bluuebunny/crossref_metadata_2025_split huggingface dataset:
The child and adolescent with HIV in resource poor countries
Authors: Yengopal V , Kolisa Y , Thekiso MD , Molete MP 
Published: February 2016

Although sub‐Saharan Africa caries the burden of paediatric and adult HIV/AIDS infections, the epidemic is spreading most rapidly in the Middle East and North Africa Region where between 2005 and 2013, AIDS‐related deaths increased by 66% in comparison with a worldwide fall of 35%. For the first time, in 2011, more than half of people in need of antiretroviral drugs were receiving them, with coverage reaching 54%; yet only 28% of children have access to HIV treatment. This review sought to provide an update of paediatric and adolescent oral HIV/AIDS issues in resource poor countries.ObjectivesTo review the literature on paediatric & adolescent HIV with a focus on oral lesions as predictors of HIV infection; as markers of the efficacy of HAART and quality of life; caries risk; management of oral lesions; and epidemiological tests for clinical significance of oral lesions.MethodsA search strategy was developed for PubMed to identify papers on paediatric oral HIV. Publications in English were selected on the basis that their titles and abstracts were relevant to the review objectives. The reference lists of included papers were screened for additional articles. The time‐search for publications was limited from 2009 to 15 October 2014.ResultsPapers on the prevalence of oral lesions lacked standardization in diagnostic criteria and the introduction of HAART had significantly reduced prevalence; oral lesions remain useful predictors for HIV infection and as markers for the efficacy of HAART. Evidence suggest that caries risk is increased with HIV infection; management of oral lesions is inconsistent with available resources and surprisingly little recent information has been published in the past 5 years. Revised case definitions are proposed for large‐scale epidemiologic studies with the development of an oral lesion index showing promise. Oral health quality of life indicators for children and adolescents are becoming important as more of these indicators are being developed and their negative oral impacts in individuals with oral lesions are now well established.ConclusionsPaediatric and adolescent oral HIV research needs to be prioritized as current studies are few and are characterized by poor quality study designs, small study samples and a lack of multicentre collaborations. There is a lack of high quality evidence for a number of interventions available for management of oral lesions.
The Use of Ultrasound to Improve Axillary Vein Access and Minimize Complications during Pacemaker Implantation
Authors: ESMAIEL ABDULLAH , HASSAN JEREMY , BLENKHORN FAY , MARDIGYAN VARTAN 
Published: February 2016

BackgroundThe Agency for Healthcare Research and Quality in the United States recommends the use of ultrasound (US) for central venous access to improve patient outcomes. However, in a recent publication, US is still underutilized for axillary vein access during pacemaker implantation.ObjectiveWe sought to describe a technique for US‐guided axillary vein access during pacemaker implantation and to report complication rates and success rate.MethodsRetrospective data collection included success rate and complications on all pacemaker implants by one operator since implementing the systematic use of US at our institution, from November 2012 to January 2015. For the last 59 cases, data were collected prospectively to include time of venous access and number of attempts.ResultsA total of 403 consecutive patients were included in the analysis. Two leads were implanted in 255 cases and one lead was implanted in 148 cases. The rate of successful US‐guided access was 99.25%. There were no access‐related complications. The average number of venipuncture attempts was 1.18 per patient. The average time to obtain venous access was 2.24 minutes including the time to apply the sterile US sleeve.ConclusionThe described technique has the potential to improve the success rate of axillary vein access and minimize complications during pacemaker implantation.
The Relationships Between Parasympathetic Function and Pain Perception: The Role of Anxiety
Authors: Nahman‐Averbuch Hadas , Sprecher Elliot , Jacob Giris , Yarnitsky David 
Published: February 2016

AbstractBackgroundPrevious studies have identified relationships between autonomic function and pain perception. Anxiety was found to influence both autonomic and pain responses. We examined the effect of anxiety level on parasympathetic function and pain perception as well as on the relationships between these 2 systems.MethodsThirty healthy females were divided into high‐ and low‐anxiety groups according to their trait anxiety levels. Parasympathetic function was obtained using heart rate variability, deep breathing, and Valsalva ratios. Pain perception parameters of heat pain thresholds, pain rating of supra‐thresholds stimulus, mechanical temporal summation, and conditioned pain modulation response were examined.ResultsThe low‐anxiety and high‐anxiety groups exhibited no significant differences in the parasympathetic function and pain perception parameters. Assessment of the associations revealed that in the high‐anxiety group, higher mean ratings of the tonic heat pain stimulus were significantly correlated with higher rMSSD (r2 = 0.358, P = 0.019), but this was not found for the low‐anxiety group (P = 0.282). In addition, in the high‐anxiety group, efficient conditioned pain modulation response was correlated with higher deep breathing ratio (r2 = 0.363, P = 0.023); however, in the low‐anxiety group, the correlation did not reach significance (P = 0.109).ConclusionsThis study demonstrates the role of anxiety level on the relationships between parasympathetic function and pain perception. We suggest that a situation of high anxiety leads to higher norepinephrine levels that can influence both parasympathetic function and pain perception, thus explaining the significant relationships found between these 2 systems only in subjects with high anxiety.
Dynamic Mechanical Allodynia—One Clinical Sign, Several Mechanisms: Five Illustrative Cases
Authors: Buonocore Michelangelo , Demartini Laura , Aloisi Anna Maria , Bonezzi Cesare 
Published: February 2016

AbstractPain evoked by tangential movement across the skin is usually defined as dynamic mechanical allodynia (DMA). Some patients complain of DMA as troublesome as spontaneous pain and refer a marked interfering with activities of daily living and sleep. Pathophysiology of DMA is complex and can be related to several mechanisms, both nociceptive and neuropathic. Five exemplificative clinical cases of DMA are presented, each associated to a possible specific mechanism: injured skin DMA, peri‐injured skin DMA, far injury DMA, nerve‐confined DMA and fear DMA (pseudo allodynia). The identification of these subcategories of DMA can stimulate further studies aimed at evaluating the usefulness of a mechanism‐based therapy for the different clinical forms of DMA.
Determining performance characteristics of an NGS‐based HLA typing method for clinical applications
Authors: Duke J. L. , Lind C. , Mackiewicz K. , Ferriola D. , Papazoglou A. , Gasiewski A. , Heron S. , Huynh A. , McLaughlin L. , Rogers M. , Slavich L. , Walker R. , Monos D. S. 
Published: February 2016

AbstractThis study presents performance specifications of an in‐house developed human leukocyte antigen (HLA) typing assay using next‐generation sequencing (NGS) on the Illumina MiSeq platform. A total of 253 samples, previously characterized for HLA‐A, ‐B, ‐C, ‐DRB1 and ‐DQB1 were included in this study, which were typed at high‐resolution using a combination of Sanger sequencing, sequence‐specific primer (SSP) and sequence‐specific oligonucleotide probe (SSOP) technologies and recorded at the two‐field level. Samples were selected with alleles that cover a high percentage of HLA specificities in each of five different race/ethnic groups: European, African‐American, Asian Pacific Islander, Hispanic and Native American. Sequencing data were analyzed by two software programs, Omixon's target and GenDx's NGSengine. A number of metrics including allele balance, sensitivity, specificity, precision, accuracy and remaining ambiguity were assessed. Data analyzed by the two software systems are shown independently. The majority of alleles were identical in the exonic sequences (third field) with both programs for HLA‐A, ‐B, ‐C and ‐DQB1 in 97.7% of allele determinations. Among the remaining discrepant genotype calls at least one of the analysis programs agreed with the reference typing. Upon additional manual analysis 100% of the 2530 alleles were concordant with the reference HLA genotypes; the remaining ambiguities did not exceed 0.8%. The results demonstrate the feasibility and significant benefit of HLA typing by NGS as this technology is highly accurate, eliminates virtually all ambiguities, provides complete sequencing information for the length of the HLA gene and forms the basis for utilizing a single methodology for HLA typing in the immunogenetics labs.
Carbon dioxide‐mediated vasomotion of extra‐cranial cerebral arteries in humans: a role for prostaglandins?
Authors: Hoiland Ryan L. , Tymko Michael M. , Bain Anthony R. , Wildfong Kevin W. , Monteleone Brad , Ainslie Philip N. 
Published: February 2016

Key points
Cerebral blood flow increases during hypercapnia and decreases during hypocapnia; it is unknown if vasomotion of the internal carotid artery is implicated in these responses.
Indomethacin, a non‐selective cyclooxygenase inhibitor (used to inhibit prostaglandin synthesis), has a unique ability to blunt cerebrovascular carbon dioxide reactivity, while other cyclooxygenase inhibitors have no effect.
We show significant dilatation and constriction of the internal carotid artery during hypercapnia and hypocapnia, respectively.
Indomethacin, but not ketorolac or naproxen, reduced the dilatatory response of the internal carotid artery to hypercapnia
The differential effect of indomethacin compared to ketorolac and naproxen suggests that indomethacin inhibits vasomotion of the internal carotid artery independent of prostaglandin synthesis inhibition.
AbstractExtra‐cranial cerebral blood vessels are implicated in the regulation of cerebral blood flow during changes in arterial CO2; however, the mechanisms governing CO2‐mediated vasomotion of these vessels in humans remain unclear. We determined if cyclooxygenase inhibition with indomethacin (INDO) reduces the vasomotor response of the internal carotid artery (ICA) to changes in end‐tidal CO2 (). Using a randomized single‐blinded placebo‐controlled study, participants (n = 10) were tested on two occasions, before and 90 min following oral INDO (1.2 mg kg–1) or placebo. Concurrent measurements of beat‐by‐beat velocity, diameter and blood flow of the ICA were made at rest and during steady‐state stages (4 min) of iso‐oxic hypercapnia (+3, +6, +9 mmHg ) and hypocapnia (−3, −6, −9 mmHg ). To examine if INDO affects ICA vasomotion independent of cyclooxygenase inhibition, two participant subsets (each n = 5) were tested before and following oral ketorolac (post 45 min, 0.25 mg kg–1) or naproxen (post 90 min, 4.2 mg kg–1). During pre‐drug testing in the INDO trial, the ICA dilatated during hypercapnia at +6 mmHg (4.72 ± 0.45 vs. 4.95 ± 0.51 mm; P < 0.001) and +9 mmHg (4.72 ± 0.45 mm vs. 5.12 ± 0.47 mm; P < 0.001), and constricted during hypocapnia at −6 mmHg (4.95 ± 0.33 vs. 4.88 ± 0.27 mm; P < 0.05) and −9 mmHg (4.95 ± 0.33 vs. 4.82 ± 0.27 mm; P < 0.001). Following INDO, vasomotor responsiveness of the ICA to hypercapnia was reduced by 67 ± 28% (0.045 ± 0.015 vs. 0.015 ± 0.012 mm mmHg −1). There was no effect of the drug in the ketorolac and naproxen trials. We conclude that: (1) INDO markedly reduces the vasomotor response of the ICA to changes in ; and (2) INDO may be reducing CO2‐mediated vasomotion via a mechanism(s) independent of cyclooxygenase inhibition.
Mesh Selection for Progressive Failure Modeling of Carbon Fiber Panels in Mode III Shear Using an Explicit Finite Element Solver
Authors: Daniels Mitchell A. , Hyder Imran , Suryan Levi J. , Parmigiani John P. 
Published: February 2016

Modeling progressive failure of composite materials can be a challenging task. It is further complicated by mesh dependency of finite element solvers when implementing the Hashin criterion. As one continues to refine the mesh, the finite element analysis (FEA) continues to yield varying solutions; hence there is no converged solution for continuous mesh refinement. This is due to mesh dependency when modeling strain softening. The FEA package Abaqus attempts to mitigate this but the issue is not eliminated.
Methods that address mesh dependency include experimental validation and numerical analysis. Experimental validation tailors the mesh to match a specific result. This mesh would then be applicable to other configurations with the same geometry and loading; however, experimental validation with increasingly complex parts for FEA is costly and time consuming. Numerical approaches to mesh selection do not require experimental validation; however, these methods may be computationally expensive depending on the analysis. A mesh selection strategy that does not require experimental validation, while computationally efficient, should be implemented for design purposes.
This study investigates a mesh selection strategy based on a converged elastic solution; the coarsest mesh that converges to a solution in the linear-elastic portion of the material response is chosen for analysis. Previous studies using an implicit solver yielded good results for out-of-plane loading conditions; however this procedure has not been implemented for explicit solvers. In this study, an investigation was conducted to determine the appropriate mesh to model progressive damage for notched, carbon fiber composite panels in out-of-plane shear (mode III) using an explicit solver in Abaqus/Explicit. This study analyzed 20 ply thick panels and considered three stacking sequences: 10%, 30%, and 50% zero degree plies. The procedure initially disabled damage and identified the coarsest mesh that approached a converged elastic solution. Using this mesh, damage was enabled and the models were run with loading proceeding through damage initiation until failure. The panels’ material response were extracted from the finite element (FE) model and filtered in order to determine their maximum load-carrying ability. The FE predicted maximum loads were then compared to corresponding experimental data in order to validate the mesh selection procedure. This process is not limited to out-of-plane shear; the potential for this mesh selection method would allow for progressive failure simulation to be more applicable in the design process of composite structures instead of post-damage analysis.
High Cycle Fatigue Strength of Modified 9Cr-1Mo Steel at Elevated Temperatures
Authors: Ochi Motoyuki , Suzuki Ken , Nonaka Isamu , Miura Hideo 
Published: February 2016

In order to clarify the characteristics of high-cycle fatigue of the modified 9Cr-1Mo steel, a high temperature rotary bending test was carried out. As a result, the fatigue strength of this alloy decreased monotonically at elevated temperatures. It decreased from 440 MPa at room temperature to about 350 MPa at 400°C. This decrease of the fatigue strength was attributed to the temperature dependence of the yielding strength of this alloy. The fatigue limit appeared near 107 cycles at 400°C, whereas it appeared around 106 cycles at room temperature. The most important result is that the fatigue limit disappeared up to 108 cycles at temperatures higher than 500°C. Thus, the number of cycles at which the fatigue limit appeared shifted to higher cycles with increasing the testing temperature. Clear striation was observed in the stable crack growth region on the fracture surface of all the specimen tested at room temperature, 400°C, 500°C, 550°C, and 600°C. Intergranular cracking, which have been observed in creep-fatigue tests, was not observed. Since the estimated operating temperature of FBR is 550°C, it is very important to consider this fatigue strength in the structural and reliability design of the modified 9Cr-1Mo steel.
In this study, the change of crystallinity of this alloy under fatigue loading was also analyzed by applying an EBSD method. The image quality (IQ) value obtained from the analysis was used for the quantitative evaluation of the crystallinity in the area where an electron beam of 20 nm in diameter was irradiated. The quality of the atomic alignment was found to degrade under the cyclic loading, and a crack started to occur on the surface of the alloy when the quality of the atomic alignment decreased to a certain critical value.
Evaluation of Fatigue Strength of AISI 4340 Steel Under Hydrostatic Pressure
Authors: Prakash Raghu V. , Raphael Deepak C. 
Published: February 2016

The presence of hydrostatic pressure in the range of 10 to 600 bar (typical of sea depths from 100 meters to 6 kilometers) and cyclic wave loading in off-shore structures and equipments operating in deep-water environment requires suitable criteria accounting for high hydrostatic load during design of such structural elements. The presence of corrosive species due to sea water and marine organisms also adds complexity to this problem. Plain fatigue data evaluated under ambient conditions or fatigue data evaluated in atmospheric conditions under soaked sea water environment may not be appropriate for the design of systems subjected to hydrostatic pressure. High hydrostatic pressure alters the yield criterion of materials. Thus, it becomes essential to generate the fatigue strength data of structural steel in pressurized simulated sea water (3.5% NaCl solution) conditions.
This paper presents the comparison of fatigue life data evaluated for a structural steel material under ambient conditions and under hyperbaric pressure conditions. A special hyperbaric chamber was designed for this purpose and 3.5% NaCl solution was pressurized into the chamber by a manual pump. Mechanical fatigue loading was applied on the specimen in the presence of two pressures, viz., 30 bar and 50 bar hydrostatic pressure. The results suggest that hydrostatic pressure has a significant influence on fatigue life data of steel. The fracture surfaces were examined using a scanning electron microscope which suggests change in fracture mode from being pure ductile to mixed mode of fracture. Work is in progress to evaluate the strength degradation of welded joints subjected to hyperbaric fatigue.
Analysis of a Diesel Engine Exhaust Manifold
Authors: Yang Yiran , He Miao , Mojtahed Masoud 
Published: February 2016

The exhaust manifold is an essential component of an engine, which has become increasingly important because of innovations in the industry. Thus, the efficiency of an exhaust manifold is a key factor in overall engine efficiency. In operating conditions, there are many factors that may influence the performance of an exhaust manifold, such as temperature, pressure, wall thickness, coolant velocity, etc.
A manufacturer of diesel engine’s exhaust manifolds was interested in investigating the performance of its manifolds. This paper describes the method of analysis and results obtained by Fluent and ANSYS software. The purpose of the project is to analyze the stress distribution and locate the areas most prone to failure.
Acupuncture for Fibromyalgia in Primary Care: A Randomised Controlled Trial
Authors: Vas Jorge , Santos-Rey Koldo , Navarro-Pablo Reyes , Modesto Manuela , Aguilar Inmaculada , Campos M Ángeles , Aguilar-Velasco José Francisco , Romero Milagrosa , Párraga Patricia , Hervás Vanesa , Santamaría Olalla , Márquez-Zurita Carmen , Rivas-Ruiz Francisco 
Published: February 2016

Objectives To evaluate the efficacy of an individualised acupuncture protocol for patients with fibromyalgia. Methods Randomised controlled multicentre trial, blinded to participants and to data analysts. Conducted in three primary care centres in southern Spain. A total of 164 participants aged over 17 years and diagnosed with fibromyalgia were enrolled in this trial; 153 participants completed the study. Participants were randomly assigned to either the real intervention (individualised acupuncture, IA) or the sham intervention (sham acupuncture, SA). In both the IA and SA groups, one session per week (lasting 20 min) was provided, in addition to usual pharmacological treatment. The primary outcome was change in pain intensity at 10 weeks. Results Intention-to-treat analysis revealed that the decrease in pain intensity at 10 weeks was greater (p=0.001) in the IA group (−41.0%, 95% CI −47.2% to −34.8%) than in the SA group (−27.1%, 95% CI −33.2% to −20.9%). During the follow-up period, significant differences (p<0.01) in favour of the IA group persisted at 12 months (IA: −19.9%, 95% CI −24.6% to −15.1%; vs SA: −6.2%, 95% CI −11.2% to −1.2%). Conclusions Individualised acupuncture treatment in primary care in patients with fibromyalgia proved efficacious in terms of pain relief, compared with placebo treatment. The effect persisted at 1 year, and its side effects were mild and infrequent. Therefore, the use of individualised acupuncture in patients with fibromyalgia is recommended. Trial Registration Number ISRCTN60217348.
Introduction of a simple guideline to improve neurological assessment in paediatric patients presenting with upper limb fractures
Authors: Marsh Andrew G , Robertson James S , Godman Anna , Boyle Jennifer , Huntley James S 
Published: February 2016

BackgroundNeurological examination in children presenting with upper limb fractures is often poorly performed in the Emergency Department (ED). We aimed to assess the improvement in documented neurological examination for children presenting with upper limb fractures following introduction of a simple guideline.MethodsWe developed and introduced a simple guideline for upper limb neurological assessment in children (‘rock, paper, scissors, OK’). We compared documentation of neurological examination and nerve injury detection at our hospital before and after introduction of this guideline, as well as for children admitted from external hospitals (where the guideline had not been introduced).ResultsIn the period following guideline introduction, 97 children with upper limb fractures were admitted (46% presenting directly to our ED and 54% admitted from external hospitals). This cohort was similar in number and distribution to the cohort reviewed prior to the guideline. Documentation of neurological examination in our ED increased from 92% to 98% after guideline introduction. Documented information on nerves examined also increased from 2% to 68% (p<0.01). Prior to the guideline, there were six nerve injuries, all of which were missed in our ED. After guideline introduction, there were four nerve injuries, all of which were detected in our ED. Documentation and nerve injury detection at external hospitals over the same time period showed no improvement.ConclusionsA simple guideline to assist neurological examination in children with upper limb fractures can significantly improve the quality of documented neurological assessment and nerve injury detection.