Combustion of n-C3-C6 Linear Alcohols: An Experimental and Kinetic Modeling Study. Part I: Reaction Classes, Rate Rules, Model Lumping, and Validation.

This work (and the companion paper, Part II) presents new experimental data for the combustion of n-C3-C6 alcohols (n-propanol, n-butanol, n-pentanol, n-hexanol) and a lumped kinetic model to describe their pyrolysis and oxidation. The kinetic subsets for alcohol pyrolysis and oxidation from the CRECK kinetic model have been systematically updated to describe the pyrolysis and high- and low-temperature oxidation of this series of fuels. Using the reaction class approach, the reference kinetic parameters have been determined based on experimental, theoretical, and kinetic modeling studies previously reported in the literature, providing a consistent set of rate rules that allow easy extension and good predictive capability. The modeling approach is based on the assumption of an alkane-like and alcohol-specific moiety for the alcohol fuel molecules. A thorough review and discussion of the information available in the literature supports the selection of the kinetic parameters that are then applied to the n-C3-C6 alcohol series and extended for further proof to describe n-octanol oxidation. Because of space limitations, the large amount of information, and the comprehensive character of this study, the manuscript has been divided into two parts. Part I describes the kinetic model as well as the lumping techniques and provides a synoptic synthesis of its wide range validation made possible also by newly obtained experimental data. These include speciation measurements performed in a jet-stirred reactor (p = 107 kPa, T = 550-1100 K, φ = 0.5, 1.0, 2.0) for n-butanol, n-pentanol, and n-hexanol and ignition delay times of ethanol, n-propanol, n-butanol, n-pentanol/air mixtures measured in a rapid compression machine at φ = 1.0, p = 10 and 30 bar, and T = 704-935 K. These data are presented and discussed in detail in Part II, together with detailed comparisons with model predictions and a deep kinetic discussion. This work provides new experimental targets that are useful for kinetic model development and validation (Part II), as well as an extensively validated kinetic model (Part I), which also contains subsets of other reference components for real fuels, thus allowing the assessment of combustion properties of new sustainable fuels and fuel mixtures.

Combustion of n-C3-C6 Linear Alcohols: An Experimental and Kinetic Modeling Study. Part II: Speciation Measurements in a Jet-Stirred Reactor, Ignition Delay Time Measurements in a Rapid Compression Machine, Model Validation, and Kinetic Analysis.

This work presents new experimental data for n-C3-C6 alcohol, combustion (n-propanol, n-butanol, n-pentanol, n-hexanol). Speciation measurements have been carried out in a jet-stirred reactor (p = 107 kPa, T = 550-1100 K, φ = 0.5, 1.0, 2.0) for n-butanol, n-pentanol, and n-hexanol. Ignition delay times of ethanol, n-propanol, n-butanol, and n-pentanol/air mixtures were measured in a rapid compression machine at φ = 1.0, p = 10 and 30 bar, and T = 704-935 K. The kinetic subsets for alcohol pyrolysis and oxidation from the CRECK kinetic model have been systematically updated to describe the pyrolysis and high- and low-temperature oxidation of this series of fuels as described in Part I of this work (Pelucchi M.; Namysl S.; Ranzi E.Combustion of n-C3-C6 linear alcohol: an experimental and kinetic modeling study. Part I: reaction classes, rate rules, model lumping and validation. Submitted to Energy and Fuels, 2020). Part II describes in detail the facilities used for this systematic experimental investigation of n-C3-C6 alcohol combustion and presents a complete validation of the kinetic model by means of comparisons with the new data and measurements previously reported in the literature for both pyrolytic and oxidative conditions. Kinetic analyses such as rate of production and sensitivity analyses are used to highlight the governing reaction pathways and reasons for existing deviations, motivating possible further improvements in our chemistry mechanism.

Snakes on the Rungs of Jacob's Ladder: Anomalous Vibrational Spectra from Double-Hybrid DFT Methods.

The computation by some double-hybrid density functionals of the vibrational modes of a number of CHNO species, including the radicals of carbonic and carbamic acids and of dimethyl carbonate, gives rise to unphysical and anomalous IR spectra with errors well in excess of 1000 cm-1. The effect is not immediately obvious since calculated entropies are largely unaffected, but by contrast, the zero point energies are significantly increased-this has not previously been documented in the literature.

Development, initial content validation and reliability of Nigerian composite lifestyle CVD risk factors questionnaire for adolescents.

BACKGROUND: Cardiovascular disease risk (CVD) factors affect every age category including adolescents in developing nations. Prevention strategies are effective only when there are epidemiological data for the targeted populations. The collection of such data is only made easy with composite lifestyle CVD risk factors measures that are culturally sensitive and acceptable among the target populations. OBJECTIVE: The objective of the study was to develop a culturally sensitive and friendly composite lifestyle CVD risk factors questionnaire for adolescents in Nigeria. METHODS: A systematic review was conducted to identify existing, published questionnaires from which items could be selected. Content and face validation were conducted using an expert panel and a sub-sample of the target population. Data was analyzed qualitatively and reliability was assessed using intra-class correlation and Kappa statistic. RESULTS: Based on the comments received from experts, the questions were restructured, simplified, clarified, formatted, some questions were added and expert reached a consensus. Kappa showed fair to moderate agreement in 65% of the questions and perfect agreement in one question. CONCLUSION: The CVD risk factors questionnaire has acceptable content validity and reliability and should be used to assess CVD risk factors among adolescents in Nigeria.

Pathogenesis of the epigastric hernia.

PURPOSE: Epigastric herniation is a rather common condition with a reported prevalence up to 10 %. Only a minority is symptomatic, presumably the reason for the scarce literature on this subject. Epigastric hernias have specific characteristics for which several anatomical theories have been developed. Whether these descriptions of pathological mechanisms still hold with regard to the characteristics of epigastric hernia is the subject of this review. METHODS: A multi-database research was performed to reveal relevant literature by free text word and subject headings 'epigastric hernia', 'linea alba', 'midline' and 'abdominal wall'. Reviewed were studies on anatomical theories describing the pathological mechanism of epigastric herniation, incidence, prevalence and female-to-male ratio and possible explanatory factors. RESULTS: Three different theories have been described of which two have not been confirmed by other studies. The attachment of the diaphragm causing extra tension in the epigastric region is the one still standing. Around 1.6-3.6 % of all abdominal hernias and 0.5-5 % of all operated abdominal hernias is an epigastric hernia. Epigastric hernias are 2-3 times more common in men, with a higher incidence in patients from 20 to 50 years. Some cadaver studies show an epigastric hernia rate of 0.5-10 %. These specific features of the epigastric hernias (the large asymptomatic proportion, male predominance, only above umbilical level) are discussed with regard to the general theories. CONCLUSIONS: The epigastric hernia is a very common condition, mostly asymptomatic. Together with general factors for hernia formation, the theory of extra tension in the epigastric region by the diaphragm is the most likely theory of epigastric hernia formation.

A systematic review of the individual determinants of research evidence use in allied health.

BACKGROUND: The use of evidence-based practice (EBP) is often not reflected in allied health (AH) practitioners' day-to-day practice (the research-practice gap). Research suggests that considerable differences between and within AH disciplines exist, which require different approaches in order to influence practice behavior. It is therefore important to develop a better understanding of what influences individual AH practitioners' adoption of evidence into daily practice. OBJECTIVE: This systematic review aims to examine the individual characteristics of AH practitioners which determine their uptake of evidence into practice. METHODS: Studies which examined individual factors or variables that influence research evidence use by any AH practitioner were included in the review. The methodological quality of the included papers was assessed using the Quality Assessment and Validity Tool for Cross-sectional Studies. A narrative summary of the findings was presented. RESULTS: Six studies were included and the methodological quality scores indicated that two were weak and the remainder had moderate-weak quality. The review demonstrated that factors such as educational degree or academic qualification, involvement in research or EBP-related activities, and practitioners' perceptions, attitudes and beliefs about research and EBP are significant predictors of self-reported research evidence use in AH. The effect of other factors such as professional characteristics, clinical setting/work environment, information-seeking behavior and sociodemographic variables are less clear. Whether there is an interaction effect between evidence-uptake factors has not been tested. CONCLUSION: Improving the research knowledge of clinicians and overcoming negative attitudes toward EBP have the potential to move AH practitioners towards regularly utilizing evidence in practice. Allied health practitioners may benefit from participation in regular educational opportunities such as case studies or journal clubs which can put them at the same level of thinking and awareness of research evidence. Future research should aim to review organizational and contextual factors and explore their interaction with individual determinants of research evidence use.

Online journal clubs: an innovative approach to achieving evidence-based practice.

Face to face journal clubs have been used as a medium to share knowledge and discuss research findings in relation to clinical practice. However, attendance at journal club meetings has always been identified as a barrier to successful and sustainable journal clubs. One of the possible solutions to this is the establishment of online journal clubs. This article provides suggestions for those who are interested in forming their own online journal club. An online journal club not only provides an opportunity for asynchronous discussion but also allows members to participate in evidence-based discussion at a time and place of convenience.

Burn prevention programs for children in developing countries require urgent attention: a targeted literature review.

BACKGROUND: Paediatric burns are a significant international public health problem. Developing and developed countries report similar challenges regarding paediatric burn prevention programs. Paediatric burns requiring healthcare often incur significant health and opportunity costs, death or long-term disability. This paper reviews international burn prevention strategies, and considers implementation of effective prevention strategies in South Africa. REVIEW QUESTION: Are there differences between developed and developing countries regarding causes and prevalence of paediatric burns, prevention strategies, and evidence of effectiveness? REVIEW FRAMEWORK: Implementing effective burn prevention strategies in South Africa. METHOD: This systematic literature review identified, and narratively synthesized information from studies reporting population-based initiatives to prevent paediatric burns. Strategies from developing and developed countries were compared. Common strategies were identified, and evidence of effectiveness described. FINDINGS: 30 studies were included from 16 developed/developing countries, reporting similar prevention strategies. Multi-pronged community-based interventions were most effective. Common elements comprised raising awareness of how burns occur, how burns can be prevented, the speed of sustaining significant injuries, and the short- and long-term effects of burns. Burn prevention strategies relevant to South Africa were provision of education in different formats (written, pictorial and verbal) in places frequented by children and parents, monitoring children more closely in hazardous areas (e.g. kitchens), and better planning of homes to reduce hazards. CONCLUSION: More work is required to establish effective, sustainable community-wide prevention programs in developed and developing countries. Effective paediatric burn prevention programs for South Africa should acknowledge parent and child literacy, how and where information is best accessed, the need to adapt effective hazard reduction programs to informal settlements, and the importance of legislated minimum safe housing standards. This requires significant commitment from Government, communities and individuals.

Analysis of antibody reactivity in paired cerebrospinal fluid and serum of a relapsing remitting multiple sclerosis patient.

Increasing evidence indicates an involvement of B cells in multiple sclerosis (MS). However, little is known about antigenic targets recognized by antibodies present in blood and cerebrospinal fluid (CSF) of MS patients. This study was therefore aimed at identifying the antigen reactivity of antibodies present in CSF and compares the identified antibody profile with that of the serum of the same patient using cDNA phage display. Selection rounds on paired CSF and serum of this patient identified 13 antigenic targets of which 5 were enriched by serum antibodies and 2 were identified by CSF antibodies. Interestingly, the six remaining antigenic targets were shown to be recognized by both CSF and serum antibodies. These findings point towards both common as well as distinct antibody profiles in CSF and serum of MS patients.

Prevalence of neck pain and headaches: impact of computer use and other associative factors.

Headaches and neck pain are reported to be among the most prevalent musculoskeletal complaints in the general population. A significant body of research has reported a high prevalence of headaches and neck pain among adolescents. Sitting for lengthy periods in fixed postures such as at computer terminals may result in adolescent neck pain and headaches. The aim of this paper was to report the association between computer use (exposure) and headaches and neck pain (outcome) among adolescent school students in a developing country. A cross-sectional study was conducted and comprehensive description of the data collection instrument was used to collect the data from 1073 high-school students. Headaches were associated with high psychosocial scores and were more common among girls. We found a concerning association between neck pain and high hours of computing for school students, and have confirmed the need to educate new computer users (school students) about appropriate ergonomics and postural health.

Physiotherapy students' and clinical teachers' perceptions of clinical learning opportunities: a case study.

BACKGROUND: The attainment of clinical competence is a key outcome of physiotherapy programmes worldwide. Clinical education forms a core component of the training of physiotherapy students. AIMS: The study on which this article is based aimed to investigate what physiotherapy students and clinical teachers at one physiotherapy training institution perceive as effective opportunities to facilitate learning in a clinical context. METHODS: A survey of staff and students at the physiotherapy division at Stellenbosch University was undertaken as one element of a situational case study. All enrolled physiotherapy students with clinical education experience and all clinical teachers involved in the clinical education of these students were invited to participate. A purpose-built questionnaire was developed and validated before being administered. RESULTS: The response rate was 80%. The clinical teaching and learning opportunities deemed most valuable for learning by students and teachers were demonstrations of patient management, feedback, discussions and assessment. Teachers and students varied in their perceptions of the learning value of peer assessment, self-assessment and reflection. CONCLUSIONS: The study provided indications for teachers on the valuable learning opportunities as perceived by students and teachers in a physiotherapy clinical setting. The activities perceived as most effective in facilitating learning in the clinical milieu were demonstrations of patient management, discussion, feedback and assessment. Participants indicated that they valued individual contact with teachers and that they learnt productively from discussions with the teachers. It was reported that immediate and verbal feedback improved the learning experience. Both formative assessment in the form of a mock assessment and summative assessment in the form of an end-of-block test were identified as important in facilitating learning. Further research is required on peer assessment, self-assessment and reflection to establish the role of these aspects of learning.

How to run an effective journal club: a systematic review.

BACKGROUND: Health-based journal clubs have been in place for over 100 years. Participants meet regularly to critique research articles, to improve their understanding of research design, statistics and critical appraisal. However, there is no standard process of conducting an effective journal club. We conducted a systematic literature review to identify core processes of a successful health journal club. METHOD: We searched a range of library databases using established keywords. All research designs were initially considered to establish the body of evidence. Experimental or comparative papers were then critically appraised for methodological quality and information was extracted on effective journal club processes. RESULTS: We identified 101 articles, of which 21 comprised the body of evidence. Of these, 12 described journal club effectiveness. Methodological quality was moderate. The papers described many processes of effective journal clubs. Over 80% papers reported that journal club intervention was effective in improving knowledge and critical appraisal skills. Few papers reported on the psychometric properties of their outcome instruments. No paper reported on the translation of evidence from journal club into clinical practice. CONCLUSION: Characteristics of successful journal clubs included regular and anticipated meetings, mandatory attendance, clear long- and short-term purpose, appropriate meeting timing and incentives, a trained journal club leader to choose papers and lead discussion, circulating papers prior to the meeting, using the internet for wider dissemination and data storage, using established critical appraisal processes and summarizing journal club findings.

A survey of the uptake and implementation of research evidence by South Australian acupuncturists in clinical practice: attitudes and associated predictive factors.

OBJECTIVE: To examine South Australian acupuncturists' attitudes towards the use of research evidence and concurrently identify predicative factors associated with the uptake and implementation of research evidence. METHODS: Questionnaires were mailed out to the entire South Australian acupuncturist population (n=94). The population was divided into two groups, medical acupuncturists (general practitioners or other medical specialists) and non-medical acupuncturists, as previous studies have suggested that clinicians' attitudes to EBP are particular to the clinical setting. RESULTS: The total response rate to the survey was 76.6% (n=72). The difference in response rates between non-medical acupuncturists (90.9%, n=60) and medical acupuncturists (42%, n=12) was significant (p<0.0001). Over half of all respondents had both prior research training and previous research experience. Both groups held positive attitudes to research utilization, the use of research information was considered to be an important component of their professional practice, although they prioritized patient care over both reading research evidence and undertaking primary research. There was no significant difference in research interest between groups. The only predicative factor that influenced research utilization was related to the non-medical acupuncturists period of time in practice; non-medical acupuncturists interest in research (rho=-0.29, p=0.036) declined as they accrued clinical experience. No predictive factors were identified for the medical acupuncturist group. CONCLUSION: South Australian acupuncturists hold favorable views towards research utilization and consider the integration of research evidence into clinical practice as an important component of professional development. Professional associations should implement strategies which capitalize on the respondents' positive attitudes in order to ensure high quality evidence-based care for patients seeking acupuncture.

Screening tools to identify hospitalised elderly patients at risk of functional decline: a systematic review.

BACKGROUND: The elderly patient admitted to the emergency department (ED) of an acute care hospital is at risk of declining functionally, both during the stay at the hospital as an inpatient and postdischarge. Accurate and early identification of this population may lead to improved outcomes through targeted early interventions. OBJECTIVES: To identify, critically appraise and characterise available screening tools to screen for elderly patients at risk of functional decline presenting to the ED of acute care hospitals. SELECTION CRITERIA: Screening tools administered in the ED to identify elderly patients at risk of functional decline during hospital stay and/or postdischarge. All primary quantitative and qualitative study types were included. Population included age > 65 years presenting to the ED of an acute care hospital. RESULTS: Six studies reporting on five screening tools were identified. Two instruments reported acceptable discriminative ability; however, one of these has not been prospectively validated. No studies that validated any of the instruments in a setting other than the development setting were identified. A single study reported good test-retest reliability data for one instrument, the Identification of Seniors at Risk. CONCLUSION: This review was unable to identify a 'gold standard' tool to screen for risk of functional decline for the elderly patient admitted to the ED. Further research should be carried out to determine adjunctive processes to increase the accuracy of the identification of elderly patients at risk of functional decline. Further research should also be carried out to determine the appropriateness, or generalisability of these tools in different healthcare settings.

Exploring cDNA phage display for autoantibody profiling in the serum of multiple sclerosis patients: optimization of the selection procedure.

We applied a cDNA phage display method called serological antigen selection (SAS) to identify immunogenic targets that evoke an autoantibody response in the serum of multiple sclerosis (MS) patients. This method involves the display of a cDNA expression library, in this study a MS brain library, on filamentous phage and subsequent selection using patient immunoglobulin G (IgG). To apply the SAS technology for autoantibodies in the serum of MS patients, an optimization was necessary to deplete cDNA products that encode IgG fragments derived from B cells present in the MS brain plaques. We describe a differential screening procedure in which positive selection rounds on MS serum and negative selection rounds on healthy control serum were alternated to optimize the selection procedure. As a result, a substantial decrease of IgG-displaying phage clones was observed after each negative selection round, thereby preventing an overgrowth of IgG-displaying phage clones. Our depletion strategy was therefore successful in preventing the enrichment of IgG-displaying phage clones. This approach will facilitate the identification of possible MS-related antigens.

Laparoscopic mesh and staple Burch colposuspension.

Our objective was to describe our experience with laparoscopic Burch colposuspension and to relate our results to traditional open Burch procedures for the treatment of genuine stress incontinence. Retrospective case series were compared to historical controls. Forty-six women found to have only genuine stress incontinence by history, examination and clinical urodynamics, underwent a mesh and staple laparoscopic Burch procedure. Follow-up ranged from 3 to 50 months. Thirty-seven women were dry, 6 were improved and 3 showed no improvement. This compared to between 75% and 90% of women cured of stress incontinence by the traditional open Burch procedure. We concluded that the results of a mesh and staple laparoscopic Burch procedure in a carefully selected population of women with genuine stress incontinence appears comparable to that reported in the literature for an open Burch procedure.

Effects of dietary cholesterol restriction in a feline model of Niemann-Pick type C disease.

A feline model of Niemann-Pick disease type C (NPC) was employed to evaluate the effect of dietary cholesterol restriction on progression of disease. Two NPC-affected treated cats were fed a cholesterol-restricted diet beginning at 8 weeks of age; the cats remained on the diet for 150 and 270 days respectively. The study goal was to lower the amount of low density lipoprotein (LDL) available to cells, hypothetically reducing subsequent lysosomal accumulation of unesterified cholesterol and other lipids. Neurological progression of disease was not altered and dietary cholesterol restriction did not significantly decrease storage in NPC-affected treated cats. One NPC-affected treated cat had decreased serum alkaline phosphatase activity (ALP) and decreased serum cholesterol concentration. Liver lipid concentrations of unesterified cholesterol, cholesterol ester and phospholipids in NPC-affected treated cats were similar to those seen in NPC-affected untreated cats. Ganglioside concentrations in the NPC-affected treated cats and NPC-affected untreated cats were similar. Histological findings in liver sections from NPC-affected treated cats showed a diffuse uniform microvacuolar pattern within hepatocytes and Kupffer cells, in contrast to a heterogeneous macro/microvacuolar pattern and prominent nodular fibrosis in NPC-affected untreated cats. Similar differences in vacuolar patterns were seen in splenic macrophages. Although some hepatic parameters were modified, dietary cholesterol restriction did not appear to alter disease progression in NPC-affected kittens.