bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of waves and currents on the growth rate of the kelp Laminaria digitata (Phaeophyceae)
Authors: Millar Rachel V. , Houghton Jonathan D. R. , Elsäβer Björn , Mensink Paul J. , Kregting Louise
Published: October 2019

The kelp Laminaria digitata growing in the low intertidal region along energetic coastlines are exposed to a range of hydrodynamic environments. Macroalgae in the intertidal zone can experience both waves and currents independently, but it is unknown how they influence growth rate. Relative growth rate of the meristematic region and the entire blade of L. digitata were measured to assess the influence of wave and current motion from three hydrodynamic environments: low current and low wave (LCLW), high current and low wave (HCLW), and high wave and low current (HWLC). Alongside hydrodynamic data, seawater nutrient concentrations and temperature were also collected and analyzed. Results suggest that differences in L. digitata relative growth rates were not attributed to the seawater nutrient concentrations or temperature, but attributed to the hydrodynamic environments. At the high current condition, kelp growth rate of the meristematic region was enhanced by 45% compared to the high wave condition. When including the entire blade growth rate, an average increase of 25% was observed between the high current and high wave condition. Potentially, the division in growth rate observed between the wave and current motion is related to the frequency and magnitude at which the hydrodynamic forces act. These findings highlight the complexity of the hydrodynamic environment and that forces associated with waves and currents may have a significant role on the productivity of kelp.
Fatal hemoptysis after bronchoscopic biopsy in a dog
Authors: Greenway Clayton , Rozanski Elizabeth , Johnson Kelsey , Cornejo Lilian , Abelson Amanda , Robinson Nicholas
Published: October 2019

An 8‐year‐old 24.6 kg mixed breed dog underwent bronchoscopy for evaluation of a persistent progressive cough. Bronchoscopy documented a markedly thick and irregular, cobblestone appearance of the mucosa. A bronchoscopic biopsy was obtained; immediately after the biopsy, a large amount of hemorrhage poured from the endotracheal tube. Multiple efforts to control the hemorrhage were unsuccessful and the dog suffered a cardiopulmonary arrest and could not be revived. A necropsy was performed, which was significant for pallor, evidence of prior heartworm disease, prominent bronchial arteries, and erosion of the submucosal vessels at the site of the biopsy. The cause of death was hemorrhage associated with transbronchial biopsy of an enlarged bronchial artery associated with heartworm disease. This report describes a rare complication of a routine diagnostic procedure.
Modal arguments against materialism
Authors: Pelczar Michael
Published: October 2019

We review existing strategies for bringing modal intuitions to bear against materialist theories of consciousness, and then propose a new strategy. Unlike existing strategies, which assume that imagination (suitably constrained) is a good guide to modal truth, the strategy proposed here makes no assumptions about the probative value of imagination. However, unlike traditional modal arguments, the argument developed here delivers only the conclusion that we should not believe that materialism is true, not that we should believe that it is false.
Ratcheting Behavior of Intervertebral Discs Under Cyclic Compression: Experiment and Prediction
Authors: Zhang Chun‐qiu , Zhang Tao , Gao Lilan , Du Cheng‐fei , Liu Qing , Liu Hai‐ying , Wang Xin
Published: October 2019

Objective

To evaluate the ratcheting behavior of intervertebral discs (IVD) by experiments and theoretical study.

Method

The lumbar spines of sheep were obtained at a local slaughterhouse, and the IVD was processed with upper and lower vertebral bodies (about 5 mm) to ensure the mechanical state of the IVD in situ. The ratcheting tests of uniaxial cyclic compression loading for disc samples is carried out using the Electronic Universal Fatigue Testing System at room temperature. The effects of different stress variations, stress rates, as well as different segments on ratcheting behavior of discs were investigated.

Results

The ratcheting strain evolution of lumbar IVD include stages of sharp increase and asymptotic stability. Both the ratcheting strain and ratcheting strain rate increase with an increase of stress variation (R = 0.962, P = 0.004) but decrease with an increase of the stress rate (R = −0.876, P = 0.019 ). Compression stiffness increases with an increase of the stress rate (R = 0.964, P = 0.004 ) or stress variation (R = 0.838, P = 0.037). Compared with L5–6, the L6–7 disc showed less ratcheting strain (P = 0.04 ), indicating that the disc at this segment was more resistant to the impact of the ratcheting cycle. In addition, ratcheting strain evolution was predicted using a ratcheting evolution constitutive equation, and the predicted results were in good agreement with experimental data.

Conclusions

The ratcheting behavior occurs in IVD, and this cumulative deformation is consistent with the general ratcheting behavior. The constitutive equation can predict the ratcheting strain evolution of IVD very well. These results are of great significance for the analysis of defects and the development of repair in IVD.
Functional analysis of RPS27 mutations and expression in melanoma
Authors: Floristán Alfredo , Morales Leah , Hanniford Douglas , Martinez Carlos , Castellano‐Sanz Elena , Dolgalev Igor , Ulloa‐Morales Alejandro , Vega‐Saenz de Miera Eleazar , Moran Una , Darvishian Farbod , Osman Iman , Kirchhoff Tomas , Hernando Eva
Published: October 2019

Next‐generation sequencing has enabled genetic and genomic characterization of melanoma to an unprecedent depth. However, the high mutational background plus the limited depth of coverage of whole‐genome sequencing performed on cutaneous melanoma samples make the identification of novel driver mutations difficult. We sought to explore the somatic mutation portfolio in exonic and gene regulatory regions in human melanoma samples, for which we performed targeted sequencing of tumors and matched germline DNA samples from 89 melanoma patients, identifying known and novel recurrent mutations. Two recurrent mutations found in the RPS27 promoter associated with decreased RPS27 mRNA levels in vitro. Data mining and IHC analyses revealed a bimodal pattern of RPS27 expression in melanoma, with RPS27‐low patients displaying worse prognosis. In vitro characterization of RPS27‐high and RPS27‐low melanoma cell lines, as well as loss‐of‐function experiments, demonstrated that high RPS27 status provides increased proliferative and invasive capacities, while low RPS27 confers survival advantage in low attachment and resistance to therapy. Additionally, we demonstrate that 10 other cancer types harbor bimodal RPS27 expression, and in those, similarly to melanoma, RPS27‐low expression associates with worse clinical outcomes. RPS27 promoter mutation could thus represent a mechanism of gene expression modulation in melanoma patients, which may have prognostic and predictive implications.
Hypoxia‐inducible factor and bacterial infections in chronic obstructive pulmonary disease
Authors: Shukla Shakti D. , Walters E. Haydn , Simpson Jodie L. , Keely Simon , Wark Peter A.B. , O'Toole Ronan F. , Hansbro Philip M.
Published: October 2019

COPD is a seriously disabling respiratory condition that inexorably progresses to disability and mortality. It affects approximately 10% of the population globally with a greater prevalence at advanced ages. Airway bacterial infections complicate the disease course in most COPD patients, leading to increased symptoms, more rapid decline in lung function, acute exacerbations and reduced quality of life. With increasing bacterial resistance to antibiotics and adverse effects of conventional treatments, new effective non‐antibiotic antimicrobial therapies are urgently needed to manage COPD. Hypoxia‐inducible factor (HIF)‐1α is an important transcriptional regulator of cellular responses to hypoxia, oxidants and inflammation, and is overexpressed in the lungs of COPD patients. Recent evidence shows that increased HIF‐1α expression can upregulate the platelet‐activating factor receptor (PAFR) on the airway epithelial surface that is increased in smokers and particularly COPD patients. The receptor is utilized by PAFR‐dependent bacteria (Streptococcus pneumoniae, Haemophilus influenzae and Pseudomonas aeruginosa) to induce infection in both the respiratory and gastrointestinal (GI) tracts. However, the importance and mechanism of HIF‐1α in augmenting PAFR‐dependent bacterial infections in COPD are poorly understood. Here, we review the evidence for the roles of local tissue hypoxia‐induced inflammation, HIF‐1α and PAFR in facilitating bacterial infections in COPD. Blocking PAFR may provide a novel antimicrobial approach to manage bacterial infections in COPD.
Characterization and confirmation of the HLA‐DQA1*04:01:01:09 allele, identified in a Brazilian individual
Authors: Vianna Romulo , Secco Danielle , Santos Angela , Porto Luís Cristóvão
Published: October 2019

Characterization and confirmation of an HLA‐DQA1*04:01:01 variant, HLA‐DQA1*04:01:01:09.
CO₂ STRIPPING FROM DIETHANOLAMINE USING MEMBRANE CONTACTORS: MODEL VALIDATION AND MEMBRANE WETTABILITY
Authors: Mohammed H. N. , Lateef Omar S. , Abdullah Ghassan H. , Ahmad A. L.
Published: October 2019

In the present work, CO2 desorption (stripping) from diethanolamine (DEA) solution using polyvinylidene ﬂuoride hollow fiber membrane contactor is theoretically investigated. A comprehensive two dimensional mathematical model is developed to evaluate the membrane wettability when DEA solution is used at different operating conditions such as sweeping gas flow rate, initial CO2 loading and liquid phase temperature. In addition, the impact of flow rate of liquid phase on the CO2 stripping performance was theoretically investigated. The simulated results were compared with the experimental data obtained from literature. The results revealed that the PVDF membrane was suffered from wetting at studied operating conditions.
GAUSSIAN FUZZY ANALYTIC HIERARCHY PROCESS FOR THE EVALUATION OF BENEFIT, COST, AND RISK ANALYSIS IN THE INDONESIAN OIL AND GAS PROCESSING AREA
Authors: Wicaksono Fermi Dwi , Arshad Yusri , Sihombing Haeryip , Baihaqi Imam
Published: October 2019

In the oil and gas processing area, adequate risk control should be prearranged to prevent serious accidents, such as major gas leak, fire, and explosion. Installing gas detectors at appropriate technology is one of indispensable conditions for an implementation of risk reduction measures. Open-path infrared and ultrasonic leak gas detector provide wide coverage of gas detection. This capability is advantageous to detect unintentionally gas release in wide coverage and windy-climate processing area. On the other hand, the installation and maintenance cost of those gas detectors are relatively high compared to point infrared and catalytic gas detector. Gaussian fuzzy analytic hierarchy process (Gaussian FAHP) is implemented to evaluate the selection of gas detector technology in terms of benefit, cost and risk criteria. Ten expert panelists from production, safety, and maintenance departments are involved in Delphi Technique to assess the sub-criteria of Gaussian FAHP. The Gaussian FAHP evaluation reveals that point infrared gas detector has the highest value among all gas detector technologies. This means that point infrared technology acquires efficient value in delivering service to process safety operation. The obtained result of consistency ratio is always below 0.1 (CR<0.1). By these terms, the Gaussian FAHP is consistent and applicable. By changing 50% amount of weight in all sub-criteria, there is no alternatives rank position change. The sensitivity analysis proves that the Gaussian FAHP evaluation in the research is consistent irrespectively of the sub-criteria change. The integration of Delphi Technique and Gaussian FAHP in the research is the scientific work to evaluate the best applied detector technology in the oil and gas processing area.
MODELLING OF PARTIAL DISCHARGE ANALYSIS SYSTEM USING WAVELET TRANSFORM DENOISING TECHNIQUE IN LABVIEW ENVIRONMENT
Authors: Nazifah Abdullah A. , Hamadi S. H. K. , Isa M. , Ismail B. , Nanyan A. N. , Abdullah A. Z.
Published: October 2019

Partial discharge (PD) measurement is an essential to detect and diagnose the existence of the PD. However, this measurement has faced noise disturbance in industrial environments. Thus, PD analysis system using discrete wavelet transform (DWT) denoising technique via Laboratory Virtual Instrument Engineering Workbench (LabVIEW) software is proposed to distinguish noise from the measured PD signal. In this work, the performance of denoising process is analyzed based on calculated mean square error (MSE) and signal to noise ratio (SNR). The result is manipulated based on Haar, Daubechies, Coiflets, Symlets and Biorthogonal type of mother wavelet with different decomposition levels. From the SNR results, all types of the mother wavelet are suitable to be used in denoising technique since the value of SNR is in large positive value. Therefore, further studies were conducted and found out that db14, coif3, sym5 and bior5.5 wavelets with least MSE value are considered good to be used in the denoising technique. However, bior5.5 wavelet is proposed as the most optimum mother wavelet due to consistency of producing minimum value of MSE and followed by db14.
NEW CUBIC TIMMER TRIANGULAR PATCHES WITH C¹ AND G¹ CONTINUITY
Authors: Mohd Ali Fatin Amani , Abdul Karim Samsul Ariffin , Dass Sarat Chandra , Skala Vaclav , Saaban Azizan , Hasan Mohammad Khatim , Hashim Ishak
Published: October 2019

In this study, a new cubic Timmer triangular patch is constructed by extending the univariate cubic Timmer basis functions. The best scheme that lies towards the control polygon is cubic Timmer curve and surface compared to the other methods. From the best of our knowledge, nobody has extended the univariate cubic Timmer basis to the bivariate triangular patch. The construction of the proposed cubic Timmer triangular patch is based on the main idea of the cubic Ball and cubic Bezier triangular patches construction. Some properties of the new cubic Timmer triangular patch are investigated. Furthermore, the composite cubic Timmer triangular patches with parametric continuity (C1) and geometric continuity (G1) are discussed. Simple error analysis between the triangular patches and one test function is provided for each continuity type. Numerical and graphical results are presented by using Mathematica and MATLAB.
A Thermal Design and Experimental Investigation for the Fast Charging Process of a Lithium-Ion Battery Module With Liquid Cooling
Authors: Chen Siqi , Bao Nengsheng , Peng Xiongbin , Garg Akhil , Chen Zhanglin
Published: October 2019

The appropriate temperature distribution is indispensable to lithium-ion battery module, especially during the fast charging of the sudden braking process. Thermal properties of each battery cell are obtained from numerical heat generation model and experimental data, and the deviation of thermophysical performance is analyzed by K-means clustering and hierarchical clustering to select battery cells with similar performance. Thermal performance of lithium-ion cells under different charging rates is investigated in experiments and the effects of different mini-channel designs discussed using numerical simulation, maximum temperature, maximum pressure, and temperature standard deviation are compared by both numerical calculation and experimental validation. Two kinds of cooling plates are selected, considering the uniformity of temperature distribution and energy consumption, respectively. All of these cooling plate designs have the ability to constrain the maximum temperature and temperature standard deviation within 306 K and 1.2 K, respectively. Additionally, this thermal management system does not need too much energy consumption. In experimental validation, deviation of maximum temperature is measured to be within 2.2 K and difference of temperature standard deviation is also within tolerance.
Battery Thermal Management Using Phase Change Material-Metal Foam Composite Materials at Various Environmental Temperatures
Authors: Barnes Derek , Li Xianglin
Published: October 2019

This investigation into phase change material (PCM)-based passive thermal management systems was conducted via an experimental approach using 19.5 A h lithium iron phosphate cells with dimensions of (7.25 × 160 × 227) mm3. Trials were conducted at currents from 1 to 5C and environmental temperatures from 4 to 35 °C to simulate applications at which a Li-ion battery would be expected to perform. Based on comparisons, including an air-only control, the system consisting of PCM combined with five pores per inch (PPI) aluminum foam is the most effective at regulating average battery temperature and temperature gradient. During a 3C discharge trial at room temperature, the PCM-Al foam (5 PPI) system kept the average battery temperature and the maximum temperature difference below 28.1 and 5.2 °C, respectively, compared to the air-only control system which reached values of 48.0 and 17.2 °C, respectively. When analyzing data from trials at 4 and 35 °C, similar results are found with the PCM-Al foam systems being effective at thermal management. Thus, when compared to other systems, preliminary results show great promise in the future for the use of an PCM-Al foam passive thermal management system to effectively regulate the temperature of Li-ion batteries during use.
Novel Specimen Design for Measurement of In-Plane Fracture Toughness of Metals
Authors: Traidia Abderrazak , Chatzidouros Elias , Jouiad Mustapha , Shibly Kaamil-Ur-Rahman
Published: October 2019

Standard-compliant measurement of the in-plane fracture toughness of metals is often challenging due to insufficient material in the through-thickness direction to extract a full single edge bending (SEB) or compact tension (CT) fracture specimen. In the present work, we propose a new specimen design methodology to overcome this challenge. A W-shaped SEB specimen (called W-SEB) was developed, and its topology was optimized using finite element simulations. The new specimen design was validated numerically and experimentally on a case study showing excellent agreement with standard ASTM E1820 actual SEB specimen geometry. In view assessing the anisotropy of the fracture toughness (KQ and crack tip opening displacement (CTOD)) of pipeline steels susceptible to hydrogen-induced cracking (HIC), the W-SEB specimen was tested on X65 and X42 pipeline steel samples taken from the field. Experimental results show an increase in the maximum CTOD along the in-plane direction as compared to the transverse direction for both steel grades. Such experimental results could lead to important considerations with respect to accurate fitness for service assessment of HIC-damaged assets.
A Gaussian Process Model-Guided Surface Polishing Process in Additive Manufacturing
Authors: Jin Shilan , Iquebal Ashif , Bukkapatnam Satish , Gaynor Andrew , Ding Yu
Published: October 2019

Polishing of additively manufactured products is a multi-stage process, and a different combination of polishing pad and process parameters is employed at each stage. Pad change decisions and endpoint determination currently rely on practitioners’ experience and subjective visual inspection of surface quality. An automated and objective decision process is more desired for delivering consistency and reducing variability. Toward that objective, a model-guided decision-making scheme is developed in this article for the polishing process of a titanium alloy workpiece. The model used is a series of Gaussian process models, each established for a polishing stage at which surface data are gathered. The series of Gaussian process models appear capable of capturing surface changes and variation over the polishing process, resulting in a decision protocol informed by the correlation characteristics over the sample surface. It is found that low correlations reveal the existence of extreme roughness that may be deemed surface defects. Making judicious use of the change pattern in surface correlation provides insights enabling timely actions. Physical polishing of titanium alloy samples and a simulation of this process are used together to demonstrate the merit of the proposed method.
Effects of Wakes on Blade Endwall Heat Transfer in High Turbulence Intensity
Authors: Park Sehjin , Sohn Ho-Seong , Cho Hyung Hee , Moon Hee Koo , Han Yang Seok , Ueda Osamu
Published: October 2019

Detailed heat transfer measurements are necessary to protect the blades under harsh and complex flow conditions. Therefore, this study investigated the heat transfer characteristics on the blade endwall under flow conditions that simulate high turbulence intensity of the main flow and the generation of wakes by the trailing edge of the vane. The endwall heat transfer was measured using the naphthalene sublimation method. A turbulence generating grid was installed in a linear cascade to simulate the main flow with high turbulence intensity and a wake generator with a rod bundle was used to simulate the wakes generated by the trailing edge of the vane. In the case of high turbulence intensity without wakes, the main flow with high turbulence intensity (turbulence intensity, T.I = 7.5%) had little impact on the effect of the horseshoe vortex and passage vortex on the heat transfer characteristics. However, increasing turbulence caused the endwall heat transfer to decrease near the pressure side of the blade and increase near the suction side of the blade. On the other hand, the wakes resulted in heat transfer characteristics similar to high turbulence intensity but decreased heat transfer by horseshoe vortex and passage vortex. The endwall heat transfer distributions were similar regardless of the turbulence intensity (T.I = 1.2% and 7.5%) in the cases with wakes (rod passing Strouhal number, S = 0.3). The flow condition of S = 0.3 has a more significant influence on the endwall heat transfer than that of T.I = 7.5%.
Increasing etching depth of sapphire nanostructures using multilayer etching mask
Authors: Chen Yi-An , Chen I-Te , Chang Chih-Hao
Published: October 2019

In this study, the etching of sapphire nanostructures in inductively coupled plasma reactive ion etching using a multilayer etch mask is studied. The goals are to increase the etching depth and enable the fabrication of higher aspect ratio nanostructures in sapphire, which is traditionally difficult to micromachine. The etching rates and chemistry of different masking materials are examined for better understanding of the etching process. The etching of sapphire nanostructures is then studied using single and multilayer masks with Cl2-based chemistry. The fabrication results show that using the multilayer mask is an effective method for sapphire nanostructure fabrication, increasing the maximum etching depth from 25 to 230 nm for a ninefold improvement. To further validate the optical properties of fabricated sapphire nanostructures, the antireflection effects have been characterized. This work indicates that applying the multilayer mask can increase the etching depth of sapphire nanostructures, which can find applications in thin-film optics, optoelectronic devices, and composite windows.
Reactivity in metal-Ge-Te systems: Thermodynamic predictions and experimental observations
Authors: Cooley Kayla A. , Mohney Suzanne E.
Published: October 2019

Thermal stability of neighboring layers in a thin film structure is critical to the device endurance and reliability. The geometry of GeTe-based devices for radio frequency switches and nonvolatile memory technologies often places GeTe thin films in contact with metal thin films. Despite the potential effect of metal/GeTe reactions on device performance, few studies have addressed the reactivity between elemental metals and GeTe or outlined the thermal stability of GeTe with metals. In this work, the authors use literature or estimated values of thermodynamic data to calculate metal-Ge-Te condensed ternary phase diagrams for a series of metals (Ag, Al, Au, Cd, Co, Cu, Fe, Hf, Ir, Mn, Mo, Os, Pd, Pt, Re, Rh, Ru, Sc, Ta, Ti, W, Y, and Zn). If present, the dominant phase of each metal-Ge-Te system is identified so that the system is classified as GeTe dominant, metal telluride or germanide dominant, or ternary phase dominant, and the authors predict whether or not there is a thermodynamic driving force for a metal to react with GeTe at room temperature. In addition to comparing the calculated work to the literature, they confirm the predictions of reactivity for a select group of metals (Ag, Al, Cu, Fe, Mn, Mo, Pd, Re, Ru, and Ti) using cross-sectional transmission electron microscopy (TEM) and/or plan view selected area electron diffraction of metal/GeTe thin film structures both after metal deposition and again after the samples are annealed for 12 h at 200 °C. TEM imaging and elemental mapping are also used to identify metal/GeTe reaction products and to observe the extent of metal diffusion into the GeTe film. Nine of the 24 studied metals are not reactive with GeTe (Au, Ir, Mo, Os, Re, Ru, Ta, W, and Zn), according to experiments or thermodynamic calculations while 15 metals are thermodynamically favored to react with GeTe at room temperature (Ag, Al, Cd, Co, Cu, Fe, Hf, Mn, Ni, Pd, Pt, Rh, Sc, Ti, and Y). Interestingly, the calculations demonstrate that most of the unreactive metals, with the exception of Au and Zn, are not necessarily in thermodynamic equilibrium with GeTe at room temperature. These metals are refractory, and the lack of reactivity is ascribed to kinetic limitations. The authors also observed diffusion and solubility of certain metals (Cu, Fe, Mn, and Pd) in the GeTe film that extended beyond the metal/GeTe reaction layer. Understanding the reactivity and extent of diffusion between metals and GeTe should be valuable for the design of future phase change material devices, where reactions could either affect reliability or be used to engineer improved interfacial behavior.
Degradation and forgone removals increase the carbon impact of intact forest loss by 626%
Authors: Maxwell Sean L. , Evans Tom , Watson James E. M. , Morel Alexandra , Grantham Hedley , Duncan Adam , Harris Nancy , Potapov Peter , Runting Rebecca K. , Venter Oscar , Wang Stephanie , Malhi Yadvinder
Published: October 2019

More complete accounting reveals how intact tropical forest loss plays a larger-than-realized role in exacerbating climate change.
What drives tectonic plates?
Authors: Coltice Nicolas , Husson Laurent , Faccenna Claudio , Arnould Maëlis
Published: October 2019

3D spherical dynamic models show how the force balance between tectonic plates and mantle evolves over supercontinent cycles.
Nuclear Genome Assembly of the Microalga Nannochloropsis salina CCMP1776
Authors: Ohan J. A. , Hovde B. T. , Zhang X. L. , Davenport K. W. , Chertkov O. , Han C. , Twary S. N. , Starkenburg S. R.
Published: October 2019

Nannochloropsis salina
is a halotolerant, high-lipid-producing microalga that is being explored as a biofuel production species. Here, we report an improved high-quality draft assembly and annotation for the nuclear genome of
N. salina
strain CCMP1776.
Complete Genome Sequencing of
Elizabethkingia
sp. Strain 2-6
Authors: Liu Kuan-Ming , Chang Hui-Lan , Hsu Ming-Hong , Lin Yi-Zhen , Lee Yu-Lin , Chen Ying-Tsong
Published: October 2019

Elizabethkingia
sp. strain 2-6 was collected from a water faucet in the intensive care unit of a medical center in Taiwan. The complete genome sequence and annotation are reported. Analysis of the genetic relatedness to the known
Elizabethkingia
genomes indicated that strain 2-6 may be a new genomospecies of
Elizabethkingia
.
Genome Sequence of a Salmonella enterica subsp. enterica Serovar Corvallis Strain Isolated from Human Blood
Authors: McCutchen Emily L. , Galac Madeline , Kapsak Curtis , Hinrichs Steven H. , Iwen Peter C. , Abdalhamid Baha
Published: October 2019

Salmonella enterica
subsp.
enterica
serovar Corvallis is commonly reported in avian populations and avian by-products. We report the draft genome sequence of a multidrug-resistant
S.
Corvallis strain (NPHL 15376). To our knowledge, this is the first reported case of this serovar isolated from human blood in the United States.
Contextual and socioeconomic variation in early motor and language development
Authors: Fink Günther , McCoy Dana Charles , Yousafzai Aisha
Published: October 2019

Objective

To compare early motor and language development of children <3 years of age growing up in high-income and low-income contexts.

Design

Cross-sectional study.

Setting

We analysed differences in motor and language skills across study sites in Cambodia, Chile, Ghana, Guatemala, Lebanon, Pakistan, the Philippines and the USA.

Main outcome measure

Cognitive and language development assessed with the Caregiver Reported Early Development Instruments (CREDI) tool.

Results

4649 children aged 0–35 months (mean age=18 months) were analysed. On average, children in sites with a low Human Development Index (HDI) had 0.54 SD (95% CI –0.63 to –0.44) lower CREDI motor scores and 0.73 SD (95% CI –0.82 to –0.64) lower language scores than children growing up in high HDI sites. On average, each unit increase in national log income per capita was associated with a 0.77-month (95% CI –0.93 to 0.60) reduction in the age of motor milestone attainment and a reduction in the age of language milestone attainment of 0.55 months (95% CI –0.79 to –0.30). These observed developmental differences were not universal: no developmental differences across sites with highly heterogeneous socioeconomic contexts were found among children growing up in households with highly educated caregivers providing stimulating early environments.

Conclusion

Developmental gaps in settings with low HDI are substantial on average, but appear to be largely attributable to differences in family-level socioeconomic status and caregiving practices. Programmes targeting the most vulnerable subpopulations will be essential to reduce early life disparities and improve long-run outcomes.
Initiatives to reduce treatments in bronchiolitis in the emergency department and primary care
Authors: Montejo Marta , Paniagua Natalia , Saiz-Hernando Carlos , Martinez-Indart Lorea , Mintegi Santiago , Benito Javier
Published: October 2019

We performed a quality improvement initiative to reduce unnecessary treatments for acute bronchiolitis (AB) in primary care (PC) and the referral paediatric emergency department (ED). The quality improvement initiative involved two seasons: 2016–2017 (preintervention) and 2017–2018 (postintervention). We distributed an evidence-based protocol, informative posters and badges with the slogan ‘Bronchiolitis, less is more’. We also held interactive sessions, and paediatricians received weekly reports on bronchodilator prescription. The main outcome was the percentage of infants prescribed salbutamol. Secondary outcomes were epinephrine, antibiotic and corticosteroid prescription rates. Control measures were ED visit and hospitalisation rates, triage level, length of stay, intensive care admission and unscheduled returns with admission. We included 1878 ED and 1192 PC visits of which 855 (44.5%) and 534 (44.7%) occurred in the postintervention period, respectively. In the ED, salbutamol and epinephrine prescription rates fell from 13.8% (95% CI 11.8% to 16%) to 9.1% (95% CI 7.3% to 11.2%) (p<0.01) and 10.4% (95% CI 8.6% to 12.4%) to 9% (95% CI 7.2% to 11.1%) (n.s.), respectively. In PC, salbutamol, corticosteroid and antibiotic prescription rates fell from 38.3% (95% CI 34.6% to 42.0%) to 15.9% (95% CI 12.9% to 19.5%) (p<0.01), 12.9% (95% CI 10.5% to 15.7%) to 3.6% (95% CI 2.2% to 5.7%) (p<0.01) and 29.6% (95% CI 26.2% to 33.2%) to 9.5% (95% CI 7.2% to 12.5%) (p<0.01), respectively. No significant variations were noted in control measures. We safely decreased the use of unnecessary treatments for AB. Collaboration between PC and ED appears to be an important factor for success.
Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis
Authors: Owen Patrick J , Miller Clint T , Mundell Niamh L , Verswijveren Simone J J M , Tagliaferri Scott D , Brisby Helena , Bowe Steven J , Belavy Daniel L
Published: October 2019

Objective

Examine the effectiveness of specific modes of exercise training in non-specific chronic low back pain (NSCLBP).

Design

Network meta-analysis (NMA).

Data sources

MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL.

Eligibility criteria

Exercise training randomised controlled/clinical trials in adults with NSCLBP.

Results

Among 9543 records, 89 studies (patients=5578) were eligible for qualitative synthesis and 70 (pain), 63 (physical function), 16 (mental health) and 4 (trunk muscle strength) for NMA. The NMA consistency model revealed that the following exercise training modalities had the highest probability (surface under the cumulative ranking (SUCRA)) of being best when compared with true control: Pilates for pain (SUCRA=100%; pooled standardised mean difference (95% CI): −1.86 (–2.54 to –1.19)), resistance (SUCRA=80%; −1.14 (–1.71 to –0.56)) and stabilisation/motor control (SUCRA=80%; −1.13 (–1.53 to –0.74)) for physical function and resistance (SUCRA=80%; −1.26 (–2.10 to –0.41)) and aerobic (SUCRA=80%; −1.18 (–2.20 to –0.15)) for mental health. True control was most likely (SUCRA≤10%) to be the worst treatment for all outcomes, followed by therapist hands-off control for pain (SUCRA=10%; 0.09 (–0.71 to 0.89)) and physical function (SUCRA=20%; −0.31 (–0.94 to 0.32)) and therapist hands-on control for mental health (SUCRA=20%; −0.31 (–1.31 to 0.70)). Stretching and McKenzie exercise effect sizes did not differ to true control for pain or function (p>0.095; SUCRA<40%). NMA was not possible for trunk muscle endurance or analgesic medication. The quality of the synthesised evidence was low according to Grading of Recommendations Assessment, Development and Evaluation criteria.

Summary/conclusion

There is low quality evidence that Pilates, stabilisation/motor control, resistance training and aerobic exercise training are the most effective treatments, pending outcome of interest, for adults with NSCLBP. Exercise training may also be more effective than therapist hands-on treatment. Heterogeneity among studies and the fact that there are few studies with low risk of bias are both limitations.
Secular trends in weight, height and weight for height among children under 7 years in nine cities of China, 1975–2015: results from five repeated cross-sectional surveys
Authors: Zhang Ya Qin , Li Hui , Wu Hua Hong , Zong Xin Nan
Published: October 2019

Objective

To analyse the secular trends in mean value and distribution of weight, height and weight for height in children under 7 years in developed regions in China.

Design

Five repeated cross-sectional surveys were conducted using the same methods at the same sites during 1975–2015.

Setting

Nine cities in northern, central and southern regions of China.

Population

Healthy children under 7 years; the sample sizes were 94 496 in 1975, 79 177 in 1985, 79 152 in 1995, 69 760 in 2005 and 83 583 in 2015.

Main outcome measures

Weight and height were measured by the same methods in the five surveys.

Results

The increasing trends in the mean value of weight, height and weight for height were observed and their distribution was found to have shifted upwards. There were unbalanced increments in various centiles and the relative increments in the 3rd centile of height for children under 7 years were larger than those in the 50th and 97th centiles. Although the relative increments in the 3rd centile of weight for children under 2 years were larger than those in the 50th and 97th centiles, the increments in the 97th centile for children older than 2 years became the largest compared with other centiles. The changes in each centile of weight for height were similar with those of weight. The annual increments of height and weight increased over time and were more significant between birth and 2 years of age for height and between ages 4 years and 6 years for weight. The per-decade increments in 1975–1985, 1985–1995 and 1995–2005 became larger, while those in 2005–2015 slowed down.

Conclusions

The rapid increasing trends of weight, height and weight for height had slowed down since 2005 in developed regions of China. The relative increments in the low centile of height were more significant, while the high centile of weight and weight for height increased more significantly in older children.
Future health providers’ willingness to provide abortion services following decriminalisation of abortion in Chile: a cross-sectional survey
Authors: Biggs M Antonia , Casas Lidia , Ramm Alejandra , Baba C Finley , Correa Sara Victoria , Grossman Daniel
Published: October 2019

Objective

To assess Chilean medical and midwifery students’ attitudes and willingness to become trained to provide abortion care, shortly after abortion was decriminalised in 2017.

Design

We fielded a cross-sectional, web-based survey of medical and midwifery students. We used generalised estimating equations to assess differences by type of university and degree sought.

Setting

We recruited students from a combination of seven secular, religiously-affiliated, public and private universities that offer midwifery or medical degrees with a specialisation in obstetrics and gynaecology, located in Santiago, Chile.

Participants

Students seeking medical or midwifery degrees at one of seven universities were eligible to participate. We distributed the survey link to medical and midwifery students at these seven universities; 459 eligible students opened the survey link and 377 students completed the survey.

Primary and secondary outcomes

Intentions to become trained to provide abortion services was our primary outcome of interest. Secondary outcomes included moral views and concerns about abortion provision.

Results

Most students intend to become trained to provide abortion services (69%), 20% reported that they will not provide an abortion under any circumstance, half (50%) had one or more concern about abortion provision and 16% agreed/strongly agreed that providing abortions is morally wrong. Most believed that their university should train medical and midwifery students to provide abortion services (70%–79%). Secular university students reported higher intentions to provide abortion services (beta 0.47, 95% CI: 0.31 to 0.63), more favourable views (beta 0.52, CI: 0.32 to 0.72) and were less likley to report concerns about abortion provision (adjusted OR 0.47, CI: 0.23 to 0.95) than students from religious universities.

Conclusion

Medical and midwifery students are interested in becoming trained to provide abortion services and believe their university should provide this training. Integrating high-quality training in abortion care into medical and midwifery programmes will be critical to ensuring that women receive timely, non-judgemental and quality abortion care.
Early PARacetamol (EPAR) trial: a study protocol for a randomised controlled trial of early paracetamol to promote closure of the ductus arteriosus in preterm infants
Authors: Schindler Tim , Smyth John , Bolisetty Srinivas , Michalowski Joanna , Lui Kei
Published: October 2019

Introduction

The optimal management of patent ductus arteriosus (PDA) remains contentious. The medications used to treat PDA are often non-steroidal anti-inflammatory drugs, which are associated with a number of unwanted adverse effects. Paracetamol is a medication with an excellent safety profile in infants and has been suggested as a safe alternative medication in situations where other medications have failed or are contraindicated. There are limited data on the use of early, intravenous paracetamol in preterm infants.

Methods and analysis

This trial aims to address whether early treatment with paracetamol will reduce the number of infants requiring intervention for PDA. This is a randomised, double-blind, placebo-controlled trial in preterm infants <29 weeks’ gestation. At 6 hours of life, infants with a ductus arteriosus >0.9 mm will be randomised to receive either (1) intravenous paracetamol at a dose of 15 mg/kg initially, followed by every 6 hours at a dose of 7.5 mg/kg for 5 days; or (2) intravenous 5% dextrose every 6 hours for 5 days. The primary outcome is the need for any intervention for management of PDA up to 5 days. Secondary outcomes include closure of the ductus arteriosus at 5 days, size of the ductus arteriosus, ductal reopening, systemic blood flow, mortality and significant morbidities. The target sample size of 100 infants yields >80% power, at the two-sided 5% level significance, to detect a 50% reduction in the need for intervention assuming that approximately 60% of infants in this study would otherwise have required intervention for PDA.

Ethics and dissemination

A report on the results of the planned analyses will be prepared. The results of the primary analysis of all end points will be presented at medical conferences and submitted for publication in peer-reviewed journals. Separate manuscripts pertaining to the second aim of the study may be written, and these will also be submitted for publication in peer-reviewed journals.

Trial registration number

ACTRN12616001517460.
Using theatre as an arts-based knowledge translation strategy for health-related information: a scoping review protocol
Authors: Hall Amanda , Furlong Bradley , Pike Andrea , Logan Gabrielle , Lawrence Rebecca , Ryan Alexandra , Etchegary Holly , Hennessey Todd , Toomey Elaine
Published: October 2019

Introduction

Substantial delays in translating evidence to practice mean that many beneficial and vital advances in medical care are not being used in a timely manner. Traditional knowledge translation (KT) strategies have tended to target academics by disseminating findings in academic journals and at scientific conferences. Alternative strategies, such as theatre-based KT, appear to be effective at targeting broader audiences. The purpose of this scoping review is to collate and understand the current state of science on the use of theatre as a KT strategy. This will allow us to identify gaps in literature, determine the need for a systematic review and develop additional research questions to advance the field.

Methods and analysis

This review will follow established scoping review methods outlined by Arksey and O’Malley in conjunction with enhanced recommendations made by Levacet al. The search strategy, guided by an experienced librarian, will be conducted in PubMed, CINHAL and OVID. Study selection will consist of three stages: (1) initial title and abstract scan by one author to remove irrelevant articles and create a shortlist for double screening, (2) title and abstract scan by two authors, and (3) full-text review by two authors. Included studies will report specifically on the use of theatre as means of KT of health-related information to any target population. Two reviewers will independently extract and chart the data using a standardised data extraction form. Descriptive statistics will be used to produce numerical summaries related to study characteristics, KT strategy characteristics and evaluation characteristics. For those studies that included an evaluation of the theatre production as a KT strategy, we will synthesise the data according to outcome.

Ethics and dissemination

Ethical approval was not required for this study. Results will be published in relevant journals, presented at conferences and distributed via social media.
Psychosocial and sexual factors associated with recent sexual health clinic attendance and HIV testing among trans people in the UK
Authors: Hibbert Matthew Peter , Wolton Aedan , Weeks Harri , Ross Michelle , Brett Caroline E , Porcellato Lorna A , Hope Vivian D
Published: October 2019

Objectives

Trans people remain an understudied population in the UK, with unmet sexual health needs. The aim of this research was to identify possible barriers and facilitators for sexual health clinic attendance and HIV testing among trans people.

Methods

Lesbian, gay, bisexual and transgender (LGBT) participants from across the UK were invited to take part in a cross-sectional online survey through Facebook advertising (April–June 2018). Psychosocial and sexual factors associated with recent sexual health clinic attendance, and ever having an HIV test were examined using multivariate logistic regression.

Results

A total of 3007 cisgender and 500 trans participants completed the survey. Trans participants were less likely to attend a sexual health clinic than cisgender participants (27% vs 36%, p<0.001) and report ever having an HIV test (49% vs 64%, p<0.001). One trans participant reported living with HIV and three reported currently taking pre-exposure prophylaxis. Factors associated with trans sexual health clinic attendance were: living in London, having a relationship with multiple partners, engaging in condomless anal intercourse, greater life satisfaction, and having alcohol and/or drugs before sex. Being a person of colour, aged 25–49 years, in a relationship with multiple partners, condomless anal intercourse, lower body dissatisfaction, and having drugs before sex were associated with ever having an HIV test among trans participants.

Conclusions

Trans people were less likely to attend sexual health services than cisgender people, and half of trans participants who reported condomless anal intercourse had never had an HIV test. Further research is needed to understand and improve uptake of sexual health services among trans people.
The use of a stronger instructional design by implementing repetitive practice in simulation-based obstetric team training: trainees’ satisfaction
Authors: van Tetering Anne A C , Fransen Annemarie F , van der Hout-van der Jagt M Beatrijs , Oei S Guid
Published: October 2019

Objective

This study compares satisfaction levels from multiprofessional obstetric care teams about simulation-based obstetric team training courses with and without the instructional design feature repetitive practice.

Methods

The present study is part of a multicentre cluster-randomised controlled trial (TOSTI trial) that investigated the effectiveness of a 1 day, multiprofessional, simulation-based obstetric team training. The initial training group received a training which was designed based on best practice. After 1 year, the control group received a training course in which the instructional design was changed by providing repetitive practice. All participants were asked to fill in a 29-item evaluation form with seven questions about baseline characteristics and 22 questions about training features. The questions about training features could be rated on a scale of 1 to 5. Finally, all participants were asked to rate the total training day on a scale of 1–10.

Results

The best practice group consisted of 471 trainees and the repetitive practice group of 549, including gynaecologists, residents, midwives and nurses. The best practice group rated the total training day significantly higher than the repetitive practice group (mean 8.8, SD 0.6 and mean 8.7, SD 0.6; p<0.003, Cohen’s d=0.19). Several training features were also scored higher in the best practice group.

Conclusion

This study showed that obstetric healthcare professionals rated a simulation-based obstetric team training course, with and without repetition of scenarios, both high. The training without the repetitive elements gained higher scores for the total training dayand several, and several training features were scored higher. The difference between the mean scores and the effect sizes for the training features were small. This implies that repetitive practice can be integrated in simulation-based team training to optimise learning effects, with small effects on trainees satisfaction.