bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synergistic
Investigation for Co-Combustion of Biochars and Lignite—Thermogravimetric Analysis
Approach
Authors: Haykiri-Acma H. , Yaman S. 
Published: August 2018

Abstract
This paper addresses whether synergistic interaction or additive behavior govern the co-combustion characteristics of lignite and biochars produced from hybrid poplar (HP), ash tree (AT), and rhododendron (RH). The biochars were blended with lignite and the burning behavior was investigated by thermal analysis. Upon carbonization, fundamental change occurred in the burning mechanisms of biomass from homogeneous to heterogeneous reactions. Blending the lignite with biochars led to improvement in the calorific value and reductions in the ash yield. Carbonization limited the high reactivity of biomass, and the reactivities of biochars became closer to the lignite's reactivity, consequently they burned in accord without segregation.
Study on Soot Mass Fraction and Size Distribution in a Direct Injection Diesel Engine Using Particulate Size Mimic Soot Model
Authors: Ibrahim Fadzli , Wan Mahmood Wan Mohd Faizal , Abdullah Shahrir , Abu Mansor Mohd Radzi 
Published: August 2018

Abstract
With today's computing technology, research on soot particles using simulation works has become more preferable as a supplementary to the existing experimental methods. The objective of this study is to investigate the effect of different engine load conditions to in-cylinder soot particles formation. This is to clarify the relationship between soot mass fraction (SMF) and size distribution. The first section of the study is conducted by computational analysis using a detailed kinetics soot model, particulate size mimic (PSM), which is based on the concept of the discrete sectional method. The analysis is carried out within closed-cycle combustion environment which is from the inlet valve closing (IVC) to the exhaust valve opening (EVO). The next section is conducted by experimental work deliberately for validation purpose. The total soot mass obtained from the computational work during EVO is comparable to the calculated value by less than 13% error for all of the experimental cases. The soot size distribution measurement indicates that exhaust out particles are dominantly in the dual-mode size range, &lt;10 nm and 11–30 nm. The relationship between the soot mass and size distribution demonstrates that soot mass fraction does not completely rely on soot size distribution as well as particle size range. In most of the cases, particles with the moderate size range (11–60 nm) hold the highest mass fraction during EVO. On the whole, this paper provides significant information that contributes key knowledge to indicate that soot mass fraction is not entirely dependent on soot size distribution as well as particle size range.
Does the performance of five back-associated exercises relate to the presence of low back pain? A cross-sectional observational investigation in regional Australian council workers
Authors: Gabel Charles Philip , Mokhtarinia Hamid Reza , Hoffman Jonathan , Osborne Jason , Laakso E-Liisa , Melloh Markus 
Published: August 2018

ObjectivesInvestigate the relationships between the ability/inability to perform five physical test exercises and the presence or absence of low back pain (LBP).SettingRegional Australian council training facility.ParticipantsConsecutive participants recruited during 39 back education classes (8–26 participants per class) for workers in general office/administration, parks/gardens maintenance, roads maintenance, library, child care and management. Total sample (n=539) was reduced through non-consent and insufficient demographic data to n=422. Age 38.6±15.3 years, range 18–64 years, 67.1% male.MethodsCross-sectional, exploratory, observational investigation. LBP presence was ascertained from a three-response option questionnaire: 0=none/rarely (no) 1=sometimes (some), 2=mostly/always (most). Statistical correlation was performed with the number of the five test exercises the individual successfully performed: (1) extension in lying: 3 s; (2) ‘toilet squat’; feet flat, feet touched: 3 s; (3) full squat then stand up: 5 times; (4) supine sit-up, knees flexed: 10 times; and (5) leg extension, supine bilateral: 10 times.InterventionsNil.ResultsFor the group ‘no-some’, 94.3% completed 4–5 test exercises, while for group ‘With’, 95.7% completed 0–1 test exercises. The relationship between LBP presence and number of exercises performed was highly significant (χ2(10)=300.61, p<0.001). Furthermore, multinomial logistic regression predicting LBP (0=no, 1=some, 2=most) from the number of exercises completed, substantially improved the model fit (initial-2LL=348.246, final-2LL=73.620, χ2(2)=274.626, p<0.001). As the number of exercises performed increased, the odds of reporting ‘some LBP’ or ‘most LBP’ dropped substantially (ORs of 0.34 and 0.17, respectively).ConclusionThe ability to complete/not complete five test exercises correlated statistically and significantly with a higher LBP absence/presence in a general working population. Training individuals to complete such exercises could facilitate reductions in LBP incidence; however, causality cannot be inferred. Randomised trials are recommended to establish the potential efficacy of exercise-based approaches, considering these five selected exercises, for predicting and managing LBP.
Sexual minority status and suicidal behaviour among Chinese adolescents: a nationally representative cross-sectional study
Authors: Huang Yeen , Li Pengsheng , Guo Lan , Gao Xue , Xu Yan , Huang Guoliang , Deng Xueqing , Lu Ciyong 
Published: August 2018

ObjectivesSuicidality among sexual minority adolescents has generated worldwide concern in recent decades, and previous Western studies have demonstrated that sexual minority status is associated with adolescent suicidality. However, whether this association exists in Chinese adolescents remains largely unknown. This study aimed to estimate the associations between sexual minority status and suicidal behaviour among Chinese adolescents.DesignCross-sectional survey.SettingA total of 506 high schools in 7 provinces of China.ParticipantsA total of 150 822 students in grades 7–12 who completed the questionnaires (response rate of 95.9%) were included.Main outcome measuresSuicidal ideation and suicide attempts were used to measure suicidal behaviour, and sexual attraction (opposite sex, same sex or both sex) was used as a measure for sexual minority status.ResultsOf the 150 822 adolescents analysed, 4.1% self-reported as sexual minorities and 17.3% were unsure. Compared with heterosexual and unsure adolescents, same-sex romantic attraction (SSA) and both-sex romantic attraction (BSA) adolescents reported a higher prevalence of past-year suicidal ideation (SSA: 21.6% for males and 30.4% for females; BSA: 34.7% for males and 42.3% for females) and suicide attempts (SSA: 6.9% for males and 8.9% for females; BSA: 12.2% for males and 10.9% for females). After adjustment for covariates, SSA and BSA adolescents were more likely to have past-year suicidal ideation and suicide attempts than their heterosexual and unsure peers. BSA adolescents reported the highest risk of suicidal ideation (males: adjusted OR (AOR) 2.42, 95% CI 2.03 to 2.88; females: AOR 2.61, 95% CI 2.41 to 2.82) and suicide attempts (males: AOR 3.83, 95% CI 2.85 to 5.14; females: AOR 2.59, 95% CI 2.19 to 3.06).ConclusionsOur study suggested that Chinese sexual minority adolescents were at increased risk of suicidality, and those with BSA had an especially high risk in this population. These findings emphasised the urgent need to develop targeted interventions to effectively address suicide-related problems among Chinese sexual minority adolescents.
Development of a simple, practice-based tool to assess quality of paediatric emergency care delivery in resource-limited settings: identifying critical actions via a Delphi study
Authors: Daftary Rajesh Kirit , Murray Brittany Lee , Reynolds Teri Ann 
Published: August 2018

ObjectiveProvision of timely, high-quality care for the initial management of critically ill children in African hospitals remains a challenge. Monitoring the completion of critical actions during resuscitations can inform efforts to reduce variability and improve outcomes. We sought to develop a practice-based tool based on contextually relevant actions identified via a Delphi process. Our goal was to develop a tool that could identify gaps in care, facilitate identification of training and standardised assessment to support quality improvement efforts.DesignSix sentinel conditions were selected based on disease epidemiology and mortality at rural and urban African emergency departments. Potential critical actions were identified through focused literature review. These actions were evaluated within a three-round modified Delphi process. A set of logistical filters was applied to the candidate list to derive a practice-based tool.Setting and participantsAttendees at an international emergency medicine conference comprised an expert panel of 25 participants, with 84% working primarily in African settings. Consensus rounds allowing novel responses were conducted via online and in-person surveys.ResultsThe expert panel generated 199 actions that apply to six conditions in emergently ill children. Application of appropriateness criteria refined this to 92 candidate actions across the following seven categories: core skills, active seizure, altered mental status, diarrhoeal illness, febrile illness, respiratory distress and polytrauma. From these, we identified 28 actions for inclusion in a practice-based tool contextually relevant to the initial management of critically ill children in Africa.ConclusionsA group consensus process identified critical actions for severely ill children with select sentinel conditions in emergency paediatric care in an African setting. Absence of these actions during resuscitation might reflect modifiable gaps in quality of care. The resulting practice-based tool is context relevant and can serve as a foundation for training and quality improvement efforts in African hospitals and emergency departments.
Mixed methods process evaluation of an enhanced community-based rehabilitation intervention for elderly patients with hip fracture
Authors: Roberts Jessica Louise , Pritchard Aaron W , Williams Michelle , Totton Nikki , Morrison Val , Din Nafees Ud , Williams Nefyn H 
Published: August 2018

ObjectivesTo describe the implementation of an enhanced rehabilitation programme for elderly hip fracture patients with mental capacity, in a randomised feasibility study compared with usual rehabilitation. To compare processes between the two and to collect the views of patients, carers and therapy staff about trial participation.DesignMixed methods process evaluation in a randomised feasibility study.SettingPatient participants were recruited on orthopaedic and rehabilitation wards; the intervention was delivered in the community following hospital discharge.ParticipantsSixty-one older adults (aged ≥65 years) recovering from surgical treatment (replacement arthroplasty or internal fixation) following hip fracture, who were living independently prior to fracture and had mental capacity and 31 of their carers.InterventionsUsual care (control) or usual care plus an enhanced rehabilitation package (intervention). The enhanced rehabilitation consisted of a patient-held information workbook, goal-setting diary and up to six additional therapy sessions.Process evaluation componentsRecruitment of sites and rehabilitation teams, response of rehabilitation teams, recruitment and reach in patient and carer participants, intervention delivery, delivery to individuals, response of individual patients to the enhanced intervention or usual rehabilitation, response of carer participants, unintended consequences and testing intervention theory and context.ResultsUsual rehabilitation care was very variable. The enhanced rehabilitation group received a mean of five additional therapy sessions. All of the returned goal-setting diaries had inputs from the therapy team, and half had written comments by the patients and carers. Focus group themes: variation of usual care and its impact on delivering the intervention; the importance of goal setting; the role of the therapist in providing reassurance about safe physical activities; and acceptability of the extra therapy sessions.ConclusionsLessons learnt for a future definitive RCT include how to enhance recruitment and improve training materials, the workbook, delivery of the extra therapy sessions and recording of usual rehabilitation care.Trial registration numberISRCTN22464643; Post- results.
Determinants of patient choice for hospital readmission after township hospitalisation: a population-based retrospective study in China
Authors: Zhang Yan , Niu Yadong , Zhang Liang 
Published: August 2018

ObjectiveThe lack of coordinated and appropriate healthcare across sectors has produced more patients for county hospitals in China. This study examined differences in patient choice between township and county hospitals for readmission after a first township hospitalisation, and the determinants that influenced this choice.DesignA retrospective study of readmissions across hospitals after a first admission in township hospital. A township–township (TT) inpatient group and a township–county (TC) inpatient group were compared. A two-level logistic regression model was used to examine the determinants of choice for hospital readmission.SettingData were drawn from a population-based health utilisation database for Qianjiang District, China, from 1 January 2008 to 31 December 2013.ParticipantsThis study focused on readmitted patients whose first admission was in a township hospital. Readmission cases were identified as the same diagnosis (International Classification of Diseases, Tenth Revision) in a subsequent hospitalisation within 30 days. In total, 6764 readmissions had first admissions in township hospitals.Primary outcome measuresPatient choice for hospital readmission after a first township hospitalisation.ResultsThe TT group accounted for 62.5% (4225) and the TC group for 37.5% (2539) of readmissions in 6 years, and the proportion of TC readmissions in total inpatients increased from 1.66% to 1.89%. Readmission rates varied among towns (p<0.001). Differences between the TC and TT groups included: length of stay (LOS) of first admission (6.96 days vs 9.23 days), average interval between admissions (6.03 days vs 14.95 days) and disease category. Admission year, age, travel time to county hospital, interval between admissions, first admission LOS and disease category were determinants of choice for hospital readmission.ConclusionsPatients whose first admission was in a township hospital were more likely to be readmitted to a county hospital. A combination of first LOS and interval between admissions may be an effective identification index for TC readmission.Trial registration numberChiCTR-OOR-14005563.
Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India
Authors: Patel Archana , Prakash Amber Abhijeet , Das Prabir Kumar , Gupta Swarnim , Pusdekar Yamini Vinod , Hibberd Patricia L 
Published: August 2018

ObjectivesTo study the trend in the prevalence of anaemia and low BMI among pregnant women from Eastern Maharashtra and evaluate if low BMI and anaemia affect pregnancy outcomes.DesignProspective observational cohort study.SettingCatchment areas of 20 rural primary health centres in four eastern districts of Maharashtra State, India.Participants72 750 women from the Nagpur site of Maternal and Newborn Health Registry of NIH’s Global Network, enrolled from 2009 to 2016.Main outcome measuresMode of delivery, pregnancy related complications at delivery, stillbirths, neonatal deaths and low birth weight (LBW) in babies.ResultsOver 90% of the women included in the study were anaemic and over a third were underweight (BMI <18 kg/m2) and with both conditions. Mild anaemia at any time during delivery significantly increased the risk (Risk ratio; 95% confidence interval (RR;(95% CI)) of stillbirth (1.3 (1.1–1.6)), neonatal deaths (1.3 (1–1.6)) and LBW babies (1.1 (1–1.2)). The risks became even more significant and increased further with moderate/severe anaemia any time during pregnancy for stillbirth (1.4 (1.2–1.8)), neonatal deaths (1.7 (1.3–2.1)) and LBW babies (1.3 (1.2–1.4)).,. Underweight at anytime during pregnancy increased the risk of neonatal deaths (1.1 (1–1.3)) and LBW babies (1.2;(1.2–1.3)).The risk of having stillbirths (1.5;(1.2–1.8)), neonatal deaths (1.7;(1.3–2.3)) and LBW babies (1.5;(1.4–1.6)) was highest when - the anaemia and underweight co-existed in the included women. Obesity/overweight during pregnancy increased the risk of maternal complications at delivery (1.6;(1.5–1.7)) and of caesarean section (1.5;(1.4–1.6)) and reduced the risk of LBW babies 0.8 (0.8–0.9)).ConclusionMaternal anaemia is associated with enhanced risk of stillbirth, neonatal deaths and LBW. The risks increased if anaemia and underweight were present simultaneously.Trial registration numberNCT01073475.
Arthroscopic-assisted balloon tibioplasty versus open reduction internal fixation (ORIF) for treatment of Schatzker II–IV tibial plateau fractures: study protocol of a randomised controlled trial
Authors: Wang Ji-Qi , Jiang Bing-Jie , Guo Wei-Jun , Zhang Wei-Jiang , Li A-Bing , Zhao You-Ming 
Published: August 2018

IntroductionArthroscopic-assisted balloon tibioplasty is an emerging technology that has shown advantages in recovering depression of the articular surface. However, studies evaluating clinical outcomes between arthroscopic-assisted balloon tibioplasty and traditional open reduction internal fixation (ORIF) are sparse. This is the first randomised study to compare arthroscopic-assisted balloon tibioplasty with ORIF, and will provide guidance for treating patients with Schatzker types II, III and IV with depression of the medial tibial plateau only.Methods and analysisA blinded randomised controlled trial will be conducted and a total of 80 participants will be randomly divided into either the arthroscopic-assisted balloon tibioplasty group or the ORIF group, at a ratio of 1:1. The primary clinical outcome measures are the knee functional scores, Rasmussen radiological evaluation scores and the quality of reduction based on postoperative CT scan. Secondary clinical outcome measures are intraoperative blood loss, surgical duration, visual analogue scale score after surgery, hospital duration after surgery, complications and 36-Item Short-Form Health Survey score.Ethics and disseminationThis study has been reviewed and approved by the Institutional Review Board of the Second Affiliated Hospital of Wenzhou Medical University (batch: 2017–12). The results will be presented in peer-reviewed journals after completion of the study.Trial registration numberNCT03327337, Pre-results.
Psychometric properties of the Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire
Authors: Chai-Adisaksopha Chatree , Skinner Mark W , Curtis Randall , Frick Neil , Nichol Michael B , Noone Declan , O’Mahony Brian , Page David , Stonebraker Jeffrey , Thabane Lehana , Crowther Mark , Iorio Alfonso 
Published: August 2018

ObjectiveTo assess the psychometric properties of the Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire.MethodsThis study was a cross-sectional, multinational study. Participants were enrolled if they were more than 10 years old and people with haemophilia A or B or people without a bleeding disorder. Participants were invited through non-governmental patient organisations in 21 countries between 01/27/2016 and 02/23/2017. The following psychometric properties: missing data, floor and ceiling effects, exploratory factor analysis and internal consistency reliability were examined. A PROBE Score was derived and assessed for its convergent and known groups validity.ResultsThe study analysed the data on 916 participants with median age of 37.0 (IQR 27.0 to 48.0) years, 74.8% male. In the domain assessing patient-reported outcomes (PROs), more than 15% of participants presented a ceiling effect for all items but two, and a floor effect for one item. Factor analysis identified three factors explaining the majority of the variance. Cronbach’s alpha coefficient indicated good internal consistency reliability (0.84). PROBE items showed moderate to strong correlations with corresponding EuroQol five dimension 5-level instrument (EQ-5D-5L) domains. The PROBE Score has a strong correlation (r=0.67) with EQ-5D-5L utility index score. The PROBE Score has a known groups validity among various groups.ConclusionsThe results of this study suggest that PROBE is a valid questionnaire for evaluating PROs in people with haemophilia as well as control population. The known-group property of PROBE will allow its use in future clinical trials, longitudinal studies, health technology assessment studies, routine clinical care or registries. Additional studies are needed to test responsiveness and sensitivity to change.Trial registration numberNCT02439710; Results.
Integration of musculoskeletal physical therapy care in the patient-centred medical home (IMPaC): protocol for a single-site randomised clinical trial
Authors: Carvalho Erik , Bettger Janet P , Bowlby Lynn , Carvalho Marissa , Dore Daniel , Corcoran Misty W , Harris Ashley A , Bond Jennifer , Goode Adam P 
Published: August 2018

IntroductionAnnually, >50% of the US population reports musculoskeletal (MSK) pain to a provider, with direct healthcare costs exceeding $185 billion. The number of MSK complaints and the associated costs are projected to rise, increasing demand for and burden on providers. Establishing new care models to decrease inefficiencies may lower costs and optimise care delivery. The purpose of the Integration of Musculoskeletal Physical Therapy Care in the Patient-Centred Medical Home (IMPaC) study is to compare initial evaluation by a physical therapist (PT) integrated into primary care versus initial evaluation by a primary care provider (PCP) for patients with an MSK complaint.Methods and analysisThis single-site, randomised clinical trial will test the hypothesis that a PT within a primary care facility as the initial evaluating provider for patients with an MSK complaint will lower costs, improve utilisation (ie, reduced opioid prescriptions, imaging, physical therapy, emergency department visits and missed appointments) and increase patient satisfaction within 90 days of the index visit compared with PCP evaluation in the same location. Participants aged ≥18 years will be randomised with equal allocation and stratified by pain site (ie, back, knee, upper extremity and other). In the initial PT evaluation arm, patients will be assessed, treated and then instructed to complete a home exercise programme. The PCP cohort will undergo a usual PCP evaluation, and if a referral to physical therapy is made, patients will be randomised to onsite versus offsite physical therapy. Differences will be calculated and tested across the two arms.Ethics and disseminationApproval was received from the Duke University Institutional Review Board (01 May 2017) and the National Institutes of Health, National Centre for Advancing Translational Sciences (01 January 2017). Findings will be communicated via quarterly reports to funding bodies and disseminated through scientific publications.Trial registration numberNCT03110211; Pre-results.