bluuebunny/crossref_metadata_2025 huggingface dataset:
In Situ Thermophysical Properties of an Evolving Carbon Nanoparticle Based Deposit Layer Utilizing a Novel Infrared and Optical Methodology
Authors: Salvi Ashwin A. , Hoard John , Styles Dan , Assanis Dennis
Published: March 2016

The use of exhaust gas recirculation (EGR) in internal combustion engines has significant impacts on engine combustion and emissions. EGR can be used to reduce in-cylinder NOx production, reduce fuel consumption, and enable advanced forms of combustion. To maximize the benefits of EGR, the exhaust gases are often cooled with liquid to gas heat exchangers. However, the build up of a fouling deposit layer from exhaust particulates and volatiles results in the decrease of heat exchanger efficiency, increasing the outlet temperature of the exhaust gases and decreasing the advantages of EGR. This paper presents an experimental data from a novel in situ measurement technique in a visualization rig during the development of a 378 μm thick deposit layer. Measurements were performed every 6 hrs for up to 24 hrs. The results show a nonlinear increase in deposit thickness with an increase in layer surface area as deposition continued. Deposit surface temperature and temperature difference across the thickness of the layer was shown to increase with deposit thickness while heat transfer decreased. The provided measurements combine to produce deposit thermal conductivity. A thorough uncertainty analysis of the in situ technique is presented and suggests higher measurement accuracy at thicker deposit layers and with larger temperature differences across the layer. The interface and wall temperature measurements are identified as the strongest contributors to the measurement uncertainty. Due to instrument uncertainty, the influence of deposit thickness and temperature could not be determined. At an average deposit thickness of 378 μm and at a temperature of 100 °C, the deposit thermal conductivity was determined to be 0.044 ± 0.0062 W/m K at a 90% confidence interval based on instrument accuracy.
Enhancement of Thermocapillary Effect in Heated Liquid Films for Large Waves at High Reynolds Numbers
Authors: Chinnov E. A.
Published: March 2016

The characteristics of the heated water film flowing down a vertical plate at Re = 150, 300, and 500 were studied. The fluorescence method was used for measuring the film thickness. The temperature field on the film surface was measured by an infrared scanner. The analysis of the temperature pulsations on the heated film surface was made. The high-frequency component of temperature pulsations faded at the bottom area of the heater. Part of the temperature perturbations (small waves) was removed from interrivulets regions (valleys) to the rivulets by transverse thermocapillary forces. At high heat flux, only largest waves with maximum ripple of temperature reached the lower edge of the heater. There is a decrease in the mean integral energy fluctuations of temperature in the interrivulets regions near the heater lower edge. In the heated regions between rivulets, the relative amplitude of large waves increases with decreasing average thickness (or local Reynolds number). The analysis of results obtained for large Reynolds numbers showed that the relative amplitudes of large waves in the regions between rivulets at high heat fluxes are much greater than those for small Reynolds numbers and in isothermal falling films. In the interrivulet zone, Marangoni number increases with a rise of the heat flux. The growth of relative amplitude of low-frequency waves in interrivulets regions helps prevent film rupture and crisis of heat transfer.
Thermal and Mechanical Modeling of Metal Foams for Thermal Interface Application
Authors: Trifale Ninad , Nauman Eric , Yazawa Kazuaki
Published: March 2016

We present a study on the apparent thermal resistance of metal foams as a thermal interface in electronics cooling applications. Metal foams are considered beneficial for several applications due to its significantly large surface area for a given volume. Porous heat sinks made of aluminum foam have been well studied in the past. It is not only cost effective due to the unique production process but also appealing for the theoretical modeling study to determine the performance. Instead of allowing the refrigerant flow through the open cell porous medium, we instead consider the foam as a thermal conductive network for thermal interfaces. The porous structure of metal foams is moderately compliant providing a good contact and a lower thermal resistance. We consider foam filled with stagnant air. The major heat transport is through the metal struts connecting the two interfaces with high thermally conductive paths. We study the effect of both porosity and pore density on the observed thermal resistance. Lower porosity and lower pore density yield smaller bulk thermal resistance but also make the metal foam stiffer. To understand this tradeoff and find the optimum, we developed analytic models to predict intrinsic thermal resistance as well as the contact thermal resistance based on microdeformation at the contact surfaces. The variants of these geometries are also analyzed to achieve an optimum design corresponding to maximum compliance. Experiments are carried out in accordance with ASTM D5470 standard. A thermal resistance between the range 17 and 5 K cm2/W is observed for a 0.125 in. thick foam sample tested over a pressure range of 1–3 MPa. The results verify the calculation based on the model consisting the intrinsic thermal conductivity and the correlation of constriction resistance to the actual area of contact. The area of contact is evaluated analytically as a function of pore size (5–40 PPI), porosity (0.88–0.95), orientation of struts, and the cut plane location of idealized tetrakaidecahedron (TKDH) structure. The model is developed based on assumptions of elastic deformations and TKDH structures which are applicable in the high porosity range of 0.85–0.95. An optimum value of porosity for minimizing the overall interface thermal resistance was determined with the model and experimentally validated.
The Effect of Oil Droplet on the Lubrication Performance
Authors: Zhang Shengguang , Wang Wenzhong , Li Xinming , Guo Feng
Published: March 2016

Oil–air lubrication is widely used in the high-speed rotary machines; the oil is usually in the form of discrete droplets. The lubrication behavior of the oil droplet is rarely investigated. This paper investigates the effect of the oil droplet on lubrication performance based on the developed transient lubrication model with consideration of starvation conditions. The oil droplet is modeled as spherical segment with different heights, base radius, and positions, which will change the inlet oil supply conditions. The results show that the oil droplet with large size can generate thick oil film which is close to the one in fully flooded condition and can remain long time; the position of the oil droplet entering the contact region also has significant effect on the lubrication performance.
Transfer and Storage of Molten Salt for the Pyroprocessing of Used Nuclear Fuel
Authors: Morrison Matthew C. , Bateman Kenneth J.
Published: March 2016

A vacuum-induced salt transfer and storage (VISTAS) system is being evaluated to improve transfer and storage of molten electrorefiner (ER) salts at Idaho National Laboratory (INL). Salt is transferred by vacuum through a heated drawtube into a storage container. To control salt flow, a redundant level switch triggered by salt thermal conductivity and a preset temperature threshold activate a solenoid, stopping argon supply to the vacuum pump. A fail-safe cooling coil freezes the salt, halting its flow if the level switch malfunctions. The VISTAS system allows safe, timely salt transfer and reduces the storage footprint of current salt-removal methods.
Differential surface activation of the A1 domain of von Willebrand factor
Authors: Tronic Elaine H. , Yakovenko Olga , Weidner Tobias , Baio Joe E. , Penkala Rebecca , Castner David G. , Thomas Wendy E.
Published: March 2016

The clotting protein von Willebrand factor (VWF) binds to platelet receptor glycoprotein Ibα (GPIbα) when VWF is activated by chemicals, high shear stress, or immobilization onto surfaces. Activation of VWF by surface immobilization is an important problem in the failure of cardiovascular implants, but is poorly understood. Here, the authors investigate whether some or all surfaces can activate VWF at least in part by affecting the orientation or conformation of the immobilized GPIbα-binding A1 domain of VWF. Platelets binding to A1 adsorbed onto polystyrene surfaces translocated rapidly at moderate and high flow, but detached at low flow, while platelets binding to A1 adsorbed onto glass or tissue-culture treated polystyrene surfaces translocated slowly, and detached only at high flow. Both x-ray photoelectron spectroscopy and conformation independent antibodies reported comparable A1 amounts on all surfaces. Time-of-flight secondary ion mass spectrometry (ToF-SIMS) and near-edge x-ray absorption fine structure spectra suggested differences in orientation on the three surfaces, but none that could explain the biological data. Instead, ToF-SIMS data and binding of conformation-dependent antibodies were consistent with the stabilization of an alternative more activated conformation of A1 by tissue culture polystyrene and especially glass. These studies demonstrate that different material surfaces differentially affect the conformation of adsorbed A1 domain and its biological activity. This is important when interpreting or designing in vitro experiments with surface-adsorbed A1 domain, and is also of likely relevance for blood-contacting biomaterials.
Physical Activity Measurement by Accelerometry Among Older Malay Adults Living in Semi-Rural Areas—A Feasibility Study
Authors: Zainol Abidin Nurdiana , Brown Wendy J. , Clark Bronwyn , Muhamed Ahmad Munir Che , Singh Rabindarjeet
Published: March 2016

We evaluated feasibility of physical activity measurement by accelerometry among older Malay adults living in semi-rural areas in Malaysia. Results showed that 95% of 146 participants (aged [SD] 67.6 [6.4] years) were compliant in wearing the accelerometer for at least five days. Fifteen participants were asked for re-wear the accelerometer because they did not have enough valid days during the first assessment. Participants wore the accelerometer an average of 15.3 hr in a 24-hr day, with 6.5 (1.2) valid wear days. No significant difference in valid wear day and time was found between men and women. Participants who are single provide more valid wear days compared with married participants (p < .05), and participants with higher levels of education provide longer periods of accelerometer wearing hours (p < .01). Eighty-seven percent of participants reported ‘no issues’ with wearing the meter. This study suggests that accelerometry is a feasible method to assess the physical activity level among older Malay adults living in semi-rural areas.
Antarctic Ice Sheet variability across the Eocene-Oligocene boundary climate transition
Authors: Galeotti Simone , DeConto Robert , Naish Timothy , Stocchi Paolo , Florindo Fabio , Pagani Mark , Barrett Peter , Bohaty Steven M. , Lanci Luca , Pollard David , Sandroni Sonia , Talarico Franco M. , Zachos James C.
Published: March 2016

Sensitive ice sheets

Why did the Antarctic Ice Sheet begin to grow 34 million years ago, and what does that have to do with us? Galeotti
et al.
studied a marine sediment core recovered from just off the coast of Antarctica (see the Perspective by Lear and Lunt). The ice sheet did not begin to grow until atmospheric CO
2
concentrations had dropped to below around 600 parts per million. Indeed, the ice sheet was unstable when CO
2
was higher. As modern atmospheric CO
2
concentrations continue their rise, a shift back to an unstable Antarctic Ice Sheet could increase harmful rises in sea level.

Science
, this issue p.
76
; see also p.
34
Autism-associated SHANK3 haploinsufficiency causes
I
h
channelopathy in human neurons
Authors: Yi Fei , Danko Tamas , Botelho Salome Calado , Patzke Christopher , Pak ChangHui , Wernig Marius , Südhof Thomas C.
Published: March 2016

Faulty channels, not faulty synapses

SHANK3 is a widely expressed scaffolding protein that is enriched in postsynaptic specializations. In mutant mice, SHANK3 mutations cause autism-like behavioral changes and exhibit alterations in synaptic transmission. Yi
et al.
produced human neurons lacking SHANK3 but not other genes that are also involved in the autism-like disease Phelan-McDermid syndrome. Instead of affecting synapses, SHANK3 mutations primarily caused a channelopathy, with the major phenotype consisting of a specific impairment of HCN channels. Chronic impairment of membrane currents through channelopathy could account for the phenotypes observed in Phelan-McDermid neurons, such as alterations in cognitive functions and the predisposition to epilepsy.

Science
, this issue p.
10.1126/science.aaf2669
Draft Genome Sequences of Three
Flavobacterium psychrophilum
Strains Isolated from Coldwater Disease Outbreaks at Three Production Hatcheries
Authors: Neiger Regg , Thomas Milton , Das Seema , Barnes Michael , Fletcher Brian , Snekvik Kevin , Thompson Jim , Scaria Joy
Published: March 2016

We report here the genome sequences of three
Flavobacterium psychrophilum
strains causing a bacterial coldwater disease (BCWD) outbreak, isolated from infected rainbow trout from hatcheries in Montana and South Dakota. The availability of these virulent outbreak-causing strain genome sequences will help further understand the pathogenesis of BCWD.
Genome Sequences of Five Clinical Isolates of
Klebsiella pneumoniae
Authors: Lopez L. Letti , Rusconi Brigida , Gildersleeve Heidi , Qi Chao , McLaughlin Milena , Scheetz Marc H. , Seshu J. , Eppinger Mark
Published: March 2016

Klebsiella pneumoniae
is a nosocomial pathogen of emerging importance and displays resistance to broad-spectrum antibiotics, such as carbapenems. Here, we report the genome sequences of five clinical
K. pneumoniae
isolates
,
four of which are carbapenem resistant. Carbapenem resistance is conferred by hydrolyzing class A β-lactamases found adjacent to transposases.
Genome Sequence of
Elizabethkingia anophelis
Strain EaAs1, Isolated from the Asian Malaria Mosquito
Anopheles stephensi
Authors: Raygoza Garay Juan Antonio , Hughes Grant L. , Koundal Vikas , Rasgon Jason L. , Mwangi Michael M.
Published: March 2016

We sequenced the genome of a strain of the Gram-negative bacterial species
Elizabethkingia anophelis
, which is an important component of the
Anopheles
mosquito microbiome. This genome sequence will add to the list of resources used to examine host-microbe interactions in mosquitoes.
Complete Genome Sequence of
Nitrosomonas ureae
Strain Nm10, an Oligotrophic Group 6a Nitrosomonad
Authors: Kozlowski Jessica A. , Kits K. Dimitri , Stein Lisa Y.
Published: March 2016

The complete genome of
Nitrosomonas ureae
strain Nm10, a mesophilic betaproteobacterial ammonia oxidizer isolated from Mediterranean soils in Sardinia, Italy, is reported here. This genome represents a cluster 6a nitrosomonad.
Draft Genome Sequences of FungusAspergillus calidoustus
Authors: Horn Fabian , Linde Jörg , Mattern Derek J. , Walther Grit , Guthke Reinhard , Scherlach Kirstin , Martin Karin , Brakhage Axel A. , Petzke Lutz , Valiante Vito
Published: March 2016

Here, we report the draft genome sequence ofAspergillus calidoustus(strain SF006504).The functional annotation ofA. calidoustuspredicts a relatively large number of secondary metabolite gene clusters. The presented genome sequence builds the basis for further genome mining.
Whole-Genome Sequence of
Staphylococcus epidermidis
Tü3298
Authors: Moran Josephine C. , Horsburgh Malcolm J.
Published: March 2016

Staphylococcus epidermidis
Tü3298 is a frequently used laboratory strain, known for its production of epidermin and absence of the
icaABCD
operon. We report the whole-genome sequence of this strain, a 2.5-kb genome containing 2,332 genes.
Draft Genome Sequence of
Acinetobacter bereziniae
HPC229, a Carbapenem-Resistant Clinical Strain from Argentina Harboring
bla
NDM-1
Authors: Brovedan Marco , Marchiaro Patricia M. , Morán-Barrio Jorgelina , Revale Santiago , Cameranesi Marcela , Brambilla Luciano , Viale Alejandro M. , Limansky Adriana S.
Published: March 2016

We report here the draft genome sequence of an NDM-1-producing
Acinetobacter bereziniae
clinical strain, HPC229. This strain harbors both plasmid and chromosomal resistance determinants toward different β-lactams and aminoglycosides as well as several types of multidrug efflux pumps, most likely representing an adaptation strategy for survival under different environments.
Genome Sequences of Two
Pseudomonas syringae
pv. tomato Race 1 Strains, Isolated from Tomato Fields in California
Authors: Thapa Shree P. , Coaker Gitta
Published: March 2016

Pseudomonas syringae
pv. tomato race 1 strains have evolved to overcome genetic resistance in tomato. Here, we present the draft genome sequences of two race 1
P. syringae
pv. tomato strains, A9 and 407, isolated from diseased tomato plants in California.
Genomic Sequence of the First Porcine Rotavirus Group H Strain in the United States
Authors: Hull Jennifer J. , Marthaler Douglas , Rossow Stephanie , Ng Terry Fei Fan , Montmayeur Anna M. , Magana Laura , Moon Sung-Sil , Jiang Baoming
Published: March 2016

The genomic sequence of a rotavirus group H was identified in the intestine of a diarrheal pig in the United States, designated RVH/Pig-wt/USA/MN9.65/2008/GxP[x].
How well does the capillary thyroid-stimulating hormone test for newborn thyroid screening predict the venous free thyroxine level?
Authors: Pokrovska Tzveta , Jones Jeremy , Shaikh M Guftar , Smith Sarah , Donaldson Malcolm D C
Published: March 2016

Objectives

To determine, in newborn infants referred with elevated capillary thyroid-stimulating hormone (TSH), a threshold below which a frankly subnormal venous free thyroxine (fT4) level of <10 pmol/L is unlikely, so that treatment with levo-thyroxine (L-T4) might be deferred until venous thyroid function tests (TFTs) become available.

Subjects and methods

All infants referred in Scotland since 1979 with capillary TSH elevation were studied, with particular focus on infants screened using the AutoDELFIA assay between 2002 and 2013.

Results

Of the 321 infants referred with capillary TSH elevation using AutoDELFIA, 35 were excluded (fT4/TSH unavailable (12), venous sample either preceding or >10 days after capillary sampling (13, 10)), leaving 286 eligible for analysis (208 definite/probable hypothyroidism, 61 transient TSH elevation, 17 of uncertain thyroid status). Capillary TSH and venous T4 were strongly correlated (Spearman's rank correlation coefficient −0.707355). The optimal capillary TSH threshold for predicting a venous fT4 of <10 pmol/L was found to be >40 mU/L (90.3% sensitivity and 65.9% specificity compared with 90.25% and 59.1% for >35 mU/L and 88.3% and 68.2% for >45 mU/L). 93 infants (32.5%) had capillary TSH ≤40 mU/L at referral of whom 15 (9.7%) had venous fT4 <10 pmol/L, comprising seven with true congenital hypothyroidism, five with transient TSH elevation and three with uncertain status, two of whom died.

Conclusion

For infants in whom capillary TSH is ≤40 mU/L, it is reasonable to defer L-T4 treatment until venous TFT results are known provided that the latter become available quickly.
Anterior humeral circumflex artery avulsion with brachial plexus injury following an isolated traumatic anterior shoulder dislocation
Authors: Shah Rohi , Koris Jacob , Wazir Akhlaq , Srinivasan Shyamsundar S
Published: March 2016

A 70-year-old man presented to accident and emergency with an isolated anteriorly dislocated shoulder, in the absence of a concomitant fracture. There was no neurovascular deficit at presentation, and the shoulder was reduced under sedation, using the Kocher's technique. Following this, the patient developed signs of hypovolaemic shock. Clinical examination revealed an expanding fullness in the deltopectoral area, with compromise of the limb neurovascular status. CT imaging confirmed an expanding haematoma from the axillary vessels, restricting left lung expansion. Once resuscitated, the patient was transferred to theatre for exploration of the bleeding vessels. Intraoperative findings included an avulsed anterior circumflex humeral artery that was subsequently ligated. Postoperatively, the patient developed axillary, radial, median and ulnar nerve neuropraxia, which improved clinically prior to discharge. The patient was ultimately discharged home after a lengthy inpatient stay.
Congenital methemoglobinaemia due to Hb F-M-Fort Ripley in a preterm newborn
Authors: Ghotra Satvinder , Jangaard Krista , Pambrun Chantale , Fernandez Conrad Vincent
Published: March 2016

Methemoglobinaemia is a rare cause of cyanosis in newborns. Congenital methemoglobinaemias due to M haemoglobin or deficiency of cytochrome b5 reductase are even rarer. We present a case of congenital methemoglobinaemia presenting at birth in a preterm infant. A baby boy born at 29 weeks and 3 days of gestation had persistent central cyanosis immediately after delivery, not attributable to a respiratory or cardiac pathology. Laboratory methemoglobin levels were not diagnostic. Cytochrome b5 reductase levels were normal and a newborn screen was unable to pick up any abnormal variants of fetal haemoglobin. Genetic testing showed a γ globin gene mutation resulting in the M haemoglobin, called Hb F-M-Fort Ripley. The baby had no apparent cyanosis at a corrected gestational age of 42 weeks. Although rare, congenital methaemoglobin aemia should be considered in the differential in a preterm with central cyanosis and investigated with genetic testing for γ globin chain mutations if other laboratory tests are non-conclusive.
Arterioureteral fistula: an unusual clinical case
Authors: Coelho Hugo , Freire Maria José , Azinhais Paulo , Temido Paulo
Published: March 2016

Arterioureteral fistulas (AUFs) are abnormal communications between a major artery and the mid to distal ureter. It is a rare but potentially life-threatening condition that is seldom recognised. We present a case of a 66-year-old man who was admitted to the surgical ward owing to infection of an aortic bifemoral bypass graft. During admission, the patient developed persistent haematuria with considerable loss of haemoglobin. He was submitted to urgent surgical exploration of the graft. An ascending pyelography performed at the beginning of the surgery clearly shows a communication between the left ureter and the vascular graft. Open surgical exploration was undertaken, the fistulised section of the ureter resected and an end-to-end ureteroplasty was performed. The vascular graft was removed and the patient later submitted to left supracondylar amputation. Urinary drainage remained intact.
Rare case of radiation-induced trigeminal schwannoma occurring in a long-term glioblastoma multiforme survivor
Authors: Al Shalchi Mina , Hussain Shaila , Giridharan Selvaraj , Albanese Erminia
Published: March 2016

Glioblastoma multiforme (GBM) is a high-grade primary brain tumour with a notably poor prognosis. Research demonstrates a median survival of just over 1 year following aggressive treatment. Long-term survival is notably rare. Cranial radiotherapy and postexcisional prophylactic treatment is associated with the development of second, histologically distinct tumours in rare cases. Radiation-induced intracranial schwannomas are uncommon, with only a small number of cranial nerve schwannoma cases reported in recent decades. To our knowledge, this is the first reported case of a radiation-induced benign trigeminal schwannoma occurring following long-term survival from glioblastoma. Here we present (1) a rare case of 14-year survival following treatment of a right parietal glioblastoma and the development of a radiation-induced benign trigeminal schwannoma in a 35-year-old man, and (2) a review of radiation-induced schwannoma cases reported in the existing literature.
Cardiac tamponade, an unusual complication of acute pancreatitis
Authors: Veron Esquivel Daniel , Aello Gerardo , Batiz Fernando , Fernandez Barrera Alejandro
Published: March 2016

A 41-year-old Hispanic man was admitted to our hospital with the diagnosis of acute pancreatitis due to hypertriglyceridemia. During his stay, he developed sudden haemodynamic instability and clinical presentation suggestive of cardiac tamponade. A transthoracic echocardiogram confirmed the diagnosis. Echocardiography-guided pericardiocentesis was performed with immediate haemodynamic improvement. The patient's condition underwent favourable evolution. The pancreatitis was resolved and a control transthoracic echocardiography was performed showing no pericardial effusion. The pathophysiology of this rare entity is unknown. Early diagnosis and treatment are crucial. Although pericardiocentesis is the treatment of choice, there have been a few reports of medical treatment with encouraging results. Although the association of acute pancreatitis and tamponade are anecdotal in literature, medics should be aware of this association in order to perform prompt diagnosis.
Household survey analysis of the impact of comprehensive strategies to improve the expanded programme on immunisation at the county level in western China, 2006–2010
Authors: Zhou Yuqing , Xing Yi , Liang Xiaofeng , Yue Chenyan , Zhu Xu , Hipgrave David
Published: March 2016

Objective

To evaluate interventions to improve routine vaccination coverage and caregiver knowledge in China's remote west, where routine immunisation is relatively weak.

Design

Prospective pre–post (2006–2010) evaluation in project counties; retrospective comparison based on 2004 administrative data at baseline and surveyed post-intervention (2010) data in selected non-project counties.

Setting

Four project counties and one non-project county in each of four provinces.

Participants

3390 children in project counties at baseline, and 3299 in project and 830 in non-project counties post-intervention; and 3279 caregivers at baseline, and 3389 in project and 830 in non-project counties post-intervention.

Intervention

Multicomponent inexpensive knowledge-strengthening and service-strengthening and innovative, multisectoral engagement.

Data collection

Standard 30-cluster household surveys of vaccine coverage and caregiver interviews pre-intervention and post-intervention in each project county. Similar surveys in one non-project county selected by local authorities in each province post-intervention. Administrative data on vaccination coverage in non-project counties at baseline.

Primary outcome measures

Changes in vaccine coverage between baseline and project completion (2010); comparative caregiver knowledge in all counties in 2010.

Analysis

Crude (χ2) analysis of changes and differences in vaccination coverage and related knowledge. Multiple logistic regression to assess associations with timely coverage.

Results

Timely coverage of four routine vaccines increased by 21% (p<0.001) and hepatitis B (HepB) birth dose by 35% (p<0.001) over baseline in project counties. Comparison with non-project counties revealed secular improvement in most provinces, except new vaccine coverage was mostly higher in project counties. Ethnicity, province, birthplace, vaccination site, dual-parental out-migration and parental knowledge had significant associations with coverage. Knowledge increased for all variables but one in project counties (highest p<0.05) and was substantially higher than in non-project counties (p<0.01).

Conclusions

Comprehensive but inexpensive strategies improved vaccination coverage and caretaker knowledge in western China. Establishing multisectoral leadership, involving the education sector and including immunisation in public-sector performance standards, are affordable and effective interventions.
Prevalence of alcohol and drug use in injured British Columbia drivers
Authors: Brubacher Jeffrey R , Chan Herbert , Martz Walter , Schreiber William , Asbridge Mark , Eppler Jeffrey , Lund Adam , Macdonald Scott , Drummer Olaf , Purssell Roy , Andolfatto Gary , Mann Robert , Brant Rollin
Published: March 2016

Objectives

Determine the prevalence of drug use in injured drivers and identify associated demographic factors and crash characteristics.

Design

Prospective cross-sectional study.

Setting

Seven trauma centres in British Columbia, Canada (2010–2012).

Participants

Automobile drivers who had blood obtained within 6 h of a crash.

Main outcome measures

We analysed blood for cannabis, alcohol and other impairing drugs using liquid chromatography/mass spectrometry (LCMS).

Results

1097 drivers met inclusion criteria. 60% were aged 20–50 years, 63.2% were male and 29.0% were admitted to hospital. We found alcohol in 17.8% (15.6% to 20.1%) of drivers. Cannabis was the second most common recreational drug: cannabis metabolites were present in 12.6% (10.7% to 14.7%) of drivers and we detected Δ-9-tetrahydrocannabinol (Δ-9-THC) in 7.3% (5.9% to 9.0%), indicating recent use. Males and drivers aged under 30 years were most likely to use cannabis. We detected cocaine in 2.8% (2.0% to 4.0%) of drivers and amphetamines in 1.2% (0.7% to 2.0%). We also found medications including benzodiazepines (4.0% (2.9% to 5.3%)), antidepressants (6.5% (5.2% to 8.1%)) and diphenhydramine (4.7% (3.5% to 6.2%)). Drivers aged over 50 years and those requiring hospital admission were most likely to have used medications. Overall, 40.1% (37.2% to 43.0%) of drivers tested positive for alcohol or at least one impairing drug and 12.7% (10.7% to 14.7%) tested positive for more than one substance.

Conclusions

Alcohol, cannabis and a broad range of other impairing drugs are commonly detected in injured drivers. Alcohol is well known to cause crashes, but further research is needed to determine the impact of other drug use, including drug–alcohol and drug–drug combinations, on crash risk. In particular, more work is needed to understand the role of medications in causing crashes to guide driver education programmes and improve public safety.
Pregnancy history and current use of contraception among women of reproductive age in Burundi, Kenya, Rwanda, Tanzania and Uganda: analysis of demographic and health survey data
Authors: Bakibinga Pauline , Matanda Dennis J , Ayiko Rogers , Rujumba Joseph , Muiruri Charles , Amendah Djesika , Atela Martin
Published: March 2016

Objective

To examine the relationship between pregnancy history and the use of contraception among women of reproductive age (15–49 years) in East Africa.

Methods

Demographic and Health Surveys data from Burundi (2010), Kenya (2008–2009), Rwanda (2010), Tanzania (2010) and Uganda (2011) were used in the analysis. Logistic regression was used to determine the effects of women's pregnancy history on their use of contraception.

Setting

Burundi, Kenya, Rwanda, Tanzania and Uganda.

Participants

3226, 2377, 4396, 3250 and 2596 women of reproductive age (15–49 years) from Burundi, Kenya, Rwanda, Tanzania and Uganda, respectively, were included in the analysis.

Results

Women who had experienced a mistimed pregnancy were more likely to use a modern contraceptive method during their most recent sexual encounter in Kenya, Rwanda, Burundi and Uganda. Other significant correlates of women's contraceptive use were: desire for more children, parity, household wealth, maternal education and access information through radio. In-country regional differences on use of modern contraceptive methods were noted across five East African countries.

Conclusions

Women's birth histories were significantly associated with their decision to adopt a modern contraceptive method. This highlights the importance of considering women's birth histories, especially women with mistimed births, in the promotion of contraceptive use in East Africa. Variations as a result of place of residency, educational attainment, access to family planning information and products, and wealth ought to be addressed in efforts to increase use of modern contraceptive methods in the East African region.
Cross-sectional survey of Good Samaritan behaviour by physicians in North Carolina
Authors: Garneau William M , Harris Dean M , Viera Anthony J
Published: March 2016

Objective

To assess the responses of physicians to providing emergency medical assistance outside of routine clinical care. We assessed the percentage who reported previous Good Samaritan behaviour, their responses to hypothetical situations, their comfort providing specific interventions and the most likely reason they would not intervene.

Setting

Physicians residing in North Carolina.

Participants

Convenience sample of 1000 licensed physicians.

Intervention

Mailed survey.

Design

Cross-sectional study conducted May 2015 to September 2015.

Main outcome and measures

Willingness of physicians to act as Good Samaritans as determined by the last opportunity to intervene in an out-of-office emergency.

Results

The adjusted response rate was 26.1% (253/970 delivered). 4 out of 5 physicians reported previous opportunities to act as Good Samaritans. Approximately, 93% reported acting as a Good Samaritan during their last opportunity. There were no differences in this outcome between sexes, practice setting, specialty type or experience level. Doctors with greater perceived knowledge of Good Samaritan law were more likely to have intervened during a recent opportunity (p=0.02). The most commonly cited reason for potentially not intervening was that another health provider had taken charge.

Conclusions

We found the frequency of Good Samaritan behaviour among physicians to be much higher than reported in previous studies. Greater helping behaviour was exhibited by those who expressed more familiarity with Good Samaritan law. These findings suggest that physicians may respond to legal protections.
Endovascular management of renal artery aneurysms using the multilayer flow modulator
Authors: Sultan Sherif , Basuoniy Alawy Mahmoud , Flaherty Rita , Kavanagh Edel P , Elsherif Mohamed , Elhelali Ala , Stefanov Florian , Lundon Violet , Hynes Niamh
Published: March 2016

Objective

Our aim was to describe our experience of the Multilayer Flow Modulator (MFM, Cardiatis, Isnes, Belgium) used in the treatment of type III renal artery aneurysms (RAA).

Methods

This is a single-centre study. 3 patients (2 men and 1 woman; mean age 59 years; range 41–77 years) underwent treatment of a type III renal artery aneurysm using the MFM. The indications were a 23.9 mm type III RAA at the bifurcation of the upper and lower pole vessels, with 4 side branches; a 42.4 mm type III saccular RAA at the renal hilum; and a 23 mm type III RAA at the origin of the artery, supplying the upper pole.

Results

Patients had a mean follow-up of 27 months, and were assessed by perioperative renal function tests, and repeat postoperative CT scan. There were no immediate postoperative complications or mortality. The first patient's aneurysm shrank by 8.6 mm, from 23.9 to 15.3 mm over 19 months, with all 4 side branches remaining patent. The largest aneurysm at 42.4 mm completely thrombosed, while the renal artery remained patent to the kidney. The final patient refused to have any follow-up scans but had no deterioration in renal function below 30 mL/min, and no further symptoms reported.

Conclusions

The MFM is safe and effective in the management of patients with complex renal artery aneurysms. The MFM can be used to treat branched or distal renal artery aneurysms with exclusion of the aneurysm from the circulation, while successfully preserving the flow to the side branches and kidney. Initial results are promising, however, longer follow-up and a larger cohort are required to prove the effectiveness of this emerging technology.
Effects of paediatric HIV infection on electrical conduction of the heart
Authors: Idris Nikmah S , Cheung Michael M H , Grobbee Diederick E , Burgner David , Kurniati Nia , Djer Mulyadi M , Uiterwaal Cuno S P M
Published: March 2016

Objective

To investigate the effects of HIV infection in children on heart electrical conduction, particularly to delineate the effects of HIV infection from treatment.

Methods

On a 12-lead ECG, available for 37 antiretroviral therapy (ART) naïve, 42 ART-exposed vertically-acquired HIV-infected and 50 healthy children in Jakarta, Indonesia, we measured cardiac conduction parameters: PR, QRS, and QTc (corrected using Bazett's formula) intervals. The associations between HIV infection/treatment status and ECG intervals were evaluated using general linear modelling with further adjustment for potential confounders or intermediary variables. Findings are presented as (adjusted) mean differences between each of the two HIV groups and healthy children.

Results

Although not exceeding the clinical threshold for long QT (QTc >460 ms for girls and >440 ms for boys) compared to healthy children, mean QTc intervals were longer in ART-naïve (difference 18.2 ms, 95% CI 7.0 to 29.3) and, to greater extent, in ART-exposed HIV-infected children (difference 28.9 ms, 19.3 to 38.5). Following adjustment for RR interval, age and height, prolongation of PR interval was seen only in ART-naïve HIV-infected children (difference 12.9 ms, 2.4 to 23.3). Cardiac mass/function, high-sensitive C reactive protein, cholesterol and glycated haemoglobin levels, systolic and diastolic blood pressures, or postnatal parental smoking exposure did not affect these associations. No difference in the QRS interval was observed between groups.

Conclusions

Prolongation of the QTc interval occurs in ART-naïve HIV-infected children and, to a greater extent, in the ART-exposed children, whereas a longer PR interval appears to be seen only among ART-naïve HIV-infected children.
Rankings of iron, vitamin D, and calcium intakes in relation to maternal characteristics of pregnant Canadian women
Authors: Morisset Anne-Sophie , Weiler Hope A. , Dubois Lise , Ashley-Martin Jillian , Shapiro Gabriel D. , Dodds Linda , Massarelli Isabelle , Vigneault Michel , Arbuckle Tye E. , Fraser William D.
Published: March 2016

Iron, vitamin D, and calcium intakes in the prenatal period are important determinants of maternal and fetal health. The objective of this study was to examine iron, vitamin D, and calcium intakes from diet and supplements in relation to maternal characteristics. Data were collected in a subsample of 1186 pregnant women from the Maternal–Infant Research on Environmental Chemicals (MIREC) Study, a cohort study including pregnant women recruited from 10 Canadian sites between 2008 and 2011. A food frequency questionnaire was administered to obtain rankings of iron, calcium, and vitamin D intake (16–21 weeks of pregnancy). Intakes from supplements were obtained from a separate questionnaire (6–13 weeks of pregnancy). Women were divided into 2 groups according to the median total intake of each nutrient. Supplement intake was an important contributor to total iron intake (median 74%, interquartile range (IQR) 0%–81%) and total vitamin D intake (median 60%, IQR 0%–73%), while the opposite was observed for calcium (median 18%, IQR 0%–27%). Being born outside of Canada was significantly associated with lower total intakes of iron, vitamin D, and calcium (p ≤ 0.01 for all). Consistent positive indicators of supplement use (iron, vitamin D, and calcium) were maternal age over 30 years and holding a university degree. In conclusion, among Canadian women, the probability of having lower iron, vitamin D, and calcium intakes is higher among those born outside Canada; supplement intake is a major contributor to total iron and vitamin D intakes; and higher education level and age over 30 years are associated with supplement intake.
Myopic choice or rational decision making? An investigation into mode choice preference structures in competitive modal arrangements in a multimodal urban area, the City of Toronto
Authors: Mahmoud Mohamed Salah , Weiss Adam , Habib Khandker Nurul
Published: March 2016

This paper presents an investigation into the preference structure of commuting mode choice in dense urban areas. The paper aims to investigate the phenomenon of myopic choice and extends the phenomenon to the concept of modal culture. Using a household travel diary survey from the greater Toronto and Hamilton Area, an empirical discrete choice model was estimated. This model was used to provide general comments on the commuting and dependent behaviour of the sample, with a particular focus on the factors that influence bicycling captivation and culture. The model was then used for a hypothetical policy scenario analysis, which found that an investment in biking infrastructure had the capacity to increase bicycling mode share by nearly 50%. Based on this result, this paper recommends further investigation into both data collection for more comprehensive empirical model development and investigation into the policy applicability of the proposed model structure.
Mass of the electroweak monopole
Authors: Kimm Kyoungtae , Yoon J. H. , Oh S. H. , Cho Y. M.
Published: March 2016

We present three independent methods to estimate the mass of the electroweak monopole. Our result strongly implies the existence of a genuine electroweak monopole of mass around 4–10 TeV, which could be detected by MoEDAL at present Large Hadron Collider (LHC). We emphasize that the discovery of the electroweak monopole should be the final test of the Standard Model.
Interactions and growth of faults in an outcrop-scale system
Authors: Nicol A. , Childs C. , Walsh J. J. , Manzocchi T. , Schöpfer M. P. J.
Published: March 2016

Fault growth could be achieved by (1) synchronous increases in displacement and length or (2) rapid fault propagation succeeded by displacement-dominated growth. The second of these growth models (here referred to as the constant length model) is rarely applied to small outcrop-scale faults, yet it can account for many of the geometric and kinematic attributes of these faults. The constant length growth model is supported here using displacement profiles, displacement–length relationships and tip geometries for a system of small strike-slip faults (lengths of 1–200 m and maximum displacements of 0.001–3 m) exposed in a coastal platform in New Zealand. Displacement profiles have variable shapes that mainly reflect varying degrees of fault interaction. Increasing average displacement gradients with increasing fault size (maximum displacement and length) may indicate that the degree of interaction increases with fault size. Horsetail and synthetic splays confined to fault-tip regions are compatible with little fault propagation during much of the growth history. Fault displacements and tip geometries are consistent with a two-stage growth process initially dominated by propagation followed by displacement accumulation on faults with near-constant lengths. Retardation of propagation may arise due to fault interactions and associated reduction of tip stresses, with the early transition from propagation- to displacement-dominated growth stages produced by fault-system saturation (i.e. the onset of interactions between all faults). The constant length growth model accounts for different fault types over a range of scales and may have wide application.
The influence of acute unloading on left ventricular strain and strain rate by speckle tracking echocardiography in a porcine model
Authors: Dahle Geir Olav , Stangeland Lodve , Moen Christian Arvei , Salminen Pirjo-Riitta , Haaverstad Rune , Matre Knut , Grong Ketil
Published: March 2016

Noninvasive measurements of myocardial strain and strain rate by speckle tracking echocardiography correlate to cardiac contractile state but also to load, which may weaken their value as indices of inotropy. In a porcine model, we investigated the influence of acute dynamic preload reductions on left ventricular strain and strain rate and their relation to the pressure-conductance catheter-derived preload recruitable stroke work (PRSW) and peak positive first derivative of left ventricular pressure (LV-dP/d tmax). Speckle tracking strain and strain rate in the longitudinal, circumferential, and radial directions were measured during acute dynamic reductions of end-diastolic volume during three different myocardial inotropic states. Both strain and strain rate were sensitive to unloading of the left ventricle ( P < 0.001), but the load dependency for strain rate was modest compared with strain. Changes in longitudinal and circumferential strain correlated more strongly to changes in end-diastolic volume ( r = −0.86 and r = −0.72) than did radial strain ( r = 0.35). Longitudinal, circumferential, and radial strain significantly correlated with LV-dP/d tmax ( r = −0.53, r = −0.46, and r = 0.86), whereas only radial strain correlated with PRSW ( r = 0.55). Strain rate in the longitudinal, circumferential and radial direction significantly correlated with both PRSW ( r = −0.64, r = −0.58, and r = 0.74) and LV-dP/d tmax ( r = −0.95, r = −0.70, and r = 0.85). In conclusion, the speckle tracking echocardiography-derived strain rate is more robust to dynamic ventricular unloading than strain. Longitudinal and circumferential strain could not predict load-independent contractility. Strain rates, and especially in the radial direction, are good predictors of preload-independent inotropic markers derived from conductance catheter.
Cytochrome P450 Allele CYP3A7*1C Associates with Adverse Outcomes in Chronic Lymphocytic Leukemia, Breast, and Lung Cancer
Authors: Johnson Nichola , De Ieso Paolo , Migliorini Gabriele , Orr Nick , Broderick Peter , Catovsky Daniel , Matakidou Athena , Eisen Timothy , Goldsmith Christy , Dudbridge Frank , Peto Julian , dos-Santos-Silva Isabel , Ashworth Alan , Ross Gillian , Houlston Richard S. , Fletcher Olivia
Published: March 2016

CYP3A enzymes metabolize endogenous hormones and chemotherapeutic agents used to treat cancer, thereby potentially affecting drug effectiveness. Here, we refined the genetic basis underlying the functional effects of a CYP3A haplotype on urinary estrone glucuronide (E1G) levels and tested for an association between CYP3A genotype and outcome in patients with chronic lymphocytic leukemia (CLL), breast, or lung cancers. The most significantly associated SNP was rs45446698, an SNP that tags the CYP3A7*1C allele; this SNP was associated with a 54% decrease in urinary E1G levels. Genotyping this SNP in 1,008 breast cancer, 1,128 lung cancer, and 347 CLL patients, we found that rs45446698 was associated with breast cancer mortality (HR, 1.74; P = 0.03), all-cause mortality in lung cancer patients (HR, 1.43; P = 0.009), and CLL progression (HR, 1.62; P = 0.03). We also found borderline evidence of a statistical interaction between the CYP3A7*1C allele, treatment of patients with a cytotoxic agent that is a CYP3A substrate, and clinical outcome (Pinteraction = 0.06). The CYP3A7*1C allele, which results in adult expression of the fetal CYP3A7 gene, is likely to be the functional allele influencing levels of circulating endogenous sex hormones and outcome in these various malignancies. Further studies confirming these associations and determining the mechanism by which CYP3A7*1C influences outcome are required. One possibility is that standard chemotherapy regimens that include CYP3A substrates may not be optimal for the approximately 8% of cancer patients who are CYP3A7*1C carriers. Cancer Res; 76(6); 1485–93. ©2016 AACR.