bluuebunny/crossref_metadata_2025_split huggingface dataset:
Starting Phenomena of Tilting Pad Bearings
Authors: Kettleborough C. F. 
Published: April 2020

Abstract
The starting of large thrust bearings in turbines is one of the most critical points in their operation as a pressure carrying oil film must be generated from initial conditions of load and zero relative velocity between the two surfaces. A force equal and opposite to the applied load must be produced before the surfaces separate. It is the purpose of this paper to discuss the origin and formation of this force. The results show that lapped and ground surfaces have inefficient lifting characteristics as compared with surfaces having irregularities on the surface of 1/20 mil and greater. In general, surface oil pockets have an important influence on the starting behavior of tilting pad bearings; without these oil pockets it is doubtful if the two bearing surfaces would part.
Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study
Authors: Zheng Shufa , Fan Jian , Yu Fei , Feng Baihuan , Lou Bin , Zou Qianda , Xie Guoliang , Lin Sha , Wang Ruonan , Yang Xianzhi , Chen Weizhen , Wang Qi , Zhang Dan , Liu Yanchao , Gong Renjie , Ma Zhaohui , Lu Siming , Xiao Yanyan , Gu Yaxi , Zhang Jinming , Yao Hangping , Xu Kaijin , Lu Xiaoyang , Wei Guoqing , Zhou Jianying , Fang Qiang , Cai Hongliu , Qiu Yunqing , Sheng Jifang , Chen Yu , Liang Tingbo 
Published: April 2020

AbstractObjectiveTo evaluate viral loads at different stages of disease progression in patients infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the first four months of the epidemic in Zhejiang province, China.DesignRetrospective cohort study.SettingA designated hospital for patients with covid-19 in Zhejiang province, China.Participants96 consecutively admitted patients with laboratory confirmed SARS-CoV-2 infection: 22 with mild disease and 74 with severe disease. Data were collected from 19 January 2020 to 20 March 2020.Main outcome measuresRibonucleic acid (RNA) viral load measured in respiratory, stool, serum, and urine samples. Cycle threshold values, a measure of nucleic acid concentration, were plotted onto the standard curve constructed on the basis of the standard product. Epidemiological, clinical, and laboratory characteristics and treatment and outcomes data were obtained through data collection forms from electronic medical records, and the relation between clinical data and disease severity was analysed.Results3497 respiratory, stool, serum, and urine samples were collected from patients after admission and evaluated for SARS-CoV-2 RNA viral load. Infection was confirmed in all patients by testing sputum and saliva samples. RNA was detected in the stool of 55 (59%) patients and in the serum of 39 (41%) patients. The urine sample from one patient was positive for SARS-CoV-2. The median duration of virus in stool (22 days, interquartile range 17-31 days) was significantly longer than in respiratory (18 days, 13-29 days; P=0.02) and serum samples (16 days, 11-21 days; P<0.001). The median duration of virus in the respiratory samples of patients with severe disease (21 days, 14-30 days) was significantly longer than in patients with mild disease (14 days, 10-21 days; P=0.04). In the mild group, the viral loads peaked in respiratory samples in the second week from disease onset, whereas viral load continued to be high during the third week in the severe group. Virus duration was longer in patients older than 60 years and in male patients.ConclusionThe duration of SARS-CoV-2 is significantly longer in stool samples than in respiratory and serum samples, highlighting the need to strengthen the management of stool samples in the prevention and control of the epidemic, and the virus persists longer with higher load and peaks later in the respiratory tissue of patients with severe disease.
Variability in estimated glomerular filtration rate and the incidence of type 2 diabetes: a nationwide population-based study
Authors: Lee You-Bin , Kim Da Hye , Roh Eun , Hong So-Hyeon , Kim Jung A , Yoo Hye Jin , Baik Sei Hyun , Han Kyungdo , Choi Kyung Mook 
Published: April 2020

ObjectiveVariability in estimated glomerular filtration rate (eGFR) has been associated with adverse outcomes in patients with diabetes or chronic kidney disease (CKD). However, no previous study has explored the relationship between eGFR variability and type 2 diabetes incidence.Research design and methodsIn this nationwide, longitudinal, cohort study, we investigated the association between eGFR variability and type 2 diabetes risk using the Korean National Health Insurance Service datasets from 2002 to 2017. eGFR variability was calculated using the variability independent of the mean (eGFR-VIM), coefficient of variation (eGFR-CV), standard deviation (eGFR-SD) and average real variability (eGFR-ARV).ResultsWithin 7 673 905.58 person-years of follow-up (mean follow-up: 3.19 years; n=2 402 668), 11 981 cases of incident type 2 diabetes were reported. The HRs and 95% CIs for incident type 2 diabetes increased according to advance in quartiles of eGFR-VIM (HR (95% CI): Q2, 1.068 (1.009 to 1.130); Q3, 1.077 (1.018 to 1.138); Q4, 1.203 (1.139 to 1.270)) even after adjusting for confounding factors including mean eGFR and mean fasting plasma glucose levels. The subgroup analyses according to risk factors as well as analyses using eGFR-CV, eGFR-SD and eGFR-ARV showed consistent results. The association between increased eGFR variability and type 2 diabetes risk was more prominent in men, individuals with dyslipidemia and those with CKD as shown in the subgroup analysis (p for interaction <0.001).ConclusionsIncreased eGFR variability may be an independent predictor of type 2 diabetes and might be useful for risk stratification of individuals without diabetes.
Adipose tissue derived bacteria are associated with inflammation in obesity and type 2 diabetes
Authors: Massier Lucas , Chakaroun Rima , Tabei Shirin , Crane Alyce , Didt Konrad David , Fallmann Jörg , von Bergen Martin , Haange Sven-Bastiaan , Heyne Henrike , Stumvoll Michael , Gericke Martin , Dietrich Arne , Blüher Matthias , Musat Niculina , Kovacs Peter 
Published: April 2020

ObjectiveBacterial translocation to various organs including human adipose tissue (AT) due to increased intestinal permeability remains poorly understood. We hypothesised that: (1) bacterial presence is highly tissue specific and (2) related in composition and quantity to immune inflammatory and metabolic burden.DesignWe quantified and sequenced the bacterial 16S rRNA gene in blood and AT samples (omental, mesenteric and subcutaneous) of 75 subjects with obesity with or without type 2 diabetes (T2D) and used catalysed reporter deposition (CARD) – fluorescence in situ hybridisation (FISH) to detect bacteria in AT.ResultsUnder stringent experimental and bioinformatic control for contaminants, bacterial DNA was detected in blood and omental, subcutaneous and mesenteric AT samples in the range of 0.1 to 5 pg/µg DNA isolate. Moreover, CARD-FISH allowed the detection of living, AT-borne bacteria.ProteobacteriaandFirmicuteswere the predominant phyla, and bacterial quantity was associated with immune cell infiltration, inflammatory and metabolic parameters in a tissue-specific manner. Bacterial composition differed between subjects with and without T2D and was associated with related clinical measures, including systemic and tissues-specific inflammatory markers. Finally, treatment of adipocytes with bacterial DNA in vitro stimulated the expression ofTNFAandIL6.ConclusionsOur study provides contaminant aware evidence for the presence of bacteria and bacterial DNA in several ATs in obesity and T2D and suggests an important role of bacteria in initiating and sustaining local AT subclinical inflammation and therefore impacting metabolic sequelae of obesity.
Laryngeal electromyography in amyotrophic lateral sclerosis
Authors: Martins Melina Pazian , de Lima Fabrício Diniz , Bernardes Leoni Tauana , Martinez Alberto R M , Nubiato Crespo Agricio , André Teixeira Kimaid Paulo , Nucci Anamarli , de Carvalho Mamede , França Jr Marcondes C 
Published: April 2020

BackgroundBulbar involvement is a hallmark of amyotrophic lateral sclerosis (ALS), but surprisingly very few studies have addressed the frequency, pattern and clinical relevance of laryngeal involvement in the disease.MethodsTwenty-six patients with spinal-onset ALS underwent nasofibroscopy (NF), followed by laryngeal electromyography (LEMG). We also studied resting activity and motor unit potentials of the genioglossus and masseter muscles.ResultsTwenty-four patients presented neurogenic changes in at least one laryngeal muscle. There were fibrillation and/or fasciculation potentials associated with chronic neurogenic changes in the same muscle in 16 patients; of these, 9 had no alteration in the genioglossus. We found no patient with tongue neurogenic changes and normal LEMG. NF was abnormal in 14 patients; in the remaining 12, LEMG identified neurogenic changes in 11 of them.ConclusionLEMG is able to identify laryngeal denervation in patients with ALS, sometimes before clinical manifestations are noticed. This technique may be a useful diagnostic tool for selected patients with suspicion of ALS.
Specialist valve clinic in a cardiac centre: 10-year experience
Authors: Chambers John B , Parkin Denise , Rimington Helen , Subbiah Sheila , Campbell Brian , Demetrescu Camelia , Hayes Anna , Rajani Ronak 
Published: April 2020

AimsGuidelines recommend specialist valve clinics as best practice for the assessment and conservative management of patients with heart valve disease. However, there is little guidance on how to set up and organise a clinic. The aim of this study is to describe a clinic run by a multidisciplinary team consisting of cardiologists, physiologist/scientists and a nurse.MethodsThe clinical and organisational aims of the clinic, inclusion and exclusion criteria, and links with other services are described. The methods of training non-clinical staff are detailed. Data were prospectively entered onto a database and the study consisted of an analysis of the clinical characteristics and outcomes of all patients seen between 1 January 2009 and 31 December 2018.ResultsThere were 2126 new patients and 9522 visits in the 10-year period. The mean age was 64.8 and 55% were male. Of the visits, 3587 (38%) were to the cardiologists, 4092 (43%) to the physiologist/scientists and 1843 (19%) to the nurse. The outcomes from the cardiologist clinics were cardiology follow-up in 460 (30%), referral for surgery in 354 (23%), referral to the physiologist/scientist clinic in 412 (27%) or to the nurse clinic in 65 (4.3%) and discharge in 230 (15%). The cardiologist needed to see 6% from the nurse clinic and 10% from the physiologist/scientist clinic, while advice alone was sufficient in 10% and 9%.ConclusionA multidisciplinary specialist valve clinic is feasible and sustainable in the long term.
Clinical Assessment of Existence of Palmaris Longus Muscle among South Indian Population
Authors: Venkatapathy Santhi , Bhargavan Rajesh 
Published: April 2020

Background: Palmaris longus tendon is often used as a donor tendon by surgeons in tendon grafts. It is one of the flexor muscles of the forearm and documented well for its variations in both morphology and number of tendons. Prevalence of absence of this muscle varies among the individuals of same population and individuals of various ethnic groups. The aim of this study was to assess the existence of Palmaris longus muscle within a group of students and its association with side of the limb and gender of the individual.Methods: Three hundred medical students of 150 males and 150 females with age group of 18–21 years were clinically assessed. The standard Schaffer’s test was used for the assessment of PL tendon. If the tendon was not found in this test, the confirmation was done by other four tests.Results: Results of this study shows that an overall absence of palmaris longus muscle in both sexes was found to be 32%, out of which 21% absence was found in males and 43% absence found in females. Among the males, the unilateral agenesis was seen in 16% and bilateral agenesis in 4% and in females the unilateral agenesis was seen in 29% and bilateral agenesis seen in 14%.Conclusions: To conclude; in the present study, prevalence of Palmaris longus muscle agenesis was found to be more in female subjects on their left side. Surgeons who plan for tendon reconstructive procedures should know variations of Palmaris longus muscle and its clinical assessment.
Tenosynovial Giant Cell Tumor in the Hand: Experience with 173 Cases
Authors: Çevik Hüseyin Bilgehan , Kayahan Sibel , Eceviz Engin , Gümüştaş Seyit Ali 
Published: April 2020

Background: Tenosynovial giant cell tumor (TSGCT) is the second most common benign tumor of the hand. Even though it is a benign lesion there is still a high incidence of local recurrence (range, 7%–44%) according to data in published papers. In this study, the clinical and epidemiological features of 173 patients who underwent excision of localized TSGCT, the recurrence rates and possible reasons for recurrence were examined in the light of current literature.Methods: Medical records of 173 patients with TSGCT were reviewed. Data on demographic characteristics as well as clinical and intraoperative findings were collected. Patients were asked about the recurrence of the TSGCT and the QuickDASH scoring was applied at the final clinical evaluation after mean follow-up of 81 months.Results: Females were predominantly involved (73%). Patients aged mean 44 years at the time of surgery. There were 93 tumors in flexor zones and 80 tumors in extensor zones of the hand. Of the tumors with flexor zone localization, zone II was most predominantly involved with 46 tumors, and 18 of these were on the index finger. The extensor zones III and IV were mostly involved with 9 tumors each on the middle and ring fingers. A total of 12 recurrences (6.9 %) were determined over the mean follow-up period of 81 months.Conclusions: The characteristics of our patients identified were similar to the previous studies. Surgical excision provides good outcomes in the treatment of TSGCT especially when clear margins are obtained.
A Comparison of Splint Versus Pinning the Distal Interphalangeal Joint for Acute Closed Tendinous Mallet Injuries
Authors: Nagura Shigeki , Suzuki Taku , Iwamoto Takuji , Matsumura Noboru , Nakamura Masaya , Matsumoto Morio , Sato Kazuki 
Published: April 2020

Background: The vast majority of acute closed tendinous mallet injuries are treated with a splint. Very few studies have directly compared splinting versus pinning the distal interphalangeal joint for this injury. The aim of this cohort study is to determine the outcomes of both methods.Methods: A total of 59 patients with acute tendinous mallet injury were retrospectively enrolled (29 patients in conservative treatment and 30 patients in surgical treatment). Conservative treatment was performed using custom-made thermoplastic splint and surgical treatment was conducted with oblique K-wire fixation of the distal interphalangeal (DIP) joint. The DIP joint was immobilized for eight weeks in both treatments. Active ranges of motion of the affected finger and Miller’s classification were evaluated postoperatively.Results: The mean extension lag of the DIP joint in the surgical treatment group was significantly better than it was with conservative treatment (2.1° vs 13.8°). Three patients who were noncompliant with the splint showed poor results, while no patients in the surgical treatment group had a poor result.Conclusions: Surgical treatment with K-wire fixation leads to satisfactory results for acute tendinous mallet injury.
Maintaining Effective Microsurgery Training with Reduced Utilisation of Live Rats
Authors: Lahiri Amitabha , Muttath Sandeep Sebastin , Yusoff Siti Khadijah , Chong Alphonsus KS. 
Published: April 2020

Background: Microvascular surgery is now an integral part of many surgical disciplines, and the success of these procedures relies on the technical skills of the surgeon. Although numerous training models and simulations have been developed, the living rat model is favoured for its high fidelity to clinical microsurgery. However, there are serious ethical concerns over the use of live models for training. The aim of this study was to demonstrate if effective skill acquisition was possible with a reduction in the number of live rats. Methods: Two course structures were designed, that were implemented. Total training hours remained the same in both the courses, but the number of rats used was reduced from conventional five rats per participant to four in group A and to three in group B while increasing the training time spent on synthetic and ex-vivo models. We assessed the effectiveness of the courses by comparing the patency rates, the time taken per anastomosis and efficiency of the utilisation rate of rats. Results: There were 30 participants in Group A and 28 participants in group B. We observed that group B was able to perform anastomosis in a significantly shorter time and with patency rates similar to group A in spite of a lesser number of rats used in the training. Conclusions: we were able to conclusively demonstrate that it was possible to reduce live rat usage in microsurgical training without compromising on the quality of training.
Permian igneous clasts from the Matzitzi Formation, southern Mexico: isotopic constraints on the final amalgamation of Pangaea
Authors: Juárez-Zúñiga Sandra , Solari Luigi A. , Ortega-Obregón Carlos 
Published: April 2020

Abstract

The tectonic reconstructions of southern Mexico during Late Paleozoic–Middle Triassic time are related to the final stages of Pangaea assembly. Petrographic analysis combined with U–Pb and Hf isotopic analyses of zircon grains belonging to volcanic conglomerate clasts from the Matzitzi Formation in southern Mexico allow characterization of the magmatism at the end of Pangaea accretion. Volcanic pebbles from the Matzitzi Formation have felsic to intermediate compositions and ages ranging from 269 to 285 Ma, which indicate the erosion of a Permian volcanic source. The
ɛ
Hf zircon values show two groups with different isotopic signatures. Intermediate hypabyssal samples have
ε
Hf

(
t
)

values ranging from −7.8 to +0.2 and two-step model ages from 1.6 to 1.7 Ga, suggesting late Paleoproterozoic to Mesoproterozoic crustal residence times. Felsic volcanic samples have
ε
Hf

(
t
)

values ranging from −3.5 to +8.8 and crustal model ages ranging from 0.7 to 1.5 Ga, suggesting Neo-Mesoproterozoic crustal sources and a juvenile depleted mantle source. Grenvillian grains in volcanic clasts, as well as their isotopic signatures, suggest that the volcanic rocks were emplaced over Mesoproterozoic Oaxaquia-type crust and are related to the Permian–Carboniferous plutonic arc in southern Mexico, which formed along the northwestern Gondwana margin.
A Simple Strategy to Communicate about Climate Attribution
Authors: Dryden Rachel , Morgan M. Granger 
Published: April 2020

AbstractHurricane Harvey and other recent weather extremes stimulated extensive public discourse about the role of anthropogenic climate change in amplifying, or otherwise modifying, such events. In tandem, the scientific community has made considerable progress on statistical “climate attribution.” However, explaining these statistical methods to the public has posed challenges. Using appropriately designed “spinner boards,” we find that even members of the general public who do not understand the difference between weather and climate are readily able to understand basic concepts of attribution and explain those concepts to others. This includes both understanding and explaining the way in which the probability of an extreme weather event may increase as a result of climate change and explaining how the intensity of hurricanes can be increased. If properly developed and used by TV weather forecasters and news reporters, this method holds the potential to significantly improve public understanding of climate attribution.
Regionally Varying Assessments of Upper-Level Tropical Width in Reanalyses and CMIP5 Models Using a Tropopause Break Metric
Authors: Martin Elinor R. , Homeyer Cameron R. , McKinzie Roarke A. , McCarthy Kevin M. , Xian Tao 
Published: April 2020

AbstractChanges in tropical width can have important consequences in sectors including ecosystems, agriculture, and health. Observations suggest tropical expansion over the past 30 years although studies have not agreed on the magnitude of this change. Climate model projections have also indicated an expansion and show similar uncertainty in its magnitude. This study utilizes an objective, longitudinally varying, tropopause break method to define the extent of the tropics at upper levels. The location of the tropopause break is associated with enhanced stratosphere–troposphere exchange and thus its structure influences the chemical composition of the stratosphere. The method shows regional variations in the width of the upper-level tropics in the past and future. Four modern reanalyses show significant contraction of the tropics over the eastern Pacific between 1981 and 2015, and slight but significant expansion in other regions. The east Pacific narrowing contributes to zonal mean narrowing, contradicting prior work, and is attributed to the use of monthly and zonal mean data in prior studies. Six global climate models perform well in representing the climatological location of the tropical boundary. Future projections show a spread in the width trend (from ~0.5° decade−1 of narrowing to ~0.4° decade−1 of widening), with a narrowing projected across the east Pacific and Northern Hemisphere Americas. This study illustrates that this objective tropopause break method that uses instantaneous data and does not require zonal averaging is appropriate for identifying upper-level tropical width trends and the break location is connected with local and regional changes in precipitation.
Urbanization Enhanced Summertime Extreme Hourly Precipitation over the Yangtze River Delta
Authors: Jiang Xiaoling , Luo Yali , Zhang Da-Lin , Wu Mengwen 
Published: April 2020

AbstractAn extensive urban agglomeration has occurred over the Yangtze River delta (YRD) region of East China as a result of rapid urbanization since the middle 1990s. In this study, a 44-yr (i.e., 1975–2018) climatology of the summertime extreme hourly precipitation (EXHP; greater than the 90th percentile) over the YRD is analyzed, using historical land-use data, surface temperature, and hourly rain gauge observations, and then the relationship between rapid urbanization and EXHP changes is examined. Results show significant EXHP contrasts in diurnal variation and storm type roughly before and after middle July. That is, tropical cyclones (TCs) account for 16.4% of the total EXHP hours, 80.5% of which occur during the late summer, whereas non-TC EXHP accounts for 94.7% and 66.2% during the early and late summer, respectively. Increasing trends in occurrence frequency and amount of the non-TC and TC-induced EXHP are detected over the urban agglomeration. Statistically significant larger increasing trends in both the EXHP and surface temperature are observed at urban stations than those at the nearby rural stations. An analysis of 113 locally developed non-TC extreme rainfall events during 2011–18 summers also suggests the contribution of the urban heat island effects to the more occurrences of EXHP, especially over a band-shaped urban region where several major cities are distributed. This study reveals a significant correlation between rapid urbanization and increased EXHP during the past two decades over the YRD region. The results have important implications for understanding the impact of urbanization on EXHP changes in a warming climate.