bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation and Characterization of Chemical Agents for Augmenting Injectivity in Low Permeability Reservoirs
Authors: Zhao Min , Zhao Xiutai , Yang Daoyong
Published: December 2017

In this paper, experimental techniques have been developed to prepare and characterize chemical agents for augmenting injectivity in low permeability reservoirs. First, chemical agents are selected, formulated, and optimized on the basis of interfacial tension (IFT), scale inhibition ratio, and clay particle size distribution and specific surface area. The spinning drop method is utilized to measure the IFT between crude oil and the formulated solution, while contact angle between brine and rock surface is measured to examine effect of the chemical agents on the rock wettability. Also, scale inhibition ratio and antiswelling ratio are, respectively, measured by performing static-state scale inhibition experiments and centrifugation experiments. Then, displacement experiments are conducted to evaluate injectivity improvement after one pore volume (PV) of such formulated chemical agents has been injected into a core plug. It is found that the optimized solution consists of 0.15 wt % fluorocarbon surfactant FC-117, 4.00 wt % isopropanol, 1.20 × 10−3 wt % scale inhibitor 2-phosphonobutane-1,2,4-tricarboxylic acid (PBTCA), and 1.50 wt % clay stabilizer diallyl dimethyl ammonium chloride (DMDAAC). The IFT between crude oil and the optimized solution can be reduced to 5.36 × 10−3 mN/m within a short time, while the scale inhibition ratio and antiswelling ratio are measured to be 94.83% and 86.96%, respectively. It is found from comprehensive evaluation experiments that such a formulated and optimized solution can not only alter the rock surface from oil-wet to water-wet but also reduce the scale formation of the reservoir brine. In addition, it is shown from displacement experiments that the pressure is decreased by 34.67% after the injection of such formulated solution. When the formulated solution contains 0–300,000 mg/L sodium chloride (NaCl) and 0–5000 mg/L calcium chloride (CaCl2) at 50–90 °C, the IFT between crude oil and the formulated solution can be reduced to lower than 10−2 mN/m.
Air-Mist Heat Extraction and Visualization of Droplets–Surface Interactions From 60 to 1200 °C Under Steady-State Conditions
Authors: Enrique Huerta L M. , Flores F Tania M. , Barraza de la P Claudia , Humberto Castillejos E A.
Published: December 2017

Heat extraction and drop impact regimes occurring when a local portion of a horizontal flat-fan air mist impinges the active surface of a Pt disk hold at Tw from ∼60 to 1200 °C are investigated. Boiling curves comprise single-phase, nucleate boiling (NB), transition boiling (TB), and film boiling (FB). Mists are generated under wide ranges of water and air flow rates, and the disk is placed at center and off-center positions along the mist footprint major axis. Conditions generate a wide spectrum of water impact flux, w, droplet diameter, dd, droplet velocity, uzs, and impingement angle. Heat flux extracted, −q, along each boiling regime correlates very well with expressions involving Reynolds, Weber, and Jakob numbers evaluated in terms of local average characteristics of free nonimpinging mists—w, volume mean diameter, d30, normal volume weighted mean velocity, uz,v—and Tw; close estimation indicates that hydrodynamic and thermal forces are well accounted. During arrival of sparse parcels visualization of mist–wall interactions, using a high speed camera aided by laser illumination, allows determination of the predominance area diagram of droplet impact regimes in terms of normal impinging Weber number, Wez, and Tw. The regimes include stick, rebound, spread, and splash; the last subclassified as fine-, crown- and jet-atomization. Arrival of parcels in close succession is ubiquitous causing rapid surface flooding and leading to formation of discontinuous well agitated thick liquid films, which interacts longer with the surface than drops in sparse parcels, acting as heat sinks for longer periods of time.
Flow Characteristics of Double Serpentine Convergent Nozzle With Different Inlet Configuration
Authors: Xiao-Lin Sun , Zhan-Xue Wang , Li Zhou , Jing-Wei Shi , Wen Cheng
Published: December 2017

Serpentine nozzles have been used in stealth fighters to increase their survivability. For real turbofan aero-engines, the existence of the double ducts (bypass and core flow), the tail cone, the struts, the lobed mixers, and the swirl flows from the engine turbine, could lead to complex flow features of serpentine nozzle. The aim of this paper is to ascertain the effect of different inlet configurations on the flow characteristics of a double serpentine convergent nozzle. The detailed flow features of the double serpentine convergent nozzle including/excluding the tail cone and the struts are investigated. The effects of inlet swirl angles and strut setting angles on the flow field and performance of the serpentine nozzle are also computed. The results show that the vortices, which inherently exist at the corners, are not affected by the existence of the bypass, the tail cone, and the struts. The existence of the tail cone and the struts leads to differences in the high-vorticity regions of the core flow. The static temperature contours are dependent on the distributions of the x-streamwise vorticity around the core flow. The high static temperature region is decreased with the increase of the inlet swirl angle and the setting angle of the struts. The performance loss of the serpentine nozzle is mostly caused by its inherent losses such as the friction loss and the shock loss. The performance of the serpentine nozzle is decreased as the inlet swirl angle and the setting angle of the struts increase.
Optimal Architectures for Dry and Wet Gas-Turbine Engines
Authors: Zarin Pass Rebecca , Ramakrishnan Sankaran , Edwards Chris
Published: December 2017

We systematically determine the maximally efficient manner of using water and air in a single-cycle steady-flow combustion gas turbine power plant. In doing so, we identify the upper limit to exergy efficiency for dry and wet gas turbine engines through architectures that employ regenerative work, heat, and matter transfers using imperfect practical devices. For existing device technology, the derived optimal architectures can theoretically achieve exergy efficiency above 65% without employing a bottoming cycle. This surpasses known efficiencies for both wet and combined cycles. We also show that when optimally used, nonreactive matter transfers, like water, provide an alternative, but not superior, thermal regeneration strategy to direct heat regeneration.
Role of the dense amorphous carbon layer in photoresist etching
Authors: Pranda Adam , Gutierrez Razo Sandra A. , Tomova Zuleykhan , Fourkas John T. , Oehrlein Gottlieb S.
Published: December 2017

The development of new photoresists for semiconductor manufacturing applications requires an understanding of the material properties that control the material's plasma etching behavior. Ion bombardment at ion energies of the order 100 s of eV is typical of plasma-based pattern-transfer processes and results in the formation of a dense amorphous carbon (DAC) layer on the surface of a photoresist, such as the PR193-type of photoresist that currently dominates the semiconductor industry. Prior studies have examined the physical properties of the DAC layer, but the correlation between these properties and the photoresist etching behavior had not been established. In this work, the authors studied the real-time evolution of a steady-state DAC layer as it is selectively depleted using an admixture of oxygen into an argon plasma. Observations of the depletion behavior for various DAC layer thicknesses motivate a new model of DAC layer depletion. This model also correlates the impact of the DAC layer thickness with the etch rate of the bulk photoresist. The authors find that up to a 40% depletion of the DAC layer thickness does not have a significant impact on the bulk photoresist etch rate. However, further depletion results in an exponential increase in the etch rate, which can be up to ten times greater at full depletion than for the fully formed DAC layer. Thus, with these trends the authors show that the photoresist etch rate is controlled by the thickness of the DAC layer. Furthermore, thickness loss of the DAC layer in an O2-containing plasma coincides with a chemical modification of the layer into an oxygen-rich surface overlayer with properties that are intermediate between those of the DAC layer and the bulk photoresist. Support for this interpretation was provided via x-ray photoelectron spectroscopy characterization. Atomic force microscopy was used to gauge the impact on surface roughness as the DAC layer is formed and depleted. The trends established in this work will provide a benchmark in our development of new photoresists, which will be suitable for pattern transfer processes that will ultimately be a part of enabling smaller semiconductor device feature sizes and pitches.
Race to improve student understanding of uncertainty: Using LEGO race cars in the physics lab
Authors: Parappilly Maria , Hassam Christopher , Woodman Richard J.
Published: December 2017

Laboratories using LEGO race cars were developed for students in an introductory physics topic with a high early drop-out rate. In a 2014 pilot study, the labs were offered to improve students' confidence with experiments and laboratory skills, especially uncertainty propagation. This intervention was extended into the intro level physics topic the next year, for comparison and evaluation. Considering the pilot study, we subsequently adapted the delivery of the LEGO labs for a large Engineering Mechanics cohort. A qualitative survey of the students was taken to gain insight into their perception of the incorporation of LEGO race cars into physics labs. For Engineering, the findings show that LEGO physics was instrumental in teaching students the measurement and uncertainty, improving their lab reporting skills, and was a key factor in reducing the early attrition rate. This paper briefly recalls the results of the pilot study, and how variations in the delivery yielded better learning outcomes. A novel method is proposed for how LEGO race cars in a physics lab can help students increase their understanding of uncertainty and motivate them towards physics practicals.
Limitations on estimation of effective scatterer diameters
Authors: Zhu Yang , Han Aiguo , O'Brien William D. , Oelze Michael L. , Insana Michael F.
Published: December 2017

The influence of spatial diversity in acoustic scattering properties on estimates of the effective scatterer diameter (ESD) applied to soft biological tissues is investigated. This study is based on two-dimensional simulations of scattering media, beginning with random distributions of simple disk structures where all scattering features are known exactly. It concludes with an analysis of histology maps from healthy and fatty rabbit liver. Further, the liver histology is decomposed using an orthonormal basis to separate acoustic scattering at various spatial scales and observe how it influences ESD estimates. Overall, the goal is to quantitatively interpret ESD results for diagnostic assessments despite wide variations in tissue scatterer properties.
Role of freeze-drying in the presence of mannitol on the echogenicity of echogenic liposomes
Authors: Kumar Krishna N. , Mallik Sanku , Sarkar Kausik
Published: December 2017

Echogenic liposomes (ELIPs) are an excellent candidate for ultrasound activated therapeutics and imaging. Although multiple experiments have established their echogenicity, the underlying mechanism has remained unknown. However, freeze-drying in the presence of mannitol during ELIP preparation has proved critical to ensuring echogenicity. Here, the role of this key component in the preparation protocol was investigated by measuring scattering from freshly prepared freeze-dried aqueous solution of mannitol—and a number of other excipients commonly used in lyophilization—directly dispersed in water without any lipids in the experiment. Mannitol, meso-erythritol, glycine, and glucose that form a highly porous crystalline phase upon freeze-drying generated bubbles resulting in strong echoes during their dissolution. On the other hand, sucrose, trehalose, and xylitol, which become glassy while freeze-dried, did not. Freeze-dried mannitol and other crystalline substances, if thawed before being introduced into the scattering volume, did not produce echogenicity, as they lost their crystallinity in the thawed state. The echogenicity disappeared in a degassed environment. Higher amounts of sugar in the original aqueous solution before freeze-drying resulted in higher echogenicity because of the stronger supersaturation and crystallinity. The bubbles created by the freeze-dried mannitol in the ELIP formulation play a critical role in making ELIPs echogenic.
mGluR5 antagonism increases autophagy and prevents disease progression in the
zQ175
mouse model of Huntington’s disease
Authors: Abd-Elrahman Khaled S. , Hamilton Alison , Hutchinson Shaunessy R. , Liu Fang , Russell Ryan C. , Ferguson Stephen S. G.
Published: December 2017

Inhibiting the glutamate receptor mGluR5 may prevent the progression of neuronal loss and motor impairment in patients with Huntington’s disease.
Environmental Stress-Induced Bacterial Lysis and Extracellular DNA Release Contribute to Campylobacter jejuni Biofilm Formation
Authors: Feng Jinsong , Ma Lina , Nie Jiatong , Konkel Michael E. , Lu Xiaonan
Published: December 2017

Campylobacter jejuni
is a microaerophilic bacterium and is believed to persist in a biofilm to antagonize environmental stress. This study investigated the influence of environmental conditions on the formation of
C. jejuni
biofilm. We report an extracellular DNA (eDNA)-mediated mechanism of biofilm formation in response to aerobic and starvation stress. The eDNA was determined to represent a major form of constitutional material of
C. jejuni
biofilms and to be closely associated with bacterial lysis. Deletion mutation of the stress response genes
spoT
and
recA
enhanced the aerobic influence by stimulating lysis and increasing eDNA release. Flagella were also involved in biofilm formation but mainly contributed to attachment rather than induction of lysis. The addition of genomic DNA from either
Campylobacter
or
Salmonella
resulted in a concentration-dependent stimulation effect on biofilm formation, but the effect was not due to forming a precoating DNA layer. Enzymatic degradation of DNA by DNase I disrupted
C. jejuni
biofilm. In a dual-species biofilm, eDNA allocated
Campylobacter
and
Salmonella
at distinct spatial locations that protect
Campylobacter
from oxygen stress. Our findings demonstrated an essential role and multiple functions of eDNA in biofilm formation of
C. jejuni
, including facilitating initial attachment, establishing and maintaining biofilm, and allocating bacterial cells.

IMPORTANCE
Campylobacter jejuni
is a major cause of foodborne illness worldwide. In the natural environment, the growth of
C. jejuni
is greatly inhibited by various forms of environmental stress, such as aerobic stress and starvation stress. Biofilm formation can facilitate the distribution of
C. jejuni
by enabling the survival of this fragile microorganism under unfavorable conditions. However, the mechanism of
C. jejuni
biofilm formation in response to environmental stress has been investigated only partially. The significance of our research is in identifying extracellular DNA released by bacterial lysis as a major form of constitution material that mediates the formation of
C. jejuni
biofilm in response to environmental stress, which enhances our understanding of the formation mechanism of
C. jejuni
biofilm. This knowledge can aid the development of intervention strategies to limit the distribution of
C. jejuni
.
Promising Prebiotic Candidate Established by Evaluation of Lactitol, Lactulose, Raffinose, and Oligofructose for Maintenance of a Lactobacillus-Dominated Vaginal Microbiota
Authors: Collins Stephanie L. , McMillan Amy , Seney Shannon , van der Veer Charlotte , Kort Remco , Sumarah Mark W. , Reid Gregor
Published: December 2017

Perturbations to the vaginal microbiota can lead to dysbiosis, including bacterial vaginosis (BV), which affects a large portion of the female population. In a healthy state, the vaginal microbiota is characterized by low diversity and colonization byLactobacillusspp., whereas in BV, these species are displaced by a highly diverse population of bacteria associated with adverse vaginal health outcomes. Since prebiotic ingestion has been a highly effective approach to invigorate lactobacilli for improved intestinal health, we hypothesized that these compounds could stimulate lactobacilli at the expense of BV organisms to maintain vaginal health. Monocultures of commensalLactobacillus crispatus,Lactobacillus vaginalis,Lactobacillus gasseri,Lactobacillus johnsonii,Lactobacillus jensenii, andLactobacillus iners, in addition to BV-associated organisms andCandida albicans, were tested for their ability to utilize a representative group of prebiotics consisting of lactitol, lactulose, raffinose, and oligofructose. The disaccharide lactulose was found to most broadly and specifically stimulate vaginal lactobacilli, including the strongly health-associated speciesL. crispatus, and importantly, not to stimulate BV organisms orC. albicans. Using freshly collected vaginal samples, we showed that exposure to lactulose promoted commensalLactobacillusgrowth and dominance and resulted in healthy acidity partially through lactic acid production. This provides support for further testing of lactulose to prevent dysbiosis and potentially to reduce the need for antimicrobial agents in managing vaginal health.

IMPORTANCEBacterial vaginosis (BV) and other dysbioses of the vaginal microbiota significantly affect the quality of life of millions of women. Antimicrobial therapy is often poorly effective, causes side effects, and does not prevent recurrences. We report one of very few studies that have evaluated how prebiotics—compounds that are selectively fermented by beneficial bacteria such asLactobacillusspp.—can modulate the vaginal microbiota. We also report use of a novelin vitropolymicrobial model to study the impact of prebiotics on the vaginal microbiota. The identification of prebiotic lactulose as enhancingLactobacillusgrowth but not that of BV organisms orCandida albicanshas direct application for retention of homeostasis and prevention of vaginal dysbiosis and infection.
The Inoculation Method Could Impact the Outcome of Microbiological Experiments
Authors: Kragh Kasper Nørskov , Alhede Maria , Rybtke Morten , Stavnsberg Camilla , Jensen Peter Ø. , Tolker-Nielsen Tim , Whiteley Marvin , Bjarnsholt Thomas
Published: December 2017

For the past 150 years, bacteria have been investigated primarily in liquid batch cultures. Contrary to most expectations, these cultures are not homogeneous mixtures of single-cell bacteria, because free-floating bacterial aggregates eventually develop in most liquid batch cultures. These aggregates share characteristics with biofilms, such as increased antibiotic tolerance. We investigated how aggregates develop and what influences this development in liquid batch cultures ofPseudomonas aeruginosa. We focused on how the method of inoculation affected aggregation by assessing aggregate frequency and size using confocal laser scanning microscopy. Several traditional methods of initiating an overnight bacterial culture, i.e., inoculation directly from frozen cultures, inoculation using agar-grown cells, or inoculation using cells grown in liquid cultures, were investigated. We discovered a direct link between the inoculation method and the size and frequency of biofilm aggregates in liquid batch cultures, with inoculation directly from a plate resulting in the most numerous and largest aggregates. These large aggregates had an overall impact on the cultures' subsequent tolerance toward tobramycin, indicating that the inoculation method has a profound impact on antibiotic tolerance. We also observed a mechanism whereby preformed aggregates recruited single cells from the surrounding culture in a “snowball effect,” building up aggregated biomass in the culture. This recruitment was found to rely heavily on the exopolysaccharide Psl. Additionally, we found that bothEscherichia coliandStaphylococcus aureusproduced aggregates in liquid batch cultures. Our results stress the importance of inoculation consistency throughout experiments and the substantial impact aggregate development in liquid batch cultures may have on the outcomes of microbiological experiments.

IMPORTANCEPure liquid cultures are fundamental to the field of microbiological research. These cultures are normally thought of as homogeneous mixtures of single-cell bacteria; the present study shows that this is not always true. Bacteria may aggregate in these liquid cultures. The aggregation can be induced by the method chosen for inoculation. The presence of aggregates can significantly change the outcomes of experiments by altering the phenotype of the cultures. The study found a mechanism whereby preformed aggregates are able to recruit surrounding single cells in a form of snowball effect, creating more and larger aggregates in the cultures. Once formed, these aggregates are hard to remove. Aggregates in liquid cultures may be an immense unseen challenge for microbiologists.
Autoimmune-Disease-Prone NOD Mice Help To Reveal a New Genetic Locus for Reducing Pulmonary Disease Caused by Mycoplasma pulmonis
Authors: Wawegama Nadeeka K. , Markham Philip F. , Elso Colleen M. , Kanci Anna , Marenda Marc S. , Browning Glenn F. , Brodnicki Thomas C.
Published: December 2017

Mycoplasmas are bacterial pathogens of a range of animals, including humans, and are a common cause of respiratory disease. However, the host genetic factors that affect resistance to infection or regulate the resulting pulmonary inflammation are not well defined. We and others have previously demonstrated that nonobese diabetic (NOD) mice can be used to investigate disease loci that affect bacterial infection and autoimmune diabetes. Here we show that NOD mice are more susceptible than C57BL/6 (B6) mice to infection with
Mycoplasma pulmonis
, a natural model of pulmonary mycoplasmosis. The lungs of infected NOD mice had higher loads of
M. pulmonis
and more severe inflammatory lesions. Moreover, congenic NOD mice that harbored different B6-derived chromosomal intervals enabled identification and localization of a new mycoplasmosis locus, termed
Mpr2
, on chromosome 13. These congenic NOD mice demonstrated that the B6 allele for
Mpr2
reduced the severity of pulmonary inflammation caused by infection with
M. pulmonis
and that this was associated with altered cytokine and chemokine concentrations in the infected lungs.
Mpr2
also colocalizes to the same genomic interval as
Listr2
and
Idd14
, genetic loci linked to listeriosis resistance and autoimmune diabetes susceptibility, respectively, suggesting that allelic variation within these loci may affect the development of both infectious and autoimmune disease.
Development of Zika Virus Serological Testing Strategies in New York State
Authors: Lee William T. , Wong Susan J. , Kulas Karen E. , Dupuis Alan P. , Payne Anne F. , Kramer Laura D. , Dean Amy B. , St. George Kirsten , White Jennifer L. , Sommer Jamie N. , Ledizet Michel , Limberger Ronald J.
Published: December 2017

The recent outbreak of Zika virus (ZIKV) in the Americas has challenged diagnostic laboratory testing strategies. At the Wadsworth Center, ZIKV serological testing was performed for over 10,000 specimens, using a combination of an enzyme-linked immunosorbent assay (ELISA) for IgM antibodies (Abs) to ZIKV, a polyvalent microsphere immunoassay (MIA) to detect Abs broadly reactive with flaviviruses, and a plaque reduction neutralization test (PRNT) for further testing. Overall, 42% of patients showed serological evidence of flavivirus infection (primarily past dengue virus [DENV] infection), while 7% possessed IgM Abs to ZIKV and/or DENV. ZIKV IgM Abs typically arose within 3 to 4 days, with only one instance of duration beyond 100 days after reported symptoms. PRNT analysis of 826 IgM-positive specimens showed 7% positive neutralization to ZIKV alone, 9% to DENV alone, and 85% to both ZIKV and DENV. Thus, the extensive Ab cross-reactivity among flaviviruses significantly reduced the value of performing PRNT analysis, especially when a traditional paired serum algorithm with viral neutralization titering was used. Nevertheless, the finding of a negative ZIKV result by PRNT was invaluable for reassuring both physicians and patients. The MIA detected both IgM and IgG, which enabled us to identify patients who presented without IgM anti-ZIKV Abs but still had ZIKV-specific neutralizing Abs. On the basis of these results, a new algorithm, which included an IgM Ab capture (MAC)-ELISA to detect recent infection, a flavivirus MIA to identify patients no longer producing IgM, and a single-dilution PRNT for ZIKV exclusion and occasional discrimination of ZIKV and DENV, was implemented.
Fine particulate pollution and asthma exacerbations
Authors: Bouazza Naïm , Foissac Frantz , Urien Saik , Guedj Romain , Carbajal Ricardo , Tréluyer Jean-Marc , Chappuy Hélène
Published: December 2017

Objective

As the results from epidemiological studies about the impact of outdoor air pollution on asthma in children are heterogeneous, our objective was to investigate the association between asthma exacerbation in children and exposure to air pollutants.

Methods

A database of 1 264 585 paediatric visits during the 2010–2015 period to the emergency rooms from 20 emergency departments (EDs) of ‘Assistance Publique Hôpitaux de Paris (APHP)’, the largest hospital group in Europe, was used. A total of 47 107 visits were classified as asthma exacerbations. Concentration of air pollutants (nitrogen dioxide, ozone, fine particulate matter (PM) with an aerodynamic diameter smaller than 10  µm (PM10) and 2.5 µm (PM2.5)), as well as meteorological data, evolution of respiratory syncytial virus infection and pollen exposition, were collected on an hourly or daily basis for the same period using institutional databases. To assess the association between air pollution and asthma, mixed-effects quasi-Poisson regression modelling was performed.

Results

The only compound independently associated with ED visits for asthma was PM2.5(P<10−4). The association between asthma exacerbation and PM2.5was not linear, and a sigmoid function described the relationshipsatisfactorily. PM2.5concentration, which gives half the maximum effect, was estimated at 13.5 µg/m3.

Conclusions

We found an association between daily asthma exacerbation in paediatric visits to the ED and fine particulate air pollutants.
Optical coherence tomography angiography analysis of foveal microvascular changes and inner retinal layer thinning in patients with diabetes
Authors: Kim Kiyoung , Kim Eung Suk , Yu Seung-Young
Published: December 2017

Aim

To evaluate the correlation between inner retinal layer thinning and the foveal microvasculature in type 2 diabetes using optical coherence tomography angiography (OCTA).

Methods

A cross-sectional study involved 155 diabetic eyes. All patients were divided into two groups based on diabetic retinopathy (DR) grade: no DR (NDR, n=80) and mild-to-moderate non-proliferative DR (NPDR, n=75). Foveal avascular zone (FAZ) area, FAZ circularity index, FAZ perimeter, vessel density and perfusion index of parafoveal and perifoveal area were calculated using OCTA. The thickness of the macular ganglion cell/inner plexiform layer (mGCIPL) was measured using OCT.

Results

In both superficial and deep retinal capillary layers (SRL and DRL), FAZ areas in the NDR (0.38 mm2 , 0.49 mm2) and NPDR (0.38 mm2, 0.48 mm2) were greater than those in the control (0.33 mm2, 0.43 mm2). The FAZ circularity index, vessel density and perfusion index in the NDR (0.63, 17.8/mm, 0.32) and NPDR (0.63, 17.5/mm, 0.32) were smaller than those in the control (0.69, 19.6/mm, 0.39). mGCIPL thickness was significantly correlated with FAZ area in the SRL and DRL, as well as with FAZ circularity index, vessel density and perfusion index in the NDR and NPDR. In multivariate regression analysis, the FAZ circularity index (OR=12.2) and vessel density of the parafovea (OR=1.95) were correlated with mGCIPL thinning.

Conclusion

OCTA revealed that early foveal microcirculatory alterations in diabetic eyes were related to mGCIPL thickness, regardless of the presence of DR. The decrease in FAZ circularity and parafoveal vessel density were highly correlated with mGCIPL thinning.
Hughes Abdominal Repair Trial (HART)—abdominal wall closure techniques to reduce the incidence of incisional hernias: feasibility trial for a multicentre, pragmatic, randomised controlled trial
Authors: Harries Rhiannon L , Cornish Julie , Bosanquet David , Rees Buddug , Horwood James , Islam Saiful , Bashir Nadim , Watkins Alan , Russell Ian T , Torkington Jared
Published: December 2017

Objectives

Incisional hernias are common complications of midline abdominal closure. The ‘Hughes Repair’ combines a standard mass closure with a series of horizontal and two vertical mattress sutures within a single suture. There is evidence to suggest this technique is as effective as mesh repair for the operative management of incisional hernias; however, no trials have compared Hughes repair with standard mass closure for the prevention of incisional hernia formation. This paper aims to test the feasibility of running a randomised controlled trial of a comparison of abdominal wall closure methods following midline incisional surgery for colorectal cancer, in preparation to a definitive randomised controlled trial.

Design and setting

A feasibility trial (with 1:1 randomisation) conducted perioperatively during colorectal cancer surgery.

Participants

Patients undergoing midline incisional surgery for resection of colorectal cancer.

Interventions

Comparison of two suture techniques (Hughes repair or standard mass closure) for the closure of the midline abdominal wound following surgery for colorectal cancer.

Primary and secondary outcomes

A 30-patient feasibility trial assessed recruitment, randomisation, deliverability and early safety of the surgical techniques used.

Results

A total of 30 patients were randomised from 43 patients recruited and consented, over a 5-month period. 14 and 16 patients were randomised to arms A and B, respectively. There was one superficial surgical site infection (SSI) and two organ space SSIs reported in arm A, and two superficial SSIs and one complete wound dehiscence in arm B. There were no suspected unexpected serious adverse reactions reported in either arm. Independent data monitoring committee found no early safety concerns.

Conclusions

The feasibility trial found no early safety concerns and demonstrated that the trial was acceptable to patients. Progression to the pilot and main phases of the trial has now commenced following approval by the independent data monitoring committee.

Trial registration number

ISRCTN 25616490.
Influencing factors of dysmenorrhoea among hospital nurses: a questionnaire survey in Taiwan
Authors: Chiu Min-Hui , Hsieh Hsiu-Fen , Yang Yi-Hsin , Chen Huei-Mein , Hsu Su-Chen , Wang Hsiu-Hung
Published: December 2017

Objectives

Nurses are at high risk of dysmenorrhoea while working with patients. The study objectives were to: (1) describe the demographic and menstruation characteristics of dysmenorrhoea, knowledge about dysmenorrhoea and menstrual attitudes towards menstruation among dysmenorrhoeal and non-dysmenorrhoeal hospital nurses; (2) identify significant differences between the groups; and (3) examine factors influencing dysmenorrhoea.

Methods

This cross-sectional survey used a structured questionnaire, administered at two hospitals in southern Taiwan. Participants included hospital nurses at least 18 years of age who agreed to participate. All participants were recruited through random sampling. The questionnaire included demographic data, the Dysmenorrhoea Knowledge Scale and Menstrual Attitude Scale (MAS).

Results

A total of 420 nurses completed the questionnaire. Among them, 297 (70.7%) had experienced dysmenorrhoea in the past 6 months and 123 (29.3%) had not. Significant differences in age (P<0.001), marital status (P<0.001), childbearing status (P<0.001), age at menarche (P<0.05) and rotating three shift ratio (P<0.05) were identified between the dysmenorrhoea and non-dysmenorrhoea groups. Analysis of the MAS results revealed significant differences between the groups regarding consideration of menstruation as a debilitating (P<0.001) or bothersome event (P<0.05), anticipation and prediction of menstruation onset (P<0.01) and denial of any effects from menstruation (P<0.001). Results of the multiple logistic regression showed that predictive factors included age <40 years (4.46 vs 1.00), working three shift rotations (2.07 vs 1.00), marital status (2.59 vs 1.00), acknowledging menstruation as a debilitating event (2.72 vs 1.00) and denial of effects from menstruation (2.59 vs 1.00).

Conclusions

These findings could help nursing managers to create a caring and friendly work environment for hospital nurses at risk of dysmenorrhoea.
Electronic nicotine delivery system use behaviour and loss of autonomy among American Indians: results from an observational study
Authors: Carroll Dana Mowls , Wagener Theodore L , Thompson David M , Stephens Lancer D , Peck Jennifer D , Campbell Janis E , Beebe Laura A
Published: December 2017

Objective

American Indians (AI) have a high prevalence of electronic nicotine delivery system (ENDS) use. However, little information exists on (ENDS) use, either alone or in combination with cigarettes (dual use), among AI. The objective of this small-scaled study was to examine use behaviours and dependence among exclusive ENDS users and dual users of AI descent. Exclusive smokers were included for comparison purposes.

Setting

Oklahoma, USA.

Participants

Adults of AI descent who reported being exclusive ENDS users (n=27), dual users (n=28) or exclusive cigarette smokers (n=27).

Measures

Participants completed a detailed questionnaire on use behaviours. The Hooked on Nicotine Checklist (HONC) was used to assess loss of autonomy over cigarettes and was reworded for ENDS. Dual users completed the HONC twice. Sum of endorsed items indicated severity of diminished autonomy. Comparisons were made with non-parametric methods and statistical significance was defined as P<0.05.

Results

Median duration of ENDS use was 2 years among ENDS users and 1 year among dual users. Most ENDS and dual users reported <20 vape sessions per day (72.0% vs 72.0%) with ≤10 puffs per vape session (70.4% vs 69.2%). Severity of diminished autonomy over ENDS was similar among ENDS and dual users (medians: 4 vs 3; P=0.6865). Among dual users, severity of diminished autonomy was lower for ENDS than cigarettes (medians: 3 vs 9; P=<0.0001). Comparing ENDS users with smokers, ENDS users had a lower severity of diminished autonomy (4 vs 8; P=0.0077). Comparing dual users with smokers, median severity of diminished autonomy over cigarettes did not differ (P=0.6865).

Conclusions

Severity of diminished autonomy was lower for ENDS than cigarettes in this small sample of AI. Future, adequately powered studies should be conducted to fully understand ENDS use patterns and dependence levels in this population.
How do women with eating disorders experience a new treatment combining guided physical exercise and dietary therapy? An interview study of women participating in a randomised controlled trial at the Norwegian School of Sport Sciences
Authors: Pettersen Gunn , Sørdal Solveig , Rosenvinge Jan H , Skomakerstuen Tone , Mathisen Therese Fostervold , Sundgot-Borgen Jorunn
Published: December 2017

Objectives

To investigate how women with bulimia nervosa (BN) and binge eating disorder (BED) experience participating in a new treatment programme for eating disorders, based on guided physical exercise and dietary therapy.

Design and participants

Six women with BN and four with BED were semistructurally interviewed. Transcribed interviews were analysed using a text-condensing analytic approach.

Results

The analysis resulted in four main categories: (1) ‘a renewed attitude towards physical activity’, (2) ‘a new perception of food’, (3) ‘mixed feelings of being in a heterogeneous treatment group’ and (4) ‘insight in one’s own recovery process’, each with 2-4 subcategories to express nuances.

Conclusion

The treatment was experienced as beneficial. Improvements in the implementation of the programme were suggested.

Trial registration number

NCT02079935.
Platelet function and cardiovascular risk in adult HIV-infected patients on HAART: a protocol for a systematic review and meta-analysis
Authors: Nkambule Bongani Brian , Mkandla Zibusiso , Mutize Tinashe , Dludla Phiwayinkosi Vusi
Published: December 2017

Introduction

The incidence of cardiovascular disease (CVD) is now at least threefold higher in HIV-infected patients as compared with the general population. Although platelet activation and reactivity are implicated in the development of CVDs in HIV-infected patients, its precise role remains inconclusive. We aim to assess the association between platelet activation and selected cardiovascular risk factors in HIV-1-infected individuals on highly active antiretroviral treatment (HAART).

Methods

This will be a systematic review and meta-analysis of published studies evaluating the association between platelet activation and CVD risk factors in HAART-treated adults. The search strategy will include medical subject headings words for MEDLINE, and this will be adapted to Embase search headings (Emtree) terms for the EMBASE database. The search will cover literature published between 1 January 1996 to 30 April 2017. Studies will be independently screened by two reviewers using predefined criteria. Relevant eligible full texts will be screened; data will be extracted, and a qualitative synthesis will be conducted. Data extraction will be performed using Review Manager V.5.3. To assess the quality and strengths of evidence across selected studies, the Grading of Recommendations Assessment Development and Evaluation approach will be used. The Cochran’s Q statistic and the I2statistics will be used to analyse statistical heterogeneity between studies. If included studies show high levels of homogeneity, a random effects meta-analysis will be performed using R statistical software.

Ethics and dissemination

This will be a review of existing studies and will not require ethical approval. The findings will be disseminated through peer-reviewed publication and presented at local and international conferences. An emerging patient management dilemma is that of the increased incidence of CVD in people living with HIV on HAART. This review may inform treatment and cardiovascular risk stratification of HIV-infected patients at increased risk of developing CVD.

PROSPERO registration number

CRD42017062393.
Yellowish lesions in the oesophagus
Authors: Hamada Kenta , Yamasaki Yasushi , Kubota Jun-ichi , Okada Hiroyuki
Published: December 2017

Clinical presentation

A 51-year-old man, who had no previous disease, underwent a screening oesophagogastroduodenoscopy, which revealed multiple yellowish lesions in the middle thoracic oesophagus. All lesions were ≤3 mm in size and slightly elevated. Each lesion showed one or two white protrusions on the surface (figure 1). We observed that one lesion looked obviously different from the others and showed yellowish granular spots (figure 2). A biopsy was performed on a representative lesion among the slightly elevated yellowish lesions with white protrusions (figure 3). A biopsy was repeated on a lesion showing yellowish granular spots (figure 4). Blood tests which were examined on the same day, including triglyceride and cholesterol, were within normal limits.
Figure 1

Slightly elevated yellowish lesions with white protrusions in the middle thoracic oesophagus.

Figure 2

A lesion showing yellowish granular spots in the middle thoracic oesophagus.

Question

What is the diagnosis?
Rates and risk of arrhythmias in cancer survivors with chemotherapy-induced cardiomyopathy compared with patients with other cardiomyopathies
Authors: Fradley Michael G , Viganego Federico , Kip Kevin , Martin Angel , Patel Aarti A , Ismail-Khan Roohi , Chae Sanders , Herweg Bengt , Labovitz Arthur
Published: December 2017

Objectives

There is little information about arrhythmia burden in cancer survivors with chemotherapy-induced cardiomyopathy (CIC). We hypothesise that the rates and risk of arrhythmias will be similar in CIC when compared with other non-ischaemic cardiomyopathy (NICMO) aetiologies.

Methods

We retrospectively identified nine patients with CIC and an implantable defibrillator and 18 age and sex-matched control patients (nine patients with NICMO and nine patients with ischaemic cardiomyopathy (ICMO)). Rates and odds of arrhythmias were calculated by type of cardiomyopathy, adjusting for days since implantable cardioverter defibrillator implantation, history of atrial fibrillation and length of follow-up using logistic regression analysis.

Results

Compared with patients with NICMO, rates and adjusted odds were similar for patients with CIC for atrial arrhythmias (44.4% vs 33.3%; adjusted OR=1.89; 95% CI0.17 to 21.03; P=0.61), non-sustained ventricular tachycardia (NSVT) (44.4% vs 33.3%; OR=2.10; 95% CI 0.21 to 20.56; P=0.53), and the combined outcome of NSVT, sustained ventricular tachycardia and/or ventricular fibrillation (44.4% vs 44.4%; OR=2.70; 95% CI 0.25 to 29.48; P=0.42). Conversely, compared with patients with NICMO, patients with ICMO demonstrated higher rates and adjusted odds of the combined outcome (88.9% vs 44.4%; OR=28.60; 95% CI 1.26 to 648.2; P=0.04) and NSVT (77.8% vs 33.3%; OR=8.95; 95% CI 0.90 to 88.94; P=0.06).

Conclusions

While tentative based on sample size, rates of arrhythmias in patients with CIC appear to be similar to those experienced by patients with other forms of NICMO.
Association of high-density lipoprotein cholesterol with non-fatal cardiac and non-cardiac events: a CANHEART substudy
Authors: Wijeysundera Harindra C , Koh Maria , Alter David A , Austin Peter C , Jackevicius Cynthia A , Tu Jack V , Ko Dennis T
Published: December 2017

Background

Emerging evidence has questioned the role of high-density lipoprotein cholesterol (HDL-C) as an independent and modifiable risk factor for cardiovascular disease. We sought to understand the relationship between HDL-C levels and subsequent non-fatal clinical events.

Methods

Individuals without prior cardiovascular disease or cancer were identified. Outcomes of interest were classified as non-fatal cardiovascular, cancer and infectious. Sex-stratified, multivariable, cause-specific Cox proportional hazards models were created. The reference level HDL-C for both women and men was 51–60 mg/dL.

Results

Our cohort consisted of 631 762 individuals. For cardiovascular events, there was a consistent inverse relationship, with higher adjusted HRs for the lower HDL-C strata in both men and women. This relationship was also seen in the composite of non-cardiovascular outcomes. In women, the HR in the <30 mg/dL HDL-C category was 2.10 (95% CI 1.66 to 2.57) and 1.86 (95% CI 1.27 to 2.72) for cardiovascular and non-cardiovascular outcomes, respectively; in contrast, in the >90 mg/dL group, it was 0.87 (95% CI 0.74 to 1.02) and 0.81 (95% CI 0.63 to 1.06). For men, HRs were 2.02 (95% CI 1.79 to 2.28) and 1.84 (95% CI 1.47 to 2.31) in the <30 mg/dL HDL-C category for cardiovascular and non-cardiovascular outcomes, respectively, compared with 0.73 (95% CI 0.53 to 1.00) and 1.07 (95% CI 0.67 to 1.70) in the >90 mg/dL group.

Conclusions

We found an inverse relationship between HDL-C and a wide spectrum of non-fatal outcomes, suggesting that HDL-C is a heavily confounded factor that may be a marker of poor overall health, rather than an independent and modifiable risk factor.
Ginkgo biloba extract improved cognitive and neurological functions of acute ischaemic stroke: a randomised controlled trial
Authors: Li Shanshan , Zhang Xinjiang , Fang Qi , Zhou Junshan , Zhang Meijuan , Wang Hui , Chen Yan , Xu Biyun , Wu Yanfeng , Qian Lai , Xu Yun
Published: December 2017

Purpose

To evaluate the efficacy and safety of Ginkgo biloba extract (GBE) in acute ischaemic stroke and its impact on the recurrence of vascular events.

Methods

We conducted a multicentre, prospective, randomised, open label, blinded, controlled clinical trial enrollingpatients with an onset of acute stroke within 7 days from five hospitals in China Jiangsu Province. Participants were assigned to the GBE group (450 mg GBE with 100 mg aspirin daily) or the control group (100 mg aspirin daily) for 6 months. The primary outcome was the decline in the Montreal Cognitive Assessment score at 6 months. Secondary outcomes were other neuropsychological tests of cognitive and neurological function, the the incidence of adverse events and vascular events.

Results

348 patients were enrolled: 179 in the GBE group and 169 in the control group. With 18 patients lost to follow-up, the dropout rate was 5.17%. Admission data between two groups were similar, but in the GBE group there was a marked slow down in the decline in the Montreal Cognitive Assessment scores (−2.77±0.21 vs −1.99±0.23, P=0.0116 (30 days); −3.34±0.24 vs −2.48±0.26, P=0.0165 (90 days); −4.00±0.26 vs −2.71±0.26, P=0.0004 (180 days)) compared with controls. The National Institutes of Health Stroke Scale scores at 12 and 30 days, the modified Rankin Scale scores for independent rate at 30, 90 and 180 days, and the Barthel Index scores at 30, 90 and 180 days in the GBE group were significantly improved compared with controls. Improvements were also observedin GBE groups for Mini-Metal State Examination scores of 30, 90 and 180 days, Webster’s digit symbol test scores at 30 days and Executive Dysfunction Index scores at 30 and 180 days. No significant differences were seen in the incidence of adverse events or vascular events.

Conclusions

We conclude that GBE in combination with aspirin treatment alleviated cognitive and neurological deficits after acute ischaemic stroke without increasing the incidence of vascular events.

Trial registration number

ChiCTR-TRC-12002688.
COMPARISON OF EFFICACY OF MECHANICAL INTERMITTENT AND KALTENBORN CERVICAL TRACTION MOBILIZATION WITH BELT IN RADIATING NECK PAIN: A RANDOMIZED CLINICAL TRIAL
Authors: Sahasrabudhe Amala , Eapen Charu , Zulfeequer C. P.
Published: December 2017

Purpose: The aim of this paper is to see the effectiveness of cervical traction manual or mechanical as an adjunct to physical therapy in the treatment of radiating neck pain. Method: 50 subjects with radiating neck pain, 25 in each group were taken. Both groups received moist heat and cervical retraction exercises for five sessions. The KTr group received Kaltenborn manual traction and the Tr group received mechanical cervical traction. Outcome measures: Numeric Pain Rating Scale and cervical ROM were taken at baseline, after first treatment and at the end of 5th day. Neck disability index and Patient-Specific Functional Scale were taken at baseline and at the end of fifth session. Results: After 5 days of treatment, statistical improvements ([Formula: see text].05) were observed in all outcome measures in both groups. The immediate reduction in pain intensity and increased range of motion was observed in the KTr group. Conclusion: The study showed that both traction methods are equally effective when used as adjunct to physical therapy in radiating neck pain treatment. Immediate effects in reduction of pain and increase in the ROM are more in the manual traction group. Hence, manual cervical traction along with physical therapy can be considered as choice of treatment for immediate improvements in pain and ROM of the cervical spine.