bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental Study on the Influence of Casing Treatment on Near-Stall Unsteady Behavior of a Mixed-Flow Compressor
Authors: Du Juan , Kauth Felix , Li Jichao , Zhang Qianfeng , Seume Joerg R.
Published: November 2019

This paper aims at experimentally demonstrating the effects of axial slot casing treatment and tip gap variation on compressor performance, unsteady tip clearance flow, and stall inception features in a highly-loaded mixed-flow compressor at partspeed. Two tip gaps (0.32% and 0.64% of rotor blade chord at mid-span) were tested at three rotational speeds. A semicircular axial slot casing treatment improves compressor stability. The experimental results show that this casing treatment significantly moves the stability limit at partial speeds towards lower mass flow for both tip gaps, compared to the reference case without casing treatment. In the case of the compressor with casing treatment, efficiency increases for the large tip gap and decreases for the small tip gap. Dynamic pressure transducers installed in the casing upstream and along the rotor tip chord direction are used to detect the unsteady behavior of tip region flow and stall inception signals of the compressor. The characteristic frequency in the tip region decreases, and the oscillating amplitude first decreases and then increases during the throttling process, regardless of tip gap size or casing treatment. For axial compressors, by contrast, the observation in previous work has been an increase of the oscillating amplitude with decreasing flow coefficient. This is a surprising result of our work. Neither experiment nor CFD so far was able to explain why the trend in this mixed-flow compressor is different from the trend expected from axial compressors. The compressor stalls through the spike stall inception both with and without casing treatment. This observation also differs from recent studies on axial compressors, which demonstrated that casing treatments could change the type of stall inception. The unstable disturbance indicating initial stall inception initially appears in the blade tip region from blade mid-chord to trailing edge, and then propagates upstream towards the leading edge. This disturbance might be generated by the reversed flow separation near mid-chord.
Effects of Emulsified Fuel on the Performance and Emission Characteristics of Aeroengine Combustors
Authors: De Giorgi M. G. , Pescini E. , Campilongo S. , Ciccarella G. , Fontanarosa D. , Ficarella A.
Published: November 2019

The aim of the present work is the experimental investigation of the effects of the addition of water and urea into jet fuels, on the reduction of nitrogen oxides (NOx) emissions and eventually improvement of the lean flame stability in aeroengine combustors.

Experiments have been carried out using a 300-kW liquid-fueled swirling combustor. Various urea and/or water concentrations have been tested at the same fuel/air ratio. In order to study the flame behavior, non-invasive optical diagnostic techniques, as charge-coupled device (CCD) cameras in different spectral ranges (Visible and UV ranges, with different optical filters), have been adopted to analyze the shape and the brightness of the flame structure. Measurements of exhaust emissions (NOx, SO2, CO, CO2 and O2) have also been performed in order to evaluate the impact of emulsification on the entire combustion process. Finally, the thermal efficiency losses with respect to the neat jet test case were also analyzed for each emulsified fuel condition.
Active Control of Unsteady Cavitating Flows in Turbomachinery
Authors: De Giorgi Maria Grazia , Ficarella Antonio , Fontanarosa Donato
Published: November 2019

A preliminary 2D numerical investigation of the active control of unsteady cavitation by means of one single synthetic jet actuator (SJA) is presented. The SJA has been applied to hinder the intrinsic instabilities of a cloud cavitating flow of water around a NACA 0015 hydrofoil with an angle of attack of 8° and ambient conditions. It has been placed inside the inception region at a distance of 16% of the chord from the leading edge. Concerning the numerical approach, a Eulerian homogeneous mixture/mass transfer model has been used, in combination with an extended Schnerr-Sauer cavitation model and a Volume of Fluid (VOF) interface tracking method. The synthetic jet has been modeled by means of a user-defined velocity boundary conditions based on a sinusoidal waveform. A sensitivity analysis has been first performed in order to evaluate the influence of the main control parameters, namely the momentum coefficient Cμ, the dimensionless frequency F+ and the jet angle αjet. By combining the cavitating vapor content and the impact on the hydrodynamic performance, the best performing SJA configuration has been retrieved. Then, a deeper analysis of the vapor cavity dynamics and the vorticity field has been conducted in order to understand the modification of the main flow produced by the synthetic jet.

The best SJA configuration was observed at Cμ = 0.0002, F+ = 0.309 and αjet = 90°, which led to a reduction of both the average vapor content and the average torsional load in the measure of 34.6% and 17.8% respectively. A reduction of the average pulsation frequency of the pressure upstream confirmed the beneficial effect of the SJA. The analysis of the coupled dynamics between vapor cavity-vorticity and their POD-based modal structures highlighted that the benefit of the SJA lies on preventing the growth of a thick sheet cavity which tends to cause the development of the highly cavitating cloud dynamics after the cavity breakup. This is mainly due to an additional vorticity close to the hydrofoil surface just downstream the SJA, as well as a local pressure modification close the SJA during the blowing stroke.
Influence of Pin Shape on Heat Transfer Characteristics of Laminated Cooling Configuration
Authors: Li Lei , Li Honglin , Gao Wenjing , Tong Fujuan , Tang Zhonghao
Published: November 2019

The laminated cooling configuration can effectively enhance heat transfer and improve cooling effectiveness through combining the advantage of impingement cooling, film cooling and pin fin cooling. In this study, four laminated configurations with different pin shape including circular pin shape, curved rib pin shape, droplet pin shape and reverse droplet pin shape are numerically investigated. Extensive analysis are conducted within the blowing ratio range of 0.2–1.8 to reveal the influence of pin shape on heat transfer characteristics and cooling performance. Compared with circular pin shape, other three pin shapes can enable more complex internal flow field, which greatly affect the heat transfer performance. Among these shapes, the droplet pin shape presents the best capacity on improving heat transfer performance and distribution due to its stramlined shape and little upstream surface, especially at relatively high blowing ratio and the augmentation can be up to 7.91% under the blowing ratio of 1.7. Besides, results show that the cooling effectiveness can be enhanced by adopting curved rib pin shape and the enhancement monotonously increases as the blowing ratio increases. When blowing ratio is 1.7, the improvement can be 2.7%. The reason is that the large lateral blockage decreases the exhausted velocity and hence forms relative firm film coverage.
Swirl Distortion Using Stream Vanes for Boundary Layer Ingestion Research
Authors: Stephens Julia E. , Celestina Mark , Hughes Christopher
Published: November 2019

The swirl distortion of a StreamVane™ was investigated in the NASA Glenn Research Center W8 test facility. The StreamVane™ was designed and generated by Virginia Tech based on CFD simulations and included a center body at the aerodynamic interface plane. The swirl pattern generated by the distortion was evaluated using a dense grid of 5-hole Pitot probe measurements captured using a rotating array of probes. Good agreement was found between the design intent and the results at 38.5 kg/s mass flow. The StreamVane™ swirl results were compared to clean facility flow at 5 inlet mass flows and found to be consistent. Additionally, the axial location of the StreamVane™ relative to the measurement plane was investigated to determine the impact on downstream total pressure loss generated by the vanes. The intent of this work was to assess the viability of using a StreamVane™ to generate a Type I or Type II distortion into a Boundary Layer Ingesting propulsor to assess its aerodynamic performance and aeromechanic response.
Reliable Temperature Measurement With Thermal History Paints: An Uncertainty Estimation Model
Authors: Peral David , Castillo Daniel , Araguas-Rodriguez Silvia , Yañez-Gonzalez Alvaro , Pilgrim Christopher , Karagiannopoulos Solon , Feist Jörg P. , Skinner Stephen
Published: November 2019

The operating temperature of turbomachinery components are increasing the drive towards higher efficiency, lower fuel consumption and reduced emissions. Accurate thermal models are required to simulate the operating temperature of gas turbine components and hence predict service life or other qualities. These models require validation through measurement. Therefore, the quality of the models and prediction are dependent on the uncertainty of the measurements used to validate them.

Currently available temperature measurement techniques have limitations in the harsh operating conditions inside gas turbines. Thermocouples are widely used, however, are practically very challenging to apply on rotating components and only provide point measurements. Furthermore, over 80% of the surface must be measured to validate complex thermal models.

A new technique under development called thermal history paints (THP) and coatings (THC) overcomes some of these limitations. While the uncertainty estimation model described in this work is directly related to THP, the principles can be applied in general to thermographic phosphors. The paint comprises a proprietary phosphor powder and a water-based silicate binder. The paint is applied to the surface of the test component. When the component is operated the paint records the maximum temperature of exposure across the complete surface of the component. After operation, the paint is read-out using automated instrumentation. The measurements are related to temperature through calibration to deliver a high-resolution temperature profile.

An uncertainty model has been developed and described for the first time. The model assesses the uncertainty sources related to the generation of the calibration data and the measurement of the component. It has been applied to determine the uncertainty of the THP in the temperature range 400–750 °C. The estimated uncertainty in this case was, for most samples, ±3–6 °C (67% confidence level). The maximum estimated uncertainty was ±6.3 °C or ±13 °C for 67% or 95% confidence levels respectively. This is believed to be well within the uncertainty of thermal models and the requirements for temperature measurements in harsh environments on gas turbines. These results combined with the fact that the THP can record the temperature at many locations demonstrates that it is a very useful tool for the validation of thermal models and lifing predictions.

The uncertainty model was validated by measuring separate test samples and comparing the temperature measured from the THP with the thermocouple data from the heat treatment. The difference was within ±7 °C and the uncertainty bounds determined by the model.
Morphological ontogeny of Caleremaeus monilipes (Acari: Oribatida: Caleremaeidae), with comments on Caleremaeus Berlese

Authors: Seniczak Anna , Seniczak Stanisław
Published: November 2019

The morphological ontogeny of Caleremaeus monilipes (Michael 1882), the type species of Caleremaeus Berlese, 1910, is described and illustrated. The nymphs of this species are quadrideficient and eupheredermous, i.e. they carry the exuvial scalps of previous instars on the gastronotum, using a cornicle. The nymphs have also a posterior apophysis, with setae h1 and p1.
Warm-Up With Dynamic Stretching: Positive Effects on Match-Measured Change of Direction Performance in Young Elite Volleyball Players
Authors: Turki Olfa , Dhahbi Wissem , Padulo Johnny , Khalifa Riadh , Ridène Sana , Alamri Khaled , Milić Mirjana , Gueid Sabri , Chamari Karim
Published: November 2019

Purpose: To explore the immediate (15-s post-warm-up) and the delayed (after 20 and 40 min of simulated volleyball play) effects of 2 different warm-up protocols—a stretching-free volleyball warm-up (NS) and a warm-up incorporating dynamic stretching (DS)—on subsequent change of direction (COD) performance in young elite volleyball players. Methods: Sixteen male players (age 16.88 [0.34] y, body mass 75.81 [5.41] kg, body height 1.91 [0.05] m, body mass index 20.84 [1.79] kg·m−2, and body fat percentage 9.48 [1.83]%) from the U-17 national volleyball team performed NS and DS on 2 different nonconsecutive days. During each testing session (NS and DS), half T-test performance measurements were performed after 5 minutes of a general warm-up (ie, baseline), immediately post-warm-up (after 15 s), and after 20 and 40 minutes of simulated volleyball play. Results: For DS, a significant improvement in COD performance (2.08%, P < .001) was observed after 20 minutes of play compared with the baseline values. In addition, COD performance recorded after 40 minutes of play was better than after 15-second post-warm-up (5.85%, P = .001). Inferential statistics showed better COD performance in the DS condition after 20 minutes of play (2.32%, likely negative, d = 0.61). Conclusions: Compared with NS, DS tended to affect the pattern of improvement of COD performance during play by intensifying and accelerating it. Consequently, to enhance COD performance for up to 40 minutes into the game, it is recommended that DS be incorporated to the warm-up preceding the match.
Mutations in Ribosomal Protein RplA or Treatment with Ribosomal Acting Antibiotics Activates Production of Aminoglycoside Efflux Pump SmeYZ in Stenotrophomonas maltophilia
Authors: Calvopiña Karina , Dulyayangkul Punyawee , Avison Matthew B.
Published: November 2019

Aminoglycoside resistance in
Stenotrophomonas maltophilia
is multifactorial, but the most significant mechanism is overproduction of the SmeYZ efflux system. By studying laboratory-selected mutants and clinical isolates, we show here that damage to the 50S ribosomal protein L1 (RplA) activates SmeYZ production. We also show that gentamicin and minocycline, which target the ribosome, induce expression of
smeYZ
.
TBAJ-876 Displays Bedaquiline-Like Mycobactericidal Potency without Retaining the Parental Drug’s Uncoupler Activity
Authors: Sarathy Jickky Palmae , Ragunathan Priya , Cooper Christopher B. , Upton Anna M. , Grüber Gerhard , Dick Thomas
Published: November 2019

The diarylquinoline F
1
F
O
-ATP synthase inhibitor bedaquiline (BDQ) displays protonophore activity. Thus, uncoupling electron transport from ATP synthesis appears to be a second mechanism of action of this antimycobacterial drug. Here, we show that the new BDQ analogue TBAJ-876 did not retain the parental drug’s protonophore activity. Comparative time-kill analyses revealed that both compounds exert the same bactericidal activity.
Brucella
Exposure Risk Events in 10 Clinical Laboratories, New York City, USA, 2015 to 2017
Authors: Ackelsberg Joel , Liddicoat Anna , Burke Taryn , Szymczak Wendy A. , Levi Michael H. , Ostrowsky Belinda , Hamula Camille , Patel Gopi , Kopetz Virginia , Saverimuttu Jessie , Sordillo Emilia Mia , D’Souza David , Mitchell Elizabeth A. , Lowe William , Khare Reeti , Tang Yi-Wei , Bianchi Anabella Lucca , Egan Christina , Perry Michael J. , Hughes Scott , Rakeman Jennifer L. , Adams Eleanor , Kharod Grishma A. , Tiller Rebekah , Saile Elke , Lee Stephen , Gonzalez Edimarlyn , Hoppe Brett , Leviton Ira M. , Hacker Susan , Ni Kuey Fen , Orsini Reina L. , Jhaveri Sangam , Mazariegos Irving , Dingle Tanis , Koll Brian , Stoddard Robyn A. , Galloway Renee , Hoffmaster Alex , Fine Annie , Lee Ellen , Dentinger Catherine , Harrison Emily , Layton Marcelle
Published: November 2019

From 2015 to 2017, 11 confirmed brucellosis cases were reported in New York City, leading to 10
Brucella
exposure risk events (
Brucella
events) in 7 clinical laboratories (CLs). Most patients had traveled to countries where brucellosis is endemic and presented with histories and findings consistent with brucellosis.
Identifying the Cellular Interactome of Epstein-Barr Virus Lytic Regulator Zta Reveals Cellular Targets Contributing to Viral Replication
Authors: Zhou Yaqi , Heesom Kate , Osborn Kay , AlMohammed Rajaei , Sweet Steve M. , Sinclair Alison J.
Published: November 2019

Epstein-Barr virus infects most people across the world and causes several kinds of cancer. Zta is an important viral protein that makes the virus replicate by binding to its DNA and turning on the expression of some genes. We used a sensitive, unbiased approach to isolate and identify viral and cellular proteins that physically interact with Zta. This revealed 39 viral and cellular proteins. We found that one protein, termed NFATc2, was already known to be important for a very early step in viral replication. We identify that once this step has occurred, Zta reduces the effectiveness of NFATc2, and we suggest that this is important to prevent cells from dying before viral replication is complete and the mature virus is released from the cells.
A CD4
+
T Cell-NK Cell Axis of Gammaherpesvirus Control
Authors: Lawler Clara , Stevenson Philip G.
Published: November 2019

Gammaherpesviruses are widespread and cause cancers. CD4
+
T cells are a key defense. We found that they defend indirectly, engaging uninfected presenting cells and recruiting innate immune cells to attack infected targets. This segregation of CD4
+
T cells from immediate contact with infection helps the immune system to cope with viral evasion. Priming this defense by vaccination offers a way to protect against gammaherpesvirus-induced cancers.
Closed Complete Annotated Genome Sequences of Five Haemophilus influenzae Biogroup
aegyptius
Strains
Authors: Phillips Zachary N. , Tram Greg , Jennings Michael P. , Atack John M.
Published: November 2019

Haemophilus influenzae
biogroup
aegyptius
is a cause of conjunctivitis in children. Biogroup
aegyptius
strains also caused fatal outbreaks of invasive disease, known as Brazilian purpuric fever (BPF), in the 1980s. BPF is fatal if untreated. Here, we report the complete genome sequences of five strains of
Haemophilus influenzae
biogroup
aegyptius
.
Whole-Genome Sequence of French Clinical Peptoniphilus catoniae Strain P8546
Authors: Anani Hussein , Hasni Issam , Zgheib Rita , Fadlane Amael , Raoult Didier , Fournier Pierre-Edouard
Published: November 2019

In 2016,
Peptoniphilus catoniae
was reported as a bacterial species isolated from a healthy Peruvian male. In 2018, a clinical strain from the same species was isolated from the stool of a French patient with kidney cancer. The genome of this strain, P8546, was 1,725,465 bp long, with 33.4% G+C content.
Diagnostic challenge of the non-specific presentation of adult intussusception
Authors: Lief Kyla , Janakan Gnananandan , Clark Calum , Coffey Duncan
Published: November 2019

The following report will discuss the diagnosis and management of non-specific abdominal pain in a 77-year-old woman who presented to a district general hospital in South London. CT imaging demonstrated ileo-colic intussusception with free air and fluid indicating perforation. The images of the specimen clearly show the ileal tumour within the intussusception. Thus, the patient underwent an emergency right hemicolectomy and formation of a double-barrelled ileostomy. Histology subsequently confirmed this was secondary to a colonic adenocarcinoma. This case report is unique as it highlights that intussusception in adults is very difficult to accurately diagnose based on clinical features (due to non-specific findings) and even with radiology can be challenging. This is also the first documented case of the site of perforation not being directly involved with the site of intussusception. The perforation site was in fact distal to the intussusception. At the time of surgery, it was noted that the patient had significantly faecal loading up to her rectum. The resulting closed loop was the cause of her perforation.
Neck and supraclavicular lymphadenopathy secondary to 9-valent human papillomavirus vaccination
Authors: Pereira Miguel Paiva , Flores Pedro , Neto Ana Serrão
Published: November 2019

We present two clinical cases of lymphadenopathy after vaccination with the human papillomavirus (HPV) 9-valent vaccine: an asymptomatic 11-year-old boy with inferior cervical and supraclavicular lymphadenopathy, and a 13-year-old girl who presented with lymphadenopathy. In both cases, medical history was unremarkable and there was no recent infection, or other clinical findings. Both adolescents had received the HPV 9-valent vaccine in the previous week. In the first case, blood tests, ultrasonography and biopsy were performed, while in the second, a watchful waiting strategy was adopted. In both cases, the lymphadenopathy resolved spontaneously. The boy received the second dose of the vaccine 6 months later and lymphadenopathy reappeared. The Naranjo scale was applied, classifying the events as definite (in the case of the boy) and probable (girl) adverse drug reactions. The vaccine is safe, but recognising this minor adverse event is important to prevent unnecessary investigation and reduce patient and parental anxiety.
Perforated necrotic appendix in Amyand’s hernia treated with appendicectomy and simple suture repair of the inguinal hernia
Authors: Malik Muhamamd Isfandyar Khan , Abbas Joshua , Shuttleworth Paul , Qureshi Nafees
Published: November 2019

A 50-year-old man was referred to the emergency department by his general practitioner with a tender right-sided irreducible inguinal hernia (previously reducible), right-sided testicular pain and scrotal swelling. Clinical examination revealed a non-reducible, tender right inguinal-scrotal hernia and swollen right scrotum. Blood tests showed raised inflammatory markers. The patient went on to have a CT scan which was reported to show an indirect right inguinal-scrotal hernia possibly containing terminal ileum and small bowel mesentery. The scan also showed increased infiltrate changes within the hernia sac suggesting incarceration with possible early strangulation but no obvious evidence of bowel obstruction. The patient was taken to the operating theatre and found to have a large right inguinal-scrotal hernia containing pus and a perforated necrotic appendix. He went to have an appendicectomy and sutured repair of the hernia. Postoperatively, the patient made a good recovery and was discharged 2 days postsurgery.
Bilateral calcified ureteral stenosis in eosinophilic granulomatosis with polyangitis
Authors: Itagane Masaki , Yano Hiroyuki , Kinjo Mitsuyo
Published: November 2019

Ureteral calcification is a rare complication of systemic vasculitis. Bilateral ureteral calcification in a patient with eosinophilic granulomatosis with polyangitis led to obstructive uropathy. A combination of immunosuppressive therapy and ureteral reconstruction successfully restored kidney function.
Methods for the early detection of drug-induced pancreatitis: a systematic review of the literature
Authors: Wolfe Dianna , Kanji Salmaan , Yazdi Fatemeh , Skidmore Becky , Moher David , Hutton Brian
Published: November 2019

Objectives

We systematically reviewed the literature to identify evidence-informed recommendations regarding the detection of drug-induced pancreatitis (DIP) and, secondarily, to describe clinical processes for the diagnosis of DIP.

Design

Systematic review.

Data sources

Ovid MEDLINE, including Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Embase Classic+Embase, the Cochrane Library.

Eligibility criteria

We included clinical practice guidelines, systematic reviews, narrative reviews and observational studies with a focus of establishing incidence, prevalence or diagnostic approaches for DIP. Clinical trials that diagnosed DIP as an outcome were also included.

Data extraction and synthesis

Two reviewers screened citations and performed data extraction. A narrative synthesis of the evidence was prepared.

Results

Fifty-nine studies were included. Early published evidence suggested serial pancreatic ultrasound could detect subclinical pancreatitis; however, subsequent studies demonstrated no utility of serial ultrasound or serial monitoring of pancreatic enzymes in the early detection of DIP. Two small studies conducted in patients with a high baseline risk of acute pancreatitis concluded serial monitoring of pancreatic enzymes may be useful to guide early discontinuation of medications with known associations with pancreatitis. Early discontinuation of medication was not advised for lower-risk patients because some medications cause transient elevations of pancreatic enzymes that do not progress to acute pancreatitis. Eight of 52 studies (15%) reporting a clinical diagnostic process for DIP reported using currently accepted criteria for the diagnosis of acute pancreatitis. A variety of methods were used to assess drug-related causality.

Conclusions

There is minimal evidence to support the use of serial monitoring by ultrasound or pancreatic enzymes to detect cases of DIP. Serial monitoring may be useful to guide early discontinuation of DIP-associated drugs in high-risk patients, but not in lower-risk patients. Greater uptake of standardised diagnostic and causality criteria for DIP is needed.

Trial registration number

CRD42017060473
Identifying priorities for primary care investment in Ireland through a population-based analysis of avoidable hospital admissions for ambulatory care sensitive conditions (ACSC)
Authors: McDarby Geraldine , Smyth Breda
Published: November 2019

Background

In 2016, the Irish acute hospital system operated well above internationally recommended occupancy targets. Investment in primary care can prevent hospital admissions of ambulatory care sensitive conditions (ACSCs).

Objective

To measure the impact of ACSCs on acute hospital capacity in the Irish public system and identify specific care areas for enhanced primary care provision.

Design

National Hospital In-patient Enquiry System data were used to calculate 2011–2016 standardised bed day rates for selected ACSC conditions. A prioritisation exercise was undertaken to identify the most significant contributors to bed days within our hospital system. Poisson regression was used to determine change over time using incidence rate ratios (IRR).

Results

In 2016 ACSCs accounted for almost 20% of acute public hospital beds (n=871 328 bed days) with adults over 65 representing 69.1% (n=602 392) of these. Vaccine preventable conditions represented 39.1% of ACSCs. Influenza and pneumonia were responsible for 99.8% of these, increasing by 8.2% (IRR: 1.02; 95% CI 1.02 to 1.03) from 2011 to 2016. Pyelonephritis represented 47.6% of acute ACSC bed days, increasing by 46.5% (IRR: 1.07; 95% CI 1.06 to 1.08) over the 5 years examined.

Conclusions

Prioritisation for targeted investment in integrated care programmes is enabled through analysis of ACSC’s in terms of acute hospital bed days. This analysis demonstrates that primary care investment in integrated care programmes for respiratory ACSC’s from prevention to rehabilitation at scale could assist with bed capacity in acute hospitals in Ireland. In adults 65 years and over, including chronic obstructive pulmonary disease patients, the current analysis supports targeting community based pulmonary rehabilitation including pneumococcal and influenza vaccination programmes in order to reduce the burden of infection and hospitalisations. Further exploration of pyelonephritis is necessary in order to ascertain patient profile and appropriateness of admissions.
Injury trend analysis in the Japan national swim team from 2002 to 2016: effect of the lumbar injury prevention project
Authors: Matsuura Yuiko , Hangai Mika , Koizumi Keisuke , Ueno Koji , Hirai Norimasa , Akuzawa Hiroshi , Kaneoka Koji
Published: November 2019

Objectives

This study aimed to clarify the trends of injury occurrence in the Japan national swim team for 15 years and to evaluate the effectiveness of the lumbar injury prevention project. It also aimed to verify the incidence of swimming-related injuries among swimmers by sex, age and swimming style.

Methods

The target group comprised 488 swimmers who participated in the Olympics, Asian Games and Universiade from 2002 to 2016; we compiled data for the total number of injuries in each body part. The lumbar injury prevention project started in 2008 and included two components (deep trunk muscle exercises and evaluation of lumbar disc degeneration using MRI). We analysed the prevalence of lumbar injury before (2002–2008) and after (2009–2016) implementation of the lumbar injury prevention project by χ2test. We compared age, sex and swim strokes between the injured and non-injured groups by χ2test and unpaired t-test.

Results

The most common injury site was the lower back, followed by the shoulder and knee. The lumbar injury prevalence was significantly lower after implementation of the prevention project (23.5% vs 14.8%; p<0.05). Shoulder injuries were common in backstroke swimmers. The injury rate was significantly higher in female than in male swimmers. The injured group was significantly older than the non-injured group.

Conclusions

Lumbar injury prevention intervention might be effective to prevent lower back injury in swimmers. Injury risk factors included female and old age; younger female athletes should prevent the development of injuries as they mature.
Cancer and the emotions in 18th-century literature
Authors: Gallagher Noelle
Published: November 2019

This essay argues that the emotional rhetoric of today’s breast cancer discourse—with its emphasis on stoicism and ‘positive thinking’ in the cancer patient, and its use of sympathetic feeling to encourage charitable giving—has its roots in the long 18th century. While cancer had long been connected with the emotions, 18th-century literature saw it associated with both ‘positive’ and ‘negative’ feelings, and metaphors describing jealousy, love and other sentiments as ‘like a cancer’ were used to highlight the danger of allowing feelings—even benevolent or pleasurable feelings—to flourish unchecked. As the century wore on, breast cancer in particular became an important literary device for exploring the dangers of feeling in women, with writers of both moralising treatises and sentimental novels connecting the growth or development of cancer with the indulgence of feeling, and portraying emotional self-control as the only possible form of resistance against the disease. If, as Barbara Ehrenreich suggests, today’s discourse of ‘positive thinking’ has been mobilised to make patients with breast cancer more accepting of their diagnosis and more cooperative with punitive treatment regimens, then 18th-century fictional exhortations to stay cheerful served similarly conservative political and economic purposes, encouraging continued female submission to male prerogatives inside and outside the household.
Urinary calcium assessment and its relation with age, sex and Encephalitozoon cuniculi serological status in otherwise healthy pet rabbits
Authors: Gallego Miguel
Published: November 2019

Background

Urinary calcium excretion by rabbits is set proportionately higher than that of other species, giving the rabbit urine its characteristic cloudy appearance. During pregnancy, lactation and growth, or when metabolic disorders interfere in the renal excretion of calcium, it is reported that less calcium is excreted and the urine appears clear. The quantification of the calcium concentration in the urine of rabbits may be of importance in the management of diseases that affect calcium metabolism, especially in kidney disease; however, reference intervals for urinary calcium concentration (UC) are unreported in pet rabbits.

Methods

Prospective data from 63 healthy pet rabbits were evaluated. An inhouse modified Arsenazo III technique, without acidifying the urine, was used to determine the reference intervals for UC and UC:creatinine ratio. Urinary protein:creatinine ratio, UC, UC:creatinine ratio, urinary gamma‐glutamyl transferase concentration (UG), UG:creatinine ratio, phosphorus, plasma total calcium, plasma creatinine, urea and ionised calcium were assessed according to age, sex, neutered status, urine collection method and Encephalitozoon cuniculi IgG status in healthy rabbits.

Results

The reference intervals for UC and UC:creatinine ratio were 4.2–31.1 mg/dl (1.03–7.78 mmol/l) and less than 0.3, respectively. The results showed that none of these variables was influenced by the parameters evaluated, except for the phosphorus value, which was higher in pet rabbits aged up to 3 years compared with those over 3 years, suggesting that published reference values for plasma phosphorus in rabbits should be adjusted according to age.

Conclusion

The modified Arsenazo III technique described in the present work and the established reference values for UC and UCC in pet rabbits could be useful in the management of kidney disease in rabbits. The results showed that E cuniculi IgG seropositivity has no influence on the variables of renal interest in otherwise healthy rabbits.
Dependence of solid-HHG on relative potential energy of occupied sites
Authors: Chen X. L. , Cai C. W. , Zhang Z. Z. , Liu H.
Published: November 2019

The role of relative potential energy of occupied sites in high-order harmonic generation from solid states is investigated. It is found that the conversion efficiency of high-order harmonic spectrum can be enhanced by tuning the relative potential energy of neighboring occupied sites in one-dimensional model. This phenomenon can be attributed to the changing of energy bands. A two-dimensional Kronig–Penney potential is applied to model the salt–rock structure. Similar phenomenon as in the one-dimensional case is also found. Our results provide a potential method to enhance the efficiency of high-order harmonic generation from solids.
EIA Practices in the Natural Gas Extraction Sector in Tanzania: Does Local Community Contribution Matter?
Authors: Mwanyoka Iddi , Selestine Will-Elimina , Nuhu Said
Published: November 2019

Community participation is an important element for implementation of various development projects including Environmental Impact Assessment (EIA) processes. However, involvement of the local community in contributing to the EIA processes is minimal. This paper sought to explore local community contribution in the EIA practices in the natural gas extraction sector in Tanzania. Household survey, in-depth interviews, focus group discussions, and document review were employed in this study. Findings revealed that the majority of respondents have inadequate understanding of the EIA process and therefore undermine its significance, their role and contribution towards the exercise. Procedures for engaging the community were also lacking according to standard measure practices. Various factors emanating from policy implementers, EIA consultants and the community were attributed to low participation. Views and opinions of participants were not considered during implementation of the gas exploration and extraction project which left communities dissatisfied with implementers and practitioners. Therefore, implementation of the EIA policy in regard to procedures should be emphasised to ensure adherence for smooth and effective community participation in the EIA processes. This will guarantee respect for community contribution and mainstreaming of suggestions in the implementation of natural gas exploration and extraction projects to avoid adverse effects and reduce on mitigation consequences.
Wide Awake Local Anesthesia No Tourniquet: A Pilot Study for Carpal Tunnel Release in the Philippine Orthopedic Center
Authors: Castro Magtoto Ian Jason , Alagar David Limlingan
Published: November 2019

Background: Wide Awake Local Anesthesia No Tourniquet (WALANT) uses a mixture of lidocaine and epinephrine for anesthesia and has found great success in hand surgery. At the Philippine Orthopedic Center (POC), we still use local anesthesia along with a tourniquet which gives the patient pain and discomfort at the tourniquet site. This study aims to determine perioperative and post-operative pain, intraoperative bleeding and immediate clinical outcomes of patients using WALANT for surgical anesthesia for carpal tunnel release.

Methods: A case series of all patients who underwent carpal tunnel release under WALANT from April 2016 to September 2016 is presented. Those with concomitant trigger finger and de quervain disease which required release on the affected hand were also included. A tourniquet was on standby in case of uncontrollable bleeding. Intraoperative bleeding, pain NRS scores, and return to daily activity were noted.

Results: Thirteen patients were included in the study; 3 were male, 10 were female. Mean age was 58 years, Mean surgical time was 15 minutes. Twelve were reported to have “some bleeding” and one was reported to have “bleeding but was still manageable”. None of the surgeries were totally bloodless or had too much bleeding that necessitated a tourniquet. Pain NRS scores during injection of local anesthesia had a mean of 2. None of the patients felt pain during and immediately after the surgery. Average time return to daily activity was 6 days. No complications were noted.

Conclusions: Patients included in the study who underwent carpal tunnel release under WALANT did not experience pain associated with a tourniquet. Visualization of the field was adequate enough for the surgeons to do the surgery without the need for a tourniquet and with no associated complications.
Prospective Evaluation of Median Nerve Dysfunctions in Patients with a Distal Radius Fracture Treated with Volar Locking Plating
Authors: Isobe Fumihiro , Yamazaki Hiroshi , Hayashi Masanori , Uchiyama Shigeharu , Miyaoka Shunsuke , Kato Hiroyuki
Published: November 2019

Background: The aim of this study was to identify the risk factors for median nerve dysfunctions after volar locking plate (VLP) fixation for distal radius fracture (DRF).

Methods: We prospectively assessed the incidence of median nerve symptoms (MNS) such as numbness, pain, paresthesia, or hypesthesia in the area innervated by the median nerve and evaluated post-operative nerve conduction (NC) in 91 hands of 121 patients after VLP fixation for DRF. Multivariate logistic regression analysis was conducted to identify factors independently associated with MNS and abnormal NC in the injured wrist.

Results: There were 18 cases (20%) of MNS on the injured side, 9 hands (10%) of both MNS and abnormal NC, 11 hands (12%) with only abnormal NC, and 9 hands with only MNS. Sensitivity, specificity, and diagnostic accuracy of abnormal NC for diagnosing MNS were 50%, 86%, and 78%, respectively. Four cases did not respond to conservative treatment and received carpal tunnel release concomitantly with plate removal. Logistic regression examination revealed that volar placement of the plate and short stature were significant independent predictors of MNS, while patient age was the sole independent predictor of abnormal NC.

Conclusions: Our study demonstrated that plate prominence, short stature, and age were significant independent risk factors for median nerve dysfunctions after VLP fixation for DRF.
Positive Ulnar Fovea Sign – Audit of Patient Outcomes Following Nonsurgical and Surgical Management
Authors: Chang Min Kai , Lim Zeus Yiwei , Tay Shian Chao
Published: November 2019

Background: Patients with ulnar-sided wrist pain and positive ulnar fovea sign are usually treated nonsurgically before surgical options are considered. However, the outcomes of nonsurgical management are unknown. Many of these patients also have unstable distal radioulnar joint, but there has been no comparison between the outcomes of these patients with stable and unstable distal radioulnar joint. The objectives of this study are to (1) determine the outcomes of nonsurgical and surgical treatment of patients with positive ulnar fovea sign, and (2) compare the outcomes of patients with stable and unstable distal radioulnar joint.

Methods: A retrospective analysis of the outcomes of patients with ulnar sided wrist pain and positive fovea sign was performed from March 2009 to December 2014. Outcomes were measured based on patient-reported pain improvement, grip strength and range of motion of the affected wrist before and after treatment. A total of 100 wrists in 98 patients were reviewed.

Results: 54% of wrists managed nonsurgically experienced pain improvement. 83% of wrists managed surgically experienced pain improvement. The mean grip strength increased by 2.8 kg and 2.7 kg, while the range of motion decreased by 14° and 5° after nonsurgical and surgical treatment respectively. When comparing patients with stable and unstable distal radioulnar joint, there were statistically more wrists with unstable distal radioulnar joint that experienced pain improvement after treatment.

Conclusions: The study showed that there is a role for nonsurgical treatment for wrists with positive ulnar fovea sign with more than half of the patients experiencing pain improvement. We also found that positive ulnar fovea sign patients with unstable distal radioulnar joint had better pain outcomes compared to those with stable distal radioulnar joint.
The Role of Early Post-Operative Radiographs Following Distal Radius Fracture Fixation with a Volar Locking Plate: Time for Change?
Authors: Sharma Vivek , Witney-Lagen Caroline , Cullen Samuel , Kim Edward , Haider Zakir , Davy Anthea , Hunter Alistair
Published: November 2019

Background: The role of early radiographic imaging in the management of distal radius fractures (DRFs) is unclear. The aim of this study was to assess whether early post-operative radiographs for DRFs influences the ongoing management of this patient group. We hypothesize that routine early radiographs do not influence the management of DRFs.

Methods: This was a retrospective review of patients undergoing open reduction and internal fixation using a volar locking plate between 2012 and 2017 at our institution. Patients were identified using hospital electronic databases. Clinical information was gathered from the electronic health records and PACS systems and analysed on a spreadsheet. An early post-operative radiograph was defined by the authors as imaging on a patient’s first postoperative visit.

Results: 237 patients were identified. The median number of days patients were reviewed post-operatively was 13 (interquartile range 9–16). 172 (73.1%) patients had early post-operative radiographs, with 100 (58.1%) intra-articular and 72 (41.9%) extra-articular fractures. Of patients who underwent imaging, 7 (4.0%) had their post-operative fracture management altered (7 intra-articular, 0 extra-articular) with 1 (0.58%) requiring immediate surgical revision as indicated by imaging.

Conclusions: Our study questions the value of routine early post-operative radiographs in the management of distal radius fracture fixations, in particular if the fracture is extra-articular. This is of importance in the setting of constrained resources and represents a poor use of limited healthcare facilities, as well as unnecessary radiation exposure.
The Validity, Reliability and Internal Consistency of the Cross-Cultural Adaptation of the FIL-DASH (Filipino Version of the Disability of the Arm, Shoulder and Hand) Questionnaire in Patients with Traumatic Brachial Plexus Injuries
Authors: Estrella Emmanuel P. , Orillaza Nathaniel S. , Castillo-Carandang Nina T. , Cordero Cynthia P. , Juban Noel R.
Published: November 2019

Background: The objective of this paper was to determine the validity, reliability and internal consistency of the translated FILIPINO DASH (FIL-DASH) questionnaire in patients with traumatic brachial plexus injuries.

Methods: Thirty-five adult patients with traumatic brachial plexus injury were enrolled in the validation stage. The same questionnaire was given to the patient between 7 to 14 days for the test-retest reliability. The validated Filipino version of the SF-36 was used as the gold standard to determine the construct validity of the translated DASH. We also compared the DASH score with the SF-36 total and subscale, validated Brief Pain Inventory Severity and Interference Scale and the Visual Acuity Scale (VAS) for Pain.

Results: The internal consistency was adequate, with Cronbach’s Alpha for the 30 items of 0.93 and an average inter-item covariance of 0.399. The test-retest reliability was 0.87 (p < 0.001). There was no significant difference in establising the validity of the translated DASH against SF-36 total and Subscale, validated Brief Pain Inventory Severity and Interference Scale and the Visual Analogue Scale (VAS).

Conclusions: The translated DASH (FIL-DASH) questionnaire was internally consistent and showed no difference in testing for test-retest reliability and validity against functional outcome measures and pain scales validated for adult Filipinos.
Pain in the Post-Operative Week Predicts Pain and Hand Use Twelve Weeks after Proximal Phalangeal Fracture Fixation
Authors: Miller Lauren , Ada Louise , Crosbie Jack , Wajon Anne
Published: November 2019

Background: The purpose of this study was to determine whether baseline characteristics predict outcomes twelve weeks after open reduction and internal fixation of proximal phalangeal fracture.

Methods: A cohort of patients (n = 48, mean 35 years; SD 11) commencing outpatient rehabilitation within one week of surgery were reviewed. Outcomes of interest were active PIP extension; active total range of motion; pain at rest; comprehensive pain; strength; and hand use (reported difficulty performing specific activities such as turning a door handle, as well as usual activities including housework and recreation) at twelve weeks. Possible predictors included which finger is injured, whether the fracture is intra or extra-articular, whether the dominant or non-dominant hand is injured and/or how much pain is experienced in the first post-operative week. Multiple linear regression was performed to produce a model of the prediction for each outcome of interest at Week 1 (baseline).

Results: Results from multivariate linear regression analyses suggest that pain at rest at baseline was significantly predictive of pain at rest (OR = 1.25, 95% CI = 1.06–1.47), p = 0.01), comprehensive pain (OR = 3.18, 95% CI = 1.47–6.84, p = 0.01), and hand use (OR = 2.38, 95% CI = 1.18–4.80, p = 0.02) twelve weeks after open reduction and internal fixation of proximal phalangeal fracture. The turning point on the receiver-operator characteristic curve of false versus true risk (AUC = 0.94, p = 0.04) indicated that at least a score of 4.5 on the 10 cm visual analogue scale for baseline resting pain was needed for significant likelihood of reduced hand use. Which finger was injured, location of fracture and side of injury were not predictive of any outcomes.

Conclusions: Moderate to high levels of resting pain in the week following surgery for proximal phalangeal fracture is predictive of pain and hand use at twelve weeks. Moderate to high levels of resting pain should be recognised as unusual, and could be targeted in rehabilitation. Further prospective studies are needed to determine whether early identification and targeted intervention to reduce pain improves outcomes at 12 weeks.