bluuebunny/crossref_metadata_2025_split huggingface dataset:
A culture‐led approach to understanding energy transitions in China: The correlative epistemology
Authors: Huang Ping , Westman Linda , Castán Broto Vanesa 
Published: April 2021

AbstractTransformations of the energy system are unfolding in China at an unprecedented scale and pace. The dynamics of China's energy transitions impact global trends of energy decarbonisation. Transition theories within the Anglophone academic tradition have been used to examine this process, but they tend to misrepresent the social, cultural, and political structures that shape energy transitions in China. This paper proposes a move from an analysis of energy transitions “with Chinese characteristics” to alternative thinking on energy transitions truly rooted in Chinese epistemological and philosophical constructs. The correlative epistemology refers to a Chinese tradition of social studies that describes the cosmos as a structured order of relations (guanxi). This tradition sees guanxi as the fundamental constituent of Chinese society. Such a relational focus enables a culture‐led reading of China's energy transitions, thus responding to calls for transition theories “from elsewhere.” In particular, correlative interpretations of innovation and transition processes in China frame energy transitions within broader societal transformations, define the operation of transition governance, and reveal that pre‐existing guanxi networks shape the activities of actors in transition processes.
Severe infection risk in patients treated with biologics for rheumatoid arthritis: a systematic review protocol
Authors: Makimoto Kiyoko , Konno Rie , Kanzaki Hatsumi , Kinoshita Atsushi 
Published: April 2021

ABSTRACT

Objective:
The objective of this review is to estimate the population-based incidence and to determine the types of severe infection experienced by patients with rheumatoid arthritis who are taking biological agents.

Introduction:
Since the late 1990s, a variety of biological and synthetic drugs have been developed to treat rheumatoid arthritis. In recent years, the incidence of severe infection in patients with rheumatoid arthritis in Western nations has been reported by observational studies; however, no systematic review has been conducted on this topic.

Inclusion criteria:
The following criteria will be considered for inclusion: i) observational studies on patients with rheumatoid arthritis who are taking biological agents; ii) studies reporting the number of severe infections requiring hospitalization for treatment; and iii) studies with person-years of observational data.

Methods:
MEDLINE, CINAHL, Embase, and Web of Science will be searched to identify published studies. The reference lists of all studies that are selected for critical appraisal will be screened for additional studies. The search for unpublished studies will include MedNar and OpenGrey. Only studies published in English from 1999 to the present will be included. Screening of studies, assessment of methodological quality, and data extraction will be performed by two independent reviewers. If possible, studies will be pooled in statistical meta-analysis.

Systematic review registration number:
PROSPERO CRD42020175137
Model-Based Predictive Control and Dithering Control for an Integrated Gasoline Engine and Three-Way Catalytic Converter System
Authors: Yang Kuo , Chen Pingen 
Published: April 2021

Abstract
Controls of integrated gasoline engine and aftertreatment systems are critical for fuel efficiency improvement and emission regulation. This paper aims to develop novel model-based three-way catalytic converter (TWC) controls to reduce the fuel consumption and tailpipe emissions for a gasoline engine. A model-based dither control and a nonlinear model predictive control (MPC)-based control are presented, respectively. The proposed TWC dither control utilizes a systematically designed dither cycle configuration (including dithering amplitude, offset, and frequency) based on a control-oriented model, with the capability to adapt the dither cycle configuration to various engine operating conditions. The MPC control can optimize engine air–fuel ratio (AFR) to maintain the oxygen storage of TWC at a desired level and thus meet the tailpipe NOx, CO, and HC emission requirements. The efficacies of both model-based TWC controls are validated in simulation with MPC control improving CO emission conversion efficiencies by 8.42% and 4.85% in simplified US06 and urban dynamometer driving schedule (UDDS) driving cycles, when compared to a baseline dithering-based AFR control. Meanwhile, NOx emission conversion efficiency is maintained above the required limit of 95%, while the fuel efficiency remains at the same level as the baseline control methodology.
Study Correlating Lead (Pb) Level Exposure and Bone Shock Absorption Capacity Based on Damping Associated With Higher Modes of Vibration
Authors: Veta Jacob , Singh Kumar V. , Bhattacharya Amit 
Published: April 2021

AbstractNoninvasive vibration testing is one of the tools for characterizing the biomechanical properties of bones and muscle groups in humans and animals. They present alternatives for evaluating bone health quality and may serve as early indicators for bone fragility and bone-related diseases. In recent years, a vibration-based bone shock absorption (BSA) method has shown potential to relate the damping capacity associated with the fundamental (first) vibration modes for developing dynamic bone quality indicators for osteoporosis patients. This research presents a study of early life (birth to age 78 months) lead (Pb) exposure on the damping capacity (bone fragility measures) with the bone shock absorption method. The damping ratio corresponding to few vibration modes is extracted and analyzed using clinical bone shock absorption data of patients with different Pb exposure levels. A method is developed for clustering and identifying three dominant vibration modes and their corresponding damping ratio. The statistical correlation between the damping parameters associated with higher vibration modes and Pb exposure level is presented here. This study highlights the importance of analyzing higher vibration modes and their damping capacity, which could be used to predict early diagnostics precursors of the bone- and/or muscle-related conditions or disorders.
Additively Manufactured Compliant Hybrid Gas Thrust Bearing for Supercritical Carbon Dioxide Turbomachinery: Design and Proof of Concept Testing
Authors: Ertas Bugra 
Published: April 2021

Abstract
The following paper presents a new type of gas lubricated thrust bearing that utilizes additive manufacturing or also known as direct metal laser melting (DMLM) to fabricate the bearing. The motivation for the new bearing concept is derived from the need for highly efficient supercritical carbon dioxide (sCO2) turbomachinery in the mega-watt power range. The paper provides a review of existing gas thrust-bearing technology, outlines the need for the new DMLM concept, and discusses proof-of-concept testing results. The new concept combines hydrostatic pressurization with individual tilting pads that are flexibly mounted using hermetic squeeze film dampers (HSFD) in the bearing-pad support. This paper describes the thrust-bearing concept and discusses the final design approach. Proof-of-concept testing in air for a 6.8 in. (173 mm) outer diameter thrust gas bearing was performed; with thrust loading, up to 1500 lbs (6.67 kN) and a thrust runner speed of 10krpm (91 m/s tip speed). The experiments were performed with a bent shaft resulting in thrust runner axial vibration magnitudes of 2.9 mils (74 μm) p-p and dynamic thrust loads of 270 lbs (1.2 kN) p-p. In addition, force deflection characteristics and stiffness coefficients of the bearing system are presented for an inlet hydrostatic pressure of 380 psi (2.62 MPa). Results at 10 krpm show that the pad support architecture was able to sustain high levels of dynamic misalignment equaling 6 times the nominal film clearance while demonstrating a unit load-carrying capacity of 55 psi (0.34 Mpa). Gas-film force deflection tests portrayed nonlinear behavior like a hardening spring, while the bearing pad support stiffness was measured to be linear and independent of gas film thickness.
Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients
Authors: Sallis Robert , Young Deborah Rohm , Tartof Sara Y , Sallis James F , Sall Jeevan , Li Qiaowu , Smith Gary N , Cohen Deborah A 
Published: April 2021

ObjectivesTo compare hospitalisation rates, intensive care unit (ICU) admissions and mortality for patients with COVID-19 who were consistently inactive, doing some activity or consistently meeting physical activity guidelines.MethodsWe identified 48 440 adult patients with a COVID-19 diagnosis from 1 January 2020 to 21 October 2020, with at least three exercise vital sign measurements from 19 March 2018 to 18 March 2020. We linked each patient’s self-reported physical activity category (consistently inactive=0–10 min/week, some activity=11–149 min/week, consistently meeting guidelines=150+ min/week) to the risk of hospitalisation, ICU admission and death after COVID-19 diagnosis. We conducted multivariable logistic regression controlling for demographics and known risk factors to assess whether inactivity was associated with COVID-19 outcomes.ResultsPatients with COVID-19 who were consistently inactive had a greater risk of hospitalisation (OR 2.26; 95% CI 1.81 to 2.83), admission to the ICU (OR 1.73; 95% CI 1.18 to 2.55) and death (OR 2.49; 95% CI 1.33 to 4.67) due to COVID-19 than patients who were consistently meeting physical activity guidelines. Patients who were consistently inactive also had a greater risk of hospitalisation (OR 1.20; 95% CI 1.10 to 1.32), admission to the ICU (OR 1.10; 95% CI 0.93 to 1.29) and death (OR 1.32; 95% CI 1.09 to 1.60) due to COVID-19 than patients who were doing some physical activity.ConclusionsConsistently meeting physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. We recommend efforts to promote physical activity be prioritised by public health agencies and incorporated into routine medical care.
Examining unit costs for COVID-19 case management in Kenya
Authors: Barasa Edwine , Kairu Angela , Ng'ang'a Wangari , Maritim Marybeth , Were Vincent , Akech Samuel , Mwangangi Mercy 
Published: April 2021

IntroductionWe estimated unit costs for COVID-19 case management for patients with asymptomatic, mild-to-moderate, severe and critical COVID-19 disease in Kenya.MethodsWe estimated per-day unit costs of COVID-19 case management for patients. We used a bottom-up approach to estimate full economic costs and adopted a health system perspective and patient episode of care as our time horizon. We obtained data on inputs and their quantities from data provided by three public COVID-19 treatment hospitals in Kenya and augmented this with guidelines. We obtained input prices from a recent costing survey of 20 hospitals in Kenya and from market prices for Kenya.ResultsPer-day, per-patient unit costs for asymptomatic patients and patients with mild-to-moderate COVID-19 disease under home-based care are 1993.01 Kenyan shilling (KES) (US$18.89) and 1995.17 KES (US$18.991), respectively. When these patients are managed in an isolation centre or hospital, the same unit costs for asymptomatic patients and patients with mild-to-moderate disease are 6717.74 KES (US$63.68) and 6719.90 KES (US$63.70), respectively. Per-day unit costs for patients with severe COVID-19 disease managed in general hospital wards and those with critical COVID-19 disease admitted in intensive care units are 13 137.07 KES (US$124.53) and 63 243.11 KES (US$599.51).ConclusionCOVID-19 case management costs are substantial, ranging between two and four times the average claims value reported by Kenya’s public health insurer. Kenya will need to mobilise substantial resources and explore service delivery adaptations that will reduce unit costs.
Estimation of overdiagnosis in colorectal cancer screening with sigmoidoscopy and faecal occult blood testing: comparison of simulation models
Authors: Wieszczy Paulina , Kaminski Michal F , Løberg Magnus , Bugajski Marek , Bretthauer Michael , Kalager Mette 
Published: April 2021

ObjectiveTo estimate overdiagnosis of colorectal cancer (CRC) for screening with sigmoidoscopy and faecal occult blood testing (FOBT).DesignSimulation study using data from randomised trials.SettingPrimary screening, UK, NorwayParticipants152 850 individuals from the Nottingham trial and 98 678 individuals from the Norwegian Colorectal Cancer Prevention (NORCCAP) trial.InterventionCRC screening.Outcome measureWe estimated overdiagnosis using long-term data from two randomised trials: the Nottingham trial comparing FOBT screening every other year to no-screening, and the NORCCAP trial comparing once-only sigmoidoscopy screening to no-screening. To estimate the natural growth of adenomas to CRC, we used the following microsimulation models: (i) the Microsimulation Screening Analysis; (ii) the CRC Simulated Population model for Incidence and Natural history; (iii) the Simulation Model of Colorectal Cancer; (iv) a model derived by the German Cancer Research Center. We defined overdiagnosed cancers as the difference between the observed number of CRCs in the no-screening arm and the expected number of cancers in screening arm (sum of observed and prevented by adenoma removal). The amount of overdiagnosis is defined as the number of overdiagnosed cancers over the number of cancers observed in the no-screening arm.ResultsOverdiagnosis estimates were highly dependent on model assumptions. For FOBT screening with 2354 cancers observed in control arm, four out of five models predicted overdiagnosis, range 2.0% (2400 cancers expected in screening) to 7.6% (2533 cancers expected in screening). For sigmoidoscopy screening with 452 cancers observed in control arm, all models predicted overdiagnosis, range 25.2% (566 cancers expected in screening) to 128.1% (1031 cancers expected in screening).ConclusionsThe amount of overdiagnosis estimated based on the microsimulation models varied substantially. Microsimulation models may not give reliable estimates of the preventive effect of adenoma removal, and should be used with caution to inform guidelines.
Impact of educational level and employment status on short-term and long-term pain relief from supervised exercise therapy and education: an observational study of 22 588 patients with knee and hip osteoarthritis
Authors: Johnsen Marianne Bakke , Roos Ewa , Grønne Dorte Thalund , Bråten Lars Christian Haugli , Skou Søren Thorgaard 
Published: April 2021

ObjectivesTo investigate the impact of educational level and employment status on change in pain intensity after treatment among patients with knee and hip osteoarthritis (OA).DesignA prospective cohort study.Setting and participantsWe analysed 22 588 patients participating in the Good Life with osteoArthritis in Denmark (GLA:D). GLA:D consists of two patient education sessions and 12 supervised exercise sessions.Primary outcomeBaseline educational level and employment status were used as exposures. We investigated the impact of both exposures separately on mean change in pain intensity (visual analogue scale 0–100 mm) from baseline to immediately after treatment (approximately 3 months) and at 12 months, using linear mixed models.ResultsOn average, all patients improved in pain intensity. The average improvement in pain did not differ by educational level, except for one group. Patients with long-term education had less improvement after treatment (2.0 mm, 95% CI 0.8 to 3.1) and at 12 months (2.0 mm, 95% CI 0.6 to 3.4) compared with primary school only (reference). According to employment status, patients on sick leave had the greatest improvement in pain after treatment (−3.4, 95% CI −4.9 to −1.9) and at 12 months (−4.5, 95% CI −6.4 to −2.6) compared with retired patients (reference).ConclusionsOn average, all patients reported improvement in pain at short-term and long-term follow-up. Change in pain intensity did not substantially differ by educational level or employment status, as the absolute differences were small and most likely not clinically important.
Minimally invasive versus conventional sternotomy for Mitral valve repair: protocol for a multicentre randomised controlled trial (UK Mini Mitral)
Authors: Maier Rebecca H , Kasim Adetayo S , Zacharias Joseph , Vale Luke , Graham Richard , Walker Antony , Laskawski Grzegorz , Deshpande Ranjit , Goodwin Andrew , Kendall Simon , Murphy Gavin J , Zamvar Vipin , Pessotto Renzo , Lloyd Clinton , Dalrymple-Hay Malcolm , Casula Roberto , Vohra Hunaid A , Ciulli Franco , Caputo Massimo , Stoica Serban , Baghai Max , Niranjan Gunaratnam , Punjabi Prakash P , Wendler Olaf , Marsay Leanne , Fernandez-Garcia Cristina , Modi Paul , Kirmani Bilal H , Pullan Mark D , Muir Andrew D , Pousios Dimitrios , Hancock Helen C , Akowuah Enoch 
Published: April 2021

IntroductionNumbers of patients undergoing mitral valve repair (MVr) surgery for severe mitral regurgitation have grown and will continue to rise. MVr is routinely performed via median sternotomy; however, there is a move towards less invasive surgical approaches.There is debate within the clinical and National Health Service (NHS) commissioning community about widespread adoption of minimally invasive MVr surgery in the absence of robust research evidence; implementation requires investment in staff and infrastructure.The UK Mini Mitral trial will provide definitive evidence comparing patient, NHS and clinical outcomes in adult patients undergoing MVr surgery. It will establish the best surgical approach for MVr, setting a standard against which emerging percutaneous techniques can be measured. Findings will inform optimisation of cost-effective practice.Methods and analysisUK Mini Mitral is a multicentre, expertise based randomised controlled trial of minimally invasive thoracoscopically guided right minithoracotomy versus conventional sternotomy for MVr. The trial is taking place in NHS cardiothoracic centres in the UK with established minimally invasive mitral valve surgery programmes. In each centre, consenting and eligible patients are randomised to receive surgery performed by consultant surgeons who meet protocol-defined surgical expertise criteria. Patients are followed for 1 year, and consent to longer term follow-up.Primary outcome is physical functioning 12 weeks following surgery, measured by change in Short Form Health Survey (SF-36v2) physical functioning scale. Early and 1 year echo data will be reported by a core laboratory. Estimates of key clinical and health economic outcomes will be reported up to 5 years.The primary economic outcome is cost effectiveness, measured as incremental cost per quality-adjusted life year gained over 52 weeks following index surgery.Ethics and disseminationA favourable opinion was given by Wales REC 6 (16/WA/0156). Trial findings will be disseminated to patients, clinicians, commissioning groups and through peer reviewed publication.Trial registration numberISRCTN13930454.
Direct discharge from the emergency department of simple stable injuries: a propensity score-adjusted non-inferiority trial
Authors: Geerdink Thijs H , Augustinus Simone , Groen Jasper J , van Dongen Johanna M , Haverlag Robert , van Veen Ruben N , Goslings J Carel 
Published: April 2021

BackgroundRecent studies suggest a large proportion of musculoskeletal injuries are simple stable injuries (SSIs). The aim of this study was to evaluate whether direct discharge (DD) from the emergency department (ED) of SSIs is non-inferior to ‘traditional care’ regarding treatment satisfaction and functional outcome, and to compare other patient-reported outcomes (PROMs), patient-reported experiences (PREMs), resource utilization, and adverse outcomes before and after DD.MethodsThis trial compared outcomes for 11 SSIs 6 months before and after the implementation of DD protocols. Pre-DD, patients were treated according to local protocols. Post-DD, patients were discharged directly using removable orthoses, discharge leaflets, smartphone application, and telephone helpline. Participants received a 3-month postinjury PROM/PREM survey to assess treatment satisfaction (Visual Analog Scale, VAS), pain (VAS), functional outcome (four validated questionnaires), and health-related quality of life (HR-QoL; EuroQol-5D). Resource utilization included general practitioner (GP) visit (yes/no), physiotherapist visit (yes/no), return to work/school/sports (days), work/school absenteeism to visit hospital (yes/no), number of hospital visits, and follow-up X-rays. Other outcomes included missed injuries (additionally to SSI) and adverse outcomes (delayed union, non-union). Between-group differences were assessed using propensity score-adjusted regression analyses. Non-inferiority was assessed for satisfaction and functional outcome using predefined margins.Results348 (pre-DD) and 371 (post-DD) patients participated; 144 (41.4%) and 153 (41.2%) patients completed the survey. Satisfaction and functional outcome post-DD were non-inferior to traditional care. Mean satisfaction was 8.13 pre-DD and 7.95 post-DD (mean difference: −0.16, p=0.408). Pain, HR-QoL, GP/physiotherapist visits, and return to work/school/sports were comparable before and after DD. Work absenteeism was higher pre-DD (OR 0.110, p<0.001), as well as school absenteeism (OR 0.084, p<0.001). Post-DD, the mean number of hospital visits and X-rays reduced: −1.68 (p<0.001) and −0.26 (p<0.001). Missed injuries occurred once pre-DD versus twice post-DD. There were no adverse outcomes.DiscussionThe results of this study confirm several SSIs can be discharged directly from the ED without compromising patient outcome/experience. Future injury-specific trials are needed to conclusively assess non-inferiority of DD.Level of evidenceII.
Estimating rill erosion and sediment transport processes along a saturated purple soil slope
Authors: Han Zhen , Chen Xiaoyan , Li Yanhai , Chen Shiqi , Gu Xiaojie , Wei Chaofu 
Published: April 2021

A plough pan with reduced permeability accumulates inﬁltrated water along slopes then saturates the cultivated layer under continuous rain. Topsoil saturation is a frequent phenomenon and an important process of the special soil slopes. A methodology and device system was used in this study to keep cultivated purple soil saturated. Strands of scouring tests were developed to quantify the rill erosion and sediment transport processes along a saturated purple soil slope at four experiment slopes (5°, 10°, 15°, and 20°) and three flow discharges (2, 4, and 8 L·min−1). The experimental results indicated that the sediment transport capacity on a saturated purple soil slope ranged from 0.03 to 1.56 kg·s−1·m−1 with the increasing trend along the slope gradient and flow discharge, and the increasing trend could be well matched by a nonlinear multivariable equation. The sediment concentration of the saturated purple soil slope exponentially increased with rill length and decreased with the increment rate, and the maximum sediment concentrations observed in this study in different hydraulic events ranged from 108.13 to 1174.20 kg·m−3. Saturated and non-saturated purple soil slopes erode differently with the maximum sediment concentration of saturated purple soil slope recorded at approximately 1.42–2.10 times the values for non-saturated purple soil slope. The findings of this research help illustrate the sediment transportation and erosion behaviors of a saturated purple soil slope and serve as the basis for determining the parameters in the erosion models of the purple soil slope.