bluuebunny/crossref_metadata_2025 huggingface dataset:
Scanning Kelvin Probe Microscopy Study of Mg-Zn-Ca Alloys
Authors: Fialkova Svitlana , Xu Zhigang , Pai Devdas , Sankar Jagannathan
Published: January 2018

This study focused on understanding the interactions between alloying elements in a magnesium (Mg) matrix and the effect of the alloying elements on corrosion behavior of Mg-alloys. The development of atomic force microscope (AFM) techniques has enabled the evaluation of physical and chemical properties of surfaces at the sub-micron level. Scanning Kelvin probe force microscopy (SKPFM) is particularly useful for studying localized corrosion phenomena of alloys. SKPFM generates a map of the potential distribution across a sample with a resolution of probe tip radius, nowadays ranging from 5 to 30 nm. Furthermore, the open circuit potential of various pure metals in solution is linearly related to the Volta potential value measured in air immediately after exposure to corrosive media. SKPFM is a useful tool to practically assess the nobility of a surface. This technique has been applied to the heterogeneous microstructure of Mg-Zn-Ca-RE (RE = Zr, Nd, Ga) alloys and provided clear evidence regarding the shape, position, compositional inhomogeneities and local practical nobility of intermetallic particles. Correlation between the measured potential distribution and the reactivity of these particles has been shown. Atomic force lithography (AFL, scratching with the hard tip) is a controlled method for local disruption of the protective oxide film that naturally formed on an Mg-surface in air. Combining SKPFM and AFL, the stability of the passive film and the tendency for stabilization of localized corrosion can be monitored. In addition, the lateral imaging capabilities of the AFM provide an approach to study the role of different microstructural features such as grain boundaries and impurities in the process of inducing localized corrosion.
Applications of Fluid Structure Interaction Analysis Techniques for Flow Regulation
Authors: Gandikota Raju , Mallela Venkat , Quiroga Andres
Published: January 2018

In fluid-structure interactions (FSI), one or more structures interact with incompressible or compressible fluids. These problems are non-linear multi-physics phenomena. Most FSI problems require a numerical solution rather than an analytical solution (Gene, 2012). This is particularly true for problems involving large deformations of elastomers and for problems related to plugging of flow. The classical two way coupling of fluid and structural solver does not work well and at times fail to reach a solution. Using a monolithic solver and non-conforming mesh techniques like Coupled Eulerian Lagrange (CEL) or Arbitrary Lagrange Eulerian (ALE) formulations we show solutions for such large deformation and plugging type FSI problems.

The technique has been applied to help develop an industrial flow regulator. The regulator uses a single piece elastomeric material that undergoes deformation due to pressure drop in the system. The deformation in turn restricts flow in the system and potentially developing flow related noise in the system. Rigorous FSI analyses techniques were used to design and develop the concepts minimizing prototype development time. The FSI analysis not only helped in designing the mechanical function of the regulator but also the helped evaluate the acoustic noise level in the system. The resulting design performance was validated by controlled performance tests. The design was shown to work reliably and meet performance requirements.
Solar Industrial Steam Production for Soap Manufacturing Factory: A Feasibility Study
Authors: Raiva Tafadzwa , Jen T. C.
Published: January 2018

Industrial use of electricity in South Africa accounts for the largest consumption fraction, and the industry has the least renewable energy resource penetration rate. In the soaps manufacturing industry, steam is used to dry the semi-liquid soap mixture into solid noodles in the dryers. This process consumes 63047tons of steam per year, and the steam is produced by boiling water in the boiler heated using biomass and heavy fuel oil (HFO).

Feasibility of the system to produce industrial steam using solar energy was to be determined using two platforms: Cost feasibility and Area feasibility. Area feasibility refers to the determination of whether the space available for collector field installation can match the area required to meet steam load.

The optimized simulation showed that the required collector area was 17500m2, while the maximum available area on the roof was 12000m2, which implies that the space would not fit the required installation. As for the cost feasibility, the system has to have a payback period of less than 5 years for it be considered feasible and thus can be funded. The cost of installation was estimated to be USD $4 million, with an annual savings rate of $329000, hence a payback period of 12.1 years, which would be regarded as a long period of time for a savings project, therefore would be difficult for it to be approved by the factory administration as it is considered that a payback period of at most 5 years is favorable and the investment would be approved.
Investigation of Using Ag/Therminol Nanofluids As Heating Fluids in PTSC-Based Power Plants
Authors: Alashkar Adnan , Gadalla Mohamed
Published: January 2018

In this paper, the effect of using Ag/Therminol nanofluids as a heating fluid in a PTSC on the performance of a PTSC-based power plant is studied. The effect of the nanofluids on the convective heat transfer coefficient and pressure drop inside the PTSC absorber, and the pumping power is investigated for different nanoparticles sizes and shapes. Moreover, the effect of the nanofluids on the performance of the PTSC is investigated. Further, the effect of the nanofluids on the performance metrics and financial metrics of a PTSC-based power plant is analyzed for three modes of operation, where the 1st assumes no storage, 2nd assumes a storage period of 5 hours, and 3rd assumes a storage period of 7 hours. The results show that the presence of the nanofluids improves the heat transfer characteristics inside the PTSC absorber tube, the power output of the PTSC, and the energetic and exergetic efficiencies. Moreover, the power output and cost parameters of a PTSC-based power plant improve when nanofluids are used. For instance, the power output increases from 117 Gwh to 119 Gwh. In addition, it is concluded that the power plant performs better with the presence of a thermal energy storage system (TES).
Thermodynamic Analysis and Design of a Heliostat Field to Co-Produce Hydrogen and Electricity
Authors: Madurawala Dona P. U. , Saghafifar Mohammad , Gadalla Mohamed
Published: January 2018

This paper investigates the use of hydrogen along with natural gases and solar energy to power a 50 MW power plant in the United Arab Emirates. Sudden changes in the climate have shifted the focus of scientists to formulate solutions to global warming and environmental pollution. Hence, numerous researches are being carried out on various renewable energy sources, such as solar energy and hydrogen. This study examines how the power generation, carbon dioxide (CO2) emission and the fuel consumption of the power plant is affected by the use of hydrogen, solar energy and natural gases. The power plant under investigation consisted of a hybrid conventional combined cycle whose bottoming cycle was allocated for the production of hydrogen during the day. The hydrogen that was produced was used at night to power the topping cycle to generate electricity. Solar energy was captured through concentrated solar power technology, while hydrogen was produced by a water electrolysis process. An extensive investigation of the performance of the power plant revealed that its annual hydrogen share was 7%, solar share 20% and natural gas share 73%. In addition, the annual CO2 emission and fuel consumption was found to be 394.1 kgCO2/MWhe and 58412 tonne respectively.
Design and Fabrication of a Novel Autonomous Pipeline Scanning Robot
Authors: Karkoub Mansour , Gharib Mohamed , Ghorbel Fathi H. , Ben Moallem Issam
Published: January 2018

Energy pipelines require regular inspection and health monitoring against defects, cracks, and corrosion due to the fluid pipe interaction and external environment conditions. Accurate and efficient pipeline inspection is extremely important to the oil and gas industry. Inspection of pipelines is usually carried out either internally using smart pigs and tethered robots or externally with limited inspection options. Internal inspection has many limitations and external inspection is still primitive. However, external inspection has the advantage of being carried out without interruption of the production process. In this paper, a novel design for an autonomous robot for pipeline external inspection is presented. Although, the proposed design is developed mainly to fit a magnetic flux leakage based inspection technique, the robot modular design will fit other inspection methods and applications with minimal design modifications. The proposed robot is designed to carry multiple hall effect sensors and allow adjustment of the radial distance between the sensors and the pipe surface. Also, the robot is able to scan different size pipes and maintain constant distance from the pipe surface. A prototype is fabricated using 3D printer and standard fasteners to evaluate the workability of the proposed design. The initial testing of the developed prototype showed that the robot can be made to move at a constant speed without slipping. The design details and the prototype elements are delineated in this paper.
Numerical Study of Combustion in a Porous Medium With Liquid Fuel Injection
Authors: Mohammadi Arash , Benhari Mona , Nouri Khajavi Mehrdad
Published: January 2018

Porous medium (PM) has potential advantage to enhance evaporation of droplets in liquid-fuel burners, low emissions and minimize instabilities of combustion. This paper represents the numerical study of liquid-fuel injection, evaporation, and combustion inside constant-volume chemically inert PM. It stabilizes lean combustion and decreases emissions. Three-dimensional numerical results were obtained based on a modified KIVA-3V code. Diesel fuel is directly injected into chamber for two cases, free volume and PM reactor. With high initial temperature, fast evaporation and self-ignited occur. The results for specified conditions were compared with experimental data in literature. Effects of injection on mixture formation was investigated. Distribution of diesel vapor, fluid and solid temperature of PM in a cutting plane, were shown. Diagram of diesel vapor, CO, NO, Soot, solid and fluid temperature versus time for different mass of injected fuel, were presented. Also, results of diesel vapor, pressure and temperature in free volume and PM reactor have compared. The results show considerable reduction in maximum pressure and temperature, carbon monoxide, nitrogen monoxide and soot formation in PM reactor in comparison with free volume.
Off-Design Modeling of Shell and Tube Transport Membrane Condenser Heat Exchangers
Authors: Soleimanikutanaei Soheil , Ghasemisahebi Esmaiil , Lin Cheng-Xian , Wang Dexin
Published: January 2018

Most of the industrial systems including the heat transfer equipment encounter with off-design conditions during their life cycles. Performance study for the off-design conditions is an important part of every industrial system which ensures the safety and efficiency of the systems for the various range of operating conditions. In this study numerical simulation of the shell and tube Transport Membrane Condenser (TMC) heat exchangers have been conducted for their off-design operating conditions. The shell and tube TMC heat exchangers have been manufactured by Gas Technology Institute (GTI) for heat and water recovery from high pressure and high water vapor content flow streams. Using a single-phase multi-component model and appropriate User Defined functions (UDFs) in the commercial software ANSYS-FLUENT software the condensation rate, heat and mass transfer inside the heat exchangers have been modeled. Finally, the performance of the shell and tube TMC heat exchangers for different inlet conditions of the cooling water and flue-gas streams has been investigated.
A Mechanical Engineering Activity-Based Freshman Course
Authors: Rios Oziel , Fadda Dani
Published: January 2018

A freshman course is offered by the Mechanical Engineering (ME) Department at the University of Texas at Dallas (UTD). This course is a core course for the second semester of the freshman year. The course is divided into four segments where each segment addresses one area of mechanical engineering. The course is designed to facilitate the improvement of design activities from one semester to another based on student feedback, the needs of the mechanical engineering curriculum and contemporary issues important to the mechanical engineering profession.

The course is described in this paper along with the student’s response to specific questions related to the design projects. Specifically, feedback from a student survey administered at the end of the course is presented. This survey includes the student’s perception of their understanding of the topics studied, value of the activities for their future education, and their enjoyment of the activities. Comments received from the survey are also included and are used, along with instructor observations, to make improvements to the learning outcomes.

The course resources needed including lab space, computer software, tools, and teaching assistants are also discussed, as well as the course organization. A sample 16-week schedule is provided.
Nonlinear Dynamic Behavior of a Rotor Bearing System With Nonlinear Viscous Damping Suspension
Authors: Yan Shuai , Lin Bin , Fei Jixiong , Liu Pengfei
Published: January 2018

Nonlinear damping suspension has gained attention owing to its excellent vibration isolation performance. In this paper, a cubic nonlinear viscous damping suspension was introduced to a rotor bearing system for vibration isolation between the bearing and environment. The nonlinear dynamic response of the rotor bearing system was investigated thoroughly. First, the nonlinear oil film force was solved based short bearing approximation and half Sommerfeld boundary condition. Then the motion equations of the system was built considering the cubic nonlinear viscous damping. A computational method was used to solve the equations of motion, and the bifurcation diagrams were used to display the motions. The influences of rotor-bearing system parameters were discussed from the results of numerical calculation, including the eccentricity, mass, stiffness, damping and lubricating oil viscosity. The results showed that: (1) medium eccentricity shows a wider stable speed range; (2) rotor damping has little effect to the stability of the system; (3) lower mass ratio produces a stable response; (4) medium suspension/journal stiffness ratio contributes to a wider stable speed range; (5) a higher viscosity shows a wider stable speed range than lower viscosity. From the above results, the rotor bearing system shows complex nonlinear dynamic behavior with nonlinear viscous damping. These results will be helpful to carrying out the optimal design of the rotor bearing system.
An Analysis Model to Predict Rotation Accuracy of High-Precision Spindles Considering Part Errors and Deformation
Authors: Sun Yanhui , Hong Jun , Guo Junkang , Zhang Yanfei , Wan Shaoke , Zheng Shuai
Published: January 2018

High-precision spindles have significant influence on the machining precision and finishing quality largely due to their motion errors. However, the analysis of rotation accuracy is quite not easy in design stage because of the neglecting of geometric errors and deformations of parts in the traditional dimension chains. Hence, a theoretical analysis model is built in present study to do the prediction. The 3D error accumulation path is recognized by Datum Flow Chain (DFC) and the key tolerances are modeled by Small Displacement Torsor (SDT). Thereafter, the variation propagation is conducted by Homogeneous Transformation Matrices (HTM) and the geometric misalignment in the spindle is calculated. Then, an FEA model is built with Timoshenko beam elements and the deformation is calculated after the geometric misalignment is applied to the model. As spindle rotates, the trajectory of the spindle nose is obtained. Finally, the Monte Carlo (MC) method is used to get the distribution and the range of motion errors. To verify the feasibility and reliability of the analysis model, the radial and axial motion errors of a double supported high-precision spindle are analyzed.
Lower Extremity Mechanism and Responses in Various Frontal Impact Configurations
Authors: Barbat Saeed , Li Xiaowei
Published: January 2018

An analysis of the lower extremity responses in various frontal impact test configurations was performed. The THOR-LX anthropomorphic test device (ATD) representing a mid-size adult male was used. Four groups of frontal crash test data were analyzed. These groups included: Rigid Fixed Barrier (RFB), Moderate Overlap Offset Deformable Barrier (ODB), Small Overlap Rigid Barrier (SORB), and Oblique Impact (OI) crash tests.. This analysis indicated that the lower extremity responses could be high especially in the oblique impact and small overlap crash tests. This study focused on understanding the causes of the resulting high responses.

ATD lower extremity kinematics and interaction with intruded body structure and/or instrument panel varied in the different frontal impact configurations. Therefore, the dominant causes of lower extremity responses in terms of tibia forces and moments were not the same for all frontal crash modes. Maximum Tibia Index results associated with the four groups of frontal impact tests were used to develop a better understanding of ATD kinematics and response mechanisms of the lower extremities. The contact sequence of the lower leg to vehicle interior components was illustrated for OI.

This paper investigated the cause of lower extremity responses in these crash tests. Analysis indicated that the time at which maximum intrusion occurs did not necessarily coincide with the time of maximum lower extremity responses expressed by the Tibia Index.
Aeromechanics of Long Jumps in Spider Crickets: Insights From Experiments and Modeling
Authors: Palmer Emily H. , Deshler Nicolas , Mittal Rajat
Published: January 2018

Flapping, gliding, running, crawling, and swimming in animals have all been studied extensively in the past and have served as sources of inspiration for engineering designs. In this paper, we describe the aeromechanics of a mode of locomotion that straddles ground and air: jumping. The subject of our study is the spider cricket of the family Rhaphidophoridae, an animal that is among the most proficient of long-jumpers in nature. The focus of the study is to understand the aeromechanics of the aerial portion of the jump of this animal. The research employs high-speed videogrammetry to track the crickets’ posture and appendage orientation throughout their jumps. Experiments demonstrate that these insects employ carefully controlled and coordinated positioning of their limbs during their jumps so as to increase jump distance and stabilize body posture. Simple phenomenological models based on drag laws indicate that the conformation of the limbs during the latter portion of the jump is stable to pitch and enables these animals to land in a controllable manner. Insights from this study could be useful in the design of micro-robots that exploit jumping as a means of locomotion.
Use of an Autonomous Surface Vehicle reveals small-scale diel vertical migrations of zooplankton and susceptibility to light pollution under low solar irradiance
Authors: Ludvigsen Martin , Berge Jørgen , Geoffroy Maxime , Cohen Jonathan H. , De La Torre Pedro R. , Nornes Stein M. , Singh Hanumant , Sørensen Asgeir J. , Daase Malin , Johnsen Geir
Published: January 2018

Using new enabling technologies, we document behavioral patterns and susceptibility to light pollution never previously seen.
In vivo tissue regeneration with robotic implants
Authors: Damian Dana D. , Price Karl , Arabagi Slava , Berra Ignacio , Machaidze Zurab , Manjila Sunil , Shimada Shogo , Fabozzo Assunta , Arnal Gustavo , Van Story David , Goldsmith Jeffrey D. , Agoston Agoston T. , Kim Chunwoo , Jennings Russell W. , Ngo Peter D. , Manfredi Michael , Dupont Pierre E.
Published: January 2018

A robotic implant for inducing tissue growth in tubular organs is demonstrated through esophageal lengthening in swine.
Dot/Icm-Translocated Proteins Important for Biogenesis of the Coxiella burnetii-Containing Vacuole Identified by Screening of an Effector Mutant Sublibrary
Authors: Crabill Emerson , Schofield Whitman B. , Newton Hayley J. , Goodman Andrew L. , Roy Craig R.
Published: January 2018

Coxiella burnetii
is an intracellular pathogen that replicates in a lysosome-derived vacuole. A determinant necessary for
C. burnetii
virulence is the Dot/Icm type IVB secretion system (T4SS). The Dot/Icm system delivers more than 100 proteins, called type IV effectors (T4Es), across the vacuolar membrane into the host cell cytosol. Several T4Es have been shown to be important for vacuolar biogenesis. Here, transposon (Tn) insertion sequencing technology (INSeq) was used to identify
C. burnetii
Nine Mile phase II mutants in an arrayed library, which facilitated the identification and clonal isolation of mutants deficient in 70 different T4E proteins. These effector mutants were screened in HeLa cells for deficiencies in
Coxiella
-containing vacuole (CCV) biogenesis. This screen identified and validated seven new T4Es that were important for vacuole biogenesis. Loss-of-function mutations in
cbu0414
(
coxH1
),
cbu0513
,
cbu0978
(
cem3
),
cbu1387
(
cem6
),
cbu1524
(
caeA
),
cbu1752
, or
cbu2028
resulted in a small-vacuole phenotype. These seven mutant strains produced small CCVs in all cells tested, which included macrophage-like cells. The
cbu2028
::Tn mutant, though unable to develop large CCVs, had intracellular replication rates similar to the rate of the parental strain of
C. burnetii
, whereas the other six effector mutants defective in CCV biogenesis displayed significant reductions in intracellular replication. Vacuoles created by the
cbu0513
::Tn mutant did not accumulate lipidated microtubule-associated protein 1A/1B light chain 3 (LC3-II), suggesting a failure in fusion of the CCV with autophagosomes. These seven T4E proteins add to the growing repertoire of
C. burnetii
factors that contribute to CCV biogenesis.
Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) adnexectomy for benign pathology compared with laparoscopic excision (NOTABLE): a protocol for a randomised controlled trial
Authors: Baekelandt Jan Filip , De Mulder Peter A , Le Roy Ilse , Mathieu Chantal , Laenen Annouschka , Enzlin Paul , Weyers Steven , Mol Ben W J , Bosteels Jan J A
Published: January 2018

Introduction

Natural orifice transluminal endoscopic surgery (NOTES) uses natural orifices to access the cavities of the human body to perform surgical interventions. NOTES limits the magnitude of surgical trauma and potentially reduces postoperative pain. Our group published a protocol on a randomised study comparing transvaginal NOTES (vNOTES) versus laparoscopy for hysterectomy (HALON). We simultaneously designed a similar randomised controlled trial (RCT) comparing vNOTES with laparoscopy for adnexectomy. To the best of our knowledge, this is the first RCT comparing vNOTES with laparoscopy for adnexal surgery.

Methods and analysis

The methodology of the Notes Adnexectomy for Benign Indication versus Laparoscopic Excision (NOTABLE) study is similar to that of the HALON trial. Women aged 18–70 years with an indication for benign adnexal surgery will be eligible. We will use stratification according to adnexal size. Entrants will be randomised to the laparoscopic treatment (control) or vNOTES (intervention). Participants will be evaluated on days 0–7 and at 3 and 6 months. The primary outcome will be the proportion of women successfully treated by removing an adnexa by the allocated technique without conversion. We will collect the following data (secondary outcomes): proportion of women hospitalised on the day of surgery, postoperative pain scores measured two times per day from day 1 to 7, total dosage of pain killers used from day 1 to 7, hospital readmission during the first 6 weeks, dyspareunia and sexual well-being at baseline, 3 and 6 months using a validated questionnaire (Short Sexual Functioning Scale), health-related quality of life at baseline, 3 and 6 months after surgery using a validated questionnaire (EQ-5D-3L), duration of surgical intervention, infection or other surgical complications and direct costs up to 6 weeks following surgery. For the primary outcome measure, a one-sided 95% CI of the difference in the proportions of women with a successful removal of the uterus by the randomised technique will be estimated. Non-inferiority will be concluded when 15% lies above the upper limit of this 95% CI.

Ethics and dissemination

The study was approved on 1 December 2015 by the EthicsCommitteeof the Imelda Hospital (registration no: 689), Bonheiden, Belgium. We aim to present the final results of the NOTABLE trial in peer-reviewed journals and at scientific meetings within 4 years after the start of the recruitment.

Trial registration number

NCT02630329.
Managing cognitive impairment following stroke: protocol for a systematic review of non-randomised controlled studies of psychological interventions
Authors: Merriman Niamh A , Sexton Eithne , Donnelly Nora-Ann , McCabe Grainne , Walsh Mary E , Rohde Daniela , Gorman Ashleigh , Jeffares Isabelle , Pender Niall , Williams David , Horgan Frances , Doyle Frank , Wren Maev-Ann , Bennett Kathleen E , Hickey Anne
Published: January 2018

Introduction

Stroke is one of the primary causes of death and disability worldwide, leaving a considerable proportion of survivors with persistent cognitive and functional deficits. Despite the prevalence of poststroke cognitive impairment, there is no established treatment aimed at improving cognitive function following a stroke. Therefore, the aims of this systematic review are to identify psychological interventions intended to improve poststroke cognitive function and establish their efficacy.

Methods and analysis

A systematic review of non-randomised controlled studies that investigated the efficacy of psychological interventions aimed at improving cognitive function in stroke survivors will be conducted. Electronic searches will be performed in the PubMed, Embase and PsycINFO databases, the search dating from the beginning of the index to February 2017. Reference lists of all identified relevant articles will be reviewed to identify additional studies not previously identified by the electronic search. Potential grey literature will be reviewed using Google Scholar. Titles and abstracts will be assessed for eligibility by one reviewer, with a random sample of 50% independently double-screened by second reviewers. Any discrepancies will be resolved through discussion, with referral to a third reviewer where necessary. Risk of bias will be assessed with the Risk of Bias in Non-randomized Studies of Interventions tool. Meta-analyses will be performed if studies are sufficiently homogeneous. This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The quality of the evidence regarding cognitive function will be assessed according to the Grading of Recommendations Assessment, Development and Evaluation.

Ethics and dissemination

This systematic review will collect secondary data only and as such ethical approval is not required. Findings will be disseminated through presentations and peer-reviewed publication. This review will provide information on the effectiveness of psychological interventions for poststroke cognitive impairment, identifying which psychological interventions are effective for improving poststroke cognitive function.

PROSPERO registration number

CRD42017069714.
A qualitative study of patients’ feedback about Outpatient Parenteral Antimicrobial Therapy (OPAT) services in Northern England: implications for service improvement
Authors: Twiddy Maureen , Czoski Murray Carolyn J , Mason Samantha J , Meads David , Wright Judy M , Mitchell Elizabeth D , Minton Jane
Published: January 2018

Objective

Outpatient parenteral antimicrobial therapy (OPAT) provides opportunities for improved cost savings, but in the UK, implementation is patchy and a variety of service models are in use. The slow uptake in the UK and Europe is due to a number of clinical, financial and logistical issues, including concern about patient safety. The measurement of patient experience data is commonly used to inform commissioning decisions, but these focus on functional aspects of services and fail to examine the relational aspects of care. This qualitative study examines patients’ experiences of OPAT.

Design

In-depth, semistructured interviews.

Setting

Purposive sample of OPAT patients recruited from four acute National Health Service (NHS) Trusts in Northern England. These NHS Trusts between them represented both well-established and recently set-up services running nurse at home, hospital outpatient and/or self-administration models.

Participants

We undertook 28 semistructured interviews and one focus group (n=4).

Results

Despite good patient outcomes, experiences were coloured by patients' personal situation and material circumstances. Many found looking after themselves at home more difficult than they expected, while others continued to work despite their infection. Expensive car parking, late running services and the inconvenience of waiting in for the nurse to arrive frustrated patients, while efficient services, staffed by nurses with the specialist skills needed to manage intravenous treatment had the opposite effect. Many patients felt a local, general practitioner or community health centre based service would resolve many of the practical difficulties that made OPAT inconvenient. Patients could find OPAT anxiety provoking but this could be ameliorated by staff taking the time to reassure patients and provide tailored information.

Conclusion

Services configurations must accommodate the diversity of the local population. Poor communication can leave patients lacking the confidence needed to be a competent collaborator in their own care and affect their perceptions of the service.
Establishing anchor-based minimally important differences (MID) with the EORTC quality-of-life measures: a meta-analysis protocol
Authors: Musoro Zebedee Jammbe , Hamel Jean-Francois , Ediebah Divine Ewane , Cocks Kim , King Madeleine T , Groenvold Mogens , Sprangers Mirjam A G , Brandberg Yvonne , Velikova Galina , Maringwa John , Flechtner Hans-Henning , Bottomley Andrew , Coens Corneel
Published: January 2018

Introduction

As patient assessment of health-related quality of life (HRQOL) in cancer clinical trials has increased over the years, so has the need to attach meaningful interpretations to differences in HRQOL scores between groups and changes within groups. Determining what represents a minimally important difference (MID) in HRQOL scores is useful to clinicians, patients and researchers, and can be used as a benchmark for assessing the success of a healthcare intervention. Our objective is to provide an evidence-based protocol to determine MIDs for the European Organisation for Research and Treatment for Cancer Quality of life Questionnaire core 30 (EORTC QLQ-C30). We will mainly focus on MID estimation for group-level comparisons. Responder thresholds for individual-level change will also be estimated.

Methods and analysis

Data will be derived from published phase II and III EORTC trials that used the QLQ-C30 instrument, covering several cancer sites. We will use individual patient data to estimate MIDs for different cancer sites separately. Focus is on anchor-based methods. Anchors will be selected per disease site from available data. A disease-oriented and methodological panel will provide independent guidance on anchor selection. We aim to construct multiple clinical anchors per QLQ-C30 scale and also to compare with several anchor-based methods. The effects of covariates, for example, gender, age, disease stage and so on, will also be investigated. We will examine how our estimated MIDs compare with previously published guidelines, hence further contributing to robust MID guidelines for the EORTC QLQ-C30.

Ethics and dissemination

All patient data originate from completed clinical trials with mandatory written informed consent, approved by local ethical committees. Our findings will be presented at scientific conferences, disseminated via peer-reviewed publications and also compiled in a MID ‘blue book’ which will be made available online on the EORTC Quality of Life Group website as a free guideline document.
Association of erythrocyte parameters with metabolic syndrome in the Pearl River Delta region of China: a cross sectional study
Authors: Huang Ling Ling , Dou Dong-Mei , Liu Nan , Wang Xiao Xiao , Fu Li-Ying , Wu Xiao , Wang Peixi
Published: January 2018

Objective

Increasing studies have reported that erythrocyte parameters, including red blood cells (RBCs), haematocrit (HCT), haemoglobin (Hb) and red blood cell distribution width (RDW), are associated with metabolic syndrome (MetS) in adults worldwide. However, the association, stratified by sex, remains to be elucidated, particularly in the Pearl River Delta region of China. Therefore, our aim was to explore the association of erythrocyte parameters with MetS, stratified by sex, in the Pearl River Delta region of China.

Methods

In this cross sectional study, 2161 men and 2511 women were enrolled. MetS was diagnosed using a modified version of the Adult Treatment Panel III criteria. Logistic regression analyses were performed to calculate adjusted ORs of erythrocyte parameters associated with MetS stratified by sex.

Results

The prevalence of MetS was higher in women than in men (35.2%vs26.7%). RBC, HCT, Hb and RDW values increased linearly with the number of MetS components from 0 to 5 identified in both men and women. Among men, the ORs of MetS risk increased across the tertiles of Hb (Q2: OR=1.921, 95% CI=1.170 to 3.151; Q3: OR=1.992, 95%CI=1.198 to 3.312). Men in the highest tertiles of RDW had a 2.752-fold increased risk of suffering from MetS compared with those in the reference group. Among women, the ORs of MetS risk also increased across the tertiles of Hb (Q2: OR=1.538, 95%CI=1.008 to 2.348; Q3: OR=1.665, 95%CI=1.075 to 2.578). Women in the highest tertiles of RBC had a 1.718-fold increased risk of experiencing MetS compared with those in the reference group.

Conclusions

MetS was more prevalent in women than in men. The association between erythrocyte parameters and MetS differed between the sexes. RBC and Hb were identified as risk factors for MetS in women and Hb and RDW as risk factors in men.
Contemporary management and outcomes in congenitally corrected transposition of the great arteries
Authors: Kutty Shelby , Danford David A , Diller Gerhard-Paul , Tutarel Oktay
Published: January 2018

Congenitally corrected transposition of the great arteries (ccTGA) can occur in isolation, or in combination with other structural cardiac anomalies, most commonly ventricular septal defect, pulmonary stenosis and tricuspid valve disease. Clinical recognition can be challenging, so echocardiography is often the means by which definitive diagnosis is made. The tricuspid valve and right ventricle are on the systemic arterial side of the ccTGA circulation, and are therefore subject to progressive functional deterioration. The natural history of ccTGA is also greatly influenced by the nature and severity of accompanying lesions, some of which require surgical repair. Some management strategies leave the right ventricle as the systemic arterial pump, but carry the risk of worsening heart failure. More complex ‘double switch’ repairs establish the left ventricle as the systemic pump, and include an atrial baffle to redirect venous return in combination with either arterial switch or Rastelli operation (if a suitable ventricular septal defect permits). Occasionally, the anatomic peculiarities of ccTGA do not allow straightforward biventricular repair, and Fontan palliation is a reasonable option. Regardless of the approach selected, late cardiovascular complications are relatively common, so ongoing outpatient surveillance should be established in an age-appropriate facility with expertise in congenital heart disease care.
Epidemiology of new-onset atrial fibrillation following coronary artery bypass graft surgery
Authors: Filardo Giovanni , Damiano Ralph J , Ailawadi Gorav , Thourani Vinod H , Pollock Benjamin D , Sass Danielle M , Phan Teresa K , Nguyen Hoa , da Graca Briget
Published: January 2018

Objectives

Postoperative atrial fibrillation (AF) following coronary artery bypass graft surgery (CABG) is significantly associated with reduced survival, but poor characterisation and inconsistent definitions present barriers to developing effective prophylaxis and management. We sought to address this knowledge gap.

Methods

From 2002 to 2010, 11 239 consecutive patients without AF underwent isolated CABG at five sites. Clinical data collected for the Society of Thoracic Surgeons (STS) Database were augmented with details on AF detected via continuous in-hospital ECG/telemetry monitoring to assess new-onset post-CABG AF (adjusted for STS risk of mortality); time to first AF; durations of first and longest AF episodes; total in-hospital time in AF; number of in-hospital AF episodes; operative mortality; stroke; discharge in AF; and length of stay (LOS).

Results

Unadjusted incidence of new-onset post-CABG AF was 29.5%. Risk-adjusted incidence was 33.1% and varied little over time (P=0.139). Among 3312 patients with post-CABG AF, adjusted median time to first AF was 52 (IQR: 48–55) hours; mean (SD) duration of first and longest events were 7.2 (5.3,9.1) and 13.1 (10.4,15.9) hours, respectively, and adjusted median total time in AF was 22 (IQR: 18–26) hours. Adjusted rates of operative mortality, stroke and discharge in AF did not vary significantly over time (P=0.156, P=0.965 and P=0.347, respectively). LOS varied (P=0.035), but in no discernible pattern.

Conclusions

Each year, ~800 000 people undergo CABG worldwide; >264 000 will develop post-CABG AF. Onset is typically 2–3 days post-CABG and episodes last, on average, several hours. Effective prophylaxis and management is urgently needed to reduce associated risks of adverse outcomes.
Low prevalence of ideal cardiovascular health in Peru
Authors: Benziger Catherine P , Zavala-Loayza José Alfredo , Bernabe-Ortiz Antonio , Gilman Robert H , Checkley William , Smeeth Liam , Malaga German , Miranda Juan Jaime
Published: January 2018

Background

The prevalence of and factors associated with ideal cardiovascular health (ICH) by sociodemographic characteristics in Peru is not well known.

Methods

The American Heart Association’s ICH score comprised 3 ideal health factors (blood pressure, untreated total cholesterol and glucose) and 4 ideal health behaviours (smoking, body mass index, high physical activity and fruit and vegetable consumption). ICH was having 5 to 7 of the ideal health metrics. Baseline data from the Center of Excellence in Chronic Diseases, a prospective cohort study in adults aged ≥35 years in 4 Peruvian settings, was used (n=3058).

Results

No one met all 7 of ICH metrics while 322 (10.5%) had ≤1 metric. Fasting plasma glucose was the most prevalent health factor (72%). Overall, compared with ages 35–44 years, the 55–64 years age group was associated with a lower prevalence of ICH (prevalence ratio 0.54, 95% CI 0.40 to 0.74, P<0.001). Compared with those in the lowest tertile of socioeconomic status, those in the middle and highest tertiles were less likely to have ICH after adjusting for sex, age and education (P<0.001).

Conclusion

There is a low prevalence of ICH. This is a benchmark for the prevalence of ICH factors and behaviours in a resource-poor setting.
Against proportional shortfall as a priority-setting principle
Authors: Altmann Samuel
Published: January 2018

As the demand for healthcare rises, so does the need for priority setting in healthcare. In this paper, I consider a prominent priority-setting principle: proportional shortfall. My purpose is to argue that proportional shortfall, as a principle, should not be adopted. My key criticism is that proportional shortfall fails to consider past health.

Proportional shortfall is justified as it supposedly balances concern for prospective health while still accounting for lifetime health, even though past health is deemed irrelevant. Accounting for this lifetime perspective means that the principle may indirectly consider past health by accounting for how far an individual is from achieving a complete, healthy life. I argue that proportional shortfall does not account for this lifetime perspective as it fails to incorporate the fair innings argument as originally claimed, undermining its purported justification.

I go on to demonstrate that the case for ignoring past health is weak, and argue that past health is at least sometimes relevant for priority-setting decisions. Specifically, when an individual’s past health has a direct impact on current or future health, and when one individual has enjoyed significantly more healthy life years than another.

Finally, I demonstrate that by ignoring past illnesses, even those entirely unrelated to their current illness, proportional shortfall can lead to instances of double jeopardy, a highly problematic implication. These arguments give us reason to reject proportional shortfall.
Major adverse cardiac and cerebrovascular event and patients’ quality of life after endoscopic vein harvesting as compared with open vein harvest (MAQEH): a pilot study
Authors: Luckraz Heyman , Cartwright Carly , Nagarajan Kumaresan , Kaur Prabhjeet , Nevill Alan
Published: January 2018

Background

This is a prospective, comparative, pilot and follow-up (2-year postoperatively) study in patients undergoing coronary artery bypass graft surgery where the long saphenous vein was harvested either by the endoscopic vein harvest (EVH) technique or open vein harvest (OVH) technique. Quality of life (QOL) and major adverse cardiac and cerebrovascular events (MACCE) were assessed.

Methods

Alive patients who were initially part of a pilot study when EVH was introduced in our institution were included (n=48 EVH, n=49 OVH). Patients were sent a QOL questionnaire (SF12v2; 12-item medical outcomes study short form health survey version 2.0), and their cardiologist and general practitioner were contacted to assess MACCE.

Results

Median follow-up was 32 and 33 months, respectively. Three patients died (2 EVH, 1 OVH). Of the remaining 97 patients who were sent a questionnaire, 76% patients returned the form. More patients from the EVH group returned the QOL questionnaire (82% vs 71%). Time taken to return to normal daily activities was much shorter in EVH (median 6 (2–30) weeks) compared with OVH (median 9 (2–50) weeks) (P<0.05). QOL questionnaire revealed significant difference in physical score at follow-up: 45.3 (10.2) for EVH group and 40.7 (11.0) for OVH group (P<0.05). There was no difference in mental scores (46.9 (10.5) vs 49.2 (9.1), P=0.4). There were no significant differences in MACCEs including death between the two groups (12.2% vs 13.9%, P=0.5).

Conclusion

EVH patients returned to normal daily activities faster than OVH patients and experienced better physical QOL even after 2 years postoperatively with no increase in MACCE during follow-up.
Polypoid cystitis in a male entire springer spaniel puppy
Authors: Ruiz Guillaume , Day Michael , Doran Ivan C P , Major Alison , Warman Sheena M
Published: January 2018

A 14‐week‐old entire male springer spaniel was presented for haematuria. Investigations identified polypoid cystitis. Medical management failed to improve the clinical signs, and the dog underwent surgical excision of the bladder polyps at eight months old. Histopathological examination of the polyps identified granulomatous foci containing crystalline material. Eighteen months after surgery, the dog has had no further episode of haematuria and repeat ultrasound‐documented resolution of the lesions. This is the youngest reported case of polypoid cystitis in dogs and the first report of this lesion associated with crystal inclusions within the polyps.
Accelerating cosmologies with nonlinear electrodynamics
Authors: Singh G.P. , Hulke N. , Singh Ashutosh
Published: January 2018

In this paper, we consider the framework of nonlinear electrodynamics in locally rotationally symmetric (LRS) Bianchi-I universe model composed of magnetic fluid. It has been shown that an accelerated universe expansion takes place if the nonlinear electromagnetic field is a source of gravitational field. In this model, after the big bang, the universe undergoes inflation and the accelerated expansion, dissipates the initial anisotropy of the curvature part without using a selected initial condition. Further validity of generalised second law of thermodynamics in the cosmological model enclosed by apparent horizon is investigated. We also discuss the classical stability of the cosmological model and observational viability of the model.
Security Collapse in the HTTPS Market
Authors: Arnbak Axel , Asghari Hadi , Van Eeten Michel , Van Eijk Nico
Published: January 2018

HTTPS (Hypertext Transfer Protocol Secure) has evolved into the de facto standard for secure Web browsing. Through the certificate-based authentication protocol, Web services and Internet users first authenticate one another ("shake hands") using a TLS/SSL certificate, encrypt Web communications end-to-end, and show a padlock in the browser to signal that a communication is secure. In recent years, HTTPS has become an essential technology to protect social, political, and economic activities online.
Polymers in Fluid Flows
Authors: Benzi Roberto , Ching Emily S.C.
Published: January 2018

The interaction of flexible polymers with fluid flows leads to a number of intriguing phenomena observed in laboratory experiments, namely drag reduction, elastic turbulence, and heat transport modification in natural convection, and is one of the most challenging subjects in soft matter physics. In this review, we examine our present knowledge on the subject. Our present knowledge is mostly based on direct numerical simulations performed in the last twenty years, which have successfully explained, at least qualitatively, most of the experimental results. Our goal is to disentangle as much as possible the basic mechanisms acting in the system in order to capture the basic features underlying different theoretical approaches and explanations.
Mosquito Immunobiology: The Intersection of Vector Health and Vector Competence
Authors: Bartholomay Lyric C. , Michel Kristin
Published: January 2018

As holometabolous insects that occupy distinct aquatic and terrestrial environments in larval and adult stages and utilize hematophagy for nutrient acquisition, mosquitoes are subjected to a wide variety of symbiotic interactions. Indeed, mosquitoes play host to endosymbiotic, entomopathogenic, and mosquito-borne organisms, including protozoa, viruses, bacteria, fungi, fungal-like organisms, and metazoans, all of which trigger and shape innate infection-response capacity. Depending on the infection or interaction, the mosquito may employ, for example, cellular and humoral immune effectors for septic infections in the hemocoel, humoral infection responses in the midgut lumen, and RNA interference and programmed cell death for intracellular pathogens. These responses often function in concert, regardless of the infection type, and provide a robust front to combat infection. Mosquito-borne pathogens and entomopathogens overcome these immune responses, employing avoidance or suppression strategies. Burgeoning methodologies are capitalizing on this concerted deployment of immune responses to control mosquito-borne disease.