bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performances and Emissions Evaluation of a Microturbojet Engine Running on Biodiesel Blends
Authors: Cican Grigore , Plesu Valentin , Deaconu Marius , Toma Adina , Cretu Mihaiella 
Published: February 2019

This paper analyzes the performances and the emissions of the JETCAT P80 microengine, when jet A jet A +  10% biodiesel (BD), jet A + 20% biodiesel, and jet A + 30% biodiesel are utilized as fuel, and to each of these combinations is added 5% of Aeroshell Oil 500. The performances will be assessed based on the engine speed, for the generated thrust force, the temperature in front of the turbine, and on the fuel flow. The paper will investigate the performances and the emissions generated by the four fuel blends burning when the engine is idle, at the cruise and at the max regime. This will be realized by maintaining each of these regimes for approximately a minute and a half. During the tests, the vibrations were monitored both radially and axially for the observation of the engine function regimes. From the measurements, the concentrations of SO2, NOx, and CH4 will be analyzed, highlighting the emissions of SO2. There were performed measurements to determine the fuel blend's density in order to transform the values of the fuel flow from liter per hour into kilogram per second. Having these data registered from the engine, a jet engine cycle analysis at max regime will be performed based on the combustion efficiency, the thermal efficiency of the engine, and the specific fuel consumption.
Functional Reorganization of Promyelocytic Leukemia Nuclear Bodies during BK Virus Infection
Authors: Jiang Mengxi , Entezami Pouya , Gamez Monica , Stamminger Thomas , Imperiale Michael J. 
Published: February 2019

ABSTRACT
BK virus (BKV) is the causative agent for polyomavirus-associated nephropathy, a severe disease found in renal transplant patients due to reactivation of a persistent BKV infection. BKV replication relies on the interactions of BKV with many nuclear components, and subnuclear structures such as promyelocytic leukemia nuclear bodies (PML-NBs) are known to play regulatory roles during a number of DNA virus infections. In this study, we investigated the relationship between PML-NBs and BKV during infection of primary human renal proximal tubule epithelial (RPTE) cells. While the levels of the major PML-NB protein components remained unchanged, BKV infection of RPTE cells resulted in dramatic alterations in both the number and the size of PML-NBs. Furthermore, two normally constitutive components of PML-NBs, Sp100 and hDaxx, became dispersed from PML-NBs. To define the viral factors responsible for this reorganization, we examined the cellular localization of the BKV large tumor antigen (TAg) and viral DNA. TAg colocalized with PML-NBs during early infection, while a number of BKV chromosomes were adjacent to PML-NBs during late infection. We demonstrated that TAg alone was not sufficient to reorganize PML-NBs and that active viral DNA replication is required. Knockdown of PML protein did not dramatically affect BKV growth in culture. BKV infection, however, was able to rescue the growth of an ICP0-null herpes simplex virus 1 mutant whose growth defect was partially due to its inability to disrupt PML-NBs. We hypothesize that the antiviral functions of PML-NBs are inactivated through reorganization during normal BKV infection.

IMPORTANCE
BK virus (BKV) is a human pathogen that causes severe diseases, including polyomavirus-associated nephropathy in kidney transplant patients and hemorrhagic cystitis in bone marrow transplant recipients. How BKV replication is regulated and the effects of a lytic BKV infection on host cells at the molecular level are not well understood. Currently, there is no specific antiviral treatment for BKV-associated disease, and a better understanding of the complete life cycle of the virus is necessary. Here, we report the interplay between BKV and one of the regulatory structures in the host cell nucleus, promyelocytic leukemia nuclear bodies (PML-NBs). Our results show that BKV infection reorganizes PML-NBs as a strategy to inactivate the negative functions of PML-NBs.
Impact of patient-centred and family-centred care meetings on intensive care and resource utilisation in patients with terminal illness: a single-centre retrospective observational study in Taiwan
Authors: Hsu Nin-Chieh , Huang Chun-Che , Chen Wei-Chun , Yu Chong-Jen 
Published: February 2019

ObjectiveShared decision making is essential for patients and their families when facing serious and life-threatening diseases. This study aimed to evaluate the impact of patient-centred and family-centred care meetings (PFCCM) on intensive measures and resource utilisation during end-of-life (EOL) hospitalisation among terminally ill patients.Design and settingA retrospective cross-sectional study using electronic medical records was conducted in a tertiary referral medical centre in Taiwan.ParticipantsWe identified 6843 deceased patients with terminal illness who either received or did not receive PFCCM during EOL hospitalisation between January 2013 and December 2015.Primary and secondary outcome measuresPatients who were transferred to the intensive care unit (ICU). Those who underwent invasive or non-invasive mechanical ventilation, tracheostomy, haemodialysis and surgical intervention during the final hospitalisation were determined by the use of intensive care measures; secondary measures were individual total and daily medical expenditures. A generalised estimating equation (GEE) model was used to compare the differences between the two groups. OR and beta coefficients (β) with 95% CI were estimated.ResultsThis study identified 459 patients (6.7%) who received PFCCM during EOL hospitalisation. Multivariate analyses showed that patients who received PFCCM were less likely to have ICU admissions (OR 0.44, 95% CI 0.34 to 0.57), undergo surgical interventions (OR 0.74, 95% CI 0.58 to 0.95) and invasive mechanical ventilation (OR 0.50, 95% CI 0.38 to 0.66) during the final hospitalisation, after adjusting for patient demographics, clinical conditions and year of admission. Additionally, a significant decrease in daily medical expenditures was observed in PFCCM patients (β −0.18, 95% CI −0.25 to −0.12) than in non-PFCCM patients.ConclusionsPatient–physician discussion through PFCCM is associated with less intensive care utilisation and daily medical expenditure during EOL hospitalisation in terminally ill patients.
Differences in burnout prevalence between clinical professionals and biomedical scientists in an academic medical centre: a cross-sectional survey
Authors: Messias Erick , Gathright Molly M , Freeman Emily S , Flynn Victoria , Atkinson Timothy , Thrush Carol R , Clardy James A , Thapa Purushottam 
Published: February 2019

ObjectiveTo determine the prevalence and associated factors for personal, work-related and patient/client-related burnout in clinical professionals and biomedical scientists in academic medicine.DesignPrevalence survey using the Copenhagen Burnout Inventory.SettingMid-size academic health centre.ParticipantsClinical providers (n=6489) and biomedical scientists (n=248) were invited to complete the survey. 1646 completed responses (response rate 24.4%) were analysed.Primary and Secondary outcome measuresPrevalence estimates and adjusted ORs (AOR) were stratified for gender, age and professional category.ResultsType of burnout varies across professional categories, with significant differences between clinicians and scientists. The prevalence of personal burnout was 52.7% (95%CI 50% to 55%), work-related burnout 47.5% (95%CI 45% to 49%) and patient/client-related burnout 20.3% (95%CI 18% to 22%). The prevalence of personal and work-related burnout was higher among women, while those aged 20–30 had a higher prevalence of all three burnout categories. Overall, clinical professionals had higher personal and work-related burnout, while biomedical scientists had higher client-related burnout. Accounting for the effects of gender and age, a significantly higher risk for personal burnout was found for physicians (AOR 1.64; 95%CI 1.3 to 2.1) and nurses (AOR 1.5; 95%CI 1.03 to 2.2). Significantly higher odds of work-related burnout were found for nurses (AOR 1.5; 95%CI 1.2 to 1.9) and residents (AOR 1.9; 95%CI 1.04 to 3.6). Basic scientists (AOR 10.0; 95%CI 5.7 to 17.6), physicians (AOR 2.8; 95%CI 1.9 to 4.1) and nurses (AOR 2.1; 95%CI 1.3 to 3.5) had higher odds of patient/client-related burnout.ConclusionsTypes of burnout are unevenly distributed in academic medical centres. Physicians have higher risk of personal and patient/client-related burnout, residents have higher risk of work-related burnout, basic scientists are at higher risk of client-related burnout and nurses have higher odds of all three types of burnout. Interventions addressing the problem of burnout in clinical environments may be inadequate to support biomedical scientists.
Application of a novel sex independent anthropometric index, termed angle index, in relation to type 2 diabetes: a Trinidadian case–control study
Authors: Ramnanansingh Terry Gavaskar , Nayak Shivananda Bijoor 
Published: February 2019

ObjectiveTo develop a novel sex independent anthropometric index, termed as angle index, related to type 2 diabetes.DesignCase–control.ParticipantsThe study comprised 121 participants and were divided into two groups. One group had no form of diabetes and served as controls (n=50). The other group had the condition of type 2 diabetes (n=71). 31% (n=37) of the subjects were male and 69% (n=84) were female. 62% (n=75) of the subjects were of East Indian ethnicity, 28% (n=34) were of African ethnicity and 10% (n=12) were of mixed ethnicity.SettingParticipants of the study were from the island of Trinidad, located in the Caribbean. Patients in the study were selected at random from hospital records.Primary outcome measureIt was hypothesised that the mean angle index of patients with type 2 diabetes would be higher than the mean angle index of patients without type 2 diabetes.ResultsPatients with type 2 diabetes had a significantly higher angle index value as compared with controls (p<0.001). Angle index was the superior sex independent anthropometric index in relation to type 2 diabetes (area under the curve=0.72; p<0.001) as compared with other sex independent variables. Angle index correlated with glycated haemoglobin (rs=0.28, p=0.003) and fasting blood glucose (rs=0.31, p=0.001) levels. Patients with type 2 diabetes were four times more likely to have an angle index greater than 184° (OR 4.2, 95% CI 1.8 to 9.9) as compared with controls.ConclusionAngle index was a superior sex independent index for discriminating between patients with and without type 2 diabetes, as compared with waist circumference, abdominal volume index, conicity index, blood pressure readings, triglyceride levels and very low-density lipoprotein levels.
Why are male Chinese smokers unwilling to quit? A multicentre cross-sectional study on smoking rationalisation and intention to quit
Authors: Huang Xinyuan , Fu Wenjie , Zhang Haiying , Li Hong , Li Xiaoxia , Yang Yong , Wang Fan , Gao Junling , Zheng Pinpin , Fu Hua , Chapman Simon , Ding Ding 
Published: February 2019

ObjectiveWe aimed to describe the rationalisation beliefs endorsed by Chinese male smokers and to examine the association between rationalisation and the intention to quit.SettingQuestionnaires were conducted among male smokers in three cities (Shanghai, Nanning and Mudanjiang) which represent different geographical locations, economic development levels and legislative status of tobacco control in China.Design and participantsIt was a multicentre cross-sectional survey involved a total of 3710 male smokers over 18 years.Outcome measuresPrimary outcomes were intention to quit, smoking rationalisation scores and sub scores in six dimensions. Smoking rationalisation was assessed using a newly developed Chinese rationalisation scale. Multivariable logistic regression was performed to examine the relationship between rationalisation and intention to quit.ResultsOn average, smokers scored 3.3 out of 5 on the smoking rationalisation scale. With a one point increase in total rationalisation scale, the odds for intention to quit in the next 6 months decreased by 48% (OR=0.52, 95% CI: 0.44 to 0.61; p<0.001). Separate logistic regressions for six subscales of rationalisation shown consistent inverse associations with intention to quit (all p values <0.001). Believing that smoking was socially acceptable was the strongest predictor (OR=0.62, 95% CI: 0.55 to 0.71; p<0.001).ConclusionsRationalisation beliefs could be important barriers to smoking cessation. Some beliefs have stronger association with quit intention than others. Eroding rationalisation beliefs endorsed by smokers is a potential strategy for smoking cessation intervention.
Association between child maltreatment and central sensitivity syndromes: a systematic review protocol
Authors: Chandan Joht Singh , Thomas Tom , Raza Karim , Bandyopadhyay Siddhartha , Nirantharakumar Krishnarajah , Taylor Julie 
Published: February 2019

IntroductionA growing body of evidence is identifying the link between a history of child maltreatment and a variety of adverse health outcomes ultimately leading to significant social and healthcare burden. Initial work has identified a potential association between child maltreatment and the development of a selection of somatic and visceral central sensitivity syndromes: fibromyalgia, chronic fatigue syndrome, temporomandibular joint disorder, chronic lower back pain, chronic neck pain, chronic pelvic pain, interstitial cystitis, vulvodynia, chronic prostatitis, tension-type headache, migraine, myofascial pain syndrome, irritable bowel syndrome and restless legs syndrome.Methods and analysisPrimary electronic searches will be performed in the Embase, MEDLINE, PubMed, Scopus, PyscINFO, CINAHL and Cochrane Library databases and a number of Grey Literature sources including child protection and paediatric conference proceedings. Following independent screening of studies by two review authors, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses template will be used to aid extraction. A meta-analysis will be conducted on the included case-control and cohort studies. The Newcastle-Ottawa grading system will be used to assess the quality of included studies. Results will be expressed as pooled ORs for binary data and mean differences for continuous data.Ethics and disseminationEthics approval will not be required. The final results of the review and meta-analysis will be submitted for peer-review publication and also disseminated at relevant conference presentations.PROSPERO registration numberCRD42018089258.
Necessity of dural tenting sutures in modern neurosurgery: protocol for a systematic review
Authors: Przepiórka Łukasz , Kunert Przemysław , Żyłkowski Jarosław , Fortuniak Jan , Larysz Patrycja , Szczepanek Dariusz , Wiśniewski Karol , Jaskólski Dariusz , Ładziński Piotr , Rola Radosław , Trojanowski Tomasz , Marchel Andrzej 
Published: February 2019

IntroductionThe ongoing need for dural tenting sutures in a contemporary neurosurgical practice has been questioned in the literature for over two decades. In the past, these sutures were supposed to prevent blood collecting in the potential space between the skull and the dura by elevating the latter. Theoretically, with modern haemostasis and proper postoperative care, this technique should not be necessary and the surgery time can be shortened. Unfortunately, there is no evidence-based proof to either support or reject this hypothesis.Methods and analysisThe systematic review will be performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and The Cochrane Handbook for Systematic Reviews of Interventions. Eight electronic databases of peer-reviewed journals will be searched, as well as other sources. Eligible articles will be assessed against inclusion criteria. The intervention is not tenting the dura and this will be compared with the usual dural tenting sutures. Where possible, ‘summary of findings’ tables will be generated.Ethics and disseminationEthical committee approval is not required for a systematic review protocol. Findings will be presented at international neurosurgical conferences and published in a peer-reviewed medical journal.PROSPERO registration numberCRD42018097089.
Complete clot ingestion with cyclical ADAPT increases first-pass recanalization and reduces distal embolization
Authors: Arslanian Rose A , Marosfoi Miklos , Caroff Jildaz , King Robert M , Raskett Christopher , Puri Ajit S , Gounis Matthew J , Chueh Ju-Yu 
Published: February 2019

BackgroundEvidence is mounting that first-pass complete recanalization during mechanical thrombectomy is associated with better clinical outcomes in patients presenting with an emergent large vessel occlusion. We hypothesize that aspiration achieving complete clot ingestion results in higher first-pass successful recanalization with quantitative reduction in distal emboli.MethodsA patient-specific cerebrovascular replica was connected to a flow loop. Occlusion of the middle cerebral artery was achieved with clot analogs. Independent variables were the diameter of the aspiration catheter (0.054–0.088in) and aspiration pattern (static versus cyclical). Outcome measures were the first-pass rates of complete clot ingestion, the extent of recanalization, and the particle-size distribution of distal emboli.ResultsAll aspiration catheters were successfully navigated to the occlusion. Complete clot ingestion during aspiration thrombectomy resulted in first-pass complete recanalization in every experiment, only achieved in 21% of experiments with partial ingestion (P<0.0001). Aspiration through the large bore 0.088in device resulted in the highest rates of complete clot ingestion (90%). Cyclical aspiration (18–29 inHg, 0.5 Hz) significantly increased the rate of complete clot ingestion (OR21 [1.6, 266]; P=0.04). In all experiments, complete clot ingestion resulted in fewer and smaller distal emboli.ConclusionsComplete clot ingestion results in fewer distal emboli and the highest rates of first-pass complete recanalization. The rate of complete ingestion during aspiration thrombectomy is a function of both the inner diameter of the aspiration catheter and use of cyclical aspiration.
Comparison of dexmedetomidine and benzodiazepine for intraoperative sedation in elderly patients: a randomized clinical trial
Authors: Silva-Jr João Manoel , Katayama Henrique T , Nogueira Fernando A M , Moura Tatiane B , Alves Thiago L , de Oliveira Barbara W 
Published: February 2019

Background and objectivesElderly individuals have a greater sensitivity to sedation, and the most commonly used drugs for sedation are benzodiazepines, which exhibit some complication. Therefore, this study aimed to compare the use of dexmedetomidine and midazolam regarding proper sedation and postoperative complications in elderly individuals who require intraoperative sedation.MethodsThis study was a parallel-randomized clinical trial, which included 120 patients aged >70 years undergoing regional anesthesia and sedation. The exclusion criteria consisted of bradycardia, heart failure, respiratory failure, a Glasgow Coma Scale ≤14, liver failure and refusal to participate. Patients were divided into two groups: the first group received midazolam (MDZ), while the second group received dexmedetomidine (DEX). The doses were titrated to achieve an intraoperative Richmond Agitation-Sedation Scale (RASS) score between −3 and −1. Incidences of complications were recorded.ResultsDuring a 120 min follow-up, the depth of sedation (RASS score) revealed variations less often in the DEX group (p=0.002). Patients in the DEX group (n=67) had lower rates of intraoperative complications (19.4% vs 73.6%, p<0.001). Intraoperatively, the incidence rates of psychomotor agitation (15.1% vs 1.5%, p=0.005), arterial hypotension (28.3% vs 3.0%, p<0.001) and respiratory depression (73.6% vs 0%, p<0.001) were higher in the MDZ group (n=53). During postanesthesia care, the incidence rates of shivering (p<0.001), residual sedation (p=0.04) and use of supplemental oxygen (p<0.001) were significantly lower in the DEX group.ConclusionsThe use of DEX for sedation during surgery provides better control over the depth of sedation and produces fewer complications in elderly individuals.Trial registration numberNCT02878837.
Safety of tirofiban and dual antiplatelet therapy in treating intracranial aneurysms
Authors: Samaniego Edgar A , Gibson Emilee , Nakagawa Daichi , Ortega-Gutierrez Santiago , Zanaty Mario , Roa Jorge A , Jabbour Pascal , Hasan David M 
Published: February 2019

BackgroundEndovascular treatment of intracranial aneurysms usually involves stent-assisted coiling (SAC) and flow diverters. Glycoprotein IIb/IIIa inhibitors such as tirofiban and dual antiplatelet therapy (DAPT) are required to prevent thromboembolic complications afterwards. We sought to determine the safety of tirofiban and DAPT in these cases.MethodsWe conducted a retrospective analysis of our database for patients with intracranial aneurysms who underwent SAC or flow diversion. The tirofiban-DAPT protocol used is described. Data regarding duration of infusion, placement of external ventricular devices (EVDs), complications, haemoglobin levels and platelet count before and 24 hours after antiplatelet therapy were collected and analysed.ResultsOne-hundred and forty-one patients with 148 aneurysms/procedures were included. 110 aneurysms were treated acutely and 38 electively. Minor and major haemorrhagic events were recognised in 20% (30/148) aneurysms. Only 5 (3.4%) intracerebral haemorrhages were symptomatic: 3 cortical/SAH and 2 EVD-related. The average blood volume in symptomatic haemorrhages was 24.8 cc versus 5.42 cc in asymptomatic haemorrhages (p=0.002). The rate of EVD-related haemorrhages was 15.7% (19/121) and only 2 (1.7%) were symptomatic. Most haemorrhagic events occurred in ruptured aneurysms (90.1%, p=0.01). No significant change in platelet count or haemoglobin levels before and 24 hours after administration of tirofiban and DAPT was documented. Concomitant administration of heparin did not increase haemorrhagic events.ConclusionThe use of the GP IIb/IIIa inhibitors tirofiban and DAPT in this series was safe. Tirofiban and DAPT did not affect platelet count or haemoglobin levels and did not increase rate of symptomatic haemorrhages or thromboembolic complications.