bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Bolt Size on the Assembly Nut Factor
Authors: Brown Warren , Lim Tze-Yew 
Published: November 2015

In a previous publication, the effect of diameter and material of the bolt and nut on Nut Factor was examined. The conclusion was that for stainless steel bolting and some anti-seize products, as the bolt diameter increased, so did the Nut Factor. Recent additional testing has revealed that this may not always be the case.
This paper presents a summary of the recent testing and draws practical conclusions regarding the need for specific Nut Factor testing and better quality control of ASTM A193 bolts and ASTM A194 nuts.
Comparison of Ring Compression Testing to Three Point Bend Testing for Unirradiated ZIRLO Cladding
Authors: Korinko Paul S. , Sindelar Robert L. , Kesterson Ronald L. 
Published: November 2015

Safe shipment and storage of nuclear reactor discharged fuel requires an understanding of how the fuel may perform under the various conditions that can be encountered. One specific focus of concern is performance during a shipment drop accident. Tests at Savannah River National Laboratory (SRNL) are being performed to characterize the properties of fuel clad relative to a mechanical accident condition such as a container drop. Unirradiated ZIRLO tubing samples have been charged with a range of hydride levels to simulate actual fuel rod levels. Samples of the hydrogen charged tubes were exposed to a radial hydride growth treatment (RHGT) consisting of heating to 400°C, applying initial hoop stresses of 90 to 170 MPa with controlled cooling and producing hydride precipitates. Initial samples have been tested using both a) ring compression test (RCT) which is shown to be sensitive to radial hydride and b) three-point bend tests which are less sensitive to radial hydride effects.
Hydrides are generated in Zirconium based fuel cladding as a result of coolant (water) oxidation of the clad, hydrogen release, and a portion of the released (nascent) hydrogen absorbed into the clad and eventually exceeding the hydrogen solubility limit. The orientation of the hydrides relative to the subsequent normal and accident strains has a significant impact on the failure susceptability. In this study the impacts of stress, temperature and hydrogen levels are evaluated in reference to the propensity for hydride reorientation from the circumferential to the radial orientation. In addition the effects of radial hydrides on the Quasi Ductile Brittle Transition Temperature (DBTT) were measured. The results suggest that a) the severity of the radial hydride impact is related to the hydrogen level-peak temperature combination (for example at a peak drying temperature of 400°C; 800 PPM hydrogen has less of an impact/ less radial hydride fraction than 200 PPM hydrogen for the same thermal history) and b) for critical strains in post drying handling, storage and accident conditions the 3 point bend strain tolerance is less affected by radial hydrides than the conventional ring compression test (the radial hydride related Quasi DBTT associated with a three point bend straining is lower (better) than that measured by the ring compression tests).
Control of Giardiasis by Interleukin-17 in Humans and Mice—Are the Questions All Answered?
Authors: Singer Steven M. 
Published: November 2015

ABSTRACT

For years, studies of the immune response to
Giardia lamblia
infection focused on the production of IgA by infected hosts and antigenic variation by the parasite to escape destruction by this IgA. A new study by Hanevik and colleagues (C. S. Saghaug, S. Sørnes, D. Peirasmaki, S. Svärd, N. Langeland, and K. Hanevik, Clin Vaccine Immunol 23:11–18, 2016,
http://dx.doi.org/10.1128/CVI.00419-15
) highlights the emerging role of interleukin-17 (IL-17) in immunity to this parasite. Along with recent studies of
Giardia
infections of animals, this work shows that IL-17 appears to be essential for the control of these infections and to be a key factor linking cellular and humoral immune responses.
Fluoroquinolones and collagen associated severe adverse events: a longitudinal cohort study
Authors: Daneman Nick , Lu Hong , Redelmeier Donald A 
Published: November 2015

ObjectivesFluoroquinolone-associated tendon ruptures are a recognised complication, but other severe collagen-associated adverse events may also be possible. Our objectives were to confirm the association of fluoroquinolones and tendon rupture, to clarify the potential association of fluoroquinolones and retinal detachment, and to test for a potentially lethal association between fluoroquinolones and aortic aneurysms.SettingPopulation-based longitudinal cohort study in Ontario, Canada.ParticipantsOlder adults turning 65 years between April 1 1997 and March 31 2012 were followed until primary outcome, death, or end of follow-up (March 31 2014). Fluoroquinolone prescriptions were measured as a time-varying covariate, with patients considered at risk during and for 30 days following a treatment course.Primary outcome measuresSevere collagen-associated adverse events defined as tendon ruptures, retinal detachments and aortic aneurysms diagnosed in hospital and emergency departments.ResultsAmong the 1 744 360 eligible patients, 657 950 (38%) received at least one fluoroquinolone during follow-up, amounting to 22 380 515 days of treatment. The patients experienced 37 338 (2.1%) tendon ruptures, 3246 (0.2%) retinal detachments, and 18 391 (1.1%) aortic aneurysms. Severe collagen-associated adverse events were more common during fluoroquinolone treatment than control periods, including tendon ruptures (0.82 vs 0.26/100-person years, p<0.001), retinal detachments (0.03 vs 0.02/100-person-years, p=0.003) and aortic aneurysms (0.35 vs 0.13/100-person-years, p<0.001). Current fluoroquinolones were associated with an increased hazard of tendon rupture (HR 3.13, 95% CI 2.98 to 3.28; adjusted HR 2.40, 95% CI 2.24 to 2.57) and an increased hazard of aortic aneurysms (HR 2.72, 95% CI 2.53 to 2.93; adjusted HR2.24, 95% CI 2.02 to 2.49) that were substantially greater in magnitude than the association of these outcomes with amoxicillin. The hazard of retinal detachment was marginal (HR 1.28, 95% CI 0.99 to 1.65; adjusted HR 1.47, 95% CI 1.08 to 2.00) and not greater in magnitude than that observed with amoxicillin.ConclusionsFluoroquinolones are associated with subsequent tendon ruptures and may also contribute to aortic aneurysms.
Defining chronic cancer: patient experiences and self-management needs
Authors: Harley Clare , Pini Simon , Bartlett Yvonne Kiera , Velikova Galina 
Published: November 2015

ObjectiveChronic cancer is poorly defined and strategies for supporting patients during this disease phase are lacking. This research defines chronic cancer, explores patient experiences and reviews patients' support needs against those described in the 2007 Department of Health Generic Choice Model for Long-term Conditions (DoH-GCM).DesignSemistructured interviews were audio recorded, transcribed and data explored for emergent themes. The a priori themes from DoH-GCM were applied: clinical support; self-care and self-management; supporting independence; psychological support; and social and economic factors.Results56 patients >12 months postdiagnosis of advanced cancer were recruited from five clinics at a Yorkshire cancer centre: breast (n=11); renal (n=11); colorectal/gastrointestinal (n=12); gynaecological (n=12); and prostate (n=10). Most patients aspired to livingnormallives. Challenges included frequent and lengthy hospital appointments, long-term symptom control and uncertainty. Only renal and prostate patients reported routine access to specialist nursing. Uptake of support services was varied and there was generally poor understanding of support pathways for non-medical problems and issues occurring when patients were not receiving active treatment. There was variation in coping strategies and ability of patients to attain a positive outlook on life.ConclusionsFor patients to do well in this cancer phase requires good self-management of symptoms plus taking an active role in accessing appropriate services as needed. Care planning at the point of transition to the chronic phase of cancer should focus on evaluating patients' needs, clarifying support pathways, increasing the profile and involvement of community services and organisations, and supporting patients and families develop effective self-management skills.
Quality indicators for palliative and end of life care: a review of Swedish policy documents
Authors: Lind Susanne , Adolfsson Jan , Axelsson Bertil , Fürst Carl Johan 
Published: November 2015

BackgroundAll patients with palliative and end of life care needs should be guaranteed equal and safe treatment and care, regardless of their disease or site of care. The inclusion of quality indicators in national guidelines and other guiding documents supports quality assurance and improvement in provision of care. The aim of this paper was to review existing quality indicators in national Swedish policy documents relevant to palliative and end of life care.MethodsWe reviewed existing guidelines for diseases expected to require palliative care issued by the National Board of Health and Welfare, existing regional clinical practice guidelines and the annual report of the Swedish Register of Palliative Care (SRPC) up until 2010.ResultsWe found 11 quality indicators pertinent to palliative and end of life care in the guidelines for cancer diseases and ‘The care and nursing of the elderly’. The indicators included assessment and treatment of pain, communication with the patient and the family, documentation in the patient record and registration in the SRPC. In the national guidelines for cardiology, pulmonary diseases, stroke, diabetes and dementia, there were no indicators relevant for palliative or end of life care.ConclusionsIn the existing Swedish national guidelines for many different diseases, there is still a great need to define clinically relevant and feasible outcome measures of quality of palliative and end of life care.
Characterising the immune profile of the kidney biopsy at lupus nephritis flare differentiates early treatment responders from non-responders
Authors: Parikh Samir V , Malvar Ana , Song Huijuan , Alberton Valeria , Lococo Bruno , Vance Jay , Zhang Jianying , Yu Lianbo , Rovin Brad H 
Published: November 2015

IntroductionThe kidney biopsy is used to diagnose and guide initial therapy in patients with lupus nephritis (LN). Kidney histology does not correlate well with clinical measurements of kidney injury or predict how patients will respond to standard-of-care immunosuppression. We postulated that the gene expression profile of kidney tissue at the time of biopsy may differentiate patients who will from those who will not respond to treatment.MethodsThe expression of 511 immune-response genes was measured in kidney biopsies from 19 patients with proliferative LN and 4 normal controls. RNA was extracted from formalin-fixed, paraffin-embedded kidney biopsies done at flare. After induction therapy, 5 patients achieved a complete clinical response (CR), 10 had a partial response (PR) and 4 patients were non-responders (NRs). Transcript expression was compared with normal controls and between renal response groups.ResultsA principal component analysis showed that intrarenal transcript expression from normal kidney, CR biopsies and NR biopsies segregated from each other. The top genes responsible for CR clustering included several interferon pathway genes (STAT1,IRF1,IRF7,MX1,STAT2,JAK2), while complement genes (C1R,C1QB,C6,C9,C5,MASP2) were mainly responsible for NR clustering. Overall, 35 genes were uniquely expressed in NR compared with CR. Pathway analysis revealed that interferon signalling and complement activation pathways were upregulated in both groups, while BAFF, APRIL, nuclear factor-κB and interleukin-6 signalling were increased in CR but suppressed in NR.ConclusionsThese data suggest that molecular profiling of the kidney biopsy at LN flare may be useful in predicting treatment response to induction therapy.
Adrenergic Stimulation of DUSP1 Impairs Chemotherapy Response in Ovarian Cancer
Authors: Kang Yu , Nagaraja Archana S. , Armaiz-Pena Guillermo N. , Dorniak Piotr L. , Hu Wei , Rupaimoole Rajesha , Liu Tao , Gharpure Kshipra M. , Previs Rebecca A. , Hansen Jean M. , Rodriguez-Aguayo Cristian , Ivan Cristina , Ram Prahlad , Sehgal Vasudha , Lopez-Berestein Gabriel , Lutgendorf Susan K. , Cole Steven W. , Sood Anil K. 
Published: November 2015

Abstract
Purpose: Chronic adrenergic activation has been shown to associate with adverse clinical outcomes in cancer patients, but the underlying mechanisms are not well understood. The focus of the current study was to determine the functional and biologic effects of adrenergic pathways on response to chemotherapy in the context of ovarian cancer.
Experimental Design: Increased DUSP1 production by sympathetic nervous system mediators (e.g., norepinephrine) was analyzed by real-time quantitative RT-PCR and by Western blotting. In vitro chemotherapy-induced cell apoptosis was examined by flow cytometry. For in vivo therapy, a well-characterized model of chronic stress was used.
Results: Catecholamines significantly inhibited paclitaxel- and cisplatin-induced apoptosis in ovarian cancer cells. Genomic analyses of cells treated with norepinephrine identified DUSP1 as a potential mediator. DUSP1 overexpression resulted in reduced paclitaxel-induced apoptosis in ovarian cancer cells compared with control; conversely, DUSP1 gene silencing resulted in increased apoptosis compared with control cells. DUSP1 gene silencing in vivo significantly enhanced response to paclitaxel and increased apoptosis. In vitro analyses indicated that norepinephrine-induced DUSP1 gene expression was mediated through ADRB2 activation of cAMP–PLC–PKC–CREB signaling, which inhibits JNK-mediated phosphorylation of c-Jun and protects ovarian cancer cells from apoptosis. Moreover, analysis of The Cancer Genome Atlas data showed that increased DUSP1 expression was associated with decreased overall (P = 0.049) and progression-free (P = 0.0005) survival.
Conclusions: These findings provide a new understanding of the mechanisms by which adrenergic pathways can impair response to chemotherapy and have implications for cancer management. Clin Cancer Res; 22(7); 1713–24. ©2015 AACR.
The incidence and treatment of bleeding episodes in non-severe haemophilia A patients with inhibitors
Authors: Velzen Alice S. van , Eckhardt Corien L. , Streefkerk Nina , Peters Marjolein , Hart Daniel P. , Hamulyak Karly , Klamroth Robert , Meijer Karina , Nijziel Marten , Schinco Piercarla , Yee Thynn T. , Bom Johanna G. van der , Fijnvandraat Karin ,   for the INSIGHT study group
Published: November 2015

SummaryThe development of an inhibitory antibody in non-severe haemophilia A patients may aggravate the bleeding phenotype considerably. Effective treatment of bleeding episodes may be challenging, with ensuing severe complications. At present, evidence is scarce for optimal treatment of bleeding episodes in this patient group. The aim of this study was to describe the incidence and the treatment of bleeding episodes in inhibitor patients in a population-based unselected cohort of non-severe haemophilia A patients with clinically relevant inhibitors. Data were available for 100 of the 107 non-severe haemophilia A patients (factor VIII (FVIII) baseline, 2–40 lU/dl) from 29 centres in Europe and one centre in Australia who had developed a clinically relevant inhibitor between 1980 and 2011. The majority (89 %) of the patients were treated during the inhibitor period for bleeding episodes or a surgical intervention: 66 % needed treatment for bleeding episodes, at a median annual bleeding rate (ABR) of 1.1 (interquartile range (IQR) 0.1–2.5) and a median total of 2 (IQR 1–6) bleeding episodes. Compared to the median ABR before inhibitor development of 0.095 bleeds per year (IQR 0.02–0.42), the increase in ABR is more than a 10-fold. More than 90 % of the bleeding episodes were treated with only one type of product, most frequently (51 %) FVIII concentrates. This study provides the incidence of bleeding episodes and treatment choices in non-severe haemophilia A patients with inhibitors. The 10-fold increase to a median ABR of 1.1 episodes per year emphasizes the impact of inhibitor development for non-severe haemophilia A patients.
Exercise Strain Echocardiography in Patients With a Hemodynamically Significant Myocardial Bridge Assessed by Physiological Study
Authors: Kobayashi Yukari , Tremmel Jennifer A. , Kobayashi Yuhei , Amsallem Myriam , Tanaka Shigemitsu , Yamada Ryotaro , Rogers Ian S. , Haddad Francois , Schnittger Ingela 
Published: November 2015

Background

Although a myocardial bridge (
MB
) is often regarded as a benign coronary variant, recent studies have associated
MB
with focal myocardial ischemia. The physiological consequences of
MB
on ventricular function during stress have not been well established.

Methods and Results

We enrolled 58 patients with
MB
of the left anterior descending artery, diagnosed by intravascular ultrasound. Patients underwent invasive physiological evaluation of the
MB
by diastolic fractional flow reserve during dobutamine challenge and exercise echocardiography. Septal and lateral longitudinal strain (LS) were assessed at rest and immediately after exercise and compared with strain of matched controls. Absolute and relative changes in strain were also calculated. The mean age was 42.5±16.0 years. Fifty‐five patients had a
diastolic fractional flow reserve
≤0.76. At rest, there was no significant difference between the 2 groups in septal LS (19.0±1.8% for patients with
MB
versus 19.2±1.5% for control,
P
=0.53) and lateral
LS
(20.1±2.0% versus 20.0±1.6%,
P
=0.83). With stress, compared with controls, patients with
MB
had a lower peak septal
LS
(18.9±2.6% versus 21.7±1.6%,
P
<0.001) and lower absolute (−0.1±2.1% versus 2.5±1.3%,
P
<0.001) and relative change (−0.6±11.2% versus 13.1±7.8%,
P
<0.001) in septal
LS
, whereas there was no significant difference in lateral
LS
. In multivariate analysis,
diastolic fractional flow reserve
and length were independent determinants of lower changes in septal LS.

Conclusions

Patients with a hemodynamically significant
MB
, determined by invasive
diastolic fractional flow reserve
, have significantly lower change in septal
LS
on exercise echocardiography, suggesting that septal
LS
may be useful for noninvasively assessing the hemodynamic significance of an
MB
.
Abdominal migraine
Authors: Napthali Kate , Koloski Natasha , Talley Nicholas J 
Published: November 2015

Background Abdominal migraine (AM) is a syndrome usually recognised in childhood. The syndrome is characterised by episodic attacks of severe abdominal pain and vasomotor symptoms, nausea and vomiting. It is a poorly understood disorder largely due to a limited recognition of this condition by the medical community. However, the publication of AM diagnostic guidelines by the International Headache Society a decade ago and the recognition of AM in the Rome Classification of functional gastrointestinal disorders have helped to legitimise this disorder and facilitate research. Overview AM is relatively common, affecting up to 4% of the paediatric population. Whilst AM is not believed to continue into adulthood for the majority of children, it has the propensity to develop into probable migraine and recurrent abdominal pain in adulthood. The pathophysiology of this condition remains unclear and as a result treatment for this condition is suboptimal with avoidance of triggers and prophylactic treatment currently recommended when an episode begins. Conclusion The recognition of AM by the IHS and the Rome Foundation should help facilitate future research into the pathophysiology of this debilitating condition and as a result better treatments for AM should emerge. Randomised controlled trials should be a priority.
Articular Cartilage Degenerates After Subtotal/Total Lateral Meniscectomy but Radiographic Arthrosis Progression Is Reduced After Meniscal Transplantation
Authors: Lee Bum-Sik , Bin Seong-Il , Kim Jong-Min 
Published: November 2015

Background: Little is known about the degree of articular cartilage degeneration after subtotal/total lateral meniscectomy in patients who later undergo isolated lateral meniscal allograft transplantation (LMAT). It has not yet been studied whether arthritic changes as shown on radiographs were lower during the posttransplantation period than during the meniscus-deficient period. Hypothesis: Articular cartilage will significantly degenerate during the meniscus-deficient period, but the progression in radiographic arthrosis is reduced after LMAT. Study Design: Case series; Level of evidence, 4. Methods: This study retrospectively reviewed 49 patients who underwent subtotal/total lateral meniscectomy before isolated LMAT performed over 1 year later by the same surgeon. International Cartilage Repair Society (ICRS) grades of the femorotibial joint at the time of subtotal/total meniscectomy and at LMAT were compared. Radiographic evaluation was performed at the time of initial meniscectomy, LMAT, and the latest follow-up in 38 patients (after 11 patients whose radiographs showed incomplete ossification at the time of meniscectomy were excluded). Arthrosis, based on Kellgren-Lawrence (K-L) grades, was determined on standing anteroposterior views. Joint space width (JSW) was measured on weightbearing flexion posteroanterior views. Results: Over a mean meniscus-deficient period of 4.5 years (range, 1-13 years), articular cartilage significantly degenerated on the femoral and tibial sides ( P < .001). Grade ≥3 degeneration on the lateral tibial plateau was observed in 13 patients (27%) at the time of initial meniscectomy; this incidence doubled to 28 patients (57%) by the time of LMAT. The K-L grades worsened ( P < .001) and JSWs narrowed significantly (–0.65 ± 1.09 mm; P = .001) during the mean meniscus-deficient period of 3.1 years. At radiographic assessment, however, the K-L grades ( P = .097) and JSWs (4.06 ± 1.19 vs 3.92 ± 1.21 mm; mean difference, –0.14 ± 0.68 mm; P = .213) did not significantly change during the mean posttransplantation period of 3.8 years. The changes in ICRS grade and JSW during the meniscus-deficient period were not associated with age, body mass index, mechanical axis deviation, or Tegner activity level ( P > .05 for all relationships). Conclusion: Patients who underwent isolated LMAT showed substantial articular cartilage degeneration at the time of initial subtotal/total lateral meniscectomy, and this degeneration progressed thereafter. Further progression of radiographic arthrosis was delayed after LMAT.