bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the host cytokine response in dogs with sepsis and noninfectious systemic inflammatory response syndrome
Authors: Goggs Robert , Letendre Jo‐Annie 
Published: October 2019

AbstractObjectiveTo quantify plasma cytokine concentrations in dogs with sepsis and noninfectious systemic inflammation and to evaluate the association between plasma cytokines and outcome in dogs with sepsis.DesignProspective, observational cohort study.SettingUniversity teaching hospital.AnimalsForty‐five dogs with sepsis, 10 dogs with noninfectious systemic inflammation (nSIRS), and 15 healthy controls were consecutively enrolled from June 2015 to February 2016 and followed to hospital discharge. Dogs with sepsis satisfied ≥2 SIRS criteria and had a documented or highly suspected bacterial infection. Dogs with nSIRS satisfied ≥2 SIRS criteria but had no evidence of infection. Dogs <3 kg and those with documented coagulopathy were excluded.InterventionsMeasurement of inflammatory cytokines and high‐mobility group box‐1 (HMGB‐1) was performed on each group.Measurements and Main ResultsHigh‐mobility group box‐1 concentrations were analyzed by ELISA. Plasma concentrations of 13 cytokines were measured in singlet using multiplex magnetic bead assays. Kruskal–Wallis with Dunn's multiple comparison tests were used to compare biomarker concentrations between groups. Mann–WhitneyU‐tests were used to compare biomarker concentrations between survivors and nonsurvivors. Associations between biomarkers were evaluated using Spearman's correlation coefficients. Independent outcome predictors were identified using multivariable logistic regression. Alpha was set at 0.05. Concentrations of interleukin (IL)‐6, C‐X‐C motif chemokine (CXCL)‐8, keratinocyte‐derived chemokine (KC)‐like, C‐C motif chemokine ligand 2 (CCL2), and HMGB‐1 were significantly greater in dogs with sepsis versus healthy controls (allP ≤ 0.034). In dogs with sepsis, only CCL2 was independently associated with survival (odds ratio [OR] 0.996, 95% CI 0.993–0.999,P = 0.004). A cut‐off of 385 pg/mL for CCL2 was 80% sensitive and 91.4% specific for nonsurvival (area under the ROC curve [AUROC] 0.866).ConclusionsDogs with sepsis have significantly increased concentrations of HMGB‐1 and inflammatory cytokines, including IL‐6, CXCL8, and KC‐like. Increased CCL2 concentration is a negative prognostic indicator in dogs with sepsis. These findings should be confirmed using duplicate analyses in larger, distinct populations of dogs with sepsis before applying them to clinical patients.
Analytical Formulation of Friction Contact Elements for Frequency-Domain Analysis of Nonlinear Vibrations of Structures With High-Energy Rubs
Authors: Petrov E. P. 
Published: October 2019

Abstract
In gas-turbine engines and other rotating machinery structures, rubbing contact interactions can occur when the contacting components have large relative motion between components: such as in rotating bladed disk-casing rubbing contacts, and rubbing in rotor bearing and labyrinth seals. The analysis of vibrations of structures with rubbing contacts requires the development of a mathematical model and special friction contact elements that would allow for the prescribed relative motion of rubbing surfaces in addition to the motion due to vibrations of the contacting components. In the proposed paper, the formulation of the friction contact elements is developed, which includes the effects of the prescribed relative motion on the friction stick-slip transitions and, therefore, on the contact interaction forces. For a first time, the formulation is made for the frequency domain analysis of coupled rubbing and vibrational motion, using the multiharmonic representation of the vibration displacements. The formulation is made fully analytically to express the multiharmonic contact interaction forces and multiharmonic tangent stiffness matrix in an explicit analytical form allowing their calculation accurately and fast. The dependency of the friction and contact stiffness coefficients on the energy dissipated during high-energy rubbing contacts and, hence, on the corresponding increase of the contact interface temperature is included in the formulation. The efficiency of the developed friction elements is demonstrated on a set of test cases including simple models and a large-scale realistic blade.
Punch-Through Risk of Jack-Up Under the Dual Uncertainty of Structure and Foundation
Authors: Lyu Tao , Xu Changhang , Chen Guoming , Zhao Yipei , Zhao Tantan , Li Qingyang 
Published: October 2019

Abstract
The preload operation of Jack-up in complex multi-layered foundation requires an enhanced understanding of its behavior in punch-through accident and suitable safety analysis tools for the assessment of their reliability in a particular site. In order to evaluate punch-through risk, a risk-consistent method is proposed based on the model of foundation hazard and structural vulnerability. Besides, foundation bearing capacity is evaluated to quantify foundation hazard. Third, to improve the solution efficiency, higher-order moment method (HOMM)-Pushover method has been developed for assessing the structural vulnerability. In addition, case studies are presented to demonstrate the advantages of these techniques and important trends are highlighted by the results of parametric sensitivity studies. More specifically, failure probability analysis has been undertaken using improved method and the punch-through risk is evaluated quantitatively in different hazard levels. The results show that the dual uncertainty of both structure and foundation is crucial for assessment of foundation hazard and structural vulnerability. The randomness of foundation parameters is the dominant factor affecting the punch-through risk, and the risk increases with the increase of preload weight. The time-varying risk in the process of preload operation can be revealed using the risk analysis method mentioned in this paper.
Non-Linear Modeling and Parameter Identification of Semi-Active Engine Mounts With Air Spring
Authors: Guo Rong , Zhou Zi-wei 
Published: October 2019

Abstract
Car manufacturers have been motivated to apply semi-active engine mounts to ensure superior performance in vibration attenuation during idle condition and better ability to isolate vibration which is generated by engine unbalanced force at high frequencies. This paper develops a non-linear lumped parameter model of semi-active engine mounts with air spring that focuses on the non-linearity of the rubber diaphragm and the air chamber. Then, the main rubber dynamic stiffness parameters are identified through experimental approaches with a novel-designed test rig. Other parameters including effective pumping area, main rubber spring bulge stiffness, fluid channel inertia and resistance, rubber diaphragm, and air-chamber parameters are attained through finite element analysis (FEA). Supported by the identified lumped parameters, the non-linear mathematical model could be simulated. In addition, the dynamic characteristics of the semi-active engine mount are tested through the original test rig. Therefore, comparing with the tested dynamic characteristics, the simulation result can validate the developed model and thus facilitate the structure design of the semi-active engine mount.
The Influence of Fan Root Flow on the Aerodynamic of a Low-Pressure Compressor Transition Duct
Authors: Walker A. Duncan , Mariah Ian , Tsakmakidou Dimitra , Vadhvana Hiren , Hall Chris 
Published: October 2019

Abstract
To reduce fuel-burn and emissions, there is a drive toward higher bypass ratio and smaller high-pressure ratio core engines. This makes the design of the ducts connecting compressor spools more challenging as the higher radius change increases aerodynamic loading. This is exacerbated at inlet to the engine core by fan root flow which is characterized by a hub-low-pressure profile and large secondary flow structures. Additionally, shorter, lighter nacelles mean that the intake may not provide a uniform inlet flow when the aircraft is at an angle of attack or subject to cross winds. Such inlet distortion can further degrade the flow entering the engine. A combination of experiments and computational fluid dynamics (CFD) has been used to examine the effects on the aerodynamics of an engine section splitter (ESS) and transition duct designed to feed the low-pressure spool of a high bypass ratio turbofan. A test facility incorporating a 1½ stage axial compressor was used to compare system performance for a flat rotor exit profile to one with a hub deficient flow. Validated Reynolds averaged Navier–Stokes (RANS) CFD was then used to further investigate the effects of increased inlet boundary layer thickness and bulk swirl distortion at rotor inlet. These changes were seen to have a surprisingly small effect on the flow at the duct exit. However, increased secondary flows were observed which degraded the performance of the ESS and significantly increased loss. Nevertheless, the enhanced mixing delayed separation in the duct suggesting that overall the design was reasonably robust albeit with increased system loss.
Effect of Pad and Liner Material Properties on the Static Load Performance of a Tilting Pad Thrust Bearing
Authors: Koosha Rasool , San Andrés Luis 
Published: October 2019

AbstractTilting pad thrust bearings (TPTBs) control rotor axial placement in rotating machinery, and their main advantages include low drag power loss, simple installation, and low-cost maintenance. The paper details a novel thermo-elasto-hydrodynamic (TEHD) analysis predictive tool for TPTBs that considers a three-dimensional (3D) thermal energy transport equation in the fluid film, coupled with heat conduction equations in the pads, and a generalized Reynolds equation with cross-film viscosity variation. The predicted pressure field and temperature rise are employed in a finite element (FE) structural model to produce 3D elastic deformation fields in the bearing pads. Solutions of the governing equations delivers the operating film thickness, required flowrate, and shear drag power loss, and the pad and lubricant temperature rises as a function of an applied load and shaft speed. To verify the model, predictions of pad subsurface temperature are benchmarked against published test data for a centrally pivoted eight-pad TPTB with 267 mm in outer diameter (OD) operating at 4–13 krpm (maximum surface speed = 175 m/s) and under a specific load ranging from 0.69 to 3.44 MPa. The current TEHD temperature predictions match well the test data with a maximum difference of 4 °C and 11 °C (<10%) at laminar and turbulent flow conditions, receptively. Next, the TEHD predictive tool is used to study the influence of both pad and liner material properties on the performance of a TPTB. The analysis takes a whole steel pad (without a liner or babbitt), a steel pad with a 2-mm-thick babbitt layer (common usage), a steel pad with a 2-mm-thick hard-polymer (polyether ether ketone, e.g., PEEK®) liner, and a pad entirely made of hard-polymer material, whose elastic modulus is just 12.5 GPa, only 6% that of steel. The bare steel pad reveals the poorest performance among all the pads as it produces the smallest fluid film thickness and consumes the largest drag power loss. For laminar flow operations (Reynolds number Re < 580), the babbitted-steel pad operates with the thickest fluid film and the lowest film temperature rise. For turbulent flow conditions Re > 800, the solid hard-polymer pad, however, shows a 23% thicker film than that in the babbitted pad and produces up to 25% lesser drag power loss. In general, the solid hard-polymer TPTB is found to be a good fit for operation at a turbulent flow condition as it shows a lower drag power loss and a larger film thickness; however, its demand for a too large supply flowrate is significant. Predictions for steel pads with various hard-polymer liner and babbitt thicknesses demonstrate that using a hard-polymer liner, instead of white metal, isolates the pad from the fluid film and results in an up to 30 °C (50%) lower temperature rise in the pads than that for a babbitted-steel pad. For operations under a heavy specific load (>3.0 MPa), however, a thick hard-polymer liner extensively deforms and results in a small film thickness.
Clinical Contrast-Enhanced Computed Tomography With Semi-Automatic Segmentation Provides Feasible Input for Computational Models of the Knee Joint
Authors: Myller Katariina A. H. , Korhonen Rami K. , Töyräs Juha , Tanska Petri , Väänänen Sami P. , Jurvelin Jukka S. , Saarakkala Simo , Mononen Mika E. 
Published: October 2019

Abstract
Computational models can provide information on joint function and risk of tissue failure related to progression of osteoarthritis (OA). Currently, the joint geometries utilized in modeling are primarily obtained via manual segmentation, which is time-consuming and hence impractical for direct clinical application. The aim of this study was to evaluate the applicability of a previously developed semi-automatic method for segmenting tibial and femoral cartilage to serve as input geometry for finite element (FE) models. Knee joints from seven volunteers were first imaged using a clinical computed tomography (CT) with contrast enhancement and then segmented with semi-automatic and manual methods. In both segmentations, knee joint models with fibril-reinforced poroviscoelastic (FRPVE) properties were generated and the mechanical responses of articular cartilage were computed during physiologically relevant loading. The mean differences in the absolute values of maximum principal stress, maximum principal strain, and fibril strain between the models generated from semi-automatic and manual segmentations were &lt;1 MPa, &lt;0.72% and &lt;0.40%, respectively. Furthermore, contact areas, contact forces, average pore pressures, and average maximum principal strains were not statistically different between the models (p &gt;0.05). This semi-automatic method speeded up the segmentation process by over 90% and there were only negligible differences in the results provided by the models utilizing either manual or semi-automatic segmentations. Thus, the presented CT imaging-based segmentation method represents a novel tool for application in FE modeling in the clinic when a physician needs to evaluate knee joint function.
Adolescent with facial swelling
Authors: Looi Wen Shen , Goh Si Hui , Tan Colin Jingxian , Yeoh Kheng Wei , Seng Michaela Su-Fern 
Published: October 2019

BackgroundA previously well 15-year-old girl presented with a 2-month history of facial swelling that progressively worsened to involve the neck. There was associated dyspnoea, orthopnoea, headache and throat discomfort. Two weeks before presentation, the patient had an episode of fever for 5 days. On examination, vital signs were within normal limits. Swelling, plethora and venous distension of the face and neck were apparent (figure 1).Figure 1(A) Patient before the onset of symptoms. (B) Patient at presentation.QuestionsWhat is the most likely diagnosis?Superior vena cava syndromeAngioedemaAnasarcaDiphtheriaDescribe the chest X-ray (figure 2).What are the acute concerns?What investigations would you order?Figure 2Chest X-ray of the patient at presentation.Answers can be found on page 02.
Hormone use among Nepali transgender women: a qualitative study
Authors: Regmi Pramod R , van Teijlingen Edwin , Neupane Sanjeev Raj , Marahatta Sujan Babu 
Published: October 2019

ObjectivesThere is a dearth of information on transgender individuals in Nepal, particularly studies exploring their use of hormone therapies. The objectives of this study therefore were to explore (1) how hormones are used, (2) types of hormones used and (3) side effects experienced by transgender women after hormone use. This is the first study of its kind in Nepal addressing this important public health issue.SettingThe study was conducted in four districts of Nepal: Kathmandu, Sunsai, Banke and Kaski.Design and participantsThis qualitative study comprises eight focus group discussions (FGDs) and nine interviews. FGDs and three face-to-face interviews were held with transgender women aged 18 years and older and six interviews with stakeholders working with and advocating on behalf of this population. The study was conducted between September 2016 and March 2017.ResultsOur participants were young. The majority of FGD participants had completed school-level education and 40% had been using hormones for 1 to 3 years. Five overlapping themes were identified: (1) reasons and motivations for hormone use; (2) accessibility and use of hormones; (3) side effects; (4) utilisation of healthcare services and (5) discontinuation of hormone use.ConclusionHormone use was common in our sample. Most received information on hormone therapy online and through their peer networks. A few study participants sought doctors’ prescriptions for hormone therapy, but hormones were more likely to be bought from local private pharmacies or abroad through friends. This kind of self-medication is associated with a range of risks to the physical and mental health of transgender individuals. Incorporating information, education and communication about hormone therapy into existing health promotion interventions targeted to this population may help transgender people to make better informed choices.
Open-labelled randomised controlled trial of 12 hours versus 24 hours modified Pritchard regimen in the management of eclampsia and pre-eclampsia in Ghana (MOPEP Study): study protocol
Authors: Beyuo Titus , Lawrence Emma , Langen Elizabeth S , Oppong Samuel A 
Published: October 2019

IntroductionHypertensive disorders of pregnancy continue to be a major contributor to maternal and perinatal morbidity and mortality. Magnesium sulfate therapy is the standard of care for seizure prophylaxis and treatment for pre-eclampsia and eclampsia respectively, despite wide disparities in dosing regimens and routes of administration. This study compares the clinical efficacy of magnesium sulfate in the reduction of seizure occurrence or recurrence with the 12 hours versus 24 hours modified Pritchard regimens in the management of severe pre-eclampsia and eclampsia.Methods and analysisThis study is an open labelled randomised controlled trial. The study participants are patients admitted to the Korle Bu Teaching Hospital (KBTH) in Accra, Ghana with a diagnosis of antepartum, intrapartum or postpartum eclampsia or pre-eclampsia with severe features. All study participants will be administered a loading dose of magnesium sulfate, followed by maintenance dosing. Participants in the control group will receive magnesium sulfate for 24 hours after diagnosis, while those in the treatment group will receive magnesium sulfate for 12 hours after diagnosis. The primary outcome of this study is the occurrence of a seizure any time after the completion of treatment in the assigned group. Secondary outcome measures include maternal health outcomes, magnesium sulfate toxicities and fetal health outcomes. Data collection was started in October 2018 with a target enrolment of 1245 participants with severe pre-eclampsia and 844 participants with eclampsia with a projected study period of 2–3 years.Ethics and disseminationEthical approval was obtained from the KBTH Institutional Review Board (IRB) in Ghana. University of Michigan involvement is limited to protocol development and statistical analysis of de-identified data, and has been granted a Not Regulated Determination by the University of Michigan IRB. Results of the study will be shared at clinical forums at the KBTH and will be submitted for publication in an international peer-reviewed journal.Trial registration numberPan African Clinical Trial Registry through the South African Medical Research Council (PACTR201811515303983).
Should we resuscitate elderly patients with blunt traumatic cardiac arrest? Analysis of National Trauma Registry Data in Japan
Authors: Norii Tatsuya , Matsushima Kazuhide , Miskimins Richard J , Crandall Cameron S 
Published: October 2019

ObjectivesRecent studies suggest that survival after traumatic cardiac arrest (TCA) has been improving. Many elderly adults enjoy active lifestyles, which occasionally result in TCA. The epidemiology and efficacy of resuscitative procedures on blunt TCA in elderly patients are largely unknown. Our primary aim was to compare the survival to discharge following blunt TCA between non-elderly adult (ages 18–59 years) and elderly patients (age ≥60 years).MethodsWe analysed 2004–2015 observational cohort data from a nationwide trauma registry in Japan. We included all adult patients (18 years and older) who experienced blunt TCA. We excluded patients missing data for age, survival, mechanism of injury or initial vital signs. Resuscitative procedures included thoracotomy and resuscitative endovascular balloon occlusion of the aorta. We compared survival for elderly patients (age ≥60 years old) to younger adults.ResultsOf 8347 patients with blunt TCA, 3547 (42.5%) were elderly. Survival differed significantly by age: 164/4800 (3.4%) of younger adults survived whereas 188/3547 (5.3%) of elderly patients survived (p<0.001). Survival increased but Injury Severity Scores (ISSs) declined with increasing patient age. The efficacy of resuscitative procedures did not vary by age. In logistic regression models, increasing age was independently associated with better survival.ConclusionIn a cohort of patients with blunt TCA, survival increased with increasing patient age. A number of patients with low ISS in the elderly group raises the possibility that this improved survival is due to preceding or concomitant medical cardiac arrest in the older cohort. Clinicians should be cautious about applying TCA algorithms to elderly patients and should not be discouraged from resuscitating TCA because of patient age.
Audit of the impact of the York faecal calprotectin care pathway on colonoscopy activity
Authors: Turvill James , Turnock Daniel 
Published: October 2019

BackgroundThe York faecal calprotectin care pathway (YFCCP) was developed to optimise effective primary care differentiation between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). We undertook an audit of colonoscopy activity at York Teaching Hospitals after the introduction of the YFCCP, to assess its impact.MethodsFaecal calprotectin (FC) results were reconciled with colonoscopy activity in patients 18–60 years after the implementation of the YFCCP. This permitted individual patient tracking of their FC values, the timing of those requests by primary care, the date of subsequent referral and investigation and the end clinical diagnoses.ResultsPrimary care uptake of FC increased fourfold with the introduction of the YFCCP. Following implementation, FC-related referrals for colonoscopy fell from 24% to 13%. The number of patients needed to colonoscope to diagnose organic colonic disease (IBD, significant adenomatous polyps or colorectal cancer) fell from 6.8 to 3.8 when the YFCCP was applied. This represents a cost saving of £41 015 per thousand patients tested in primary care. We estimate that outpatient time to diagnosis fell from a median of 41 to 29 days.ConclusionThis audit of FC activity and colonoscopy outcomes provides substantial supportive evidence for the effectiveness of the YFCCP. Popular in primary care, it has led to a reduction in referrals. The diagnostic accuracy determined in this audit is in line with earlier evaluations. Accepting the weaknesses of audit we conclude that this evaluation likely underestimates the benefits of the YFCCP in terms of resource use saving and time to diagnosis.