bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stability Analysis of Multiharmonic Nonlinear Vibrations for Large Models of Gas-Turbine Engine Structures With Friction and Gaps
Authors: Petrov E. P. 
Published: September 2016

An efficient method is proposed for the multiharmonic frequency domain analysis of the stability for nonlinear periodic forced vibrations in gas-turbine engine structures and turbomachines with friction, gaps and other types of nonlinear contact interfaces. The method allows using large-scale finite element models for structural components together with detailed description of nonlinear interactions at contact interfaces between these components. The highly accurate reduced models are applied in the assessment of stability of periodic regimes for large-scale model of gas-turbine structures. An approach is proposed for the highly-accurate calculation of motion of a structure after it is perturbed from the periodic nonlinear forced response.
Efficiency of the developed approach is demonstrated on a set of test cases including simple models and large-scale realistic bladed disc models with different types of nonlinearities: friction, gaps and cubic nonlinear springs.
Detailed Investigation of RANS and LES Predictions of Loss Generation in an Axial Compressor Cascade at Off Design Incidences
Authors: Leggett John , Priebe Stephan , Sandberg Richard , Michelassi Vittorio , Shabbir Aamir 
Published: September 2016

In the design of modern jet engines the need for accurate loss prediction techniques is ever present. The most common tool currently in use is Reynolds Averaged Navier-Stokes model which provides good estimation at design conditions but can struggle with off design conditions. With accuracy being such an important requirement, an alternative method such as Large Eddy Simulation presents an opportunity to improve and assess the off design performance.
Although still limited by computational resources, the use of Large Eddy Simulations in conjunction with more detailed loss analysis methods forms a powerful tool for assessing and improving current Reynolds Averaged Navier-Stokes techniques. The simulations performed here are an incidence sweep at off-design conditions with free stream turbulence. The results of the two methodologies are compared with the use of loss breakdown analysis and the best practice of applying the loss breakdown technique to compressors is outlined.
Optimizing Ceramic Matrix Composite Interlaminar Fracture Toughness (Mode I) Wedge Test
Authors: Abdi Frank , DorMohammadi Saber , Ahmad Jalees , Godines Cody , Morscher Gregory N. , Choi Sung , Mansour Rabih , Gonczy Steve 
Published: September 2016

ASTM test standards for CMC’s Crack Growth Resistance (CGR) may exhibit a zig-zag (wavy) crack path pattern, and fiber bridging. The experimental parameters that may contribute to the difficulty can be summarized as: specimen width and thickness, interface coating thickness, mixed mode failure evolution, and interlaminar defects. Modes I crack growth resistances, GI were analytically determined at ambient temperature using wedge test, a modified double cantilever beam (DCB). Several Finite Element (FE) based Multi-scale modeling potential techniques were investigated: a) Multi-scale progressive failure analysis (MS-PFA); b) Virtual Crack Closure Technique (VCCT). Advantages and disadvantages of each were identified. The final modeling algorithm recommended was an integrated damage and fracture evolution methodology using combined MS-PFA and VCCT.
The material tested in this study was a slurry-cast melt-infiltrated SiC/SiC composite with Tyranno ZMI fibers (Ube Industries, Kyoto, Japan) and a BN interphase. The fiber architecture consisted of eight plies of balanced 2-D woven five-harness satin. The total fiber volume fraction was about 30% with half of the fibers in the 0° direction and half in the 90° direction. All specimens had a nominal thickness of 4 mm. An alumina wedge with 18° head angle (2α) was used. In this method, a splitting force is created by inserting a vertically-moving wedge in a notch causing the arms to separate and forcing an interlaminar crack at the sharpest end of the notch The MS-PFA numerical model predicted the damage and fracture evolution and utilized the GENOA UMAT (User Material Subroutine) for Damage and FEM (Finite Element Model) stress intensity and LEFM (Linear elastic Fracture Model), Cohesive Model for Fracture. The analysis results (Fracture energy vs. crack length, Fracture energy vs. load, Fracture energy vs. crack opening displacement) matched the Mode I coupon tests and revealed the following key findings. Mode I-Wedge specimen exhibits: 1) failure mode is due to interlaminar tension (ILT) only in the interface section and a zig-zag pattern observed; 2) VCCT crack growth resistance is well matched to the test data; and 3) failure mode is a mixed mode behavior of Interlaminar tension (ILT) to interlaminar shear (ILS). The final Wedge test specimen configuration optimization includes the sensitivity of design parameters to CGR: a) wedge contact coefficient of friction; b) lever arms thickness, and c) inclined head angle, distance between the initial crack and wedge tip.
A Multilaboratory, Multicountry Study To Determine Bedaquiline MIC Quality Control Ranges for Phenotypic Drug Susceptibility Testing
Authors: Kaniga Koné , Cirillo Daniela M. , Hoffner Sven , Ismail Nazir A. , Kaur Devinder , Lounis Nacer , Metchock Beverly , Pfyffer Gaby E. , Venter Amour 
Published: September 2016

ABSTRACT

The aim of this study was to establish standardized drug susceptibility testing (DST) methodologies and reference MIC quality control (QC) ranges for bedaquiline, a diarylquinoline antimycobacterial, used in the treatment of adults with multidrug-resistant tuberculosis. Two tier-2 QC reproducibility studies of bedaquiline DST were conducted in eight laboratories using Clinical Laboratory and Standards Institute (CLSI) guidelines. Agar dilution and broth microdilution methods were evaluated.
Mycobacterium tuberculosis
H37Rv was used as the QC reference strain. Bedaquiline MIC frequency, mode, and geometric mean were calculated. When resulting data occurred outside predefined CLSI criteria, the entire laboratory data set was excluded. For the agar dilution MIC, a 4-dilution QC range (0.015 to 0.12 μg/ml) centered around the geometric mean included 95.8% (7H10 agar dilution; 204/213 observations with one data set excluded) or 95.9% (7H11 agar dilution; 232/242) of bedaquiline MICs. For the 7H9 broth microdilution MIC, a 3-dilution QC range (0.015 to 0.06 μg/ml) centered around the mode included 98.1% (207/211, with one data set excluded) of bedaquiline MICs. Microbiological equivalence was demonstrated for bedaquiline MICs determined using 7H10 agar and 7H11 agar but not for bedaquiline MICs determined using 7H9 broth and 7H10 agar or 7H9 broth and 7H11 agar. Bedaquiline DST methodologies and MIC QC ranges against the H37Rv
M. tuberculosis
reference strain have been established: 0.015 to 0.12 μg/ml for the 7H10 and 7H11 agar dilution MICs and 0.015 to 0.06 μg/ml for the 7H9 broth microdilution MIC. These methodologies and QC ranges will be submitted to CLSI and EUCAST to inform future research and provide guidance for routine clinical bedaquiline DST in laboratories worldwide.
Resistance to Mutant Group 2 Influenza Virus Neuraminidases of an Oseltamivir-Zanamivir Hybrid Inhibitor
Authors: Wu Yan , Gao Feng , Qi Jianxun , Bi Yuhai , Fu Lifeng , Mohan Sankar , Chen Yuhang , Li Xuebing , Pinto B. Mario , Vavricka Christopher J. , Tien Po , Gao George F. 
Published: September 2016

ABSTRACTInfluenza virus neuraminidase (NA) drug resistance is one of the challenges to preparedness against epidemic and pandemic influenza virus infections. NA N1- and N2-containing influenza viruses are the primary cause of seasonal epidemics and past pandemics. The structural and functional basis underlying drug resistance of the influenza virus N1 NA is well characterized. Yet drug resistance of the N2 strain is not well understood. Here, we confirm that replacement of N2 E119 or I222 results in multidrug resistance, and when the replacements occur together, the sensitivity to NA inhibitors (NAI) is reduced severely. Using crystallographic studies, we showed that E119 replacement results in a loss of hydrogen bonding to oseltamivir and zanamivir, whereas I222 replacement results in a change in the hydrophobic environment that is critical for oseltamivir binding. Moreover, we found that MS-257, a zanamivir-oseltamivir hybrid inhibitor, is less susceptible to drug resistance. The binding mode of MS-257 shows that increased hydrogen bonding interactions between the inhibitor and NA active site anchor the inhibitor within the active site and allow adjustments in response to active-site modifications. Such stability is likely responsible for the observed reduced susceptibility to drug resistance. MS-257 serves as a next-generation anti-influenza virus drug candidate and serves also as a scaffold for further design of NAIs.IMPORTANCEOseltamivir and zanamivir are the two major antiviral drugs available for the treatment of influenza virus infections. However, multidrug-resistant viruses have emerged in clinical cases, which pose a challenge for the development of new drugs. N1 and N2 subtypes exist in the viruses which cause seasonal epidemics and past pandemics. Although N1 drug resistance is well characterized, the molecular mechanisms underlying N2 drug resistance are unknown. A previous report showed that an N2 E119V/I222L dual mutant conferred drug resistance to seasonal influenza virus. Here, we confirm that these substitutions result in multidrug resistance and dramatically reduced sensitivity to NAI. We further elucidate the molecular mechanism underlying N2 drug resistance by solving crystal structures of the N2 E119V and I222L mutants and the dual mutant. Most importantly, we found that a novel oseltamivir-zanamivir hybrid inhibitor, MS-257, remains more effective against drug-resistant N2 and is a promising candidate as a next-generation anti-influenza virus drug.
Discontinuing financial incentives for adherence to antipsychotic depot medication: long-term outcomes of a cluster randomised controlled trial
Authors: Priebe Stefan , Bremner Stephen A , Pavlickova Hana 
Published: September 2016

ObjectivesIn a cluster randomised controlled trial, offering financial incentives improved adherence to antipsychotic depot medication over a 1-year period. Yet, it is unknown whether this positive effect is sustained once the incentives stop.Methods and analysesPatients in the intervention and control group were followed up for 2 years after the intervention. Primary and secondary outcomes were assessed at 6 months and 24 months post intervention. Assessments were conducted between September 2011 and November 2014.ResultsAfter the intervention period, intervention and control groups did not show any statistically significant differences in adherence, neither in the first 6 months (71% and 77%, respectively) nor in the following 18 months (68%, 74%). There were no statistically significant differences in secondary outcomes, that is, adherence ≥95% and untoward incidents either.ConclusionsIt may be concluded that incentives to improve adherence to antipsychotic maintenance medication are effective only for as long as they are provided. Once they are stopped, adherence returns to approximately baseline level with no sustained benefit.Trial registration numberISRCTN77769281; Results.
Systematic evaluation of patient-reported outcome (PRO) protocol content and reporting in UK cancer clinical trials: the EPiC study protocol
Authors: Ahmed Khaled , Kyte Derek , Keeley Thomas , Efficace Fabio , Armes Jo , Brown Julia M , Calman Lynn , Copland Chris , Gavin Anna , Glaser Adam , Greenfield Diana M , Lanceley Anne , Taylor Rachel , Velikova Galina , Brundage Michael , Mercieca-Bebber Rebecca , King Madeleine T , Calvert Melanie 
Published: September 2016

IntroductionEmerging evidence suggests that patient-reported outcome (PRO)-specific information may be omitted in trial protocols and that PRO results are poorly reported, limiting the use of PRO data to inform cancer care. This study aims to evaluate the standards of PRO-specific content in UK cancer trial protocols and their arising publications and to highlight examples of best-practice PRO protocol content and reporting where they occur. The objective of this study is to determine if these early findings are generalisable to UK cancer trials, and if so, how best we can bring about future improvements in clinical trials methodology to enhance the way PROs are assessed, managed and reported. Hypothesis: Trials in which the primary end point is based on a PRO will have more complete PRO protocol and publication components than trials in which PROs are secondary end points.Methods and analysisCompleted National Institute for Health Research (NIHR) Portfolio Cancer clinical trials (all cancer specialities/age-groups) will be included if they contain a primary/secondary PRO end point. The NIHR portfolio includes cancer trials, supported by a range of funders, adjudged as high-quality clinical research studies. The sample will be drawn from studies completed between 31 December 2000 and 1 March 2014 (n=1141) to allow sufficient time for completion of the final trial report and publication. Two reviewers will then review the protocols and arising publications of included trials to: (1) determine the completeness of their PRO-specific protocol content; (2) determine the proportion and completeness of PRO reporting in UK Cancer trials and (3) model factors associated with PRO protocol and reporting completeness and with PRO reporting proportion.Ethics and disseminationThe study was approved by the ethics committee at University of Birmingham (ERN_15-0311). Trial findings will be disseminated via presentations at local, national and international conferences, peer-reviewed journals and social media including the CPROR twitter account and UOB departmental website (http://www.birmingham.ac.uk/cpro0r).Trial registration numberPROSPERO CRD42016036533.
Performance of a simplified termination of resuscitation rule for adult traumatic cardiopulmonary arrest in the prehospital setting
Authors: Chiang Wen-Chu , Huang Yu-Sheng , Hsu Shu-Hsien , Chang Anna Marie , Ko Patrick Chow-In , Wang Hui-Chih , Yang Chih-Wei , Hsieh Ming-Ju , Huang Edward Pei-Chuan , Chong Kah-Meng , Sun Jen-Tang , Chen Shey-Ying , Ma Matthew Huei-Ming 
Published: September 2016

ObjectiveThe prehospital termination of resuscitation (TOR) guidelines for traumatic cardiopulmonary arrest (TCPA) was proposed in 2003. Its multiple descriptors of cases where efforts can be terminated make it complex to apply in the field. Here we proposed a simplified rule and evaluated its predictive performance.MethodsWe analysed Utstein registry data for 2009–2013 from a Taipei emergency medical service to test a simplified TOR rule that comprises two criteria: blunt trauma injury and the presence of asystole. Enrolees were adults (≥18 years) with TCPA. The predicted outcome was in-hospital death. We compared the areas under the curve (AUC) of the simple rule with each of four descriptors in the guidelines and with a combination of all four to assess their discriminatory ability. Test characteristics were calculated to assess predictive performance.ResultsA total of 893 TCPA cases were included. Blunt trauma occurred in 459 (51.4%) cases and asystole in 384 (43.0%). In-hospital mortality was 854 (95.6%) cases. The simplified TOR rule had greater discriminatory ability (AUC 0.683, 95% CI 0.618 to 0.747) compared with any single descriptor in the 2003 guidelines (range of AUC: 0.506–0.616) although the AUC was similar when all four were combined (AUC 0.695, 95% CI 0.615 to 0.775). The specificity of the simplified rule was 100% (95% CI 88.8% to 100%) and positive predictive value 100% (95% CI 96.8% to 100%). The false positive value, false negative value and decreased rate of unnecessary transport were 0% (95% CI 0% to 3.2%), 94.8% (95% CI 92.9% to 96.2%) and 16.4% (95% CI 14.1% to 19.1%), respectively.ConclusionsThe simplified TOR rule appears to accurately predict non-survivors in adults with TCPA in the prehospital setting.
Reducing time to surgery after anterior cruciate ligament injury
Authors: Sapsford H , Sutherland AG 
Published: September 2016

Introduction Recent work suggests that reconstruction of the ruptured anterior cruciate ligament within 12 months of injury results in better outcomes. We present a complete audit cycle examining the effect of establishment of an Acute Knee Clinic on time to surgery. Methods Records of 20 anterior cruciate ligament reconstructions undertaken by the senior author between June 2003 and May 2004 were examined to identify the time to surgery. The Acute Knee Clinic was established in December 2004. Prospectively collected data on patients attending the Acute Knee Clinic between May 2005 and July 2007 and patients undergoing anterior cruciate ligament reconstruction from September 2006 to 2007 were reviewed with respect to referral route, time from injury to specialist review and time to surgery. Results Mean time from injury to surgery of the initial cohort was 14 months (range 3–56). After establishment of the Acute Knee Clinic, 90% of referrals from Accident and Emergency (A&E) were seen by a specialist within four weeks. Between September 2006 and September 2007, 49 patients underwent anterior cruciate ligament reconstruction: 21 came via the Acute Knee Clinic, with a mean time from injury to surgery of 6 months; 28 patients from the elective clinic had a mean time to surgery of 25 months. 95% of Acute Knee Clinic patients and 53 % of elective clinic patients had surgery within 12 months of injury. Discussion The Acute Knee Clinic has been shown to reduce the time from injury to anterior cruciate ligament reconstruction. The Acute Knee Clinic only accounts for the referral of 40% of anterior cruciate ligament reconstructions in this series: Further education work is required with A&E staff and GPs regarding the referral of knee injuries. Access to the Acute Knee Clinic could be extended to GPs, although this could create service overload.
Randomized Trial of PMTO in Foster Care: Six-Month Child Well-Being Outcomes
Authors: Akin Becci A. , Lang Kyle , McDonald Thomas P. , Yan Yueqi , Little Todd 
Published: September 2016

Objective: This study tested the effectiveness of Parent Management Training, Oregon (PMTO) model on child social–emotional well-being. Methods: Using a randomized controlled design and three measures of social–emotional well-being, the study investigated effectiveness of PMTO with families of children in foster care with serious emotional disturbance (SED). Participants included children (3–16 years) and parents who were randomly assigned to PMTO ( n = 461) or services as usual ( n = 457). Study condition was known to participants and assessors. Six months after baseline, analysis of covariance models examined the intervention’s overall effect and time interactions using intent-to-treat analysis. Follow-up analyses identified salient predictors of well-being. Results: PMTO demonstrated small but significant positive effects on three primary outcomes: social–emotional functioning (Cohen’s d = .31), problem behaviors (Cohen’s d = .09), and prosocial skills (Cohen’s d = .09). Conclusion: Results suggest that PMTO was effective at improving short-term social–emotional well-being in a high-risk population of children with SED.
Bridge Therapy Outcomes in Patients With Mechanical Heart Valves
Authors: Delate Thomas , Meisinger Stephanie M. , Witt Daniel M. , Jenkins Daniel , Douketis James D. , Clark Nathan P. 
Published: September 2016

Background: Bridge therapy is associated with an increased risk of major bleeding in patients with atrial fibrillation and venous thromboembolism (TE) without a corresponding reduction in TE. The benefits of bridge therapy in patients with mechanical heart valve (MHV) prostheses interrupting warfarin for invasive procedures are not well described. Methods and Results: A retrospective cohort study was conducted at an integrated health-care delivery system. Anticoagulated patients with MHV interrupting warfarin for invasive diagnostic or surgical procedures between January 1, 2006, and March 31, 2012, were identified. Patients were categorized according to exposure to bridge therapy during the periprocedural period and TE risk (low, medium, and high). Outcomes validated via manual chart review included clinically relevant bleeding, TE, and all-cause mortality in the 30 days following the procedure. There were 547 procedures in 355 patients meeting inclusion criteria. Mean cohort age was 65.2 years, and 38% were female. Bridge therapy was utilized in 466 (85.2%) procedures (95.2%, 77.3%, and 65.8% of high, medium, and low TE risk category procedures, respectively). The 30-day rate of clinically relevant bleeding was numerically higher in bridged (5.8%; 95% confidence interval [CI], 3.9%-8.3%) versus not bridged procedures (1.2%; 95% CI, <0.1%-6.7%; P = .102). No TEs or deaths were identified. Conclusion: The use of bridge therapy is common among patients with MHV and may be associated with increased bleeding risk. Further research is needed to determine whether bridge therapy reduces TE in patients with MHV interrupting warfarin for invasive procedures.
Both canonical and non-canonical NF-κB activation contribute to the proliferative response of the middle ear mucosa during bacterial infection
Authors: Cho Chang Gun , Pak Kwang , Webster Nicholas , Kurabi Arwa , Ryan Allen F 
Published: September 2016

A major aspect of pathology in otitis media (OM), the most common childhood bacterial disease, is hyperplasia of the middle ear mucosa. Activation of innate immune receptors during OM leads to the activation of NF-κB, a pleiotropic transcription factor involved both in inflammation and tissue growth. To explore the role of NF-κB in mucosal hyperplasia during OM, we evaluated the expression of genes involved in two modes of NF-κB activation during a complete episode of acute, bacterial OM in mice. We also determined the effects of inhibitors of each pathway on infection-stimulated mucosal growth in vitro. A majority of the genes that mediate both the canonical and the non-canonical pathways of NF-κB activation were regulated during OM, many with kinetics related to the time course of mucosal hyperplasia. Inhibition of either pathway reduced the growth of cultured mucosal explants in a dose-dependent manner. However, inhibition of the canonical pathway produced a greater effect, suggesting that this mode of NF-κB activation dominates mucosal hyperplasia during OM.
Open Reduction Internal Fixation of Posterior Malleolus Fractures and Iatrogenic Injuries
Authors: Karbassi John A. , Braziel Andrew , Garas Peter K. , Patel Abhay R. 
Published: September 2016

Open reduction internal fixation of posterior malleolus fractures from a posterior approach is gaining popularity. One concern that has not been studied is the risk of iatrogenic injury to anatomical structures on the anterior ankle. The purpose of this study is to determine the proximity of these anterior structures with relation to K-wires advanced through the anterior cortex. A total of 10 cadaver ankles were utilized in the study. A posterolateral approach to the ankle was used. K-wires were advanced at varying levels above the articular surface, and then, the proximity of the wires to the following structures was determined: the neurovascular bundle, tibialis anterior (TA), and extensor hallucis longus. Overall, the structure most in danger of being injured was the TA (P < .001). This tendon was injured by 52% of all K-wires. These data suggest that K-wires should be advanced under direct fluoroscopic visualization to minimize the risk of iatrogenic injury. Levels of Evidence: Level IV