bluuebunny/crossref_metadata_2025 huggingface dataset:
The Making of Democratic Citizens: How Regime‐Specific Socialization Shapes Europeans’ Expectations of Democracy
Authors: Heyne Lea
Published: December 2018

When analysing support for democracy, researchers tend to assume that ‘democracy’ is a concept that travels across countries. This paper argues that democracy is not the same thing for every citizen, because collective and individual socialization experiences strongly shape the criteria citizens expect a democracy to fulfil. Based on the literature on varieties of democracy, I suppose that individual expectations of democracy are influenced by regime‐specific socialization, and depend on the democratic history, authoritarian legacies, and the prevalent democratic model. Due to socialization and democratic learning, individuals acquire democratic preferences and value those dimensions more which they experience in their own democracy. Using data from the European Social Survey (ESS) and the Democracy Barometer, I test how the national democratic context in 26 European democracies influences these individual democratic ideals. I find evidence for both socialization and participation effects of the democratic context on citizens’ democratic expectations.
Differential HLA allele frequency in Mycobacterium africanum vs Mycobacterium tuberculosis in Mali
Authors: Kone Amadou , Diarra Bassirou , Cohen Keira , Diabate Seydou , Kone Bourahima , Diakite Mahamane T. , Diarra Hawa , Sanogo Moumine , Togo Antieme C. G. , Sarro Yeya dit Sadio , Baya Bocar , Coulibaly Nadie , Kodio Ousmane , Achenbach Chad J. , Murphy Robert L. , Holl Jane L. , Siddiqui Sophia , Doumbia Seydou , Bishai William R. , Diallo Souleymane , Maiga Mamoudou
Published: December 2018

Tuberculosis (TB) is caused by Mycobacterium tuberculosis complex (MTBC), however, the distribution and frequency of MTBC lineages and sublineages vary in different parts of the globe. Mycobacterium africanum, a member of MTBC is responsible for a large percentage of TB cases in West Africa, however, it is rarely identified outside of this part of the World. Whether or not differential HLA polymorphism (an important host factor) is contributing to the geographic restriction of M. africanum to West Africa is unknown. Here, we conducted a cohort study in Mali of newly diagnosed individuals with active pulmonary TB and normal healthy controls. The MTBC isolates were spoligotyped to determine the TB study groups (M. tuberculosis sensu stricto LAM10 and M. africanum), and HLA typing was performed on peripheral blood. Unlike previous reports on other populations, we found that HLA class‐I alleles were significantly associated with active TB disease in this population. HLA‐B alleles (B*07:02, B*08:01, B*14:02, B*15:03, B*15:10, B*18:01, B*42:01, B*42:02, B*51:01 and B*81:01) were significantly associated with M. africanum (40%‐45%) and M. tuberculosis (75%) compared with healthy controls. Many HLA‐A alleles (A*02:05, A*34:02, A*66:01 and A*68:02) were also associated with both TB groups (65%‐70%). However, many class II HLA‐DR variants were found to be associated with M. tuberculosis but not M. africanum with the exception of the DRB1*03:01, which was associated with both groups. The differential HLA distribution observed in this study might be at least partially responsible for the geographical restriction of M. africanum infections to West Africa.
Exclusion criteria and adverse events in perioperative trials of tranexamic acid: a systematic review and meta‐analysis
Authors: Yates Jeffrey , Perelman Iris , Khair Simonne , Taylor Joshua , Lampron Jacinthe , Tinmouth Alan , Saidenberg Elianna
Published: December 2018

BACKGROUND

Tranexamic acid (TXA) is an inexpensive therapy effective at minimizing perioperative blood loss and transfusion. However, it remains underutilized due to safety concerns. To date, no evidence‐based guidelines exist identifying which patients should not receive TXA therapy. This study determined patient groups for whom safety information regarding TXA is lacking due to common exclusion from perioperative TXA trials.

STUDY DESIGN AND METHODS

A systematic review searching the databases Medline, EMBASE, CENTRAL, and Clinicaltrials.gov was performed. Randomized controlled trials (RCTs) administering systemic TXA perioperatively to elective or emergent surgery patients were eligible. Our primary outcome was to describe exclusion criteria of RCTs, and the secondary outcome was TXA safety. A descriptive synthesis of exclusion criteria was performed, and TXA safety was assessed by meta‐analysis.

RESULTS

A total of 268 eligible RCTs were included. Meta‐analysis showed that systemic TXA did not increase risk of adverse events compared to placebo or no intervention (relative risk, 1.05; 95% confidence interval, 0.99‐1.12). Patient groups commonly excluded from perioperative TXA trials, and thus potentially lacking TXA safety data, were those with major comorbidities, a history of thromboembolism, medication use affecting coagulation, TXA allergy, and coagulopathy. Exclusion of patients with major comorbidities may not be necessary; we showed that the risk of adverse events was similar in studies that excluded patients with major comorbidities and those that did not.

CONCLUSION

Sufficient evidence exists to develop perioperative guidelines for TXA use in many populations. Further studies evaluating perioperative TXA use in patients with a history of thromboembolism are warranted.
Outcome in dogs with presumptive idiopathic pericardial effusion after thoracoscopic pericardectomy and pericardioscopy
Authors: Carvajal Jose L. , Case J. Brad , Mayhew Philipp D. , Runge Jeffrey , Singh Ameet , Townsend Sarah , Monnet Eric
Published: December 2018

Objective

To report the outcome of dogs with presumptive echocardiographic idiopathic pericardial effusion treated with thoracoscopic pericardectomy and pericardioscopy.

Study design

Multi‐institutional retrospective study (2011‐2017).

Animals

Eighteen dogs.

Methods

Records were searched for dogs with pericardial effusion and no identified cause by preoperative echocardiography and subsequent thoracoscopic pericardectomy and pericardioscopy. Collected data included presenting complaint, physical examination, laboratory results, imaging, and operative findings. Follow‐up was obtained via telephone interview and/or recheck examination.

Results

No evidence of mass lesions or cause for the effusion was identified in any of the dogs by preoperative echocardiography. Nine dogs had unremarkable pericardioscopic examination results. Nine dogs had pericardioscopic abnormalities consistent with masses, nodules, or adhesions. Median survival time (MST) for the 9 dogs with abnormalities identified by pericardioscopy was 66 days, whereas MST for the 9 dogs with unremarkable pericardioscopic examination results was not reached (P = .0067). Median survival time for dogs based on histopathologic diagnosis alone was not different between dogs with a diagnosis of neoplasia and dogs with a diagnosis of pericarditis (P = .1056). Among dogs with lesions identified during pericardioscopy, MST did not differ between those with a diagnosis of malignancy and those with a diagnosis of pericarditis (P = .78).

Conclusion

Dogs with presumptive idiopathic pericardial effusion without evidence of masses, nodules, and/or adhesions during thoracoscopic pericardectomy and pericardioscopy lived longer than dogs in which abnormalities were identified during pericardioscopy.

Clinical significance

Thoracoscopic pericardectomy/pericardioscopy and targeted biopsy of the pericardium and pleura are recommended in dogs with echocardiographic idiopathic pericardial effusion.
Removal of tetracycline antibiotic by Lemna gibba L. from aqueous solutions
Authors: Topal Murat , Öbek Erdal , Uslu Şenel Gülşad , Arslan Topal E. Işıl
Published: December 2018

In this study, the efficiency of Lemna gibba L. on tetracycline (TC) removal from the solutions prepared at various initial TC concentrations (50, 100 and 300 µg/L) was investigated. The study was conducted in the reactors planted with Lemna gibba L. plants. Lemna gibba L. plants in the reactors were harvested at various hydraulic retention times. Then, the concentrations of TC were determined by using LC/‐MS‐MS. The maximum removal efficiencies for the TC50, TC100 and TC300 in the planted reactors were 99.8 ± 4.1; 99.9 ± 4.9 and 99 ± 4.9%, respectively. The harvesting times for Lemna gibba L. at TC50, TC100 and TC300 concentrations were determined to be 12, 8 and 12 hours, respectively. First‐, second‐ and pseudo‐first‐order kinetics are determined in the planted reactors (with Lemna gibba L.). According to the study results, second‐order kinetics were obtained at TC50, TC100, TC300 concentrations. As a result, the Lemna gibba L. plant can be used as an alternative treatment method to other advanced treatment methods and it can be done with a cheap method by adapting to existing treatment plants. Lemna gibba L. plants can be used to remove pollutants by applying them to polluted lakes and water bodies.
Advancement in Phosphoric Acid Doped Polybenzimidazole Membrane for High Temperature PEM Fuel Cells: A Review
Authors: Tahrim A. A. , Amin I. N. H. M.
Published: December 2018

High-temperature polymer electrolyte membrane fuel cell as a sustainable green technology has been developed throughout the years as it provides several benefits compared to Nafion-based fuel cells (e.g., CO tolerance, improved kinetic and enhance water management). Polybenzimidazole which one of the best membrane candidates was extensively studied due to excellent properties to be used in high-temperature application. Impregnating polybenzimidazole with phosphoric acid are most commonly practised as an electrolyte membrane in the PEMFC. In this paper, recent advancement of the existing literature regarding work revolving polybenzimidazole to improve the performance of phosphoric acid doped polybenzimidazole membrane for high-temperature polymer electrolyte membrane fuel cell are reviewed. Notable works such as using aluminium containing silicate (Al-Si), silicon carbide whisker (mSiC) and sulfonated graphene oxide in the composite PBI derivatives were observed. Proton conductivity are recorded at 0.371, 0.271 and 0.280 S/cm, respectively.
Histone demethylase UTX is a therapeutic target for diabetic kidney disease
Authors: Chen Hong , Huang Yixue , Zhu Xiuqin , Liu Chong , Yuan Yangmian , Su Hua , Zhang Chun , Liu Chengyu , Xiong Mingrui , Qu Yannan , Yun Peng , Zheng Ling , Huang Kun
Published: December 2018

Key points

Diabetic kidney disease (DKD) is a major complication of diabetes. We found that UTX (ubiquitously transcribed tetratricopeptide repeat on chromosome X, also known as KDM6A), a histone demethylase, was upregulated in the renal mesangial and tubular cells of diabetic mice and DKD patients.

In cultured renal mesangial and tubular cells, UTX overexpression promoted palmitic acid‐induced elevation of inflammation and DNA damage, whereas UTX knockdown or GSK‐J4 treatment showed the opposite effects.

We found that UTX demethylase activity‐dependently regulated the transcription of inflammatory genes and apoptosis; moreover, UTX bound with p53 and p53‐dependently exacerbated DNA damage.

Administration of GSK‐J4, an H3K27 demethylase inhibitor, ameliorated the diabetes‐induced renal abnormalities in db/db mice, an animal model of type 2 diabetes.

These results revealed the possible mechanisms underlying the regulation of histone methylation in DKD and suggest UTX as a potential therapeutic target for DKD.

Diabetic kidney disease (DKD) is a microvascular complication of diabetes and the leading cause of end‐stage kidney disease worldwide without effective therapy available. UTX (ubiquitously transcribed tetratricopeptide repeat on chromosome X, also known as KDM6A), a histone demethylase that removes the di‐ and tri‐methyl groups from histone H3K27, plays important biological roles in gene activation, cell fate control and life span regulation in Caenorhabditis elegans. In the present study, we report upregulated UTX in the kidneys of diabetic mice and DKD patients. Administration of GSK‐J4, an H3K27 demethylase inhibitor, ameliorated the diabetes‐induced renal dysfunction, abnormal morphology, inflammation, apoptosis and DNA damage in db/db mice, comprising an animal model of type 2 diabetes. In cultured renal mesanglial and tubular cells, UTX overexpression promoted palmitic acid induced elevation of inflammation and DNA damage, whereas UTX knockdown or GSK‐J4 treatment showed the opposite effects. Mechanistically, we found that UTX demethylase activity‐dependently regulated the transcription of inflammatory genes; moreover, UTX bound with p53 and p53‐dependently exacerbated DNA damage. Collectively, our results suggest UTX as a potential therapeutic target for DKD.
Numerical Investigation of the Clocking Effect Between Inducer and Impeller on Pressure Pulsations in a Liquid Rocket Engine Oxygen Turbopump
Authors: Yang Baofeng , Li Bin , Chen Hui , Liu Zhanyi , Xu Kaifu
Published: December 2018

The clocking positions between the inducer and the impeller have a certain impact on the performance of the high-speed centrifugal pump, which however, is often ignored by designers. In the present study, three-dimensional numerical simulation based on detached eddy simulation method is adopted to evaluate the influence of this clocking effect on unsteady pressure pulsations in a full-scale liquid rocket engine oxygen turbopump. A new omega vortex identification method is introduced to clarify the internal correlation between unsteady flow structures and pressure pulsations and to shed comprehensive light on the formation mechanism of this clocking effect. Results show that the clocking effect has little influence on the unsteady pressure field in inducer passages while it significantly affects the rotor–stator interaction (RSI) effect leading to the alteration of the pressure spectra in RSI region, diffuser and volute diffuser pipe. The components at the inducer blade passing frequency in the pressure spectra are remarkably suppressed and the total pressure pulsation energy in these regions is decreased by an average of 13.94%, 12.94%, and 34.65%, respectively, when the inducer blade trailing edges are located in the middle of two adjacent impeller blades. The vortex analysis in the specific region reveals that the pressure pulsations in RSI region and the downstream regions are closely associated with the unsteady vortex shedding from the diffuser blades and the formation of the clocking effect is precisely due to different processes of the periodic vortex shedding from the diffuser blade pressure surfaces.
Tonal Noise Prediction of a Modern Turbofan Engine With Large Upstream and Downstream Distortion
Authors: Daroukh Majd , Moreau Stéphane , Gourdain Nicolas , Boussuge Jean-François , Sensiau Claude
Published: December 2018

Ultra-high bypass ratio (UHBR) engines are designed as compact as possible and are characterized by a short asymmetric air inlet and heterogeneous outlet guide vanes (OGVs). The flow close to the fan is therefore circumferentially nonuniform (or distorted) and the resulting noise might be impacted. This is studied here at take-off conditions by means of a simulation of the unsteady Reynolds-averaged Navier–Stokes (URANS) equations of a full-annulus fan stage. The model includes an asymmetric air inlet, a fan, heterogeneous OGVs, and homogeneous inlet guide vanes (IGVs). Direct acoustic predictions are given for both inlet and aft noises. A novel hydrodynamic/acoustic splitting method based on a modal decomposition is developed and is applied for the aft noise analysis. The noise mechanisms that are generally considered (i.e., interaction of fan-blade wakes with OGVs and fan self-noise) are shown to be impacted by the distortion. In addition, new sources caused by the interaction between the stationary distortion and the fan blades appear and contribute to the inlet noise.
Flow Physics of Diffused-Exit Film Cooling Holes Fed by Internal Crossflow
Authors: McClintic John W. , Fox Dale W. , Jones Fraser B. , Bogard David G. , Dyson Thomas E. , Webster Zachary D.
Published: December 2018

Internal crossflow, or internal flow that is perpendicular to the overflowing mainstream, reduces film cooling effectiveness by disrupting the diffusion of coolant at the exit of axial shaped holes. Previous experimental investigations have shown that internal crossflow causes the coolant to bias toward one side of the diffuser and that the severity of the biasing scales with the inlet velocity ratio, VRi, or the ratio of crossflow velocity to the jet velocity in the metering section of the hole. It has been hypothesized and computationally predicted that internal crossflow produces an asymmetric swirling flow within the hole that causes the coolant to bias in the diffuser and that biasing contributes to ingestion of hot mainstream gas into the hole, which is undesirable. However, there are no experimental measurements as of yet to confirm these predictions. In the present study, in- and near-hole flow field and thermal field measurements were performed to investigate the flow structures and mainstream ingestion for a standard axial shaped hole fed by internal crossflow. Three different inlet velocity ratios of VRi = 0.24, 0.36, and 0.71 were tested at varying injection rates. Measurements were made in planes normal to the nominal direction of coolant flow at the outlet plane of the hole and at two downstream locations—x/d = 0 and 5. The predicted swirling structure was observed for the highest inlet velocity ratio and flow within the hole was shown to scale with VRi. Ingestion within the diffuser was significant and also scaled with VRi. Downstream flow and thermal fields showed that increased biasing contributed to more severe jet detachment and coolant dispersion away from the surface.
Numerical Investigation of the Effects of Nonsinusoidal Motion Trajectory on the Propulsion Mechanisms of a Flapping Airfoil
Authors: Boudis A. , Bayeul-Lainé A. C. , Benzaoui A. , Oualli H. , Guerri O. , Coutier-Delgosha O.
Published: December 2018

The effect of nonsinusoidal trajectory on the propulsive performances and the vortex shedding process behind a flapping airfoil is investigated in this study. A movement of a rigid NACA0012 airfoil undergoing a combined heaving and pitching motions at low Reynolds number (Re = 11,000) is considered. An elliptic function with an adjustable parameter S (flattening parameter) is used to realize various nonsinusoidal trajectories of both motions. The two-dimensional (2D) unsteady and incompressible Navier–Stokes equation governing the flow over the flapping airfoil are resolved using the commercial software starccm+. It is shown that the nonsinusoidal flapping motion has a major effect on the propulsive performances of the flapping airfoil. Although the maximum propulsive efficiency is always achievable with sinusoidal trajectories, nonsinusoidal trajectories are found to considerably improve performance: a 110% increase of the thrust force was obtained in the best studied case. This improvement is mainly related to the modification of the heaving motion, more specifically the increase of the heaving speed at maximum pitching angle of the foil. The analysis of the flow vorticity and wake structure also enables to explain the drop of the propulsive efficiency for nonsinusoidal trajectories.
The Effects of Bone Microstructure on Subsidence Risk for ALIF, LLIF, PLIF, and TLIF Spine Cages
Authors: Palepu Vivek , Helgeson Melvin D. , Molyneaux-Francis Michael , Nagaraja Srinidhi
Published: December 2018

Several approaches (anterior, posterior, lateral, and transforaminal) are used in lumbar fusion surgery. However, it is unclear whether one of these approaches has the greatest subsidence risk as published clinical rates of cage subsidence vary widely (7–70%). Specifically, there is limited data on how a patient's endplate morphometry and trabecular bone quality influences cage subsidence risk. Therefore, this study compared subsidence (stiffness, maximum force, and work) between anterior (ALIF), lateral (LLIF), posterior (PLIF), and transforaminal (TLIF) lumbar interbody fusion cage designs to understand the impact of endplate and trabecular bone quality on subsidence. Forty-eight lumbar vertebrae were imaged with micro-ct to assess trabecular microarchitecture. micro-ct images of each vertebra were then imported into image processing software to measure endplate thickness (ET) and maximum endplate concavity depth (ECD). Generic ALIF, LLIF, PLIF, and TLIF cages made of polyether ether ketone were implanted on the superior endplates of all vertebrae and subsidence testing was performed. The results indicated that TLIF cages had significantly lower (p < 0.01) subsidence stiffness and maximum subsidence force compared to ALIF and LLIF cages. For all cage groups, trabecular bone volume fraction was better correlated with maximum subsidence force compared to ET and concavity depth. These findings highlight the importance of cage design (e.g., surface area), placement on the endplate, and trabecular bone quality on subsidence. These results may help surgeons during cage selection for lumbar fusion procedures to mitigate adverse events such as cage subsidence.
Study on the Effect of Climate Change on Ship Responses Based on Nonlinear Simulations
Authors: Guo Bingjie , Gramstad Odin , Vanem Erik , Bitner-Gregersen Elzbieta
Published: December 2018

Hull girder ultimate strength governs sagging and hogging failures, which is one of the most critical failure modes for a ship hull. The structural reliability analysis methodology has been used to develop common structural rules for tankers and bulk carriers. A linear model for bending moment in extreme weather with a nonlinear correction factor has been adopted in the analysis. It is difficult to conclude on the model uncertainty associated with nonlinear effects of bending moment as, until now, there are few studies addressing this topic. In this paper, the nonlinear effect on ship responses is analyzed, and the potential effect of climate change on ship responses is investigated with the improved three-dimensional (3D) Rankine Panel method using nonlinear wave input. The nonlinear wave input is generated by the higher-order spectral method (HOSM) wave model incorporating higher-order nonlinear effects, including nonlinear free-wave modulation as well as higher-order bound harmonics. The past and projected future wave climates of selected locations in the North Atlantic and North Norwegian Sea are considered.
Reduced Order Models for Transstenotic Pressure Drop in the Coronary Arteries
Authors: Mirramezani Mehran , Diamond Scott L. , Litt Harold I. , Shadden Shawn C.
Published: December 2018

The efficacy of reduced order modeling for transstenotic pressure drop in the coronary arteries is presented. Coronary artery disease is a leading cause of death worldwide and the computation of pressure drop in the coronary arteries has become a standard for evaluating the functional significance of a coronary stenosis. Comprehensive models typically employ three-dimensional (3D) computational fluid dynamics (CFD) to simulate coronary blood flow in order to compute transstenotic pressure drop at the arterial stenosis. In this study, we evaluate the capability of different hydrodynamic models to compute transstenotic pressure drop. Models range from algebraic formulae to one-dimensional (1D), two-dimensional (2D), and 3D time-dependent CFD simulations. Although several algebraic pressure-drop formulae have been proposed in the literature, these models were found to exhibit wide variation in predictions. Nonetheless, we demonstrate an algebraic formula that provides consistent predictions with 3D CFD results for various changes in stenosis severity, morphology, location, and flow rate. The accounting of viscous dissipation and flow separation were found to be significant contributions to accurate reduce order modeling of transstenotic coronary hemodynamics.
A Coupled Model for the Prediction of Surface Variation in Face Milling Large-Scale Workpiece With Complex Geometry
Authors: Liu Shun , Jin Sun , Zhang Xue-Ping , Chen Kun , Tian Ang , Xi Li-Feng
Published: December 2018

Face milling commonly generates surface quality of variation, is especially severe for milling of large-scale components with complex surface geometry such as cylinder block, engine head, and valve body. Thus surface variation serves as an important indicator both for machining parameter selection and components' service performance such as sealing, energy consumption, and emission. An efficient and comprehensive numerical model is highly desired for the prediction of surface variation of entire surface. This study proposes a coupled numerical simulation method, updating finite element (FE) model iteratively based on integration of data from abaqus and matlab, to predict surface variation induced by face milling of large-scale components with complex surfaces. Using the coupled model, three-dimensional (3D) variation of large-scale surface can be successfully simulated by considering face milling process including dynamic milling force, spiral curve of milling trajectory, and intermittently rotating contact characteristics. Surface variation is finally represented with point cloud from iterative FE analysis and verified by face milling experiment. Comparison between measured and predicted results shows that the new prediction method can simulate surface variation of complex components well. Based on the verified model, a set of analyses are conducted to evaluate the effects of local stiffness nonhomogenization and milling force variation on machined surface variation. It demonstrates that surface variation with surface peaks and concaves is strongly correlated with local stiffness nonhomogenization especially in feed direction. And thus the coupled prediction method provides a theoretical and efficient way to study surface variation induced by face milling of large-scale complex components.
Fatigue Life Prediction of Vortex Reducer Based on Stress Gradient
Authors: Luo Yanbin , Wang Yanrong , Zhong Bo , Zhao Jiazhe , Zhang Xiaojie
Published: December 2018

The effects of stress gradient and size effect on fatigue life are investigated based on the distribution of stress at the notch root of notched specimens of GH4169 alloy. The relationship between the life of notched specimens and smooth specimens is correlated by introducing the stress gradient impact coefficient, and a new life model of predicting notched specimens based on the Walker modification for the mean stress effect is established. In order to improve the prediction precision of life model with the equation parameters having a definite physical significance, the relationships among fatigue parameters, monotonic ultimate tensile strength, and reduction of area are established. Three-dimensional elastic finite element (FE) analysis of a vortex reducer is carried out to obtain the data of stress and strain for predicting its life. The results show that there is a high-stress gradient at the edge of the air holes of the vortex reducer, and it is thus a dangerous point for fatigue crack initiation. The prediction result of the vortex reducer is more reasonable if the mean stress, the stress gradient, and the size effect are considered comprehensively. The developed life model can reflect the effects of many factors well, especially the stress concentration. The life of notched specimens predicted by this model give a high estimation precision, and the prediction life data mainly fall into the scatter band of factor 2.
Microstructure and Tribological Performance of Alumina–Aluminum Matrix Composites Manufactured by Enhanced Stir Casting Method
Authors: Sardar Santanu , Karmakar Santanu Kumar , Das Debdulal
Published: December 2018

Al–Zn–Mg–Cu matrix composites reinforced with (0–20 wt %) Al2O3 particles have been manufactured by enhanced stir casting technique. Microstructural characterization of cast composites by optical, field emission scanning electron microscope (FESEM), energy dispersive X-ray (EDS) and X-ray diffraction (XRD) reveals homogeneous distribution of reinforcements in Al-alloy matrix with MgZn2 plus Al2CuMg intermetallics. With increasing particle content, hardness of composite rises considerably in spite of marginal rise in porosity. Tribological performance under two-body abrasion has been studied considering central composite design (CCD) apart from identification of mechanisms of wear via characterizations of abraded surfaces and debris. Composites exhibit significantly reduced wear rate and coefficient of friction (COF) irrespective of test conditions, since mechanisms of abrasion are observed to change from microplowing and microcutting in unreinforced alloy to mainly delamination with limited microplowing in composites. Effects of four independent factors (reinforcement content, load, abrasive grit size, and sliding distance) on wear behavior have been evaluated using response surface-based analysis of variance (ANOVA) technique. Dominant factors on both wear rate and COF are identified as reinforcement content followed by grit size and load. Combined optimization of wear rate and COF employing multiresponse optimization technique with desirability approach as well as regression models of individual responses have been developed, and their adequacies are validated by confirmatory tests. The developed mathematical models provide further insight on the complex interactions among wear performances of the selected materials and variables of abrasive system. The optimum amount of reinforcement is identified at around 15 wt % for achieving the lowest values of both wear rate and COF.
Considerations for Translation of Tissue Engineered Fibrocartilage From Bench to Bedside
Authors: Donahue Ryan P. , Gonzalez-Leon Erik A. , Hu Jerry C. , Athanasiou Kyriacos A.
Published: December 2018

Fibrocartilage is found in the knee meniscus, the temporomandibular joint (TMJ) disc, the pubic symphysis, the annulus fibrosus of intervertebral disc, tendons, and ligaments. These tissues are notoriously difficult to repair due to their avascularity, and limited clinical repair and replacement options exist. Tissue engineering has been proposed as a route to repair and replace fibrocartilages. Using the knee meniscus and TMJ disc as examples, this review describes how fibrocartilages can be engineered toward translation to clinical use. Presented are fibrocartilage anatomy, function, epidemiology, pathology, and current clinical treatments because they inform design criteria for tissue engineered fibrocartilages. Methods for how native tissues are characterized histomorphologically, biochemically, and mechanically to set gold standards are described. Then provided is a review of fibrocartilage-specific tissue engineering strategies, including the selection of cell sources, scaffold or scaffold-free methods, and biochemical and mechanical stimuli. In closing, the Food and Drug Administration (FDA) paradigm is discussed to inform researchers of both the guidance that exists and the questions that remain to be answered with regard to bringing a tissue engineered fibrocartilage product to the clinic.
A division of labor in mTORC1 signaling and autophagy
Authors: Martens Sascha
Published: December 2018

Autophagy and mTORC1 signaling are mediated by distinct p62 protein species (Sanchez-Garrido
et al
., in 4 December 2018 issue).
Complete Genome Sequences of 12 Human Respiratory Syncytial Virus (
Human Orthopneumovirus
) Strains Detected in Children with Repeated Subgroup B Infections in the Philippines
Authors: Okamoto Michiko , Sakamoto Masahiro , Dapat Clyde , Saito Mayuko , Saito-Obata Mariko , Tamaki Raita , Lupisan Socorro P. , Oshitani Hitoshi
Published: December 2018

Complete genome sequences were determined for 12 human respiratory syncytial virus strains collected from nasopharyngeal samples obtained from children with repeated subgroup B infections. Eight common amino acid polymorphisms in the G, F, and L proteins were identified between the viruses detected in initial and subsequent infections.
Draft Genome Sequence of “
Candidatus
Spirobacillus cienkowskii,” a Pathogen of Freshwater
Daphnia
Species, Reconstructed from Hemolymph Metagenomic Reads
Authors: Bresciani Luana , Lemos Leandro N. , Wale Nina , Lin Jonathan Y. , Strauss Alexander T. , Duffy Meghan A. , Rodrigues Jorge L. M.
Published: December 2018

We report here the near-complete genome sequence of “
Candidatus
Spirobacillus cienkowskii,” a spiral-shaped, red-pigmented uncultivated bacterial pathogen of
Daphnia
spp. The genome is 2.74 Mbp in size, has a GC content of 32.1%, and contains genes associated with bacterial motility and the production of carotenoids, which could explain the distinctive red color of hosts infected with this pathogen.
First Complete Genome Sequence of a Hare Calicivirus Strain Isolated from
Lepus europaeus
Authors: Droillard Clément , Lemaitre Evelyne , Chatel Marina , Guitton Jean-Sébastien , Marchandeau Stéphane , Eterradossi Nicolas , Le Gall-Reculé Ghislaine
Published: December 2018

The first full-genome sequence of a hare calicivirus (HaCV), recently characterized as a novel member of the
Caliciviridae
, is described. This presumed nonpathogenic lagovirus is 7,433 nucleotides long, shows the same genomic organization as that of other lagoviruses, and has the highest nucleotide identity (79%) with pathogenic European brown hare syndrome viruses.
Complete Genome Sequence of a Novel Swine Acute Diarrhea Syndrome Coronavirus, CH/FJWT/2018, Isolated in Fujian, China, in 2018
Authors: Li Kai , Li Hao , Bi Zhen , Gu Jun , Gong Wang , Luo Suxian , Zhang Fanfan , Song Deping , Ye Yu , Tang Yuxin
Published: December 2018

The full-length genome sequence of a novel swine acute diarrhea syndrome coronavirus (SADS-CoV), CH/FJWT/2018, was determined, which was genetically most closely related to CN/GDWT/2017, recently discovered in Fujian, China. The indel sites of the spike (S) gene of CH/FJWT/2018 were most similar to those of bat-origin SADS-related coronaviruses.
Draft Whole-Genome Sequences of 10 Atypical Enteropathogenic Escherichia coli Strains Isolated in Brazil
Authors: Santos Fernanda F. , Richardson Emily J. , Bryant Jack A. , Yamamoto Denise , Elias Waldir P. , Gomes Tânia A. T. , Henderson Ian R.
Published: December 2018

The number of diarrhea cases caused by atypical enteropathogenic
Escherichia coli
(aEPEC) has been increasing worldwide. Here, we report the draft whole-genome sequences of 10 aEPEC strains isolated in Brazil.
Reference Echovirus 7 and 19 Genomes from Nigeria
Authors: Faleye T. O. C. , Adewumi O. M. , Adeniji J. A.
Published: December 2018

We describe the genomes of two echovirus isolates from Nigeria as reference enterovirus species B genomes for the region. These echovirus 7 and 19 genomes have 7,411 nucleotides (nt) and 7,426 nt and were recovered from sewage-contaminated water (in 2010) and an acute flaccid paralysis case (in 2014), respectively.
Scaling up quality improvement intervention for perinatal care in Nepal (NePeriQIP); study protocol of a cluster randomised trial
Authors: KC Ashish , Bergström Anna , Chaulagain Dipak , Brunell Olivia , Ewald Uwe , Gurung Abhishek , Eriksson Leif , Litorp Helena , Wrammert Johan , Grönqvist Erik , Edin Per-Anders , Le Grange Claire , Lamichhane Bikash , Shrestha Parashuram , Pokharel Amrit , Pun Asha , Singh Chahana , Målqvist Mats
Published: December 2018

Introduction

Nepal Perinatal Quality Improvement Project (NePeriQIP) intends to scale up a quality improvement (QI) intervention for perinatal care according to WHO/National guidelines in hospitals of Nepal using the existing health system structures. The intervention builds on previous research on the implementation of Helping Babies Breathe-quality improvement cycle in a tertiary healthcare setting in Nepal. The objective of this study is to evaluate the effect of this scaled-up intervention on perinatal health outcomes.

Methods/design

Cluster-randomised controlled trial using a stepped wedged design with 3 months delay between wedges will be conducted in 12 public hospitals with a total annual delivery rate of 60 000. Each wedge will consist of 3 hospitals. Impact will be evaluated on intrapartum-related mortality (primary outcome), overall neonatal mortality and morbidity and health worker’s performance on neonatal care (secondary outcomes). A process evaluation and a cost-effectiveness analysis will be performed to understand the functionality of the intervention and to further guide health system investments will also be performed.

Discussion

In contexts where resources are limited, there is a need to find scalable and sustainable implementation strategies for improved care delivery. The proposed study will add to the scarce evidence base on how to scale up interventions within existing health systems. If successful, the NePeriQIP model can provide a replicable solution in similar settings where support and investment from the health system is poor, and national governments have made a global pledge to reduce perinatal mortality.

Trial registration number

ISRCTN30829654.
Measuring ability to assess claims about treatment effects: the development of the ‘Claim Evaluation Tools’
Authors: Austvoll-Dahlgren Astrid , Semakula Daniel , Nsangi Allen , Oxman Andrew David , Chalmers Iain , Rosenbaum Sarah , Guttersrud Øystein
Published: December 2018

Objectives

To describe the development of the Claim Evaluation Tools, a set of flexible items to measure people's ability to assess claims about treatment effects.

Setting

Methodologists and members of the community (including children) in Uganda, Rwanda, Kenya, Norway, the UK and Australia.

Participants

In the iterative development of the items, we used purposeful sampling of people with training in research methodology, such as teachers of evidence-based medicine, as well as patients and members of the public from low-income and high-income countries. Development consisted of 4 processes: (1) determining the scope of the Claim Evaluation Tools and development of items; (2) expert item review and feedback (n=63); (3) cognitive interviews with children and adult end-users (n=109); and (4) piloting and administrative tests (n=956).

Results

The Claim Evaluation Tools database currently includes a battery of multiple-choice items. Each item begins with a scenario which is intended to be relevant across contexts, and which can be used for children (from age 10  and above), adult members of the public and health professionals. People with expertise in research methods judged the items to have face validity, and end-users judged them relevant and acceptable in their settings. In response to feedback from methodologists and end-users, we simplified some text, explained terms where needed, and redesigned formats and instructions.

Conclusions

The Claim Evaluation Tools database is a flexible resource from which researchers, teachers and others can design measurement instruments to meet their own requirements. These evaluation tools are being managed and made freely available for non-commercial use (on request) through Testing Treatmentsinteractive(testingtreatments.org).

Trial registration numbers

PACTR201606001679337and
PACTR201606001676150; Pre-results.
Trends and population-attributable risk estimates for predictors of early neonatal mortality in Nigeria, 2003–2013: a cross-sectional analysis
Authors: Ezeh Osita Kingsley
Published: December 2018

Objectives

To assess trends in early neonatal mortality (ENM) and population-attributable risk (PAR) estimates for predictors of ENM in Nigeria.

Design, setting and participants

A cross-sectional data on 63 844 singleton live births within the preceding 5 years from the 2003, 2008 and 2013 Nigeria Demographic and Health Surveys were used. Adjusted PARs were used to estimate the number of early neonatal deaths attributable to each predictor in the final multivariable Cox regression model.

Main outcome measures

ENM, defined as the death of a live-born singleton between birth and 6 days of life.

Results

The ENM rate slightly declined from 30.5 (95% CI 26.1 to 34.9) to 26.1 (CI 24.3 to 27.9) during the study period. Approximately 36 746 (CI 14 656 to 56 920) and 37 752 (CI 23 433 to 51 126) early neonatal deaths were attributable to rural residence and male sex, respectively. Other significant predictors of ENM included small neonates (attributable number: 25 884, CI 19 172 to 31 953), maternal age <20 years (11 708, CI 8521 to 17 042), caesarean section (6312, CI 4260 to 8521) and birth order ≥4 with a short birth interval (≤2 years) (18 929, CI 12 781 to 25 563)).

Conclusions

To improve early neonatal survival in Nigeria, community-based interventions are needed for small neonates, and to promote delayed first pregnancy, child spacing and timely referral for sick male neonates and caesarean delivery.
Understanding determinants of unequal distribution of stillbirth in Tehran, Iran: a concentration index decomposition approach
Authors: Almasi-Hashiani Amir , Sepidarkish Mahdi , Safiri Saeid , Khedmati Morasae Esmaeil , Shadi Yahya , Omani-Samani Reza
Published: December 2018

Objective

The present inquiry set to determine the economic inequality in history of stillbirth and understanding determinants of unequal distribution of stillbirth in Tehran, Iran.

Methods

A population-based cross-sectional study was conducted on 5170 pregnancies in Tehran, Iran, since 2015. Principal component analysis (PCA) was applied to measure the asset-based economic status. Concentration index was used to measure socioeconomic inequality in stillbirth and then decomposed into its determinants.

Results

The concentration index and its 95% CI for stillbirth was −0.121 (−0.235 to −0.002). Decomposition of the concentration index showed that mother’s education (50%), mother’s occupation (30%), economic status (26%) and father’s age (12%) had the highest positive contributions to measured inequality in stillbirth history in Tehran. Mother’s age (17%) had the highest negative contribution to inequality.

Conclusions

Stillbirth is unequally distributed among Iranian women and is mostly concentrated among low economic status people. Mother-related factors had the highest positive and negative contributions to inequality, highlighting specific interventions for mothers to redress inequality.
Cost-effectiveness of telehealthcare to patients with chronic obstructive pulmonary disease: results from the Danish ‘TeleCare North’ cluster-randomised trial
Authors: Witt Udsen Flemming , Lilholt Pernille Heyckendorff , Hejlesen Ole , Ehlers Lars
Published: December 2018

Objectives

To investigate the cost-effectiveness of a telehealthcare solution in addition to usual care compared with usual care.

Design

A 12-month cost-utility analysis conducted alongside a cluster-randomised trial.

Setting

Community-based setting in the geographical area of North Denmark Region in Denmark.

Participants

26 municipality districts define randomisation clusters with 13 districts in each arm. 1225 patients with chronic obstructive pulmonary disease were enrolled, of which 578 patients were randomised to telehealthcare and 647 to usual care.

Interventions

In addition to usual care, patients in the intervention group received a set of telehealthcare equipment and were monitored by a municipality-based healthcare team. Patients in the control group received usual care.

Main outcome measure

Incremental costs per quality-adjusted life-years gained from baseline up to 12 months follow-up.

Results

From a healthcare and social sector perspective, the adjusted mean difference in total costs between telehealthcare and usual care was €728 (95% CI −754 to 2211) and the adjusted mean difference in quality-adjusted life-years gained was 0.0132 (95% CI −0.0083 to 0.0346). The incremental cost-effectiveness ratio was €55 327 per quality-adjusted life-year gained. Decision-makers should be willing to pay more than €55 000 to achieve a probability of cost-effectiveness >50%. This conclusion is robust to changes in the definition of hospital contacts and reduced intervention costs. Only in the most optimistic scenario combining the effects of all sensitivity analyses, does the incremental cost-effectiveness ratio fall below the UK thresholds values (€21 068 per quality-adjusted life-year).

Conclusions

Telehealthcare is unlikely to be a cost-effective addition to usual care, if it is offered to all patients with chronic obstructive pulmonary disease and if the willingness-to-pay threshold values from the National Institute for Health and Care Excellence are applied.

Trial registration

Clinicaltrials.gov,NCT01984840, 14 November 2013.
Cost-effectiveness of a randomised trial of physical activity in Alzheimer’s disease: a secondary analysis exploring patient and proxy-reported health-related quality of life measures in Denmark
Authors: Sopina Elizaveta , Sørensen Jan , Beyer Nina , Hasselbalch Steen Gregers , Waldemar Gunhild
Published: December 2018

Objectives

To explore the cost-effectiveness of a supervised moderate-to-high intensity aerobic exercise programme in people diagnosed with Alzheimer’s disease (AD) and estimate incremental cost-effectiveness ratios (ICER) using participant-reported and proxy-reported measures of health-related quality of life (HRQoL)

Design

A cost-effectiveness analysis of economic and HRQoL data from a randomised trial delivered over 16 weeks.

Setting

Memory clinics in Denmark.

Participants

200 individuals with mild AD aged 50–90 years gave informed consent to participate in the study. Participants were randomised to control or intervention group.

Interventions

Control group received treatment as usual. The intervention group performed 1 hour of supervised moderate-to-high intensity aerobic exercise three times weekly for 16 weeks.

Primary and secondary outcomes measures

Different physical, functional and health measures were obtained at inclusion (baseline) and 4 and 16 weeks after. HRQoL (EuroQol-5 Dimensions-5 Levels/EQ-Visual Analogue Scale) was reported by the participants and the primary caregivers as proxy respondents. Differences in HRQOL as reported by the participant and caregiver were explored as were different values of caregiver time with respite from care tasks.

Results

The intervention cost was estimated at €608 and €496 per participant, with and without transport cost, respectively. Participants and caregivers in the intervention group reported a small, positive non-significant improvement in EQ-5D-5L and EQ-VAS after 16 weeks. The ICER was estimated at €72 000/quality-adjusted life year using participant-reported outcomes and €87000 using caregiver-reported outcomes.

Conclusions

The findings suggest that the exercise intervention is unlikely to be cost-effective within the commonly applied threshold values. The cost of the intervention might be offset by potential savings from reduction in use of health and social care.

Trial registration number

https://clinicaltrials.gov/ct2/show/NCT01681602.