bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Fuel Properties on Gasoline Direct Injection Particulate Matter Emissions Over First 200 s of World-Harmonized Light-Duty Test Procedure Using an Engine Dynamometer and Novel “Virtual Drivetrain” Software
Authors: Bock Noah R. , Northrop William F. 
Published: March 2021

Abstract
The influence of fuel properties on particulate matter (PM) emissions from a catalytic gasoline particulate filter (GPF) equipped gasoline direct injection (GDI) engine was investigated using novel “virtual drivetrain” software and an engine mated to an engine dynamometer. The virtual drivetrain software was developed in labview to operate the engine on an engine dynamometer as if it were in a vehicle undergoing a driving cycle. The software uses a physics-based approach to determine vehicle acceleration and speed based on engine load and a programed “shift” schedule to control engine speed. The software uses a control algorithm to modulate engine load and braking to match a calculated vehicle speed with the prescribed speed trace of the driving cycle of choice. The first 200 s of the World-harmonized Light-duty Test Procedure (WLTP) driving cycle was tested using six different fuel formulations of varying volatility, aromaticity, and ethanol concentration. The first 200 s of the WLTP was chosen as the test condition because it is the most problematic section of the driving cycle for controlling PM emissions due to the cold start and cold drive off. It was found that there was a strong correlation between aromaticity of the fuel and the engine-out PM emissions, with the highest emitting fuel producing more than double the mass emissions of the low PM production fuel. However, the post-GPF PM emissions depended greatly on the soot loading state of the GPF. The fuel with the highest engine-out PM emissions produced comparable post-GPF emissions to the lowest PM producing fuel over the driving cycle when the GPF was loaded over three cycles with the respective fuels. These results demonstrate the importance of GPF loading state when aftertreatment systems are used for PM reduction. It also shows that GPF control may be more important than fuel properties, and that regulatory compliance for PM can be achieved with proper GPF control calibration irrespective of fuel type.
IJV thrombophlebitis: be wary of the occult
Authors: Oshinyemi Pamela , Lee Charlotte , Gough-Palmer Antony , McKay-Davies Iain 
Published: March 2021

A 43-year-old woman was referred to the Ear, Nose and Throat Department with a 3-day history of left-sided neck pain and swelling associated with fevers and night sweats. She also reported a cough, oral thrush and a dental extraction more than a month previously. A CT scan of the neck with contrast revealed left internal jugular vein (IJV) thrombophlebitis and the patient was initially managed for suspected Lemierre’s syndrome. Subsequent investigations revealed a locally advanced metastatic colorectal adenocarcinoma as the cause of her thrombosis, which was deemed inoperable. The patient was referred to oncology and commenced on palliative chemotherapy.The incidence of thrombophlebitis in patients with cancer is high. Although the IJV is a relatively uncommon site of thrombus formation, IJV thrombophlebitis is associated with significant morbidity and mortality. As it may be the first manifestation of an occult malignancy, a neoplastic cause should always be considered.
Myopia control effect of defocus incorporated multiple segments (DIMS) spectacle lens in Chinese children: results of a 3-year follow-up study
Authors: Lam Carly SY , Tang Wing Chun , Lee Paul H , Zhang Han Yu , Qi Hua , Hasegawa Keigo , To Chi Ho 
Published: March 2021

AimsTo determine myopia progression in children who continued to wear the defocus incorporated multiple segments (DIMS) lenses or switched from single vision (SV) to DIMS lenses for a 1-year period following a 2-year myopia control trial.Methods128 children participated in this study. The children who had worn DIMS lenses continued to wear DIMS lenses (DIMS group), and children who had worn SV lenses switched to wear DIMS lenses (Control-to-DIMS group). Cycloplegic spherical equivalent refraction (SER) and axial length (AL) were measured at 6-month interval. Historical controls were age matched to the DIMS group at 24 months and used for comparing the third-year changes.ResultsOver 3 years, SER and AL changes in the DIMS group (n=65) were −0.52±0.69D and 0.31±0.26 mm; these changes were not statistically significant over time (repeated measures analysis of variance, p>0.05).SER (−0.04±0. 38D) and AL (0.08±0.12 mm) changes in the Control-to-DIMS group (n=55) in the third year were less compared with the first (mean difference=0.45 ± 0.30D, 0.21±0.11 mm, p<0.001) and second (0.34±0.30D, 0.12±0.10 mm, p<0.001) years.Changes in SER and AL in both groups over that period were significantly less than in the historical control group (DIMS vs historical control: mean difference=−0.18±0.42D, p=0.012; 0.08±0.15 mm, p=0.001; Control-to-DIMS versus historical control: adjusted mean differences=−0.30±0.42D, p<0.001; 0.12±0.16 mm, p<0.001).ConclusionsMyopia control effect was sustained in the third year in children who had used the DIMS spectacles in the previous 2 years and was also shown in the children switching from SV to DIMS lenses.
Proof-of-concept single-arm trial of bevacizumab therapy for brain arteriovenous malformation
Authors: Muster Rachel , Ko Nerissa , Smith Wade , Su Hua , Dickey Melissa A , Nelson Jeffrey , McCulloch Charles E , Sneed Patricia K , Clarke Jennifer L , Saloner David A , Eisenmenger Laura , Kim Helen , Cooke Daniel L 
Published: March 2021

Brain arteriovenous malformations (bAVMs) are relatively rare, although their potential for secondary intracranial haemorrhage (ICH) makes their diagnosis and management essential to the community. Currently, invasive therapies (surgical resection, stereotactic radiosurgery and endovascular embolisation) are the only interventions that offer a reduction in ICH risk. There is no designated medical therapy for bAVM, although there is growing animal and human evidence supporting a role for bevacizumab to reduce the size of AVMs. In this single-arm pilot study, two patients with large bAVMs (deemed unresectable by an interdisciplinary team) received bevacizumab 5 mg/kg every 2 weeks for 12 weeks. Due to limitations of external funding, the intended sample size of 10 participants was not reached. Primary outcome measure was change in bAVM volume from baseline at 26 and 52 weeks. No change in bAVM volume was observed 26 or 52 weeks after bevacizumab treatment. No clinically important adverse events were observed during the 52-week study period. There were no observed instances of ICH. Sera vascular endothelial growth factor levels were reduced at 26 weeks and returned to baseline at 52 weeks. This pilot study is the first to test bevacizumab for patients with bAVMs. Bevacizumab therapy was well tolerated in both subjects. No radiographic changes were observed over the 52-week study period. Subsequent larger clinical trials are in order to assess for dose-dependent efficacy and rarer adverse drug effects.Trial registration number:NCT02314377.
Outcomes and care priorities for older people living with frailty and advanced chronic kidney disease: a multiprofessional scoping review protocol
Authors: Hurst Helen , Jones Elizabeth , Ormandy Paula , Brettle Alison , Nixon Andrew Christopher , Young Hannah , Mooney Andrew , Winterbottom Anna , Bekker Hilary , Brown Edwina , Murtagh Fliss EM , Da Silva-Gane Maria , Coyle David , Finnigan Robert 
Published: March 2021

IntroductionReported outcomes for older people with advanced chronic kidney disease (CKD) often focus on survival and mortality and little attention is paid to symptom burden and health-related quality of life. Recognising frailty and providing interventions that may improve outcomes have been studied in the general population with a growing research interest within CKD.Methods and analysisA scoping review will be undertaken following a recommended process to understand relevant research and priorities for older people living with frailty and advanced CKD. Databases will be searched and following a systematic process by a core team, a final list of included studies will be analysed. Focus groups will then be conducted with older people with advanced CKD to incorporate stakeholder views.Ethics and disseminationOur scoping review will use robust methodology to identify relevant literature focused on outcomes and care priorities for older people with advanced CKD. Ethical approval will be sought to conduct the focus groups. The result of this review will be disseminated through patient networks and national conferences. The interdisciplinary team collaborating plan to continue work in this area to improve the care and management of older people with advanced CKD.
Prevalence and correlates of sex-selective abortions and missing girls in Nepal: evidence from the 2011 Population Census and 2016 Demographic and Health Survey
Authors: Channon Melanie Dawn , Puri Mahesh , Gietel-Basten Stuart , Stone Lucy Williams , Channon A 
Published: March 2021

ObjectivesThese were to: (1) produce national and subnational estimates of the sex ratio at birth (SRB) and number of missing girl births in Nepal and (2) understand the socioeconomic correlates of these phenomena.DesignObservational secondary data analysis of (1) the 2011 population census of Nepal and (2) the Nepal Demographic and Health Survey (DHS) 2006, 2011 and 2016.SettingNepal.Participants(1) 2 567 963 children age 0–4 in the 2011 population census and (2) 27 329 births recorded in DHSs.Primary and secondary outcomesWe estimate the SRB, and number and proportion of missing girls in the year and 5 years before the census by district. We also calculate conditional sex ratios (the SRB dependant on parity and sex of previous children) by province, time, education and wealth.ResultsWe find that 11 districts have significantly skewed sex ratios at birth in the 2011 population census, with the highest SRBs observed in Arghakhanchi (SRB=127) and Bhaktapur (SRB=123). 22 540 girl births were missing in the 5 years before the 2011 population census. Sex-selective abortion is geographically concentrated, especially in the Kathmandu Valley and Lumbini Province, with 53% of missing girls found in only 11 out of 75 districts.DHS data confirm this, with elevated conditional sex ratios observed in Bagmati and Lumbini Provinces; conditional sex ratios where previous births were all female also became more skewed over time. Skewed sex ratios are concentrated among wealthier more educated groups.ConclusionsIt is clear that sex selection will persist and develop in Nepal unless a coordinated effort is made to address both the demand for and supply of this service. Policies should be holistic and encompass economic and legal gender equity, and strengthen monitoring mechanisms to prevent technology misuse, without jeopardising the right to safe, free and legal abortion.
How much could a low COVID-19 pandemic change the injury trends? A single-institute, retrospective cohort study
Authors: Kuo Ling-Wei , Fu Chih-Yuan , Liao Chien-An , Liao Chien-Hung , Wu Yu-Tung , Huang Jen-Fu , Hsieh Chi-Hsun , Cheng Chi-Tung 
Published: March 2021

ObjectivesCOVID-19 has changed the epidemiology of trauma. However, Taiwan is a country with a low COVID-19 threat, and people’s daily lives have remained mostly unchanged during this period. The purpose of this study is to investigate whether the trend of trauma incidence and the service of trauma care is affected by the relatively minor COVID-19 pandemic in Taiwan.DesignA single-institute, retrograde cohort study.SettingAn observational study based on the trauma registry of Chang Gung Memorial Hospital (CGMH).ParticipantsTrauma patients presented to the emergency department of CGMH in the period of 1 January to 30 June 2020 (week 1 to week 26) were designated as the COVID-19 group, with 1980 patients in total. Patients of the same period in 2015–2019 were designated as the pre-COVID-19 group, with 10 334 patients overall.Primary and secondary outcome measuresThe primary outcome is the incidence of trauma admission. Differences in trauma mechanism, severity, location and outcome were also compared in both groups.ResultsA decrease in trauma incidence during March and April 2020 was noticed. Significant change (p<0.001) in trauma mechanisms was discovered, with decreased burn (5.8% vs 3.6%) and assault (4.8% vs 1.2%), and increased transport accidents (43.2% vs 47.2%) and suicide (0.2% vs 1.0%) in the COVID-19 cohort. A shift in injury locations was also found with a 5% decrement of workplace injuries (19.8% vs 14.8%, p<0.001).ConclusionThe limited COVID-19 outbreak in Taiwan has led to a decreased incidence of trauma patients, and the reduction is mostly attributed to the decline in workplace injuries.
Surgical service monitoring and quality control systems at district hospitals in Malawi, Tanzania and Zambia: a mixed-methods study
Authors: Clarke Morgane , Pittalis Chiara , Borgstein Eric , Bijlmakers Leon , Cheelo Mweene , Ifeanyichi Martilord , Mwapasa Gerald , Juma Adinan , Broekhuizen Henk , Drury Grace , Lavy Chris , Kachimba John , Mkandawire Nyengo , Chilonga Kondo , Brugha Ruairí , Gajewski Jakub 
Published: March 2021

BackgroundIn low-income and middle-income countries, an estimated one in three clinical adverse events happens in non-complex situations and 83% are preventable. Poor quality of care also leads to inefficient use of human, material and financial resources for health. Improving outcomes and mitigating the risk of adverse events require effective monitoring and quality control systems.AimTo assess the state of surgical monitoring and quality control systems at district hospitals (DHs) in Malawi, Tanzania and Zambia.MethodsA mixed-methods cross-sectional study of 75 DHs: Malawi (22), Tanzania (30) and Zambia (23). This included a questionnaire, interviews and visual inspection of operating theatre (OT) registers. Data were collected on monitoring and quality systems for surgical activity, processes and outcomes, as well as perceived barriers.Results53% (n=40/75) of DHs use more than one OT register to record surgical operations. With the exception of standardised printed OT registers in Zambia, the register format (often handwritten books) and type of data collected varied between DHs. Monthly reports were seldom analysed by surgical teams. Less than 30% of all surveyed DHs used surgical safety checklists (n=22/75), and <15% (n=11/75) performed surgical audits. 73% (n=22/30) of DHs in Tanzania and less than half of DHs in Malawi (n=11/22) and Zambia (n=10/23) conducted surgical case reviews. Reports of surgical morbidity and mortality were compiled in 65% (n=15/23) of Zambian DHs, and in less than one-third of DHs in Tanzania (n=9/30) and Malawi (n=4/22). Reported barriers to monitoring and quality systems included an absence of formalised guidelines, continuous training opportunities as well as inadequate accountability mechanisms.ConclusionsSurgical monitoring and quality control systems were not standard among sampled DHs. Improvements are needed in standardisation of quality measures used; and in ensuring data completeness, analysis and utilisation for improving patient outcomes.
Clinical characteristics and outcomes of adult patients admitted with COVID-19 in East London: a retrospective cohort analysis
Authors: Cheng Daryl , Calderwood Claire , Skyllberg Erik , Ainley Adam 
Published: March 2021

BackgroundDescriptions of clinical characteristics of patients hospitalised withCOVID-19, their clinical course and short-term inpatient and outpatient outcomes in deprived urban populations in the UK are still relatively sparse. We describe the epidemiology, clinical course, experience of non-invasive ventilation and intensive care, mortality and short-term sequelae of patients admitted to two large District General Hospitals across a large East London National Health Service Trust during the first wave of the pandemic.MethodsA retrospective analysis was carried out on a cohort of 1946 patients with a clinical or laboratory diagnosis of COVID-19, including descriptive statistics and survival analysis. A more detailed analysis was undertaken of a subset of patients admitted across three respiratory units in the trust.ResultsIncreasing age, male sex and Asian ethnicity were associated with worse outcomes. Increasing severity of chest X-ray abnormalities trended with mortality. Radiological changes persisted in over 50% of cases at early follow-up (6 weeks). Ongoing symptoms including hair loss, memory impairment, breathlessness, cough and fatigue were reported in 70% of survivors, with 39% of patients unable to return to work due to ongoing symptoms.ConclusionsUnderstanding the acute clinical features, course of illness and outcomes of COVID-19 will be crucial in understanding the effect of differences in risk, as well as the effectiveness of new interventions and vaccination between the successive waves of the pandemic.
Neuroinflammation predicts disease progression in progressive supranuclear palsy
Authors: Malpetti Maura , Passamonti Luca , Jones Peter Simon , Street Duncan , Rittman Timothy , Fryer Timothy D , Hong Young T , Vàsquez Rodriguez Patricia , Bevan-Jones William Richard , Aigbirhio Franklin I , O'Brien John Tiernan , Rowe James Benedict 
Published: March 2021

IntroductionIn addition to tau pathology and neuronal loss, neuroinflammation occurs in progressive supranuclear palsy (PSP). However, the prognostic value of the in vivo imaging markers for these processes in PSP remains unclear. We test the primary hypothesis that baseline in vivo imaging assessment of neuroinflammation in subcortical regions predicts clinical progression in patients with PSP.MethodsSeventeen patients with PSP–Richardson’s syndrome underwent a baseline multimodal imaging assessment, including [11C]PK11195 positron emission tomography (PET) to index microglial activation, [18F]AV-1451 PET for tau pathology and structural MRI. Disease severity was measured at baseline and serially up to 4 years with the Progressive Supranuclear Palsy Rating Scale (PSPRS) (average interval of 5 months). Regional grey-matter volumes and PET ligand binding potentials were summarised by three principal component analyses (PCAs). A linear mixed-effects model was applied to the longitudinal PSPRS scores. Single-modality imaging predictors were regressed against the individuals’ estimated rate of progression to identify the prognostic value of baseline imaging markers.ResultsPCA components reflecting neuroinflammation and tau burden in the brainstem and cerebellum correlated with the subsequent annual rate of change in the PSPRS. PCA-derived PET markers of neuroinflammation and tau pathology correlated with regional brain volume in the same regions. However, MRI volumes alone did not predict the rate of clinical progression.ConclusionsMolecular imaging with PET for microglial activation and tau pathology can predict clinical progression in PSP. These data encourage the evaluation of immunomodulatory approaches to disease-modifying therapies in PSP and the potential for PET to stratify patients in early phase clinical trials.
Woven EndoBridge device shape modification can be mitigated with an appropriate oversizing strategy: a VasoCT based study
Authors: Caroff Jildaz , Cortese Jonathan , Girot Jean-Baptiste , Mihalea Cristian , Aguiar Guilherme , Vergara Martinez Jeickson , Ikka Léon , Chalumeau Vanessa , Rehem Marcelle , Gallas Sophie , Ozanne Augustin , Moret Jacques , Spelle Laurent 
Published: March 2021

BackgroundThe Woven EndoBridge (WEB) shape modification (WShM) during follow-up may be a potential cause of poor angiographic outcomes. WShM predisposing factors have not yet been determined. Our systematic use of rotational cone beam computed tomography (VasoCT) imaging during follow-up allowed us to perform the first quantitative analysis of the shape of WEBs over time. Our goal was to identify possible strategies to reduce the occurrence of this phenomenon.MethodsAll patients treated in our hospital with a WEB device between October 2015 and January 2019 were included. Using VasoCT acquisitions, systematically performed after implantation and during follow-up, we analyzed WEB morphology. WShM was defined as the percentage reduction in the distance between the two WEB markers.ResultsSixty-three aneurysms treated with a WEB device were finally included in this analysis. At the last follow-up (mean 15.5 months), mean WShM was 48%±24. The mean WShM was significantly higher in the aneurysm recurrence group than in the adequate occlusion group (51±6.5% vs 36±3.4%, difference 15% points (95% CI 0.7 to 30); p<0.05). Conversely, the extent of WShM did not directly correlate with occlusion rates. Indeed, 32% of completely occluded aneurysms presented severe WShM (≥50%). Importantly, the absence of WShM guaranteed complete occlusion in our study (n=12). We demonstrated that oversizing the width of the WEB significantly correlated with WShM reduction during follow-up (r=−0.38, p=0.002).ConclusionWShM can be partly overcome by use of an appropriate width oversizing strategy that could lead to improved angiographic results.
Effects of post-exercise sodium bicarbonate ingestion on acid-base balance recovery and time-to-exhaustion running performance: a randomised crossover trial in recreational athletes
Authors: Gurton William , Macrae Heather , Gough Lewis , King David G. 
Published: March 2021

This study investigated the effect of post-exercise sodium bicarbonate (NaHCO3) ingestion on acid-base balance recovery and time-to-exhaustion (TTE) running performance. Eleven male runners (stature, 1.80 ± 0.05 m; body mass, 74.4 ± 6.5 kg; maximal oxygen consumption, 51.7 ± 5.4 mL·kg−1·min−1) participated in this randomised, single-blind, counterbalanced and crossover design study. Maximal running velocity (v-V̇O2max) was identified from a graded exercise test. During experimental trials, participants repeated 100% v-V̇O2max TTE protocols (TTE1, TTE2) separated by 40 min following the ingestion of either 0.3 g·kg−1 body mass NaHCO3 (SB) or 0.03 g·kg−1 body mass sodium chloride (PLA) at the start of TTE1 recovery. Acid-base balance (blood pH and bicarbonate, HCO3–) data were studied at baseline, post-TTE1, after 35 min recovery and post-TTE2. Blood pH and HCO3– concentration were unchanged at 35 min recovery (p > 0.05), but HCO3– concentration was elevated post-TTE2 for SB vs. PLA (+2.6 mmol·L−1; p = 0.005; g = 0.99). No significant differences were observed for TTE2 performance (p > 0.05), although a moderate effect size was present for SB vs. PLA (+14.3 s; g = 0.56). Post-exercise NaHCO3 ingestion is not an effective strategy for accelerating the restoration of acid-base balance or improving subsequent TTE performance when limited recovery is available. Novelty: Post-exercise sodium bicarbonate ingestion did not accelerate the restoration of blood pH or bicarbonate after 35 min. Performance enhancing effects of sodium bicarbonate ingestion may display a high degree of inter-individual variation. Small-to-moderate changes in performance were likely due to greater up-regulation of glycolytic activation during exercise.