumption that simultaneously provides maximal heat exchange and minimal pressure drop, based on a topology optimization method incorporating Pareto front exploration. First, the formulation of governing equations for the coupled thermal-fluid problem and a level set-based topology optimization method are briefly discussed. Next, an optimum design problem for a microchannel heat sink is formulated as a bi-objective optimization problem. An algorithm for Pareto front exploration is then constructed, based on a scheme that adaptively determines weighting coefficients by solving a linear programming problem. Finally, in the numerical example, the proposed method yields a Pareto front approximation and enables the analysis of the trade-off relationship between heat exchange and pressure drop, confirming the utility of the proposed method.
The Subgrid-Scale Approach for Modeling Impingement Cooling Flow in the Combustor Pedestal Tile
Authors: Ammour Dalila , Page Gary J.
Published: October 2017

The widely used gas turbine combustor double-walled cooling scheme relies on very small pedestals. In a combustor it is impractical for computational fluid dynamics (CFD) to resolve each pedestal individually as that would require a very large amount of grid points and consequent excessive computation time. These pedestals can be omitted from the mesh and their effects captured on the fluid via a pedestal subgrid-scale (SGS) model. The aim is to apply the SGS approach, which takes into account the effects on pressure, velocity, turbulence, and heat transfer, in an unstructured CFD code. The flow inside a two-dimensional (2D) plain duct is simulated to validate the pedestal SGS model, and the results for pressure, velocity, and heat transfer are in good agreement with the measured data. The conjugate heat transfer inside a three-dimensional (3D) duct is also studied to calibrate the heat source term of the SGS model due to the pedestals. The resolved flow in the combustor pedestal tile geometry is numerically investigated using Reynolds-averaged Navier–Stokes (RANS) and large eddy simulation (LES) in order to first assess the viability of the RANS and LES to predict the impinging flow and second to provide more validation data for the development of the SGS pedestal correlations. It is found that the complexity of such a flow, with high levels of curvature, impingement, and heat transfer, poses a challenge to the standard RANS models. The LES provides more details of the impinging flow features. The pedestal model is then applied to the complete tile to replace the pedestals. The results are close to both the fully resolved CFD and the measurements. To improve the flow features in the impingement zone, the first two rows were resolved with the mesh and combined with the SGS modeling for the rest of the tile; this gave optimum results of pressure, velocity, and turbulence kinetic energy (TKE) distribution inside the pedestal cooling tile.
Open System Tribology in the Wheel–Rail Contact—A Literature Review
Authors: Olofsson Ulf , Lyu Yezhe
Published: October 2017

The tiny contact zone (approximately 1 cm2) where steel wheel meets steel rail is fundamental to rail transport. This work is a comprehensive presentation of recent research in wheel–rail contact tribology. It stresses that, unlike gears or rolling bearings which are sealed contacts with reduced exposure to the surrounding environment, a wheel–rail contact is an open system that is exposed to dirt and particles as well as to applied and natural lubrication (the latter category includes rain, dew, and biological materials such as leaves). As an open system contact, it also radiates sound and airborne wear particles. These characteristics of an open system underscore the need for special studies of open system tribology. Areas requiring study include airborne particle emissions and the environmental effects of applied lubrication and friction modification. Given that adhesion, wear, and sound and particle emission are closely related in an open system, these should be studied together rather than independently.
Effectiveness of Rack-Level Fans—Part I: Energy Savings Through Consolidation
Authors: Eiland Richard , Fernandes John Edward , Nagendran Bharath , Mulay Veerendra , Agonafer Dereje
Published: October 2017

In general, smaller fans operate at lower efficiencies than larger fans of proportional linear dimensions. In this work, the applicability of replacing smaller, 60 mm baseline fans from within the chassis of web servers with an array of larger, geometrically proportional 80 mm and 120 mm fans consolidated to the back of a rack is experimentally tested. Initial characterization of the selected fans showed that the larger fans operate at double peak total efficiency of the smaller fans. A stack of four servers were used in a laboratory setting to represent a rack of servers. When all four servers were stressed at uniform computational loadings, the 80 mm fans resulted in 50.1–52.6% reduction in total rack fan power compared to the baseline fans. The 120 mm fans showed similar reduction in rack fan power of 47.6–54.0% over the baseline. Since actual data centers rarely operate at uniform computational loading across servers in a rack, a worst case scenario test was conceived in which the array of larger fans were controlled by a single server operating at peak computational workload while the other three in the rack remained idle. Despite significant overcooling in the three idle servers, the 80 mm and 120 mm fan configurations still showed 35% and 34% reduction in total rack fan power compared to the baseline fans. The findings strongly suggest that a rack-level fan scheme in which servers share airflow from an array of consolidated larger fans is superior to traditional chassis fans.
Forced Convection Heat Transfer of Nanofluids: A Review
Authors: Kuchibhotla Aditya , Banerjee Debjyoti
Published: October 2017

Stable homogeneous colloidal suspensions of nanoparticles in a liquid solvents are termed as nanofluids. In this review the results for the forced convection heat transfer of nanofluids are gleaned from the literature reports. This study attempts to evaluate the experimental data in the literature for the efficacy of employing nanofluids as heat transfer fluids (HTF) and for Thermal Energy Storage (TES). The efficacy of nanofluids for improving the performance of compact heat exchangers were also explored. In addition to thermal conductivity and specific heat capacity the rheological behavior of nanofluids also play a significant role for various applications. The material properties of nanofluids are highly sensitive to small variations in synthesis protocols. Hence the scope of this review encompassed various sub-topics including: synthesis protocols for nanofluids, materials characterization, thermo-physical properties (thermal conductivity, viscosity, specific heat capacity), pressure drop and heat transfer coefficients under forced convection conditions. The measured values of heat transfer coefficient of the nanofluids varies with testing configuration i.e. flow regime, boundary condition and geometry. Furthermore, a review of the reported results on the effects of particle concentration, size, temperature is presented in this study. A brief discussion on the pros and cons of various models in the literature is also performed — especially pertaining to the reports on the anomalous enhancement in heat transfer coefficient of nanofluids. Furthermore, the experimental data in the literature indicate that the enhancement observed in heat transfer coefficient is incongruous compared to the level of thermal conductivity enhancement obtained in these studies. Plausible explanations for this incongruous behavior is explored in this review. A brief discussion on the applicability of conventional single phase convection correlations based on Newtonian rheological models for predicting the heat transfer characteristics of the nanofluids is also explored in this review (especially considering that nanofluids often display non-Newtonian rheology). Validity of various correlations reported in the literature that were developed from experiments, is also explored in this review. These comparisons were performed as a function of various parameters, such as, for the same mass flow rate, Reynolds number, mass averaged velocity and pumping power.
A Numerical Study of Liquid Carryover Based on the VOF Model
Authors: Lu Meng , Xie Heng
Published: October 2017

Liquid carryover is an important phenomenon during the small break loss of coolant accidents (LOCA). The coolant loss rate due to liquid entrained decides the decreasing height of water level and the ability that the core can be cooled. It is especially important in nuclear heating reactor as it is integral arranged without safety injection system. Therefore, the initial water volume in the reactor vessel and coolant loss rate determines whether the core could be submerged. Numerous experiments have been conducted to investigate the phenomenon of liquid carryover in the pool system. Fruitful outcomes have been proposed involving mechanism of entrained liquid produced as well as semi-empirical formula for engineering purposes. However, the semi-empirical correlations on entrainment are highly data-depended and are less applicable under different experiment settings. This paper presents a numerical method based on the VOF to study the liquid carryover in the pool system. The numerical results are analyzed with mesh independence analysis and compared with previous experiments. Several types of liquid carryover are found in the simulation. The exit effect on liquid loss rate is specifically studied including the setting of exit as well as the range that exit effect dominates.
A Study About Software-Implemented Fault Injection Strategy for Digital RPS in Nuclear Power Plant
Authors: Xi Wang , Gu Pengfei , Bai Tao , Liu Wei , Chen Weihua
Published: October 2017

With the widely use of digital instrumentation and control (I&C) system in nuclear power plant (NPP), the safety and economic efficiency of NPP could be affected directly by the performance (reliability, fault tolerance etc.) of software, an effective evaluation technology plays critical role in ensuring the safety operation of NPP. At present, the main evaluation method for digital Reactor Protection System (RPS) is uncomprehensive that only pay attention to the correctness of logic function. In order to improve the evaluation method, this paper make a study about bringing in Software-Implemented Fault Injection technology, which inject fault inside the software artificially, the reliability and fault tolerance of software can be evaluated while the inside errors are activated. Based on the practice about Yang-Jiang units 5 and 6 projects, which is a generation II+ pressurized water reactor named CPR1000, this study analyze the RPS architecture, network transmission model, CPU design, data types, and software code, build the fault model with types, positions, and test items. As a result, achieves a software-implemented fault injection method for RPS, provides a comprehensive and advanced evaluation strategy for equipment in NPP.
Preliminary Verification of the High-Fidelity Neutronics and Thermal-Hydraulics Coupling System NECP-X/SUBSC
Authors: Chen Jun , Cao Liangzhi , Liu Zhouyu , Wu Hongchun , Zhang Yijun
Published: October 2017

PWR core phenomena can be simulated and predicted more precisely and in more details with high-fidelity neutronics and thermal-hydraulics coupling calculations. An internal coupling between a newly developed high-fidelity neutronics code NECP-X and the sub-channel code SUBSC has been realized. In order to verify the NECP-X/SUBSC coupling system, another high-fidelity neutronics and thermal-hydraulics coupling system OpenMC/SUBSC was developed through external coupling method. Both coupling systems were applied to a simplified PWR 3×3 pin cluster case. The numerical result shows good agreement in both eigenvalue and normalized axial power distribution for a selected pin, demonstrating the success of the internal coupling of NECP-X and SUBSC.