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In high pressure fuel injectors, needle opening and closing transients cause complex off-design fluid dynamics behaviors that profoundly impact the spray and mixture formation processes. These dynamics are completely different from what is known to occur in steady state conditions. In this study, diesel spray transients have been investigated in single-hole and 3-hole nozzles, encompassing internal and external nozzle flow and including needle motion, performing highly resolved (2.5 μm) computational fluid dynamics (CFD) simulations. We focused on end-of-injection (EOI) and start-of-injection (SOI) processes, in order to provide insights in to the physics. The liquid fuel, vapor and gas species are modeled with a single-fluid multiphase mixture approach, with diffuse interface, and with large eddy simulations (LES) of the turbulence. Occurrence of phase change due to cavitation is accounted for, and the spray dispersion is described with a turbulent dispersion model. Detailed needle motion data and orifice internal surface are available from x-ray synchrotron source measurements carried out at Argonne National Laboratory, and shared through the Engine Combustion Network (ECN) community. Simulations are compared against x-ray phase contrast imaging and radiography of the internal and near-exit flow, in addition to optical microscopy data of the near-exit sprays. Simulation results are found to agree well with available experimental data, and are able to realistically capture local and global features. The simulations allow to gain insight into the physics of gas ingestion and dribbles at EOI, for different hole diameters, operating conditions and number of holes. At SOI, timing of liquid appearance out of the injector and spray tip penetration are adequately predicted, by using the EOI flow field as in-nozzle initialization, and by prescribing the measured tip needle displacement with an informed effective valve opening point inferred from the x-ray observations. Lastly, the variation of spreading angle over time is also discussed in detail for the multi-hole case, including hole-to-hole variations. Due to real geometry features and asymmetric needle motion with eccentric components, it is found that the three holes exhibit swirling flows of increasing intensity as the lift decreases, causing the near cone angle to open and spread, in a quasi-hollow cone structure. These features are not observed in axial single-hole injectors because of their relative simplicity and intrinsic symmetry.

A computational study was performed to investigate the influence of transient needle motion on gasoline direct injection (GDI) internal nozzle flow and near-field sprays. Simulations were conducted with a compressible Eulerian flow solver modeling liquid, vapor, and non-condensable gas phases with a diffuse interface. Variable rate generation and condensation of fuel vapor were captured using the homogeneous relaxation model (HRM). The non-flashing (spray G) and flashing (spray G2) conditions specified by the Engine Combustion Network were modeled using the nominal spray G nozzle geometry. Transient needle lift and wobble were based upon ensemble averaged X-ray imaging preformed at Argonne National Lab. The minimum needle lift simulated was 5 µm and dynamic mesh motion was achieved with Laplacian smoothing. The results were qualitatively validated against experimental imaging and the experimental rate of injection profile was captured accurately using pressure boundary conditions and needle motion to actuate the injection. Low needle lift is shown to result in vapor generation near the injector seat. Finally, the internal injector flow is shown to be highly complex, containing many transient and interacting vortices which result in perturbations in the spray angle and fluctuations in the mass flux. This complex internal flow also results in intermittent string flash-boiling when a strong vortex is injected and the resulting swirling spray contains a thermal non-equilibrium vapor core.

Acute Traumatic Coagulopathy occurs immediately after massive trauma when shock, hypoperfusion, and vascular damage are present. Mechanisms for this acute coagulopathy include activation of protein C, endothelial glycocalyx disruption, depletion of fibrinogen, and platelet dysfunction. Hypothermia and acidaemia amplify the endogenous coagulopathy and often accompany trauma. These multifactorial processes lead to decreased clot strength, autoheparinization, and hyperfibrinolysis. Furthermore, the effects of aggressive crystalloid administration, haemodilution from inappropriate blood product transfusion, and prolonged surgical times may worsen clinical outcomes. We review normal coagulation using the cell-based model of haemostasis and the pathophysiology of acute traumatic coagulopathy. Developed trauma systems reduce mortality, highlighting critical goals for the trauma patient in different phases of care. Once patients reach a trauma hospital, certain triggers reliably indicate when they require massive transfusion and specialized trauma care. These triggers include base deficit, international normalized radio (INR), systolic arterial pressure, haemoglobin concentration, and temperature. Early identification for massive transfusion is critically important, as exsanguination in the first few hours of trauma is a leading cause of death. To combat derangements caused by massive haemorrhage, damage control resuscitation is a technique that addresses each antagonist to normal haemostasis. Components of damage control resuscitation include damage control surgery, permissive hypotension, limited crystalloid administration, haemostatic resuscitation, and correction of hyperfibrinolysis.

Process simulation of sorption enhanced chemical-looping reforming for hydrogen production from biomass was investigated. Corn stover was converted to bio-oil via pyrolysis prior to sorption enhanced chemical-looping reforming (SE-CLR). NiO was used as a catalyst and oxidizing agent and CaO was used as a CO 2 sorbent which are cycled between the reduction and oxidation reactors. Modification of the process to incorporate a step for catalyst and sorbent regeneration was examined and compared with conventional sorption enhanced chemical-looping reforming process. By modifying the SE-CLR process with the recirculating of solids from the air reactor directly to the reformer, a maximum bio-oil conversion rate of 92%, a maximum hydrogen production yield of 153.4 g H 2 /kg corn stover, and a maximum hydrogen purity of 77% v/v can be obtained with a circulated NiO to bio-oil molar ratio ( CNB ) of 12.3; a circulated CaO to bio-oil molar ratio ( CCB ) of 125.2; and where the ratio of solids recovered by the air reactor from the calcination reactor ( α ) was set as 1, and the ratio of solids flowing directly from the air reactor to the reformer ( β ) was set as 0.02. The split of a fraction of solids streams to feed directly back to the reformer offers a great impact process control as operating conditions can be broadened.

Bottom-trawl fisheries are wide-spread and have large effects on benthic ecosystems.We investigate the effect of scallop dredging on sand and otter trawling on mud by measuring changes in the infaunal community and the biogeochemical processes which they mediate. We hypothesize that changes in biogeochemistry due to fishing will be larger in mud where macrofauna-mediated processes are expected to play a greater role, than in sand where hydrodynamics mediate the redox system. We sampled benthic infauna, sediment pore-water nutrients, oxygen, chlorophyll a (Chl a), apparent redox potential discontinuity layer, organic carbon and nitrogen content over a gradient of fishing intensity in sand and mud. The effects of fishing on biogeochemistry were stronger on mud than on sand, where biogeochemistry appeared to be more strongly influenced by tidal currents and waves. On mud, trawling increased sediment-surface Chl a and ammonium concentration beyond 5 cm depth, but decreased ammonium and silicate concentration in the upper sediment layers. The effects of fauna and bioturbation potential on biogeochemistry were very limited in both mud and sand habitats. Our results suggests that otter trawling may be affecting organic-matter remineralization and nutrient cycling through sediment resuspension and burial of organic matter to depth rather than through the loss of bioturbation potential of the benthic community. In conclusion, our hypothesis that the effects of trawling on biogeochemistry are larger in mud is supported, but the hypothesis that these effects are mediated by changes in the infauna is not supported. These results imply that management of trawling on muddy sediments should have higher priority.

To assess cochlear implant (CI) outcomes, and factors affecting outcomes, for children with aplasia/ hypoplasia of the cochlea nerve. We also developed a new grading system for the nerves of the internal auditory meatus (IAM) and cochlea nerve classification.Retrospective patient review.Tertiary referral hospital and cochlear implant program.Children 0 to 16 years inclusive with a CI who had absent/hypoplastic cochlea nerve on magnetic resonance imaging (MRI).Cochlear implant.MRI, trans-tympanic electrical auditory brainstem response, intraoperative electrical auditory brainstem response, Neural Response Telemetry, Categories of Auditory Perception score, Main mode of communication.Fifty CI recipients (26 males and 24 females) were identified, 21 had bilateral CIs, 27 had developmental delay. MRI showed cochlea nerve aplasia in 64 ears, hypoplasia in 25 ears, and a normal nerve in 11 ears. Main mode of communication was analyzed for 41 children: 21 (51%) used verbal language (15 speech alone, 5 speech plus some sign, 1 bilingual in speech and sign), and 20 (49%) used sign language (10 sign alone, 9 sign plus some speech, 1 tactile sign). Seventy-three percent of children used some verbal language. Cochlea nerve aplasia/ hypoplasia and developmental delay were both significant factors affecting main mode of communication. Categories of Auditory Performance scores were available for 59 CI ears; 47% with CN Aplasia (IAM nerve grades 0-III) and 89% with CN hypoplasia (IAM nerve grade IV) achieved Categories of Auditory Performance scores of 5 to 7 (some verbal understanding) (p = 0.003).Our results are encouraging and useful when counselling families regarding the likelihood of language outcomes and auditory understanding.

Modified sorbents (NiO CaO and Ca12Al14O33 CaO) were synthesized by hydration followed by wet mixing (HW) and tested in terms of their CO2 sorption/desorption performance over multiple cycles. The results indicated the sorption capacities for Ni–CaO-HW and Al–CaO-HW decreased by only 3.8% and 6.4%, respectively, over 10 cycles. Various sequences of Ni2+ loading onto modified CaO were investigated. The results indicated Ni–Al–CaO-HW to be the best performing exhibiting a pre-breakthrough time 30 min longer than the other samples. However, the H2 purity and CH4 conversion did not differ significantly amongst the various sorbents (approx. 94% purity H2 and approx. 90% CH4 conversion pre-breakthrough). The stability of the Ni–Al–CaO-HW was also investigated and the results indicated that the pre-breakthrough CH4 conversion could be maintained at steady values for five cycles. However, the post-breakthrough CH4 conversion decreases slightly over five cycles. A plausible explanation is that the formation of CaCO3 results in the blockage of pores and active sites, which is supported by XPS results.

Internal combustion engines have been and still are key players in today's world. Ever increasing fuel consumption standards and the ongoing concerns about exhaust emissions have pushed the industry to research new concepts and develop new technologies that address these challenges. To this end, the diesel direct injection system has recently seen the introduction of direct-acting piezoelectric injectors, which provide engineers with direct control over the needle lift, and thus instantaneous rate of injection (ROI). Even though this type of injector has been studied previously, no direct link between the instantaneous needle lift and the resulting rate of injection has been quantified. This study presents an experimental analysis of the relationship between instantaneous partial needle lifts and the corresponding ROI. A prototype direct-acting injector was utilized to produce steady injections of different magnitude by partially lifting the needle. The ROI measurements were carried out at CMT-Motores Termicos utilizing a standard injection rate discharge curve indicator based on the Bosch method (anechoic tube). The needle lift measurements were performed at the Advanced Photon Source at Argonne National Laboratory. The analysis seeks both to contribute to the current understanding of the influence that partial needle lifts have over the instantaneous ROI and to provide experimental data with parametric variations useful for numerical model validations. Results show a strong relationship between the steady partial needle lift and the ROI. The effect is non-linear, and also strongly dependent on the injection pressure. The steady lift value at which the needle ceases to influence the ROI increases with the injection pressure. Finally, a transient analysis is presented, showing that the needle velocity may considerably affect the instantaneous ROI, because of the volume displaced inside the nozzle. Results presented in this study show that at constant injection pressure and energizing time, this injector has the potential to control many aspects of the ROI and thus, the heat release rate. Also, data presented are useful for numerical model validations, which would provide detailed insight into the physical processes that drive these observations, and potentially, to the effects of these features on combustion performance., The submitted manuscript has been created by UChicago Argonne, LLC, Operator of Argonne National Laboratory (Argonne). Argonne, a U.S. Department of Energy Office of Science laboratory, is operated under Contract No. DE-AC02-06CH11357. The U.S. Government retains for itself, and others acting on its behalf, a paid-up nonexclusive, irrevocable worldwide license in said article to reproduce, prepare derivative works, distribute copies to the public, and perform publicly and display publicly, by or on behalf of the Government.

Modified sorbents – produced by adding compounds of Mg2+, Sr2+ and Al3+ to calcium oxide – have been tested in terms of their CO2 sorption/desorption performance in a fixed bed reactor at high temperatures. In particular this study focuses on the stability of the sorbents as well as the sorption capacity, both of which are important factors when selecting sorbents. X-ray diffraction (XRD) and scanning electron microscope (SEM), coupled with energy dispersive X-ray spectroscopy (EDX), were used for characterization of the modified sorbents. XRD results indicated that samples produced using the wet mixing process and those produced using the hydration with wet mixing process, contained MgO–CaO, Ca0.2Sr0.8O–CaO and Ca12Al14O33–CaO phases, respectively. The operating conditions have been investigated and results showed that the CaO showed the highest sorption capacity ( 0.571 g CO 2 / g sorbent ) when compared with MgO, SrO and Al2O3 at temperature of 600 °C. In terms of sorption capacity performance for sorbents produced by the CaO hydration and wet mixing method, Mg-CaO-HW showed the best sorption/desorption stability for more than 10 cycles (CO2 sorption capacity of 0.259 for 1st cycle to 0.252 g CO 2 / g sorbent for the 10th cycle). Al-CaO-HW and Sr-CaO-HW exhibited a decrease in sorption capacity due to the sintering as confirmed by SEM images (0.257 and 0.286 g CO 2 / g sorbent for 1st cycle dropping to 0.243 and 0.251 g CO 2 / g sorbent for 10th cycle resulting in decreasing approximately of 5.45% and 12.24%, respectively).

Direct injection (DI) strategy of natural gas (NG) into internal combustion engines (ICE) has led to higher thermal efficiency and lower exhaust emissions. In order to thoroughly understand the most relevant phenomena affecting the performances of such engines, computational fluid dynamics (CFD) plays a key role as an accurate description of the jet evolution and interaction within the combustion chamber is required to that aim. Accurate description of high-pressure gaseous jets is rather challenging at high Mach numbers, as the injected gas is strongly under-expanded once in the ambient, giving room to shocks due to compressibility effects. Also the interaction between shock waves and mixing layers needs to be carefully represented with a multi-dimensional model, calling for substantial computational resources requirements. In this paper a numerical investigation of the behavior of a gaseous jet (Argon) through an outward opening injector has been carried out. A Large Eddy Simulation (LES) approach has been used in order to track the structures derived by the interaction of the injected fuel with the surrounding ambient. Although already good results were obtained using a Reynolds Averaged Navier-Stokes (RANS) approach, the adoption of LES is required to characterize more accurately the jet properties in terms of vortex structures and mixing effectiveness. The effect of the Nozzle Pressure Ratio (NPR) on the jet evolution has been highlighted in the paper, showing how a higher NPR would give a faster injection process, compromising however the homogeneity of the mixture.

Underwater noise pollution from shipping is globally pervasive and has a range of adverse impacts on species which depend on sound, including marine mammals, sea turtles, fish, and many invertebrates. International bodies including United Nations agencies, the Arctic Council, and the European Union are beginning to address the issue at the policy level, but better evidence is needed to map levels of underwater noise pollution and the potential benefits of management measures such as ship-quieting regulations. Crucially, corroboration of noise maps with field measurements is presently lacking, which undermines confidence in their application to policymaking. We construct a computational model of underwater noise levels in the Northeast Atlantic using Automatic Identification System (AIS) ship-tracking data, wind speed data, and other environmental parameters, and validate this model against field measurements at 4 sites in the North Sea. Overall, model predictions of the median sound level were within ±3 dB for 93% of the field measurements for one-third octave frequency bands in the range 125 Hz-5 kHz. Areas with median noise levels exceeding 120 dB re 1 μPa and 20 dB above modelled natural background sound were predicted to occur in the Dover Strait, the Norwegian trench, near to several major ports, and around offshore infrastructure sites in the North Sea. To our knowledge, this is the first study to quantitatively validate large-scale modelled noise maps with field measurements at multiple sites. Further validation will increase confidence in deeper waters and during winter months. Our results highlight areas where anthropogenic pressure from shipping noise is greatest and will inform the management of shipping noise in the Northeast Atlantic. The good agreement between measurements and model gives confidence that models of shipping noise can be used to inform future policy and management decisions to address shipping noise pollution.

Cranial nerve (CN) VII palsy is a rare complication of neuraxial blockade. The likely etiology of the palsy is intracranial hypotension from cerebrospinal fluid loss leading to traction on CN VII. The presentation of symptoms of CN VII palsy from intracranial hypotension closely resembles a more common cause of CN VII injury, Bell's palsy, and the 2 can be difficult to differentiate. We present a patient who had a dural puncture with development of a headache and CN VII palsy, which improved with epidural blood patch (EBP). EBP should be considered for patients with suspected CN palsy from intracranial hypotension.

Future demand for middle distillates in the commercial sector is expected to rise in step with increased economic activity in much of the world. Simultaneously, the passenger car fleet will experience various degrees of electrification and demand for gasoline is expected to fall. This divergence in demand will offer an opportunity to commercial vehicle owners if gasoline fuel streams can be burned efficiently in commercial engines.

Objective To analyse the epidemiology of otosclerosis in a British cohort collected between 2011 and 2017. Design Retrospective cohort study. Setting Five UK ENT Departments. Patients Patients with surgically confirmed otosclerosis. Main outcome measures Questionnaire data documented family history of otosclerosis, age of onset, medical history, and information on associated risk factors for 657 patients. Pre and post-surgical pure-tone audiometry was collected for 154 of these patients. Results The age of onset, incidence of bilateral disease, tinnitus and vertigo, a higher prevalence of women (65%) than men (35%) are similar to those reported previously for otosclerosis cohorts. No association with measles infection was detected. Patients with a family history (40%) have an earlier age of onset and a higher incidence of bilateral disease and vertigo than non-familial subjects. Pedigree analysis is consistent with an autosomal dominant inheritance with reduced penetrance being apparent in 44/91 pedigrees studied. Women who associate their hearing loss with pregnancy have an earlier age of onset than those that do not (p = 6 × 10). Conclusions This study confirms that otosclerosis is an early adult onset disease that is more prevalent in women than men with a large minority of patients having a family history of otosclerosis. We report new evidence to support a relationship between pregnancy and otosclerosis progression in a proportion of women. In addition, this is the first study to identify differences in severity between familial and non-familial cases of otosclerosis, highlighting the possibility that more than one etiology may be involved.

BACKGROUND Intrathecal bupivacaine's long duration of action can unnecessarily increase the time to meet Postanesthesia Care Unit (PACU) discharge criteria for patients undergoing short obstetric procedures. We sought to use a technique known as epidural volume extension (EVE) to determine if we could provide an adequate surgical block while significantly decreasing the time required to meet PACU discharge criteria for patients undergoing short obstetric procedures. METHODS Fifty participants were randomized into two groups. The control group received a 10 mg of 0.5% isobaric bupivacaine plus 15 µg of fentanyl injection in the intrathecal space via a combined spinal-epidural technique. The EVE group received a 5 mg of 0.5% isobaric bupivacaine plus 15 µg of fentanyl injection in the intrathecal space followed immediately by a 10 mL injection of sterile saline through the epidural needle for the EVE. RESULTS Data were analyzed on 45 of the 50 patients. Time to meet PACU discharge criteria was significantly reduced in the EVE group when compared to the control group (50 vs. 135 minutes, P

Renibacterium salmoninarum infection causes bacterial kidney disease (BKD) in salmonid freshwater and saltwater life stages, with potentially severe financial loss for the aquaculture industry. Preventing vertical transmission, from infected broodstock to eggs, is key to disease management. As there is no perfect reference standard for detecting R. salmoninarum, we used Bayesian latent class analyses to compare real-time reverse transcriptase PCR (RT-rPCR, mRNA target) and enzyme-linked immunosorbent assay (ELISA; p57 antigen target) diagnostic accuracy for detection in Atlantic salmon broodstock from British Columbia, Canada, and assessed ELISA repeatability. In 2016, 4,544 Atlantic salmon broodstock (no clinical signs of BKD or gross lesions) were sampled for ELISA testing of kidney tissue. Two groups of ELISA positives (n = 132) and two groups of a random sample of ELISA negatives (n = 137) were then tested with RT-rPCR, and ELISA testing was repeated. ELISA testing of broodstock provided the best diagnostic sensitivity (DSe; less chance of false-negative results). The use of joint RT-rPCR and ELISA testing improved DSe over that from each test alone, if a sample was considered positive when either test result was positive. Using these testing schemes in combination with management practices can decrease the likelihood of vertical transmission from subclinically infected broodstock.

Aizoaceae is the largest succulent plant family in the world, including in excess of 1800 species. Despite its richness, a large proportion of its taxa are listed as data deficient and as such, has been identified as the top priority for taxonomic research in South Africa. Limitations to accurate taxonomic identification of taxa in the family may be partly attributed to the degree of technical knowledge required to identify taxa in the Aizoaceae. DNA barcoding may provide an alternative method of identification; however, the suitability of commonly used gene regions has not been tested in the family. Here, we analyse variable and parsimony informative characters (PIC), as well as the barcoding gap, in commonly used plastid regions (atpB-rbcL, matK, psbA-trnH, psbJ-petA, rpl16, rps16, trnD-trnT, trnL-trnF, trnQ-rps16, and trnS-trnG) and the nuclear region ITS (for Aizooideae only) across two subfamilies and two expanded clades within the Aizoaceae. The relative percentage of PIC was much greater in subfamilies Aizooideae and Mesembryanthemoideae than in Ruschioideae. Although nrITS had the highest percentage of PIC, barcoding gap analyses identified neither ITS nor any chloroplast region as suitable for barcoding of the family. From the results, it is evident that novel barcoding regions need to be explored within the Aizoaceae.

To examine inter-aural hearing preservation results in children undergoing simultaneous bilateral cochlear implantation (CI).Retrospective case review in tertiary referral centre. All children undergoing simultaneous bilateral CI between January 2013 and June 2014 (18 months). Patients eligible for inclusion in the study had pre-operative hearing thresholds of90 dB at 250 Hz and ≥100 dB at 500 Hz. Patients with anatomical cochlear anomalies or missing data were excluded. Seven patients were included, 1 male, 6 female, mean age of 12 years 11 months at the time of surgery. All patients had simultaneous bilateral cochlear implant surgery, using the same implant and technique. All patients had pre- and post-operative unaided pure tone audiometry. Inter-aural hearing preservation results were compared in each patient.The achieved hearing preservation for 14 ears was complete in 5, partial in 7, and minimal in 2. Measurable hearing preservation was achieved in 86% overall. Inter-aural analysis revealed that only 2 (subjects 1 and 4) of the 7 patients had preservation results within the same preservation group (complete/partial/minimal). The mean inter-aural preservation difference was 30.7% with a range from 12.4% to 65.2%.Several factors and techniques have already been identified in the wider literature to explain differences in hearing preservation results in CI. However, despite controlling for known factors, we demonstrate variable inter-aural results. This suggests that there may be more factors beyond the surgeon's control influencing our ability to provide consistent results.

Objective:To report a novel management strategy for mixed hearing loss in advanced otosclerosis.Methods:A 50-year-old male was referred to St Thomas’ Hearing Implant Centre with otosclerosis; he was no longer able to wear conventional hearing aids because of recurrent otitis externa. The patient underwent short process incus vibroplasty (using the Med-El Vibrant Soundbridge device), followed at a suitable interval (six weeks) by stapes surgery. The main outcome measures were: pure tone audiometry, functional gain and monosyllabic word recognition scores.Results:Post-operative pure tone audiometry showed a reduction of the mean air–bone gap from 55 dB HL to 20 dB HL. The residual mixed hearing loss was rehabilitated with the Vibrant Soundbridge, with an average device gain of 32 dB. The monosyllabic word recognition scores in quiet at 65 dB improved from 37 to 100 per cent when using the Vibrant Soundbridge at six months after switch-on of the device.Conclusion:Stapedotomy in conjunction with incus short process vibroplasty (i.e. inner-ear vibroplasty) is a safe and promising procedure for managing advanced otosclerosis with mixed hearing loss in selected patients.

The auditory brainstem implant (ABI) is indicated in severe to profound hearing loss when congenital or acquired abnormalities of the cochlea or auditory nerve preclude cochlear implantation (CI). The aim of ABI is to rehabilitate patients with no hearing as a result of absence or damage to the auditory nerves and thereby no cochlea to brainstem connections. ABIs were initially designed for patients with neurofibromatosis type 2 (NF2). The English consensus protocol for auditory rehabilitation in NF2 recommends annual audiological assessment as part of the regular review process for NF2. This involves pure-tone audiometry (PTA) and speech discrimination testing with the Arthur Boothroyd (AB) word test as well as hearing aid review to maintain optimum performance. Intra-operative monitoring of the auditory nerve to aid hearing preservation has been used with varying degrees of success. The aim of surgery in NF2 is total tumour removal with preservation of the facial nerve and CN.

Mendelian adult-onset leukodystrophies are a spectrum of rare inherited progressive neurodegenerative disorders affecting the white matter of the central nervous system. Among these, cerebral autosomal dominant and recessive arteriopathy with subcortical infarcts and leukoencephalopathy, cerebroretinal vasculopathy, metachromatic leukodystrophy, hereditary diffuse leukoencephalopathy with spheroids, and vanishing white matter disease present with rapidly progressive dementia as dominant feature and are caused by mutations in NOTCH3, HTRA1, TREX1, ARSA, CSF1R, EIF2B1, EIF2B2, EIF2B3, EIF2B4, and EIF2B5, respectively. Given the rare incidence of these disorders and the lack of unequivocally diagnostic features, leukodystrophies are frequently misdiagnosed with common sporadic dementing diseases such as Alzheimer's disease (AD), raising the question of whether these overlapping phenotypes may be explained by shared genetic risk factors. To investigate this intriguing hypothesis, we have combined gene expression analysis (1) in 6 different AD mouse strains (APPPS1, HOTASTPM, HETASTPM, TPM, TAS10, and TAU) at 5 different developmental stages (embryo [E15], 2, 4, 8, and 18 months), (2) in APPPS1 primary cortical neurons under stress conditions (oxygen-glucose deprivation) and single-variant-based and single-gene-based (c-alpha test and sequence kernel association test (SKAT)) genetic screening in a cohort composed of 332 Caucasian late-onset AD patients and 676 Caucasian elderly controls. Csf1r was significantly overexpressed (log2FC > 1, adj. p-value < 0.05) in the cortex and hippocampus of aged HOTASTPM mice with extensive Aβ core-dense plaque pathology. We identified 3 likely pathogenic mutations in CSF1R TK domain (p.L868R, p.Q691H, and p.H703Y) in our discovery and validation cohort, composed of 465 AD and mild cognitive impairment (MCI) Caucasian patients from the United Kingdom. Moreover, NOTCH3 was a significant hit in the c-alpha test (adj p-value = 0.01). Adult-onset Mendelian leukodystrophy genes are not common factors implicated in AD. Nevertheless, our study suggests a potential pathogenic link between NOTCH3, CSF1R, and sporadic late-onset AD, which warrants further investigation.

Premise of the study The development of pipelines for locus discovery has spurred the use of target enrichment for plant phylogenomics. However, few studies have compared pipelines from locus discovery and bait design, through validation, to tree inference. We compared three methods within Leguminosae (Fabaceae) and present a workflow for future efforts. Methods Using 30 transcriptomes, we compared Hyb-Seq, MarkerMiner, and the Yang and Smith (Y&S) pipelines for locus discovery, validated 7501 baits targeting 507 loci across 25 genera via Illumina sequencing, and inferred gene and species trees via concatenation- and coalescent-based methods. Results Hyb-Seq discovered loci with the longest mean length. MarkerMiner discovered the most conserved loci with the least flagged as paralogous. Y&S offered the most parsimony-informative sites and putative orthologs. Target recovery averaged 93% across taxa. We optimized our targeted locus set based on a workflow designed to minimize paralog/ortholog conflation and thus present 423 loci for legume phylogenomics. Conclusions Methods differed across criteria important for phylogenetic marker development. We recommend Hyb-Seq as a method that may be useful for most phylogenomic projects. Our targeted locus set is a resource for future, community-driven efforts to reconstruct the legume tree of life.

[EN] In order to improve understanding of the primary atomization process for diesel-like sprays, a collaborative experimental and computational study was focused on the near-nozzle spray structure for the Engine Combustion Network (ECN) Spray D single-hole injector. These results were presented at the 5th Workshop of the ECN in Detroit, Michigan. Application of x-ray diagnostics to the Spray D standard cold condition enabled quantification of distributions of mass, phase interfacial area, and droplet size in the near-nozzle region from 0.1 to 14 mm from the nozzle exit. Using these data, several modeling frameworks, from Lagrangian-Eulerian to Eulerian-Eulerian and from Reynolds-Averaged Navier-Stokes (RANS) to Direct Numerical Simulation (DNS), were assessed in their ability to capture and explain experimentally observed spray details. Due to its computational efficiency, the Lagrangian-Eulerian approach was able to provide spray predictions across a broad range of conditions. In general, this "engineering-level" simulation was able to reproduce the details of the droplet size distribution throughout the spray after calibration of the spray breakup model constants against the experimental data. Complementary to this approach, higher-fidelity modeling techniques were able to provide detailed insight into the experimental trends. For example, interface-capturing multiphase simulations were able to capture the experimentally observed bimodal behavior in the transverse interfacial area distributions in the near-nozzle region. Further analysis of the spray predictions suggests that peaks in the interfacial area distribution may coincide with regions of finely atomized droplets, whereas local minima may coincide with regions of continuous liquid structures. The results from this study highlight the potential of x-ray diagnostics to reveal salient details of the near-nozzle spray structure and to guide improvements to existing primary atomization modeling approaches.

Weekend admission is associated with higher in-hospital mortality than weekday admission. Whether providing enhanced weekend staffing for acute medical inpatient services reduces mortality or length of stay is unknown Methods This paper describes a retrospective analysis of in-hospital mortality and length of stay before and after introduction of an enhanced, consultant-led weekend service in acute medicine in November 2012. In-hospital mortality was compared for matching admission calendar months before and after introduction of the new service, adjusted for case volume. Length of stay and 30-day post-discharge mortality were also compared; illness severity of patients admitted was assessed by cross-sectional acuity audits. Results Admission numbers increased from 6,304 (November 2011–July 2012) to 7,382 (November 2012–July 2013), with no change in acuity score in elderly medical patients but a small fall in younger patients. At the same time, however, a 57% increase in early-warning score triggered calls was seen in 2013 (410 calls vs 262 calls in 2012; pConclusions Introduction of an enhanced, consultant-led model of working at weekends was associated with reduced in-hospital and 30-day post discharge mortality rates as well as reduced length of stay. These results require confirmation in rigorously designed prospective studies.

SUMMARYAn abattoir-based study was undertaken between January and May 2013 to estimate the prevalence ofSalmonellaspp. andYersiniaspp. carriage and seroprevalence of antibodies toToxoplasma gondii andporcine reproductive and respiratory syndrome virus (PRRSv) in UK pigs at slaughter. In total, 626 pigs were sampled at 14 abattoirs that together process 80% of the annual UK pig slaughter throughput. Sampling was weighted by abattoir throughput and sampling dates and pig carcasses were randomly selected. Rectal swabs, blood samples, carcass swabs and the whole caecum, tonsils, heart and tongue were collected.Salmonellaspp. was isolated from 30·5% [95% confidence interval (CI) 26·5–34·6] of caecal content samples but only 9·6% (95% CI 7·3–11·9) of carcass swabs, which was significantly lower than in a UK survey in 2006–2007.S.Typhimurium andS.4,[5],12:i:- were the most commonly isolated serovars, followed byS.Derby andS.Bovismorbificans. The prevalence ofYersinia enterocoliticacarriage in tonsils was 28·7% (95% CI 24·8–32·7) whereas carcass contamination was much lower at 1·8% (95% CI 0·7–2·8). The seroprevalence of antibodies toToxoplasma gondiiand PRRSv was 7·4% (95% CI 5·3–9·5) and 58·3% (95% CI 53·1–63·4), respectively. This study provides a comparison to previous abattoir-based prevalence surveys forSalmonellaandYersinia, and the first UK-wide seroprevalence estimates for antibodies toToxoplasmaand PRRSv in pigs at slaughter.

The aim of this study was to assess if large vestibular aqueduct syndrome (LVAS), with the increase in perilymphatic pressure, affects impedance changes over time with different types of Cochlear(®) implant electrode arrays Contour, Straight, and CI 422. To report speech perception outcomes for these cochlear implant recipients.Retrospective case review of impedance levels and categories of auditory performance. Impedance data were collected at switch on, 1 month, 3, 6, 12, and 24 months after cochlear implantation and compared with control (non-LVAS cochlear implant recipient) data for each array type. Forty-seven patients with exclusive LVAS and no other vestibulocochlear abnormalities or other identifiable cause of deafness were eligible for inclusion in the study.In LVAS patients, there was a significant difference in impedance between the three types of device (P0.0001). Time since switch on was associated with a decrease in impedance for all three devices (P0.0001). The mean impedance reduced between switch on and 1 month and remained relatively constant thereafter. Sound variation with softening of sounds was seen in four CI 422 (Straight Research Array) recipients due to ongoing fluctuations in electrode compliance.For all three array types, there was no significant difference in the mean impedance between the LVAS patients and controls over the first 12 months. In keeping with previous studies cochlear implant recipients with LVAS hear very well through the cochlear implant.

This paper implements a coupled approach to integrate the internal nozzle flow and the ensuing fuel spray using a Volume-of-Fluid (VOF) method in the finite-volume framework. A VOF method is used to model the internal nozzle two-phase flow with a cavitation description closed by the homogeneous relaxation model of Bilicki and Kestin (1990). An Eulerian single velocity field approach by Vallet et al. (2001) is implemented for near-nozzle spray modeling. This Eulerian approach considers the liquid and gas phases as a complex mixture with a highly variable density to describe near nozzle dense sprays. The liquid mass fraction is transported with a model for the turbulent liquid diffusion flux into the gas. Fully-coupled nozzle flow and spray simulations are performed in three dimensions and validated against the X-ray radiography measurements of Kastengren et al. (2014) for a diesel fuel surrogate. A standard k – ∊ Reynolds Averaged Navier Stokes based turbulence model is used in this study and the influence of model constants is evaluated. First, the grid convergence study is performed. The effect of grid size is also evaluated by comparing the fuel distribution against experimental data. Finally, the fuel distribution predicted by the coupled Eulerian approach is compared against that by Lagrangian–Eulerian spray model along with experimental data. The coupled Eulerian approach provides a unique way of coupling the nozzle flow and sprays so that the effects of in-nozzle flow can be directly realized on the fuel spray. Both experiment and numerical simulations show non-cavitation occurring for this injector with convergent nozzle geometry. The study shows that the Eulerian approach has advantages over near-field dense spray distributions.

Montane riparian areas across the Sky Island region of the southwestern United States and northwestern Mexico contribute disproportionally to biodiversity at local and regional scales. We explored how composition and structure of vegetation influenced species richness and community composition of songbirds breeding in riparian areas of southern Arizona. We surveyed birds and vegetation during two breeding seasons at 45 stations established across three riparian canyons in two mountain ranges. Species richness of songbirds increased as volume of understory vegetation, density of Arizona sycamore (Platanus wrightii), and density of alligator juniper (Juniperus deppeana) increased; species richness decreased as density of Acacia and Mimosa species increased and oak (Quercus) trees increased. Composition of breeding bird communities was structured along an elevation and vegetation gradient, from open-canopy desert scrub to closed-canopy oak woodlands. Richness and composition of breeding bird communi...

To define the impact of care standardization on caffeine and cardiorespiratory monitoring at neonatal intensive care unit (NICU) discharge.Electronic records were abstracted for infants aged 24-36 weeks gestation with birth weights appropriate for gestational age. Infants who died, transferred prior to discharge, had major pulmonary anomalies, required a home monitor for mechanical ventilation or had a family history of sudden infant death syndrome were excluded. Data and records were used to indicate when the new definition of clinically significant cardiopulmonary events (CSCPEs) and concurrent education was implemented. Preimplementation and postimplementation cohorts were compared.Incidence fell from 74% diagnosed with apnea of prematurity at baseline to 49% diagnosed with CSCPE postimplementation (P0.001). Infants discharged on caffeine reduced from 17% to 5% (P0.001), and home monitor use also fell from 54% to 16% (P0.001).Standardizing definitions and treatments reduced the use of caffeine and cardiorespiratory monitors upon NICU dismissal.

Root nodule symbioses (nodulation) and whole genome duplication (WGD, polyploidy) are both important phenomena in the legume family (Leguminosae). Recently, it has been proposed that polyploidy may have played a critical role in the origin or refinement of nodulation. However, while nodulation and polyploidy have been studied independently, there have been no direct studies of mechanisms affecting the interactions between these phenomena in symbiotic, nodule-forming species. Here, we examined the transcriptome-level responses to inoculation in the young allopolyploid Glycine dolichocarpa (T2) and its diploid progenitor species to identify underlying processes leading to the enhanced nodulation responses previously identified in T2. We assessed the differential expression of genes and, using weighted gene co-expression network analysis (WGCNA), identified modules associated with nodulation and compared their expression between species. These transcriptomic analyses revealed patterns of non-additive expression in T2, with evidence of transcriptional responses to inoculation that were distinct from one or both progenitors. These differential responses elucidate mechanisms underlying the nodulation-related differences observed between T2 and the diploid progenitors. Our results indicate that T2 has reduced stress-related transcription, coupled with enhanced transcription of modules and genes implicated in hormonal signaling, both of which are important for nodulation.