bluuebunny/crossref_metadata_2025 huggingface dataset:
Fuel and Engine Management System for Gaseous-Fueled Spark-Ignition Non-Road Engines
Authors: Sherwin Daniel , Dees Jesse
Published: December 2020

A fuel and engine management system have been successively applied to a 4.5L spark-ignition gaseous-fueled engine used for stationary power generation applications up to 80 kW. The system operates on low-pressure commercial grade natural gas or liquid propane gas and governs engine speed at either 1500 or 1800 rpm, for generator frequencies of 50 Hz and 60 Hz respectively. The fuel and engine management system consist of an engine control module, an electronically controlled fuel mixer, a fuel pressure sensor, and other supporting sensors/actuators. This new system replaces a legacy of fixed-orifice metering or vacuum-actuated-valve mechanical mixer designs. This new system allows for closed-loop control of stoichiometric combustion that meets both performance and emissions requirements without the need for a fuel pressure regulator within the genset frame. It also allows a single fuel system assembly to be used on all 4.5L engines regardless of fuel type (LP/NG) or nominal speed (50/60Hz), as these are now selected with standard J1939 CAN protocol messages from the genset controller. This paper reviews the development aspects for the new fuel system on the 4.5L engine.

The electronic-actuated fuel mixer system offers a wider range of fuel flow control compared to mechanical-actuated mixers, this results in better air-fuel control due to variations in fuel quality, low fuel supply pressure and changing ambient conditions. The range of fuel control is result of the different mixer valve construction and control. The fuel metering valve is a butterfly type and is controlled from a stepper motor. The valve controls the fuel flow rate just before the fuel mixes with the combustion air passing thought a venturi. Lag in fuel flow, typical of low supply pressure and low restriction / signal venturi, is corrected for using a feedforward control strategy based on genset electrical load. The mixer sizing and flow bench measurements for calibration, will be reviewed.

The ECM uses a speed-density air flow model, along with fuel supply and air filter pressure, to determine the best mixer valve position. The engine air flow model is used for determining venturi flow and the resulting mixer vacuum signal, but a final calibration correction was created with hot wire-anemometer-flow meters on a running engine. A long-term fuel trim is also applied to the mixer position, but unlike a fuel-injection system which corrects volumetric efficiency based on known fuel flow rate and HEGO sensor feedback, this mixer control strategy learns a steady-state mixer correction or offset. The entire control strategy was developed within a Simulink model and auto code generation tools were used to create final ECM C and machine code. The development of the mixer and ECM control strategy will be detailed herein.
Modification of copper and copper oxide surface states due to isopropyl alcohol treatment toward area-selective processes
Authors: Mawaki Takezo , Teramoto Akinobu , Ishii Katsutoshi , Shiba Yoshinobu , Kuroda Rihito , Suwa Tomoyuki , Azumo Shuji , Shimizu Akira , Umezawa Kota , Shirai Yasuyuki , Sugawa Shigetoshi
Published: December 2020

The reduction of copper oxide by isopropyl alcohol (IPA) gas and its mechanism were investigated toward the selective process of copper (Cu) wiring. Also, the decomposition behavior of IPA gas and surface modification during the IPA treatment on Cu and copper oxide surfaces were studied. Two samples were measured: Cu surface having native oxide film and a metal Cu surface after a hydrogen reduction treatment. The decomposition and reaction behaviors and adsorption characteristics of IPA were investigated using the inline evaluation system equipped with a Cu reactor and Fourier transform infrared spectroscopy. The chemical structures of the Cu and copper oxide surfaces before and after IPA treatment were analyzed by x-ray photoelectron spectroscopy. Based on the experiments, the process condition to induce reduction of copper oxide by IPA gas during the Cu processes temperature range was identified. It was also found that different organic matter derived from IPA was adsorbed on each surface.
On the Origin of Candida auris: Ancestor, Environmental Stresses, and Antiseptics
Authors: Sharma Megha , Chakrabarti Arunaloke
Published: December 2020

Candida auris
has emerged as a serious threat to the health care settings. Advancements in molecular biology have provided several insights into the evolution of
C. auris
since it was first described in 2009.
Intracellular Staphylococcus aureus Perturbs the Host Cell Ca
2+
Homeostasis To Promote Cell Death
Authors: Stelzner Kathrin , Winkler Ann-Cathrin , Liang Chunguang , Boyny Aziza , Ade Carsten P. , Dandekar Thomas , Fraunholz Martin J. , Rudel Thomas
Published: December 2020

Despite being regarded as an extracellular bacterium, the pathogen
Staphylococcus aureus
can invade and survive within human cells. The intracellular niche is considered a hideout from the host immune system and antibiotic treatment and allows bacterial proliferation.
Stapled Peptides Based on Human Angiotensin-Converting Enzyme 2 (ACE2) Potently Inhibit SARS-CoV-2 Infection
In Vitro
Authors: Curreli Francesca , Victor Sofia M. B. , Ahmed Shahad , Drelich Aleksandra , Tong Xiaohe , Tseng Chien-Te K. , Hillyer Christopher D. , Debnath Asim K.
Published: December 2020

SARS-CoV-2 is a novel virus with many unknowns. No vaccine or specific therapy is available yet to prevent and treat this deadly virus.
Identification of a Novel Cobamide Remodeling Enzyme in the Beneficial Human Gut Bacterium Akkermansia muciniphila
Authors: Mok Kenny C. , Sokolovskaya Olga M. , Nicolas Alexa M. , Hallberg Zachary F. , Deutschbauer Adam , Carlson Hans K. , Taga Michiko E.
Published: December 2020

Cobamides, comprising the vitamin B
12
family of cobalt-containing cofactors, are required for metabolism in all domains of life, including most bacteria. Cobamides have structural variability in the lower ligand, and selectivity for particular cobamides has been observed in most organisms studied to date.
Supplemental Material: “Missing links” for the long-lived Macdonald and Arago hotspots, South Pacific Ocean
Authors: Buff Lindsay , al. et
Published: December 2020

Figures S1–S3, and Tables S1–S4.
Complete resolution of acute pancreatitis-induced chylous ascites following transhepatic portal vein stenting
Authors: Tindale Alexander , Jackson James , Kohoutova Darina , Vlavianos Panagiotis
Published: December 2020

We introduce a case of a 73-year-old man who developed intractable chylous ascites due to portal vein compression as a result of peripancreatic inflammatory changes after acute biliary pancreatitis. After stenting the portal vein stenosis, the chylous ascites improved from requiring weekly paracentesis to requiring no drainage within 4 months of the procedure and at the 15-month follow-up. To our knowledge, it is the first case reported in the literature where portal vein stenting has successfully been used to treat pancreatitis-induced chylous ascites.
Glomangiopericytoma of the sphenoethmoid complex
Authors: Shemen Larry , Yan Wayne , Hasanovic Adnan , Tong Jiankun
Published: December 2020

Sinonasal glomangiopericytoma is a rare sinonasal tumour accounting for less than. 5% of all sinonasal tumours. This tumour often presents as another, more common type of vascular lesion and is similarly prone to haemorrhage. The optimal treatment includes complete surgical resection. We, herein, present two such cases adding to the world literature of this rare tumour.
Rhinomyiasis: clinical and surgical management
Authors: Bertone Fabio , Cerutti Marta , Serusi Elena , Gervasio Carmine Fernando
Published: December 2020

Myiasis byOestrus ovis, the zoonotic infestation with Diptera larvae, primarily diagnosed in goats and rams in tropical and Mediterranean countries, is an uncommon disease in humans; indeed, literature data are still lacking. Nevertheless, few cases of human myiasis have been reported, leading to benign or severe complications. Here, we report a rare case of human rhinomyiasis detected in Northern Italy. A 39-year-old Italian woman, returning from vacation in Corsica, showed several sinusal symptoms and progressive asthenia and was therefore admitted at the Otorhinolaryngology Unit of Biella Hospital, Italy. Endoscopic examination of the nasal cavity revealed some formations, morphologically identified asO. ovislarvae. The patient then underwent endoscopic sinus surgery, followed by complete resolution of symptoms. Clinical presentation, diagnostic work-up and therapeutic procedures have been compared with few other cases found in the literature.
Use of viscoelastic monitoring and prothrombin complex concentrate in a paediatric patient with polytrauma and severe traumatic brain injury
Authors: Sribnick Eric A , Wenger Nicole , Nicol Kathleen , Tobias Joseph D
Published: December 2020

Viscoelastic monitoring (VEM) tools, such as rotational thrombelastometry, have been used extensively to measure coagulopathy in adults but have received less attention in paediatric care. The presented case involves a 5-year-old boy who was brought to the emergency department after a motor vehicle collision with a Glasgow Coma Scale score of 6T and extensive injuries, including a subdural hematoma. VEM was used to monitor the patient’s coagulopathy and to inform treatment measures by allowing real-time visualisation of the patient’s coagulation status. VEM was additionally used to direct blood product replacement in preparation for neurosurgical intervention, and 4-factor prothrombin complex concentrate (PCC) was used to help reverse the coagulopathy. The patient underwent successful hemicraniectomy after improvement of his coagulopathy. In paediatrics, VEM and PCC are increasingly being used for post-trauma coagulopathy, and this case highlights their potential promise and the need for further research.
Pathogenic potential ofParabacteroides distasonisrevealed in a splenic abscess case: a truth unfolded
Authors: Gunalan Anitha , Biswas Rakhi , Sridharan Balamurugan , Elamurugan Thirthar Palanivelu
Published: December 2020

Splenic abscess is a rare entity, however if unrecognised or left untreated, it is invariably fatal. We herein report a case of splenic abscess in a 40-year-old man presenting with fever, left-sided abdominal pain, altered sensorium and vomiting. On clinical examination, hepatosplenomegaly was noted and the ultrasound of the abdomen showed multiple hypoechoic regions in the upper pole of spleen, and the diagnosis of splenic abscess was made. The patient received antimicrobial therapy and underwent an open splenectomy with full recovery. Pus aspirated from the splenic abscess grew an unusual organism namedParabacteroides distasonis. In the literature, there are only a few recorded cases ofP. distasoniscausing splenic abscess. Through this case report, we would like to emphasise the pathogenic role ofP. distasonisin causing clinical disease, as this organism is typically known to constitute a part of the normal flora.
Fast and furious: flecainide toxicity presenting as monomorphic ventricular tachycardia
Authors: Donthi Nisha , Chandrabhatla Tejasri , Genovese Leonard , deFilippi Christopher
Published: December 2020

A 63-year-old woman on flecainide, furosemide, and triamterene–hydrochlorothiazide presented with weakness and diarrhoea. She had profound hyponatraemia, hypokalaemia and a pre-renal acute kidney injury (AKI). Her ECG showed a regular wide complex tachycardia concerning for monomorphic ventricular tachycardia. She was haemodynamically stable and treated with aggressive electrolyte repletion and amiodarone. Flecainide toxicity can present as a variety of arrhythmias and early recognition is crucial. This case focuses on flecainide toxicity from multiple concomitant insults: diuretic use, diarrhoea, hypokalaemia, hyponatraemia and pre-renal AKI. We emphasise the importance of close outpatient monitoring of electrolytes in a patient on diuretics and flecainide to prevent life-threatening arrhythmias. We discourage use of multiple diuretics in patients taking flecainide.
Cavernous sinus embolisation prior to removal of penetrating foreign body in a 6-year-old child
Authors: Bhatia Kartik D , French Heath , Olsson Gemma , Tumuluri Krishna
Published: December 2020

Transorbital penetrating foreign bodies are extremely rare in children and may penetrate the cavernous sinus or the underlying internal carotid artery. Parent vessel sacrifice and temporary balloon occlusion are feasible options for managing arterial injury during removal of the foreign body. Even in the absence of arterial injury, the ophthalmologist may encounter significant bleeding from the cavernous sinus deep in their operative field that is difficult to control. We present a case of a 6-year-old child with a stick penetrating the left superior orbit to enter the cavernous sinus but sparing the internal carotid artery. We describe the first reported experience of prophylactic coil embolisation of the cavernous sinus to minimise intraoperative bleeding during transorbital removal of a foreign body with an excellent clinical outcome.
Neonatal lupus presenting as a non-specific rash in primary care
Authors: Bernard Heather , Rea Corinna
Published: December 2020

Neonatal lupus erythematosus is a rare autoimmune disease caused by passive transplacental acquisition of maternal autoantibodies manifesting in cutaneous, cardiac, haematological and hepatobiliary abnormalities. The hallmark dermatological finding is erythematous annular lesions with a predilection for photo-exposed areas of the skin. We present a case of a female infant born to a mother with Sjogren’s syndrome, who initially presented to an ambulatory care setting with non-specific erythematous papules involving the face and scalp. Within 6 days the rash changed in appearance, consisting of widespread erythematous annular and polycyclic lesions with central violaceous clearing and atrophy. Serological tests revealed asymptomatic anemia and leukopenia, elevated liver enzymes, and positive antinuclear antibodies (ANA) and anti-SSb/La antibodies. Further cardiac evaluation was normal. She was managed conservatively in the outpatient setting with topical steroids, avoidance of sunlight and fluorescent light exposure, and primary care, rheumatological and dermatological follow-up.
Corynebacterium amycolatum: an unusual cause of corneal ulcer
Authors: Sugumaran Radha , Sistla Sujatha , Chavhan Pratima , Deb Amit Kumar
Published: December 2020

Here, we report a novel case of corneal ulcer in a 72-year-old patient with diabetes caused byCorynebacterium amycolatum. This organism should not be ignored as a harmless commensal whenever it is isolated in pure form in repeat cultures of the specimen along with a leucocyte reaction in direct microscopic examination. Moreover, this organism is multidrug-resistant, so species identification of diphtheroids is important to start appropriate antibiotic therapy. There are very few published reports of ocular infection and none of corneal ulcer by this organism.
Hyperandrogenism caused by ovarian Leydig cell tumour: finding the needle in a haystack
Authors: Tong Chin Voon , Tai Yong Ting
Published: December 2020

Leydig cell tumours (LCTs) of the ovary are rare ovarian tumours that usually present with hyperandrogenism. Conventional radiological imagings are helpful in localising these tumours. However, some tumours may be too small to be localised before curative surgical removal. It is important to identify these androgen-secreting neoplasms which originate mostly from adrenals or ovaries because they are potentially malignant and require specific treatment. When conventional imagings are unrevealing, selective ovarian and adrenal venous sampling (SOAVS) is the next option. We report a case of LCT that was localised by SOAVS after results from other imaging modalities remained inconclusive.
Chronic strongyloidiasis: a case of B symptoms and recurrent asthma exacerbations
Authors: Latif Zara , Crupie Marc J
Published: December 2020

Strongyloidiasis is one of the neglected helminths infection that is often underdiagnosed and undertreated. Due to its variable presentation, its diagnosis is often a challenge. We report a case of an immigrant patient with asthma who later developed eosinophilia. After 3 years of unexplained eosinophilia, he developed B symptoms and had frequent asthma exacerbations. He was later diagnosed with strongyloidiasis and treated with ivermectin. His B symptoms resolved, and his asthma exacerbations decreased significantly. Due to the frequent use of corticosteroids in asthma exacerbations, this case illustrates the importance ofStrongyloidesscreening in asthmatics from high-risk regions. It also displays the importance of further investigating patients with asthma who develop eosinophilia and have frequent exacerbations while on optimal asthma treatment. Having a high index of suspicion is essential when making this diagnosis, as clinical presentation is often variable and does not follow a standard time course.
Recurrent phyllodes tumour of breast infiltrating the latissimus dorsi reconstruction flap
Authors: Saxena Pradeep , Lalchandani Ankit , Dausage Chirag
Published: December 2020

Phyllodes tumour is a rare breast tumour with potential of malignancy. Recurrence in phyllodes tumour may also be suggestive of malignant transformation. We report a case of 29-year-old woman with recurrent phyllodes tumour infiltrating the latissimus dorsi reconstruction flap. Re-excision of the tumour along with excision of latissimus dorsi flap was done. Histopathology confirmed malignant phyllode tumour. A significantly higher incidence of recurrence is seen in phyllodes tumour of large size, tumours with infiltrative borders, increased mitotic activity, malignant histology and positive margins. Surgeons should always take into consideration the risk factors for recurrence before planning reconstructive breast surgery in recurrent phyllodes tumour. A preoperative MRI imaging and incisional biopsy are essential in planning surgery for these patients.
Mixed infection ofActinomyces israeliiandFusobacterium nucleatumpresenting as a neck mass
Authors: King James Patrick , Dhar Mili , Smith Stephanie Jane , Emmanuel Julian
Published: December 2020

This report presents the case of a mixed infection ofActinomyces israeliiandFusobacterium nucleatum,presenting as an extensive neck mass progressing through tissue planes and causing bony destruction. Despite multiple abscess aspirates, imaging and serological investigations, the causative organisms proved elusive over the course of the patient’s long admission, only to be identified postdischarge. The patient was successfully initiated on a prolonged course of intravenous antibiotics and did not suffer from any complications. This report aims to raise awareness of the presentation, pathogenicity and treatment of Actinomyces and Fusobacteria infections, given a notable difficulty in diagnosis.
Symptomatic relapse and long-term sequelae of COVID-19 in a previously healthy 30-year-old man
Authors: Abdallah Hatem , Porterfield Florence , Fajgenbaum David
Published: December 2020

Much has been reported on the clinical course of severe COVID-19, but less is known about the natural history and sequalae of mildly symptomatic cases and the prospects of reinfection or recurrence of symptoms. We report a case of a patient with mildly symptomatic PCR-confirmed COVID-19 who, after being symptom-free for 2 weeks, redeveloped symptoms and was found to be PCR-positive again >4 weeks from original testing. Surprisingly, IgG and IgM antibody testing was negative 2 months after reinfection. Although no negative testing was performed between the two symptomatic bouts, this case raises the possibility of reinfection after controlling the virus and highlights the long period with which a patient can shed virus and experience symptoms after initial infection. Characterising variations in clinical symptoms and length of viral shedding after improvement is essential for informing recommendations on patients safely resuming contact with others.
Nonsensus in the treatment of proximal humerus fractures: uncontrolled, blinded, comparative behavioural analysis between Homo chirurgicus accidentus and Macaca sylvanus
Authors: Razaeian Sam , Wiese Birgitt , Zhang Dafang , Harb Afif , Krettek Christian , Hawi Nael
Published: December 2020

Objective

To investigate the inter-rater reliability of Barbary macaques compared with an expert group of surgeons for the choice of treatment and predicted outcome of proximal humerus fractures.

Design

Uncontrolled, blinded, comparative behavioural analysis.

Setting

Germany and United States.

Participants

10 blinded experts in the field of orthopaedic trauma surgery (
Homo chirurgicus accidentus
), with special focus on upper extremity surgery from Germany and the US, and five Barbary macaques (
Macaca sylvanus
) from a semi-free range enclosure.

Main outcome measures

The reliability of agreement between raters assessed with Fleiss’ ĸ.

Results

Barbary macaques seem to have inferior inter-rater reliability in comparison with experts for choice of treatment (non-surgical
v
surgical), but for the geriatric age group most frequently affected by proximal humeral fractures, they performed similarly to the experts in their choices of treatment and choice of surgical procedure. Agreement about predicted outcome was poor among the macaques and slight among the experts. All experts almost always predicted the outcome incorrectly and tended to underestimate it. While only 4 (4.4%) of 90 experts’ predictions were correct, 13 (28.9%) of 45 macaques’ predictions were correct.

Conclusions

Consensus on treatment and expected outcomes of proximal humeral fractures is lacking even beyond the human species. Although Barbary macaques tend to predict the clinical outcome more accurately, their reliability to assist surgeons in making a consistent decision is limited. Future high quality research is needed to guide surgeons’ decision making on the optimal treatment of this common injury.
Cross-sectional study on the awareness, susceptibility and use of heated tobacco products among adolescents in Guatemala City, Guatemala
Authors: Gottschlich Anna , Mus Sophia , Monzon Jose Carlos , Thrasher James F , Barnoya Joaquin
Published: December 2020

Objectives

Heated tobacco products (HTPs) are increasingly marketed worldwide, yet limited research on HTPs has been conducted in low and middle-income countries (LMICs) or among adolescents. Guatemala is one of the few LMICs where HTPs are available. This study examined prevalence and correlates of HTP awareness, susceptibility and use among adolescents in Guatemala.

Design, setting and participants

A cross-sectional survey on HTP awareness, susceptibility and use was conducted among 2870 students between the ages of 13 and 17 in private schools in Guatemala City, Guatemala.

Primary and secondary outcome measures

The primary outcome was susceptibility to future use of HTP among school-aged current and never smokers in Guatemala. We also explored awareness and use of HTPs. Multivariate binomial regression models were used to explore associations between these outcomes and both sociodemographic factors and established smoking correlates.

Results

Of all students (n=2870), about half were aware of HTPs (52.4%) and susceptible to future or continued use (52.4%). Whereas 8.4% of students had tried HTPs in the lifetime (but not in the last month), only 2.9% used HTPs in the past month. Independent correlates of HTP susceptibility and ever-use included: use of other tobacco products (current smoking: adjusted OR (AOR)=10.53 and 6.63, respectively; current e-cigarette use: AOR=21.87 and 10.40, respectively), moderate alcohol consumption (AOR=1.49 and 1.19, respectively), marijuana use in the past 30 days (AOR=3.49 and 2.29, respectively) and having friends who use HTPs (AOR=1.83 and 7.28, respectively).

Conclusions

Among this sample of adolescents in Guatemala City, where tobacco control is weak, the prevalence of HTP use was low but susceptibility to future use was high. Tobacco prevention and intervention strategies for cigarettes and e-cigarettes should now also include HTPs, which tend to be used by similar adolescent populations (ie, those who use other substances or are exposed to tobacco through family and friends).
Community health workers for non-communicable disease prevention and control in Nepal: a qualitative study
Authors: Rawal Lal B , Kharel Chandani , Yadav Uday Narayan , Kanda Kie , Biswas Tuhin , Vandelanotte Corneel , Baral Sushil , Abdullah Abu S
Published: December 2020

Background/objective

The increasing burden of non-communicable diseases (NCDs) in Nepal underscores the importance of strengthening primary healthcare systems to deliver efficient care. In this study, we examined the barriers and facilitators to engaging community health workers (CHWs) for NCDs prevention and control in Nepal.

Design

We used multiple approaches including (a) review of relevant literature, (b) key personnel and stakeholders’ consultation meetings and (c) qualitative data collection using semistructured interviews. A grounded theory approach was used for qualitative data collection and the data were analysed thematically.

Setting

Data were collected from health facilities across four districts in Nepal and two stakeholder consultative meetings were conducted at central level.

Participants

We conducted in-depth interviews with CHWs (Health Assistants, Auxiliary Health Workers, Auxiliary Nurse Midwife) (n=5); key informant interviews with health policymakers/managers (n=3) and focus group discussions (FGDs) with CHWs (four FGDs; total n=27). Participants in two stakeholder consultative meetings included members from the government (n=8), non-government organisations (n=7), private sector (n=3) and universities (n=6).

Results

The CHWs were engaged in a wide range of public health programmes and they also deliver NCDs specific programmes such as common NCDs screening, provisional diagnosis, primary care, health education and counselling, basic medication and referral and so on. These NCD prevention and control services are concentrated in those districts, where the WHO, Package for prevention and control of NCDs) program is being implemented. Some challenges and barriers were identified, including inadequate NCD training, high workload, poor system-level support, inadequate remuneration, inadequate supply of logistics and drugs. The facilitating factors included government priority, formation of NCD-related policies, community support systems, social prestige and staff motivation.

Conclusion

Engaging CHWs has been considered as key driver to delivering NCDs related services in Nepal. Effective integration of CHWs within the primary care system is essential for CHW’s capacity buildings, necessary supervisory arrangements, supply of logistics and medications and setting up effective recording and reporting systems for prevention and control of NCDs in Nepal.
Population-based comparison of chronic kidney disease prevalence and risk factors among adults living in the Punjab, Northern India and the USA (2013–2015)
Authors: Bragg-Gresham Jennifer , Thakur JS , Jeet Gursimer , Jain Sanjay , Pal Arnab , Prasad Rajendra , Pennathur Subramaniam , Saran Rajiv
Published: December 2020

Objectives

India is witnessing a disturbing growth in non-communicable diseases (NCDs), including chronic kidney disease (CKD). Recently, a WHO STEPS survey was conducted in the state of Punjab, India to collect data from the adult population on NCD risk factors. We sought to compare the prevalence of CKD and its risk factors between this large state in northern India and the USA.

Setting

Samples were drawn from both locations, Punjab, India and the USA, using multistage stratified sampling designs to collect data representative of the general population.

Participants

Data from 2002 participants in the Punjab survey (2014–2015) and 5057 in the USA (National Health and Nutrition Examination Survey (NHANES; 2013–2014), between the ages of 18–69 years were examined.

Primary and secondary outcome measures

Modified Poisson regression was employed to compare prevalence between the two samples for markers of CKD and its risk factors. All analyses used sampling weights.

Results

The average age in the Punjab sample was significantly lower than the USA (38.3 vs 42.5 years, p<0.0001). While smoking and obesity were higher in the USA, hypertension was much more common in Punjab (48.2% vs 33.4%, p<0.0001). Significant differences were seen in the prevalence of CKD, with lower prevalence of eGFR <60 mL/min/1.73 m2 (2.0% vs 3.8%, p<0.0001), but markedly higher prevalence of albuminuria (46.7% vs 8.9%, p<0.0001) in Punjab. These differences could not be explained by traditional risk factors such as diabetes and hypertension.

Conclusions

We report a strikingly high prevalence of albuminuria in Punjab, India, compared with the USA. This requires further study and may have enormous public health implications for future burden of progressive CKD, end-stage kidney disease, morbidity, mortality and specifically for elevated risk or presence of cardiovascular disease in the northern state of Punjab, India.

Funding came from the National Health Mission, Punjab, India, JST and the Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Pilot cluster randomised trial of an evidence-based intervention to reduce avoidable hospital admissions in nursing home residents (Better Health in Residents of Care Homes with Nursing—BHiRCH-NH Study)
Authors: Sampson Elizabeth L , Feast Alexandra , Blighe Alan , Froggatt Katherine , Hunter Rachael , Marston Louise , McCormack Brendan , Nurock Shirley , Panca Monica , Powell Catherine , Rait Greta , Robinson Louise , Woodward-Carlton Barbara , Young John , Downs Murna
Published: December 2020

Objectives

To pilot a complex intervention to support healthcare and improve early detection and treatment for common health conditions experienced by nursing home (NH) residents.

Design

Pilot cluster randomised controlled trial.

Setting

14 NHs (7 intervention, 7 control) in London and West Yorkshire.

Participants

NH residents, their family carers and staff.

Intervention

Complex intervention to support healthcare and improve early detection and treatment of urinary tract and respiratory infections, chronic heart failure and dehydration, comprising: (1) ‘Stop and Watch (S&W)’ early warning tool for changes in physical health, (2) condition-specific care pathway and (3) Situation, Background, Assessment and Recommendation tool to enhance communication with primary care. Implementation was supported by Practice Development Champions, a Practice Development Support Group and regular telephone coaching with external facilitators.

Outcome measures

Data on NH (quality ratings, size, ownership), residents, family carers and staff demographics during the month prior to intervention and subsequently, numbers of admissions, accident and emergency visits, and unscheduled general practitioner visits monthly for 6 months during intervention. We collected data on how the intervention was used, healthcare resource use and quality of life data for economic evaluation. We assessed recruitment and retention, and whether a full trial was warranted.

Results

We recruited 14 NHs, 148 staff, 95 family carers and 245 residents. We retained the majority of participants recruited (95%). 15% of residents had an unplanned hospital admission for one of the four study conditions. We were able to collect sufficient questionnaire data (all over 96% complete). No NH implemented intervention tools as planned. Only 16 S&W forms and 8 care pathways were completed. There was no evidence of harm.

Conclusions

Recruitment, retention and data collection processes were effective but the intervention not implemented. A full trial is not warranted.

Trial registration number

ISRCTN74109734(https://doi.org/10.1186/ISRCTN74109734).

Original protocol

BMJ Open. 2019;9(5):e026510. doi:10.1136/bmjopen-2018-026510.
Use of guideline-recommended drug therapy in patients undergoing percutaneous coronary intervention for stable coronary heart disease in Germany: a multilevel analysis of nationwide routine data
Authors: Frank-Tewaag Julia , Bleek Julian , Horenkamp-Sonntag Dirk , Marschall Ursula , Zeymer Uwe , Donner-Banzhoff Norbert , Sundmacher Leonie
Published: December 2020

Objectives

To determine the prescription of guideline recommended drug therapy in patients with stable coronary heart disease (sCHD) prior to percutaneous coronary intervention (PCI) in Germany and to examine the role of patient characteristics and features of regional healthcare supply in a multilevel model.

Design

Secondary data analysis of factors associated with the prescription of guideline recommended drug therapy using a multilevel model to analyse regional-level effects, over and above the effects of patient-level demographic and health status.

Setting

Office-based prescriptions in the year prior to the invasive procedure.

Participants

A linked nationwide dataset from Germany’s three largest statutory health insurance funds of all patients receiving PCI in the year 2016.

Main outcome measures

Patients’ odds of receiving optimal medical therapy and symptom-oriented therapy within 1 year prior to PCI.

Results

68.6% of patients received at least one lipid-lowering drug and one symptom-oriented therapy prior to PCI. 43.6% received at least two agents to control their symptoms. Patients who received treatment in accordance with the recommendations had a greater number of diagnosed risk factors, a more severe history of cardiac disease and used a higher volume of ambulatory office-based physician services. The prescriptions prevalence for the symptom-oriented therapies differed significantly between eastern and western Germany, with a higher prevalence in the eastern districts.

Conclusions

Guidelines can only provide decision-making corridors, and the applicability of recommendations must always be assessed on a case by case basis. Nevertheless, our analysis indicates that the prevalence of prescriptions in routine practice is subject to substantial variation and that conservative therapy options are not fully exhausted prior to PCI. This suggests that there might be room for improvement in the care of patients with sCHD.
Tensile behaviour of ultra-high-performance steel fiber reinforced concrete
Authors: Yang Yuechen , Ismail Mohammed , Pantazopoulou S.J. , Palermo Dan
Published: December 2020

Recent developments in the area of ultra-high-performance steel fiber reinforced concrete (UHP-SFRC) has enabled a reduction in the use of steel reinforcement and has led to enhanced ductility and toughness of structural components owing to its resilient tensile behaviour. This paper presents the results of an experimental study that was conducted to investigate the tensile behaviour of UHP-SFRC. Four commercial mixes and two in-house mixes were evaluated using the procedures prescribed in the 2019 edition of Annex U of CSA-A23.1 and in Annex 8.1 of CSA-S6 2018. The tensile strength of UHP-SFRC was quantified and correlated through the direct tension test, splitting test, inverse analysis of four-point bending tests using either code expressions or nonlinear finite element analysis, and a calibrated empirical expression that links this property to the cylinder compressive strength. In addition, the effect of important parameters on flexural strength including casting methodology, volumetric ratio of steel fibers, and aspect ratio (shear span to depth ratio) of bending prisms have been assessed. The casting methodology affected the fiber distribution, an attribute that directly relates to flexural strength. Prisms containing 1% steel fibers by unit volume failed in a relatively brittle manner and possessed less flexural strength than the prisms containing 2% steel fibers. Prisms with an aspect ratio of 1 tended to develop greater flexural strength than the prisms tested with an aspect ratio of 2. The tensile strength obtained from inverse analysis is generally greater than the strength obtained from the direct tension test, the finite element analysis, and the calibrated empirical expression. Furthermore, it was determined that tensile strength obtained from the splitting test should be multiplied by a correction factor of ≈1/π, to match the strength obtained from the direct tension test. The majority of the mixes tested exhibited a tension hardening behaviour with a hardening ratio greater than 1.1 and an ultimate tensile strain greater than 0.001.
Analytic treatment of near-extremal charged black holes supporting non-minimally coupled massless scalar clouds
Authors: Hod Shahar
Published: December 2020

It has recently been revealed that massless scalar fields which are non-minimally coupled to the Maxwell electromagnetic tensor can be supported in the exterior spacetime regions of spherically symmetric charged black holes. The boundary between scalarized charged black-hole spacetimes and bald (scalarless) Reissner–Nordström black holes is determined by the presence of a critical existence-line which describes spatially regular linearized scalar ‘clouds’ that are supported in the black-hole spacetime. In the present paper we use analytical techniques in order to solve the Klein–Gordon wave equation for the non-minimally coupled linearized scalar fields in the spacetimes of near-extremal supporting black holes. In particular, we derive a remarkably compact analytical formula for the discrete resonant spectrum $$\{\alpha (l,Q/M;n)\}^{n=\infty }_{n=1}$$

{
α

(
l
,
Q
/
M
;
n
)

}

n
=
1

n
=
∞

which characterizes the dimensionless coupling parameter of the composed Reissner–Nordström-black-hole-nonminimally-coupled-massless-scalar-field configurations along the critical existence-line of the Einstein–Maxwell-scalar theory (here Q/M is the dimensionless charge-to-mass ratio of the central supporting black hole and l is the angular harmonic index of the supported scalar configurations).
A two-parameter entropy and its fundamental properties
Authors: Dutta Supriyo , Furuichi Shigeru , Guha Partha
Published: December 2020

This article proposes a new two-parameter generalized entropy, which can be reduced to the Tsallis and Shannon entropies for specific values of its parameters. We develop a number of information-theoretic properties of this generalized entropy and divergence, for instance, the sub-additive property, strong sub-additive property, joint convexity, and information monotonicity. This article presents an exposit investigation on the information-theoretic and information-geometric characteristics of the new generalized entropy and compare them with the properties of the Tsallis and Shannon entropies.
Computational fluid dynamics and experimental study of the effect of inclination angle on turbulent natural convection in an upward open cubic cavity
Authors: Pinã-Ortiz A. , Hinojosa J. F. , Hernández-López I.
Published: December 2020

The effect of inclination angle on heat transfer by turbulent natural convection in an inclined open cubic cavity with side length of 1[Formula: see text]m is experimentally and numerically studied. The wall opposite to the aperture is subjected to uniform heat flux condition with a value of 110[Formula: see text]W/m2, whereas the remaining walls were kept thermally insulated. Six most used two equations turbulence models were tested, with Computational Fluid Dynamics (CFD) software ANSYS FLUENT. The results were obtained for four inclination angle values: 0∘, 15∘, 30∘ and 45∘. The spatial distribution for temperature, flow pattern and magnitude of velocity are determined and analyzed. An experimental prototype was built to obtain experimental temperature profiles and heat transfer coefficients. The experimental average Nusselt number increases as the inclination angle increases, having a minimum of 203 for 0∘ case and a maximum of 225 for 45∘ case. The comparison between experimental and numerical average Nusselt numbers indicates that the minimum average difference is with the realizable [Formula: see text] turbulence model, therefore, this turbulence model is recommended to model this type of systems.
Painlevé analysis of a nonlinear Schrödinger equation discussing dynamics of solitons in optical fiber
Authors: Rizvi Syed T. R. , Seadawy Aly R. , Ali Ijaz , Younis Muhammad
Published: December 2020

In this paper, we investigated a new form of nonlinear Schrödinger equation (NLSE), namely the Biswas–Arshed model (BAM) for the analysis of complete integrability with the help of Painlevé test ([Formula: see text]-test). By applying this test, we analyze the singularity structure of the solutions of BAM, knowing the fact that the absence of specific sort of singularities like moveable branch points is a patent signal for the complete integrability of the discussed model. Passing the [Formula: see text]-test is a powerful indicator that the studied model is resolvable by means of inverse scattering transformation (IST).
CBLM: Cluster-Based Location Management for 5G Small Cell Network Under Stochastic Environment
Authors: Chakraborty Sheuli , Mazumdar Kaushik , De Debashis
Published: December 2020

Internet of Things (IoT) applications are connecting several Mobile Stations (MSs) to form the Mobile Communication Network (MCN). MSs are moving through macrocell and picocell recurrently due to the discontinuous deployment of the picocell over the macrocell. Each time they cross the cell boundary, they need to register with the Mobility Management Entity (MME). It incurs a high registration cost and elevates the signaling overhead ratio. To reduce the signaling overhead ratio, earlier techniques were attempted either by forming closed subscriber groups or by delaying the registration process, but that may create inconsistency in user location information. With this motivation, in this paper, MSs with similar mobility pattern which are moving from the picocell to macrocell, are grouped in clusters. A representative MS, called Cluster Representative (CR), performs the location management task on behalf of the whole cluster. The stochastic process has been employed to analyze the model. This study proposes Cluster-Based Location Management (CBLM) scheme and compares it with two state-of-the-art algorithms, named Group Mobility Management (GMM) and Closed Subscriber Group (CSG). On average, the CBLM scheme exhibits approximately 70% better performance than the CSG scheme whereas, 30% better than the GMM algorithm to mitigate the signaling overhead.
Hybrid Energy Source Fed Fuzzy-Based SVPWM for 5-Level NPC Inverter with Grid Connected System
Authors: Palanisamy R. , Vijayakumar K. , Karthikeyan B.
Published: December 2020

This paper presents the fuzzy-based Space Vector Pulse Width Modulation (SVPWM) for 5-level Neutral Point Clamped inverter with hybrid energy source fed grid connected system. The proposed scheme is energized using Photovoltaic and Wind energy system combination. The Neural Network-(NN) based Maximum Power Point Tracking algorithm (MPPT) has been implemented to track maximum power under different operating conditions.

First, we proposed fuzzy-based SVPWM, which is developed for 5-level NPC inverter to provide voltage and current control, reduced THD, predetermined switching pattern, capacitor voltage unbalance minimization and maintain good control under nonlinearities and suspicions of PV-Wind energy connected hybrid system.

Second, we proposed the inverter output voltage, which has been synchronized with grid connected system using split inductor (SI). The reference voltages for SVPWM implementation were obtained using feedback current control method.

Third, we proposed different solar radiations, the proposed system has attained better performance by trailing maximum power from hybrid energy system. The simulation and experimental responses have been validated using Matlab/simulink and FPGA processor.
A Model Parameter Estimation Scheme Based on Fast Search for CTU-Level Rate Control in HEVC
Authors: Zhou Mingliang , Mao Qin , Wei Xuekai
Published: December 2020

The estimation of a model parameter is very important for coding tree unit (CTU)-level rate control as it can significantly affect bit allocation and coding performance. However, CTU-level rate control models sometimes fail as the accuracy of the model parameter is not well considered in high efficiency video coding (HEVC). Based on this observation, a model parameter estimation scheme that is based on a fast search for CTU-level rate control is proposed. First, the estimation of a model parameter is formulated as an optimization problem. Second, we transform the optimal model parameter estimation into a process to search for the most similar CTU. To improve the searching efficiency and reduce the parameter estimation error, a new spiral search mechanism is proposed to find the most similar CTU from inside to outside. According to the experimental results, the proposed method can distinctly enhance the accuracy of the CTU-level rate control and consistently outperform HM16.18 and other state-of-the-art algorithms for all testing configurations. An average reduction of 7.8% and a maximum reduction of 10.0% of the BD-Rate were achieved compared with HM16.18. An average reduction of 3.4% and a maximum reduction of 4.6% of the BD-Rate were achieved compared with other state-of-the-art algorithms. A slight computational complexity overhead is observed.
SODIUM GLUCONATE INTERCALATED Mg-Al LDH COATING TO IMPROVE THE CORROSION RESISTANCE OF AZ31
Authors: ALI HAMID , WAKEEL ANEELA , ANJUM MUHAMMAD JUNAID , KHAN WAHEED QAMAR , GHAURI FAIZAN ALI , RAZA MUHAMMAD , YASIN GHULAM
Published: December 2020

Mg-Al layer double hydroxide (LDH) intercalated with sodium gluconate (SG) is successfully synthesized on the AZ31. The hydrothermal treatment is utilized to develop the LDH coating and three different concentrations of SG, such as 0.1, 0.15, and 0.30[Formula: see text]M were tried to intercalate into the Mg-Al LDH. The crystalline structure of the produced coating reveals that only 0.30[Formula: see text]M of SG can provide sufficient anions to develop the LDH structure. The morphological features are evincing the concentration dependence of produced coatings. Fourier transform infra-red (FTIR) spectroscopy is performed to confirm the intercalation of SG. Moreover, the electrochemical characterization shows that the optimum concentration of SG can provide better corrosion resistance against aggressive electrolyte. Hence, the results of the study reveal that 0.30[Formula: see text]M SG intercalated LDH can provide excellent corrosion resistance to AZ31.