bluuebunny/crossref_metadata_2025 huggingface dataset:
0D Modeling of Fuel Tank for Vapor Generation
Authors: Romagnuolo Luca , Andreozzi Assunta , Senatore Adolfo , Frosina Emma , Fortunato Francesco , Mirante Vincenzo
Published: October 2021

Petrol vapor emissions are the main source of pollution for both standard and hybrid vehicles. They are mainly generated by gasoline evaporation from the fuel tank of both running and parked vehicles; it is mostly driven by fuel temperature variation due to daily temperature changes (if parked) and heat from engine (if running). To prevent its dispersion in the environment, the vapor generated in the fuel tank is usually stored in a carbon canister filter that must be periodically “purged” in order to prevent its saturation, by venting it to the intake manifold. Canister management, made by the Engine Control Unit (ECU), becomes even more critical for hybrid-electric vehicles because thermal engine is often off, thus purging cannot take place. A pressurized fuel tank is often used for hybrid applications, to further isolate vapor from environment, making the fuel system even more complex to model. System design optimization is usually based on experience and experimental correlations, which require time and cost. Thus, comes the need for a comprehensive predictive model useful for both vehicle components (fuel tank and carbon canister) and ECU software design.

A 0D Matlab® model is proposed, which can predict vapor generation from an arbitrary tank in standard and arbitrary thermal cycles, with arbitrary tank capacity, geometry and construction and at different filling levels. It is based on a system of thermo-fluid-dynamic differential equations and semi-empirical correlations that is iteratively solved in time. Model calibration has been performed by using a small size test tank and validation has been completed on full size tanks for both standard and hybrid-electric applications. The main driving force for vapor generation has been shown to be the amount of empty volume on top of the tank; other significant effects come from tank volume, material, external surface as well as fuel properties. Ongoing work is to develop and integrate a carbon canister loading/purging model, with the aim to build a full model of the vapor system.
Do I have a hearing loss?
Authors: Yost William A.
Published: October 2021

The Reflections series takes a look back on historical articles from The Journal of the Acoustical Society of America that have had a significant impact on the science and practice of acoustics.
Examination of Body Mass Changes Among Division I Collegiate Football Players With Sickle Cell Trait
Authors: Hirschhorn Rebecca M. , Phillips Gilbert Jessica L. , Cadet Danielle A. , Murphy Tenley E. , Haggard Clinton , Rosehart Stephanie , Yeargin Susan W.
Published: October 2021

American football athletes are frequently hypohydrated before and during activity. Hypohydration increases the risk of exertional sickling in student-athletes with sickle cell trait (SCT). The authors examined weight charts from the 2010/2011 to 2018/2019 seasons at one Division I institution to determine if differences in percentage body mass losses (%BML) exist between those with and without SCT. Seventeen student-athletes with SCT and 17 matched-controls were included. A Bonferroni correction was applied to account for multiple comparisons (0.05/8), resulting in p < .006 considered significant. There was a significant difference for %BML between groups (SCT: 0.84 ± 0.65% vs. control: 1.21 ± 0.71%; p = .002) but not for the number of days %BML exceeded 2% (SCT: 0 ± 1 vs. control: 1 ± 1; p = .016). Implementation of proper hydration strategies minimized %BML in athletes with SCT, decreasing the risk of hypohydration and exertional sickling. The same strategies ensured all players remained below threshold to optimize performance and reduce heat illness risk.
The ETS transcription factor ERF controls the exit from the naïve pluripotent state in a MAPK-dependent manner
Authors: Vega-Sendino Maria , Olbrich Teresa , Tillo Desiree , Tran Andy D. , Domingo Catherine N. , Franco Mariajose , FitzGerald Peter C. , Kruhlak Michael J. , Ruiz Sergio
Published: October 2021

ERF is the MAPK-dependent switch controlling the transition between naïve and primed pluripotency.
Thermal evolution of Mercury with a volcanic heat-pipe flux: Reconciling early volcanism, tectonism, and magnetism
Authors: Peterson Georgia A. , Johnson Catherine L. , Jellinek A. Mark
Published: October 2021

A new thermal evolution model for Mercury can explain early volcanism, tectonism, and magnetism in a self-consistent manner.
The role of H3K36 methylation and associated methyltransferases in chromosome-specific gene regulation
Authors: Lindehell Henrik , Glotov Alexander , Dorafshan Eshagh , Schwartz Yuri B. , Larsson Jan
Published: October 2021

H3K36 methylation promotes balanced transcriptional output from chromosome 4 but is dispensable for dosage compensation.
Quantized critical supercurrent in SrTiO
3
-based quantum point contacts
Authors: Mikheev Evgeny , Rosen Ilan T. , Goldhaber-Gordon David
Published: October 2021

A superconducting quantum constriction is realized by locally screening ionic liquid gating in SrTiO
3
.
c-MAF–dependent perivascular macrophages regulate diet-induced metabolic syndrome
Authors: Moura Silva Hernandez , Kitoko Jamil Zola , Queiroz Camila Pereira , Kroehling Lina , Matheis Fanny , Yang Katharine Lu , Reis Bernardo S. , Ren-Fielding Christine , Littman Dan R. , Bozza Marcelo Torres , Mucida Daniel , Lafaille Juan J.
Published: October 2021

Embryonically derived tissue-resident perivascular macrophages rely on the transcription factor c-MAF for cell function and identity.
Welcoming c-MAF to the macrophage transcription factor VAM-ily
Authors: Louwe Pieter A. , Scott Charlotte L.
Published: October 2021

The transcription factor c-MAF regulates perivascular macrophage phenotypes across tissues, including white adipose tissue, where its loss from murine vasculature–associated macrophages leads to increased vascularization and protection from metabolic syndrome (see the related Research Article by

Moura Silva
et al
.

).
T
regs
and inflammation—bring it on!
Authors: Gouirand Victoire , Rosenblum Michael D.
Published: October 2021

Regulatory T cells can function in and reverse established autoimmunity.
Course of papilloedema following surgical decompression in CHIARI I malformation with raised intracranial pressure
Authors: Jiang Li , Thant Kyaw Zayar , Bao Hongguang , Ivanova Tsveta
Published: October 2021

Arnold-Chiari malformations (ACM) is a rare congenital hindbrain maldevelopment, leading to downward herniation of the cerebellar tonsils. Clinical features relates to cerebrospinal fluid disturbances, manifesting as symptoms of headaches, pseudotumour-like episodes, cranial nerve palsies and cerebellar dysfunction. Ocular manifestations includes varying ophthalmoloplegia and accommodation abnormalities. Papilloedema has been rarely implicated and remains an uncommon feature of ACM. We report a case of ACM who developed papilloedema and visual disturbance, that was successfully treated with suboccipital decompression. The presentation of patients with ACM-I and papilloedema unaccompanied by localising signs may resemble that of IIH. Neuroimaging with special attention to the craniocervical junction in saggital and transverse planes is crucial. Surgical decompression of the posterior fossa seems to improve headache symptoms and clinical signs of papilloedema.
Spectrum of presentation in primary anorectal malignant melanoma and its management
Authors: Singh Barun Kumar , Ray Samrat , Dhawan Shashi , Nundy Samiran
Published: October 2021

The article presents a series of four patients with primary anorectal melanoma presenting to our institute between 2016 and 2021. The primary objective of the series is to give an overview of the variable presentation of this rare entity from a high-volume colorectal tertiary care centre in a developing country. The patients ranged in age from 55 to 73 years and were mostly women (except one). The clinical presentation varied from bleeding per rectum to tenesmus and mucus in stools, overlapping with those of inflammatory bowel disease and primary anorectal adenocarcinoma. All patients were treated with surgery (laparoscopic or open), ranging from local excision to abdominoperineal resection. All our patients had a good outcome after surgery with no mortality at 30 or 90 days after surgery. The article aims to present a comprehensive overview of the various options of management with evidence from the surgical literature.
Complexity of antidiabetic medication regimen is associated with increased diabetes-related distress in persons with type 2 diabetes mellitus
Authors: Luzuriaga Maria , Leite Rafael , Ahmed Hammad , Saab Patrice G , Garg Rajesh
Published: October 2021

Introduction

Diabetes-related distress is present in a high proportion of people with type 2 diabetes mellitus. We hypothesized that complexity of the antidiabetic medication regimen is a factor that is associated with diabetes-related distress.

Research design and methods

This was a retrospective study including a group of 74 patients managed at a tertiary care center. Patients with type 1 diabetes mellitus, steroid-induced diabetes, post-transplant diabetes, and other types of diabetes were excluded. Patients were screened using the Diabetes Distress Scale-2 (DDS-2). A Diabetes Medication Complexity Scoring (DMCS) system was developed to objectively assess the diabetes medication complexity. Based on DMCS, participants were categorized into three groups: low (n=26), moderate (n=22), and high (n=26) medication complexity.

Results

Complexity groups were similar in sociodemographic characteristics, diabetes duration, body mass index, and blood pressure as well as the prevalence of hypertension, hyperlipidemia and hypoglycemic episodes. However, there were significant differences for HbA1c with higher HbA1c in the high and moderate complexity groups than in the low group (p=0.006). The microvascular complications were also more common in higher complexity groups (p=0.003). The prevalence of diabetes-related distress (DDS-2 ≥6) was 34.6% in the low, 36.4% in the moderate and 69.2% in the high complexity groups (p=0.021). There were significant differences in DDS-2 score among complexity groups (p=0.009), with higher DDS-2 score in the high complexity group compared with the moderate (p=0.008) and low complexity groups (p=0.009). The difference in DDS-2 score remained significant after adjusting for HbA1c (p=0.024) but did not reach statistical significance after controlling for both HbA1c and microvascular complications (p=0.163).

Conclusions

A complex antidiabetic medication regimen may be associated with high levels of diabetes-related distress.
Cost-effectiveness of a Community-based Hypertension Improvement Project (ComHIP) in Ghana: results from a modelling study
Authors: Pozo-Martin Francisco , Akazili James , Der Reina , Laar Amos , Adler Alma J , Lamptey Peter , Griffiths Ulla K , Vassall Anna
Published: October 2021

Objective

To undertake a cost-effectiveness analysis of a Community-based Hypertension Improvement Project (ComHIP) compared with standard hypertension care in Ghana.

Design

Cost-effectiveness analysis using a Markov model.

Setting

Lower Manya Krobo, Eastern Region, Ghana.

Intervention

We evaluated ComHIP, an intervention with multiple components, including: community-based education on cardiovascular disease (CVD) risk factors and healthy lifestyles; community-based screening and monitoring of blood pressure by licensed chemical sellers and CVD nurses; community-based diagnosis, treatment, counselling, follow-up and referral of hypertension patients by CVD nurses; telemedicine consultation by CVD nurses and referral of patients with severe hypertension and/or organ damage to a physician; information and communication technologies messages for healthy lifestyles, treatment adherence support and treatment refill reminders for hypertension patients; Commcare, a cloud-based health records system linked to short-message service (SMS)/voice messaging for treatment adherence, reminders and health messaging. ComHIP was evaluated under two scale-up scenarios: (1) ComHIP as currently implemented with support from international partners and (2) ComHIP under full local implementation.

Main outcome measures

Incremental cost per disability-adjusted life-year (DALY) averted from a societal perspective over a time horizon of 10 years.

Results

ComHIP is unlikely to be a cost-effective intervention, with current ComHIP implementation and ComHIP under full local implementation costing on average US$12 189 and US$6530 per DALY averted, respectively. Results were robust to uncertainty analyses around model parameters.

Conclusions

High overhead costs and high patient costs in ComHIP suggest that the societal costs of ensuring appropriate hypertension care are high and may not produce sufficient impact to achieve cost-effective implementation. However, these results are limited by the evidence quality of the effectiveness estimates, which comes from observational data rather than from randomised controlled study design.
Are patients’ goals in treatment associated with expected treatment outcomes? Findings from a mixed-methods study on outpatient pharmacological treatment for opioid use disorder
Authors: Rosic Tea , Naji Leen , Panesar Balpreet , Chai Darren B , Sanger Nitika , Dennis Brittany B , Marsh David C , Rieb Launette , Worster Andrew , Thabane Lehana , Samaan Zainab
Published: October 2021

Objectives

Existing methods of measuring effectiveness of pharmacological treatment for opioid use disorder (OUD) are highly variable. Therefore, understanding patients’ treatment goals is an integral part of patient-centred care. Our objective is to explore whether patients’ treatment goals align with a frequently used clinical outcome, opioid abstinence.

Design

Triangulation mixed-methods design.

Setting and participants

We collected prospective data from 2030 participants who were receiving methadone or buprenorphine-naloxone treatment for a diagnosis of OUD in order to meet study inclusion criteria. Participants were recruited from 45 centrally-managed outpatient opioid agonist therapy clinics in Ontario, Canada. At study entry, we asked, ‘What are your goals in treatment?’ and used NVivo software to identify common themes.

Primary outcome measure

Urine drug screens (UDS) were collected for 3 months post-study enrolment in order to identify abstinence versus ongoing opioid use (mean number of UDS over 3 months=12.6, SD=5.3). We used logistic regression to examine the association between treatment goals and opioid abstinence.

Results

Participants had a mean age of 39.2 years (SD=10.7), 44% were women and median duration in treatment was 2.6 years (IQR 5.2). Six overarching goals were identified from patient responses, including ‘stop or taper off of treatment’ (68%), ‘stay or get clean’ (37%) and ‘live a normal life’ (14%). Participants reporting the goal ‘stay or get clean’ had lower odds of abstinence at 3 months than those who did not report this goal (OR=0.73, 95% CI 0.59 to 0.91, p=0.005). Although the majority of patients wanted to taper off or stop medication, this goal was not associated with opioid abstinence, nor were any of their other goals.

Conclusions

Patient goals in OUD treatment do not appear to be associated with programme measures of outcome (ie, abstinence from opioids). Future studies are needed to examine outcomes related to patient-reported treatment goals found in our study; pain management, employment, and stopping/tapering treatment should all be explored.
Maintenance of physical activity level, functioning and health after non-pharmacological treatment of pelvic girdle pain with either transcutaneous electrical nerve stimulation or acupuncture: a randomised controlled trial
Authors: Svahn Ekdahl Annika , Fagevik Olsén Monika , Jendman Tove , Gutke Annelie
Published: October 2021

Objective

To investigate if there are differences between acupuncture and transcutaneous electrical nerve stimulation (TENS) as treatment for pelvic girdle pain (PGP) in pregnancy in order to manage pain and thus maintain health and functioning in daily activities and physical activity (PA).

Design

Randomised controlled trial.

Setting and participants

Pregnant women (n=113) with clinically verified PGP in gestational weeks 12–28, recruited from maternity healthcare centres, randomised (1:1) into two groups. Exclusion criteria: any obstetrical complication, systemic disease or previous disorder that could contradict tests or treatment.

Interventions

The intervention consisted of either 10 acupuncture sessions (two sessions per week) provided by a physiotherapist or daily home-based TENS during 5 weeks.

Primary outcome variables

Disability (Oswestry Disability Index), functioning (Patient Specific Functional Scale), work ability (Work Ability Index) and PA-level according to general recommendations.

Secondary outcome variables

Functioning related to PGP (Pelvic Girdle Questionnaire), evening pain intensity (Numeric Rating Scale, NRS), concern about pain (NRS), health (EuroQoL 5-dimension), symptoms of depression/catastrophising (Edinburgh Postnatal Depression Scale/Coping Strategies Questionnaire).

Results

No mean differences were detected between the groups. Both groups managed to preserve their functioning and PA level at follow-up. This may be due to significantly (p<0.05) reduced within groups evening pain intensity; acupuncture −0.96 (95% CI −1.91 to −0.01; p=0.049), TENS −1.29 (95% CI −2.13 to −0.44; p=0.003) and concern about pain; acupuncture −1.44 (95% CI −2.31 to −0.57; p=0.0012), TENS −1.99 (95% CI −2.81 to −1.17; p<0.0001). The acupuncture group showed an improvement in functioning at follow-up; 0.82 (95% CI 0.01 to 1.63; p=0.048)

Conclusion

Treating PGP with acupuncture or TENS resulted in maintenance of functioning and physical activity and also less pain and concern about pain. Either intervention could be recommended as a non-pharmacological alternative for pain relief and may enable pregnant women to stay active.

Trial registration number

12726. https://www.researchweb.org/is/sverige/project/127261
Evaluation of an interactive web-based programme on relapse management for people with multiple sclerosis (POWER@MS2): study protocol for a process evaluation accompanying a randomised controlled trial
Authors: Wenzel Lisa , Heesen Christoph , Scheiderbauer Jutta , van de Loo Markus , Köpke Sascha , Rahn Anne Christin
Published: October 2021

Introduction

Process evaluations accompanying complex interventions examine the implementation process of the underlying intervention, identify mechanisms of impact and assess contextual factors. This paper presents the protocol for a process evaluation conducted alongside the randomised controlled trial POWER@MS2. The trial comprises the evaluation of a web-based complex intervention on relapse management in 188 people with multiple sclerosis conducted in 20 centres. The web-based intervention programme focuses on relapse treatment decision making and includes a decision aid, a nurse-led webinar and an online chat. With the process evaluation presented here, we aim to assess participants’ responses to and interactions with the intervention to understand how and why the intervention produces change.

Methods and analysis

A mixed methods design is used to explore the acceptance of the intervention as well as its use and impact on participants. Participants are people with multiple sclerosis, neurologists, nurses and stakeholders. Quantitative semistandardised evaluation forms will be collected throughout the study. Qualitative semistructured telephone interviews will be conducted at the end of the study with selected participants, especially people with multiple sclerosis and neurologists. Quantitative data will be collected and analysed descriptively. Based on the results, the qualitative interviews will be conducted and analysed thematically, and the results will be merged in a joint display table.

Ethics and dissemination

The process evaluation has received ethical approval from the Ethical Committee of the University of Lübeck (reference 19–024). Findings will be disseminated in peer-reviewed journals, at conferences, meetings and on relevant patient websites.

Trial registration number

NCT04233970.
Music to prevent deliriUm during neuroSurgerY (MUSYC) Clinical trial: a study protocol for a randomised controlled trial
Authors: Kappen Pablo R , Jeekel Johannes , Dirven Clemens M F , Klimek M , Kushner Steven A , Osse Robert-Jan , Coesmans Michiel , Poley Marten J , Vincent Arnaud J P E
Published: October 2021

Introduction

Delirium is a neurocognitive disorder characterised by an acute and temporary decline of mental status affecting attention, awareness, cognition, language and visuospatial ability. The underlying pathophysiology is driven by neuroinflammation and cellular oxidative stress.

Delirium is a serious complication following neurosurgical procedures with a reported incidence varying between 4% and 44% and has been associated with increased length of hospital stay, increased amount of reoperations, increased costs and mortality.

Perioperative music has been reported to reduce preoperative anxiety, postoperative pain and opioid usage, and attenuates stress response caused by surgery. We hypothesize that this beneficial effect of music on a combination of delirium eliciting factors might reduce delirium incidence following neurosurgery and subsequently improve clinical outcomes.

Methods

This protocol concerns a single-centred prospective randomised controlled trial with 6 months follow-up. All adult patients undergoing a craniotomy at the Erasmus Medical Center in Rotterdam are eligible. The music group will receive recorded music through an overear headphone before, during and after surgery until postoperative day 3. Patients can choose from music playlists, offered based on music importance questionnaires administered at baseline. The control group will receive standard of clinical care

Delirium is assessed by the Delirium Observation Scale and confirmed by a delirium-expert psychiatrist according to the DSM-5 criteria. Risk factors correlated with the onset of delirium, such as cognitive function at baseline, preoperative anxiety, perioperative medication use, depth of anaesthesia and postoperative pain, and delirium-related health outcomes such as length of stay, daily function, quality of life (ie, EQ-5D, EORTC questionnaires), costs and cost-effectiveness are collected.

Ethics and dissemination

This study is being conducted in accordance with the Declaration of Helsinki. The Medical Ethics Review Board of Erasmus University Medical Center Rotterdam, The Netherlands, approved this protocol. Results will be disseminated via peer-reviewed scientific journals and conference presentations.

Trial registration numbers

NL8503 andNCT04649450.
Barriers and facilitators to accessing tuberculosis care in Nepal: a qualitative study to inform the design of a socioeconomic support intervention
Authors: Dixit Kritika , Biermann Olivia , Rai Bhola , Aryal Tara Prasad , Mishra Gokul , Teixeira de Siqueira-Filha Noemia , Paudel Puskar Raj , Pandit Ram Narayan , Sah Manoj Kumar , Majhi Govinda , Levy Jens , Rest Job van , Gurung Suman Chandra , Dhital Raghu , Lönnroth Knut , Squire S Bertel , Caws Maxine , Sidney Kristi , Wingfield Tom
Published: October 2021

Objective

Psychosocial and economic (socioeconomic) barriers, including poverty, stigma and catastrophic costs, impede access to tuberculosis (TB) services in low-income countries. We aimed to characterise the socioeconomic barriers and facilitators of accessing TB services in Nepal to inform the design of a locally appropriate socioeconomic support intervention for TB-affected households.

Design

From August 2018 to July 2019, we conducted an exploratory qualitative study consisting of semistructured focus group discussions (FGDs) with purposively selected multisectoral stakeholders. The data were managed in NVivo V.12, coded by consensus and analysed thematically.

Setting

The study was conducted in four districts, Makwanpur, Chitwan, Dhanusha and Mahottari, which have a high prevalence of poverty and TB.

Participants

Seven FGDs were conducted with 54 in-country stakeholders, grouped by stakeholders, including people with TB (n=21), community stakeholders (n=13) and multidisciplinary TB healthcare professionals (n=20) from the National TB Programme.

Results

The perceived socioeconomic barriers to accessing TB services were: inadequate TB knowledge and advocacy; high food and transportation costs; income loss and stigma. The perceived facilitators to accessing TB care and services were: enhanced championing and awareness-raising about TB and TB services; social protection including health insurance; cash, vouchers and/or nutritional allowance to cover food and travel costs; and psychosocial support and counselling integrated with existing adherence counselling from the National TB Programme.

Conclusion

These results suggest that support interventions that integrate TB education, psychosocial counselling and expand on existing cash transfer schemes would be locally appropriate and could address the socioeconomic barriers to accessing and engaging with TB services faced by TB-affected households in Nepal. The findings have been used to inform the design of a socioeconomic support intervention for TB-affected households. The acceptability, feasibility and impact of this intervention on TB-related costs, stigma and TB treatment outcomes, is now being evaluated in a pilot implementation study in Nepal.
Statin associated adverse reactions in Latin America: a scoping review
Authors: Urina-Jassir Manuel , Pacheco-Paez Tatiana , Paez-Canro Carol , Urina-Triana Miguel
Published: October 2021

Objectives

We aim to describe the frequency and type of adverse drug reactions (ADRs) in patients on statins in published studies from Latin American (LATAM) countries.

Design

Scoping review.

Methods

A literature search was conducted in three databases (PubMed, EMBASE and LILACS) in addition to a manual search in relevant journals from LATAM universities or medical societies. A snowballing technique was used to identify further references. Randomised controlled trials (RCTs) and observational studies between 2000 and 2020 were included. Studies were considered eligible if they included adults on statin therapy from LATAM and reported data on ADRs. Data on ADRs were abstracted and presented by study design.

Results

Out of 8076 articles, a total of 20 studies were included (7 RCTs and 13 observational studies). We identified three head-to-head statin RCTs, two statin-versus-policosanol RCTs and only two placebo-controlled trials. The statin-related ADRs frequency ranged from 0% to 35.1% in RCTs and 0% to 28.4% in observational studies. The most common ADRs were muscle-related events including myalgia and elevated creatine phosphokinase. Other reported ADRs were gastrointestinal symptoms, headache and altered fasting plasma glucose.

Conclusions

We identified differences in the frequency of ADRs in both observational studies and RCTs from LATAM countries. This could be due to the absence of standard definitions and reporting of ADRs as well as differences among the study’s interventions, population characteristics or design. The variability of ADRs and the absence of definitions are similar to studies from other geographical locations. Further placebo-controlled trials and real-world data registries with universal definitions should follow.
Factors associated with COVID-19 viral and antibody test positivity and assessment of test concordance: a retrospective cohort study using electronic health records from the USA
Authors: Lindsay Lisa , Secrest Matthew H , Rizzo Shemra , Keebler Daniel S , Yang Fei , Tsai Larry
Published: October 2021

Objectives

To identify factors associated with COVID-19 test positivity and assess viral and antibody test concordance.

Design

Observational retrospective cohort study.

Setting

Optum de-identified electronic health records including over 700 hospitals and 7000 clinics in the USA.

Participants

There were 891 754 patients who had a COVID-19 test identified in their electronic health record between 20 February 2020 and 10 July 2020.

Primary and secondary outcome measures

Per cent of viral and antibody tests positive for COVID-19 (‘positivity rate’); adjusted ORs for factors associated with COVID-19 viral and antibody test positivity; and per cent concordance between positive viral and subsequent antibody test results.

Results

Overall positivity rate was 9% (70 472 of 771 278) and 12% (11 094 of 91 741) for viral and antibody tests, respectively. Positivity rate was inversely associated with the number of individuals tested and decreased over time across regions and race/ethnicities. Antibody test concordance among patients with an initial positive viral test was 91% (71%–95% depending on time between tests). Among tests separated by at least 2 weeks, discordant results occurred in 7% of patients and 9% of immunocompromised patients. Factors associated with increased odds of viral and antibody positivity in multivariable models included: male sex, Hispanic or non-Hispanic black or Asian race/ethnicity, uninsured or Medicaid insurance and Northeast residence. We identified a negative dose effect between the number of comorbidities and viral and antibody test positivity. Paediatric patients had reduced odds (OR=0.60, 95% CI 0.57 to 0.64) of a positive viral test but increased odds (OR=1.90, 95% CI 1.62 to 2.23) of a positive antibody test compared with those aged 18–34 years old.

Conclusions

This study identified sociodemographic and clinical factors associated with COVID-19 test positivity and provided real-world evidence demonstrating high antibody test concordance among viral-positive patients.
Treatment-free survival after discontinuation of immune checkpoint inhibitors in metastatic renal cell carcinoma: a systematic review and meta-analysis
Authors: Tzeng Alice , Tzeng Tony H , Ornstein Moshe C
Published: October 2021

While immune checkpoint inhibitors (ICI) can lead to sustained responses in metastatic renal cell carcinoma (mRCC), the optimal duration of therapy remains unknown. We aimed to examine treatment-free survival (TFS) in objective responders who discontinued ICI and to explore factors that may impact objective response rate (ORR) and TFS. MEDLINE/PubMed, Embase, and the Cochrane Library were searched for prospective studies reporting individual outcomes after ICI discontinuation in patients with mRCC. Pooled ORR and TFS were estimated using random-effects meta-analyses, and associations between ICI regimen type or treatment line and ORR or TFS were evaluated. Sixteen cohorts comprising 1833 patients treated with ICI were included. The pooled ORR was 43% (95% CI 33% to 53%), and significant differences in summary estimates existed among patients who received ICI monotherapy (22%, 95% CI 18% to 26%), ICI plus a vascular endothelial growth factor (VEGF) pathway inhibitor (57%, 95% CI 48% to 65%), and dual ICI (40%, 95% CI 36% to 44%). Of 572 responders who had available data, 327 stopped ICI, with 86 (26%) continuing to respond off-treatment. Pooled TFS rates at 6 and 12 months were 35% (95% CI 20% to 50%) and 20% (95% CI 8% to 35%), respectively, and were highest for responders treated with dual ICI and lowest for those treated with ICI plus a VEGF pathway inhibitor. Thus, a subset of patients with mRCC who are treated with ICI-based therapy can have durable TFS after therapy discontinuation. Prospective clinical trials and biomarkers are needed to identify patients who can discontinue ICI therapy without compromising clinical outcomes.
Graduated Compression Stockings Reduce the Venous Velocity Augmentation of Foot Pumps
Authors: Higgs David , Uglow Michael , Fail Theresa
Published: October 2021

The use of the A-V Impulse System of foot pumps and graduated compression stockings to reduce the incidence of thrombo-embolic disease after total hip arthroplasty is well recognised. It is not known if they have a synergistic effect as all clinical trials have used them in combination.

We examined the effect compression stockings had on the ability of the A-V Impulse System to accelerate peak venous velocities in the common femoral vein in ten healthy volunteers using a duplex scanner.

The use of foot pumps without stockings produced the greatest increase in peak venous velocity and this was 34% greater than using a foot pump with stockings.

It is not known if this difference could account for a reduction in thrombo-embolic episodes and so we propose a randomised clinical trial.
SARS-CoV-2 surveillance strategy in essential workers of the Madrid City Council during the first epidemic wave in Spain, March–July 2020
Authors: Martínez-Cortés Mercedes , León-Dominguez Carmen Maria , Fernandez-Pinero Jovita , Rodriguez Mercedes , Almonacid Mercedes , Ferrari Maria José , Romero Rosario , Antona Alfonso , Rivas M. Dolores , de La Fuente Miguel , Pérez-Gómez Beatriz , Pollán Marina
Published: October 2021

Objectives

To study prevalence of infection in essential workers of Madrid City Council by occupation, related characteristics, use of protective devices, risk perception, and main concerns about COVID-19 during lockdown.

Methods

A total of 30 231 workers were PCR tested for SARS-CoV-2 infection. Information was collected on COVID-19-related symptoms, risk factors, preventive equipment, and risk perception. The crude prevalence was calculated for infection, use of protective devices, perceived risk and main concerns. Additionally, adjusted prevalence and prevalence ratios (PR) were estimated for these variables using logistic regression models with age, gender, occupation, epidemiological week and laboratory as confounding factors.

Results

Overall prevalence of infection was 3.2% (95% CI 3.0% to 3.4%), being higher among policemen (4.4%) and bus drivers (4.2%), but lower among emergency healthcare personnel, firefighters, food market workers and burial services (<2%). Lower excess risk was observed in workers reporting occupational contact with COVID-19 cases only (PR=1.42; 95% CI 1.18 to 1.71) compared with household exposure only (PR=2.75; 95% CI 2.32 to 3.25). Infection was more frequent in symptomatic workers (PR=1.28; 95% CI 1.11 to 1.48), although 42% of detected infections were asymptomatic. Use of facial masks (78.7%) and disinfectants (86.3%) was common and associated with lower infection prevalence (PRmasks=0.68; 95% CI 0.58 to 0.79; PRdisinfectants=0.75; 95% CI 0.61 to 0.91). Over 50% of workers felt being at high risk of infection and worried about infecting others, yet only 2% considered quitting their work.

Conclusions

This surveillance system allowed for detecting and isolating SARS-CoV-2 cases among essential workers, identifying characteristics related to infection and use of protective devices, and revealing specific needs for work-safety information and psychological support.
Autoinflammatory syndromes in neurology: when our first line of defence misbehaves
Authors: Diprose William K , Jordan Anthony , Anderson Neil E
Published: October 2021

Autoinflammatory syndromes result from a defective innate immune system. They are characterised by unexplained fever and systemic inflammation involving the skin, muscle, joints, serosa and eyes, along with elevated acute phase reactants. Autoinflammatory syndromes are increasingly recognised as a cause of neurological disease with a diverse range of manifestations. Corticosteroids, colchicine and targeted therapies are effective if started early, and hence the importance of recognising these syndromes. Here, we review the neurological features of specific autoinflammatory syndromes and our approach (as adult neurologists) to their diagnosis.
Native owned and grown or demeaning and offensive? American Indian adults’ perspectives on Natural American Spirit branded cigarettes
Authors: Epperson Anna E , Prochaska Judith J
Published: October 2021

Introduction

Owned by a major US tobacco company with no American Indian/Alaska Native (AI/AN) tribal affiliation, Natural American Spirit (NAS) cigarette packs feature an American Indian warrior, thunderbird and peace pipe. The current study examined AI/AN adults’ perceptions of NAS cigarette packs in the US, which have not been reported on prior.

Methods

AI/AN adults were recruited via Qualtrics national panels (n=500; 64% female, age M=39.9 years, 47% current smokers) in 2020. After viewing NAS pack images online (front, back and sides), participants were asked about NAS tribal affiliation, health perceptions and purchase intentions. Participants also wrote-in what the NAS pack logos meant to them.

Results

Most participants (65%) believed NAS is AI/AN-owned and/or grown on tribal lands. Among current smokers, beliefs of an AI/AN affiliation were associated with misperceptions of NAS being a healthier cigarette and with greater intention to purchase NAS cigarettes (p’s<0.01). Participants who did not believe NAS was grown or owned by AI/AN tribes were more likely to describe the NAS warrior logo as cultural misappropriation (17%) than participants who believed NAS was AI/AN tribally affiliated (4%, p<0.001).

Conclusions

The findings indicate a dichotomy in beliefs among surveyed AI/AN adults regarding NAS brand cigarettes. A majority held the misconception that NAS is tribally affiliated, while an informed and concerned minority characterised the branding as cultural misappropriation. The current packaging is reasonably expected to result in beliefs that NAS cigarettes are AI/AN tribally affiliated, and these beliefs may be associated with misperceptions of lesser harm.
Seismic response of pile groups improved with deep cement mixing columns in liquefiable sand: shaking table tests
Authors: Zhang Dingwen , Wang Anhui , Ding Xuanming
Published: October 2021

A series of shaking table model tests were performed to examine the effects of deep cement mixing (DCM) columns with different reinforcement depths on the seismic behavior of a pile group in liquefiable sand. Due to the DCM column reinforcement, the fundamental natural frequency of the model ground increases noticeably. The excess pore pressure of soils reduces with the increase of reinforcement depths of the DCM columns. Before liquefaction, the acceleration response of soils in the improved cases is obviously lower than that in the unimproved case, but the acceleration attenuation is greater after liquefaction in the unimproved case. Moreover, the lateral displacement of the superstructure, the settlement of the raft, and the bending moment of the piles in the improved cases are significantly reduced compared with those in the unimproved case, and the reduction ratios rise with the increase of reinforcement depth of the DCM columns. However, reinforcement by the DCM columns may result in the variation of the location of the maximum moment that occurs in the pile.
Trends in phytoplankton communities within large marine ecosystems diverge from the global ocean
Authors: Friedland Kevin D. , Moisan John R. , Maureaud Aurore A. , Brady Damian C. , Davies Andrew J. , Bograd Steven J. , Watson Reg A. , Rousseau Yannick
Published: October 2021

Large marine ecosystems (LMEs) are highly productive regions of the world ocean under anthropogenic pressures; we analyzed trends in sea surface temperature (SST), cloud fraction (CF), and chlorophyll concentration (CHL) over the period 1998–2019. Trends in these parameters within LMEs diverged from the world ocean. SST and CF inside LMEs increased at greater rates inside LMEs, whereas CHL decreased at a greater rates. CHL declined in 86% of all LMEs and of those trends, 70% were statistically significant. Complementary analyses suggest phytoplankton functional types within LMEs have also diverged from those characteristic of the world ocean, most notably, the contribution of diatoms and dinoflagellates, which have declined within LMEs. LMEs appear to be warming rapidly and receiving less solar radiation than the world ocean, which may be contributing to changes at the base of the food chain. Despite increased fishing effort, fishery yields in LMEs have not increased, pointing to limitations related to productivity. These changes raise concerns over the stability of these ecosystems and their continued ability to support services to human populations.
INFLUENCE OF TEMPERATURE, IMPINGEMENT ANGLE, VELOCITY AND STANDOFF DISTANCE ON THE EROSION CHARACTERISTICS OF INCONEL 718 AND Ti-6Al-4V
Authors: RAJAMURUGAN G. , KRISHNASAMY PRABU , BHUSHAN GAUTAM D. , JEYAKUMAR P. D.
Published: October 2021

Erosion is the primary concern in gas turbines, power plants, fertilizer plants, jet aircraft and civil aircraft. The military, gas turbine blades are affected by dust clouds ingestion and impingement of slurry particles. In this study, we investigated the erosion rate of Inconel 718 and Ti-6Al-4V turbine blades in the air jet-erosion test rig by ([Formula: see text]m) silica erodent. The primary process parameters, such as velocity (100 and 150[Formula: see text]m/s), impingement angle (30–90∘), feed rate (5–10[Formula: see text]g/min), temperature (30–650∘C) and standoff distance (10–50[Formula: see text]mm) were optimized using response surface methodology (RSM). The design of experiments (DOE) and experimental screening tests were performed to identify the significant process parameters on the erosion of turbine blade materials. To optimize the process parameters, the experiment was conducted to obtain a lowest erosion rate. The ploughing and cutting mechanism of both Inconel 718 and Ti-6Al-4V materials were identified through a scanning electron microscope. As a result, the erosion rate increases with an increase in velocity and temperature; however, the erosion rate decreases with an increase in the impingement angle. The experimental analysis showed that the erosion rate ranged between 0.051–1.914[Formula: see text]mg/g for Inconel 718 and 0.02–1.0095[Formula: see text]mg/g for Ti-6Al-4V.
The Market Weighton High in the 21st century – new understanding of a long-standing problem
Authors: Wright John K.
Published: October 2021

The sequence of Jurassic and Cretaceous strata laid down in north Lincolnshire is traced northwards onto the Market Weighton High, and compared with the equivalent Cleveland Basin sequence as it is traced south onto the High. Understanding of the manner of operation of the High has long been hindered by the amount of erosion of strata over it, particularly in the Early Cretaceous. Facies analysis of the remaining strata present on either side of the High is used to estimate the thickness and the facies of strata originally deposited over it. Although there were periodic uplifts of the High, leading to increasing omissions of strata approaching it, there is little evidence that during the Jurassic the High was emergent for significant periods. Most strata were either originally present at Market Weighton in marginal marine facies, or continued across the High without interruption. The operation of the High in the light of modern understanding of crustal stresses during the Mesozoic is reviewed.
Coronary vasodilation mediated by T cells expressing choline acetyltransferase
Authors: Chester Adrian H. , McCormack Ann , Miller Edmund J. , Ahmed Mohamed N. , Yacoub Magdi H.
Published: October 2021

This study shows ChAT-expressing T cells can induce vasodilation of the blood vessel in the coronary circulation and that this effect relies on a direct interaction between T cells and the coronary vascular endothelium. The study establishes a potential immunomodulatory role for T cells in the coronary circulation. The present findings offer an additional possibility that a deficiency of ChAT-expressing T cells could contribute to reduced coronary blood flow and ischemic events in the myocardium.
Modified PWM Direct Instantaneous Torque Control System for SRM
Authors: Cheng Yong
Published: October 2021

Torque ripple is a defect of switched reluctant motors. DITC (direct instantaneous torque control) is harnessed to solve the problem as a traditional method, which is superior to TSF (torque sharing function). In this paper, a new controller is proposed with modified hysteresis and PWM in DITC. With the modified algorithm, the torque error will be reduced with PWM in DITC. The proposed algorithm is effective to improve sample and 0 status in a period. The modified algorithm is based on application of zero in the asymmetric half bridge, which is implemented as the buffer zone. In case of big torque error, hysteresis will mitigate error under the characteristic of fast responding. In case of small errors, the modified PWM will solve torque error in the equivalent strategy, which has adopted the essence of the impulse equivalent method. The modified controller is designed to reduce responding time and minimize the torque ripple under the proposed algorithm, which has been designed to harness different functions in different torque errors. Based on final simulation and experimental results, responding speed and reduction of output torque ripple are enhanced effectively.
Pancreatic Cancer Survival Prediction: A Survey of the State-of-the-Art
Authors: Bakasa Wilson , Viriri Serestina
Published: October 2021

Cancer early detection increases the chances of survival. Some cancer types, like pancreatic cancer, are challenging to diagnose or detect early, and the stages have a fast progression rate. This paper presents the state-of-the-art techniques used in cancer survival prediction, suggesting how these techniques can be implemented in predicting the overall survival of pancreatic ductal adenocarcinoma cancer (pdac) patients. Because of bewildering and high volumes of data, the recent studies highlight the importance of machine learning (ML) algorithms like support vector machines and convolutional neural networks. Studies predict pancreatic ductal adenocarcinoma cancer (pdac) survival is within the limits of 41.7% at one year, 8.7% at three years, and 1.9% at five years. There is no significant correlation found between the disease stages and the overall survival rate. The implementation of ML algorithms can improve our understanding of cancer progression. ML methods need an appropriate level of validation to be considered in everyday clinical practice. The objective of these techniques is to perform classification, prediction, and estimation. Accurate predictions give pathologists information on the patient’s state, surgical treatment to be done, optimal use of resources, individualized therapy, drugs to prescribe, and better patient management.
Investigating the Relationship of Test Anxiety and Time Management with Academic Procrastination in Students of Health Professions
Authors: Roshanisefat Sarvenaz , Azizi Seyyed Mohsen , Khatony Alireza
Published: October 2021

Academic procrastination is a harmful phenomenon among students and has many negative consequences. The present study aimed to investigate the relationship of test anxiety and time management with academic procrastination in students of health professions. The population of this correlational study consisted of 281 Iranian students of health professions. The Tuckman Procrastination Scale, Time Management Scale, and Sarason’s Test Anxiety Scale were used to measure the variables. Pearson’s correlation and multivariate regression tests were also performed. The mean score of students’ academic procrastination was higher than the average level. A significantly negative correlation was found between time management and academic procrastination (r = −0.487,

P

 ≤ 0.01). Additionally, there was a significantly positive correlation between test anxiety and academic procrastination (r = 0.443,

P

 ≤ 0.01). The linear regression model indicated that independent predictors including time management and test anxiety accounted for 32.6% of the variation in academic procrastination (R2 = 32.6%). The findings of this study indicated that test anxiety and time management were associated with academic procrastination. Therefore, purposeful educational and psychological interventions are required to reduce academic procrastination in students.