bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perspectives on Component Downsizing in Electro-Hydraulic Variable-Speed Drive Networks
Authors: Schmidt Lasse , Ketelsen Søren , Hansen Kenneth Vorbøl 
Published: November 2022

Abstract
The field of electro-hydraulic variable-speed drive technology is expanding, and application areas are increasing across both stationary and mobile industry segments. Developments have mainly concerned standalone drives, and the effective compensation of asymmetric volume variation in cylinders, fully closed circuit functionalities and so forth. In multi-cylinder systems, conventional valve-controlled drives supplied by centralized power units, provide for flexible power distribution among cylinders but generally suffer from poor efficiencies. On the contrary, standalone electro-hydraulic variable-speed drives provide much improved efficiency in comparison, but suffer from inflexible power distribution necessitating maximum cylinder power to be installed for each actuator, hence resulting in potentially high cost levels. Component downsizing potentials of electro-hydraulic variable-speed drive systems with multiple cylinders have only been considered to a minor extend at this point. In this area, recently introduced electro-hydraulic variable-speed drive networks allow for a more flexible distribution of hydraulic power compared to standalone drives, while providing efficiencies on a similar level. Furthermore, such drive networks may eliminate the necessity for various auxiliary valves and potentially allow to reduce the number of variable-speed drives to be installed compared to standalone solutions. The study presented aims to demonstrate that components in electro-hydraulic variable-speed drive networks may be substantially reduced compared to standalone drive systems, via considerations on the dimensioning load cycles for a given application. A case study on a crane application is used to exemplify the downsizing potential, and results here demonstrate a reduction in the required installed power of up to 25% compared to standalone solutions.
Family Integrated Care in Uganda: a feasibility study
Authors: Duby Jessica , Kabajaasi Olive , Muteteri Judith , Kisooka Efulansi , Barth Delaney , Feeley Nancy , O'Brien Karel , Nathan Kenya-Mugisha , Tagoola Abner , Wiens Matthew O 
Published: November 2022

ObjectiveTo determine the feasibility of adapting Family Integrated Care to a neonatal hospital unit in a low-income country.DesignSingle-centre, pre/post-pilot study of an adapted Family Integrated Care programme in Uganda (UFICare).SettingSpecial Care Nursery at a Ugandan hospital.PatientsSingleton, inborn neonates with birth weight ≥2 kg.InterventionsAs part of UFICare, mothers weighed their infant daily, assessed for severe illness (‘danger signs’) twice daily and tracked feeds.Main outcome measuresFeasibility outcomes included maternal proficiency and completion of monitoring tasks. Secondary outcomes included maternal stress, discharge readiness and post-discharge healthcare seeking.ResultsFifty-three mother–infant dyads and 51 mother–infant dyads were included in the baseline and intervention groups, respectively. Most mothers were proficient in the tasks 2–4 days after training (weigh 43 of 51; assess danger signs 49 of 51; track feeds 49 of 51). Mothers documented their danger sign assessments 82% (IQR 71–100) of the expected times and documented feeds 83% (IQR 71–100) of hospital days. In the baseline group, nurses weighed babies 29% (IQR 18–50) of hospitalised days, while UFICare mothers weighed their babies 71% (IQR 57–80) of hospitalised days (p<0.001). UFICare mothers had higher Readiness for Discharge scores compared with the baseline group (baseline 6.8; UFICare 7.9; p<0.001). There was no difference in maternal stress scores or post-discharge healthcare seeking.ConclusionsUgandan mothers can collaborate in the medical care of their hospitalised infant. By performing tasks identified as important for infant care, mothers felt more prepared to care for their infant at discharge.
Ibuprofen efficacy, tolerability and safety in obese children: a systematic review
Authors: Shamsaee Eman , Huws Alaw , Gill Andrea , McWilliam Stephen J , Hawcutt Daniel B 
Published: November 2022

ObjectiveChildhood obesity can affect drug disposition and efficacy of ibuprofen. The primary objective was to assess efficacy of ibuprofen in obese children.DesignA systematic review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Studies were identified from 12 databases. Two independent reviewers evaluated studies against the inclusion criteria and assessed for methodological quality.SettingAny clinical setting.PatientsPatients under 18 years who were overweight/obese.InterventionsPatients taking ibuprofen for any indication, dose or regimen.Main outcome measuresThe efficacy and tolerability of ibuprofen treatment in obese children and presence of any adverse drug reactions.ResultsSearches identified 1305 studies. Four studies met inclusion criteria: three retrospective cohort studies (n=583, median age: 6 years, range: 1–18 years; n=200, median age: 11 years, range: 3–18 years; n=358 median age: 3.1 years, range: 1.2–8.5 years, respectively) and one case study. Each study differed in their method of dosing ibuprofen (weight-based, age-based and adjusted body weight dosing). Various doses were used: 5 mg/kg every 6 hours, 400 mg three times a day, 120 mg/dose and a dose calculated using adjusted body weight. One study reported efficacy (obese n=189, non-obese, n=394), where adequate pain control was achieved using 5 mg/kg. The other three studies did not determine if efficacy differed between obese and non-obese children.One study described adverse effects. An increased risk of bleeding with ibuprofen was noted but did not differentiate between obese and non-obese children.ConclusionThere are little published data to guide clinicians prescribing ibuprofen in obese children.PROSPERO registration numberCRD42021213500.
Combination of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) in the treatment of knee osteoarthritis: a meta-analysis of randomised controlled trials
Authors: Zhao Jinlong , Liang Guihong , Han Yanhong , Yang Weiyi , Xu Nanjun , Luo Minghui , Pan Jianke , Liu Jun , Zeng Ling-Feng 
Published: November 2022

ObjectivesThe purpose of this meta-analysis was to investigate the efficacy and safety of mesenchymal stem cells (MSCs) combined with platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA).DesignSystematic review and meta-analysis.ParticipantsPatients with KOA.InterventionsUse of MSCs+PRP.Primary and secondary outcomesVisual Analogue Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS) and adverse reactions.Data sourcesPubMed, Cochrane Library, Embase and China National Knowledge Infrastructure were searched from inception to 15 July 2021.MeasuresThe OR or weighted mean difference (WMD) of relevant outcome indicators was calculated. Study quality was evaluated using the risk-of-bias assessment tool version 2.0. Heterogeneity among studies was evaluated by calculating I2. If I2＜50%, a fixed-effect model was applied; conversely, if I2≥50%, a random-effect model was applied.ResultsSix controlled clinical trials with 493 cases were included. The meta-analysis results showed that in terms of the VAS score 3 months after treatment, MSCs+PRP had no significant effect on the reduction of the VAS score in patients with KOA compared with the control (p=0.09), hyaluronic acid (HA) (p=0.15) or PRP alone (p=0.07). MSCs+PRP was more effective in reducing the VAS score at 6 and 12 months after treatment than the control (WMD=−0.55, 95% CI −0.87 to −0.22, p<0.001), HA (WMD=−1.20, 95% CI −2.28 to −0.13, p=0.03) or PRP alone (WMD=−0.54, 95% CI −0.89 to −0.18, p=0.003). Regarding the decrease in the total WOMAC score at 3 and 6 months after treatment, MSCs+PRP showed better clinical efficacy than the control or HA alone (p<0.01). Compared with the control, MSCs+PRP exhibited no significant difference in reducing the total WOMAC score 12 months after treatment (p=0.39). There was no significant difference between MSCs+PRP and the control in terms of improvement of the KOOS 12 months after treatment (p=0.16). Compared with MSCs alone, MSCs+PRP exhibited no significant difference in the incidence of adverse reactions (p=0.22) 12 months after treatment.ConclusionsTreatment with MSCs+PRP showed good clinical efficacy in improving pain and joint function in patients with KOA. Compared with MSCs alone, there was no significant difference in the incidence of adverse reactions with MSCs+PRP.PROSPERO registration numberCRD 42021275830.
Long-term health conditions in UK working-age adults: a cross-sectional analysis of associations with demographic, socioeconomic, psychosocial and health-related factors in an inner-city population
Authors: Stagg Anne L , Hatch Stephani , Fear Nicola T , Dorrington Sarah , Madan Ira , Stevelink Sharon A M 
Published: November 2022

ObjectivesTo study the overall disease prevalence, and associations between demographic, socioeconomic, psychosocial, and health-related factors, and self-reporting one or more long-term health conditions (LTCs) in a working-age inner-city population.DesignCross-sectional household-based survey with a follow-up timepoint.SettingSouth-East London Community Health survey data.Participants893 adults aged 16–64 years living in Lambeth and Southwark, London.Outcome measuresPrevalence estimates of individual and multiple LTCs. Multinomial logistic regression was used to analyse the association of demographic, socioeconomic, psychosocial and health-related indicators with having one and multiple LTCs at two timepoints.ResultsMore than one third of participants reported at least one LTC, with the most prevalent being musculoskeletal conditions and asthma. The prevalence of one LTC at both timepoints was 20.6% and 21.4%, and of multimorbidity was 14.0% and 16.4%. At both timepoints, the 35–44 age group showed the largest increase in prevalence of one LTC compared with the preceding age group (16–34). After adjusting for age and gender, small social networks and a larger number of stressful life events were associated with increased risk of having both one and multiple LTCs. The risk of multimorbidity was greater than for initial LTCs for small social networks (3.8 (95% CI: 1.8 to 7.8) compared with 2.0 (95% CI: 1.0 to 3.9)), and three to five stressful life events (3.0 (95% CI: 1.7 to 5.3) compared with 1.5 (95% CI 1.0 to 2.2)).ConclusionsIn this study, the prevalence of multimorbidity increased more than the prevalence of one LTC between the two timepoints, indicating a progression of the overall disease prevalence over time. The 35–44 age group showed the greatest increase in the number of initial LTCs which support health-promotion interventions targeting younger age groups. Focusing on increasing social support networks and treating the psychological impact of stressful life events may also be of benefit.
Effect of compression by elastic bandages on pain and function in individuals with knee osteoarthritis: protocol of a randomised controlled clinical trial
Authors: Ferrari Angelica Viana , Perea Julya Pegatin Moreno , Dantas Lucas Ogura , Silva Hugo Jário Almeida , Serrão Paula Regina Mendes da Silva , Sendín Francisco Alburquerque , Salvini Tania F 
Published: November 2022

IntroductionAlthough compression is used to control pain in knee osteoarthritis (KOA), its clinical application is poorly supported, and there is a lack of scientific evidence to support its clinical use. As a low-cost and accessible protocol, compression using elastic bands could be a non-pharmacological intervention to reduce pain and improve physical function in individuals with KOA. This study aims to evaluate the effects of compression on pain and function in individuals with KOA.Methods and analysisA randomised controlled clinical trial will be conducted. Individuals with KOA (n=90; both sexes; between 40 and 75 years old) will be allocated to three groups (n=30/group): compression (compression by the elastic bandage on the affected knee, once a day for 20 min, on four consecutive days); sham (same protocol, but the elastic band is placed around the affected knee without compression) and control (no intervention). The individuals in the three groups will be evaluated 1 day before the first intervention, 1 day after the last intervention, and at the 12th and 24th weeks after the end of the intervention. Pain intensity by the Visual Analogue Scale and pain scale from Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) will be the primary outcomes. The secondary variables will be physical function assessed by the WOMAC questionnaire and physical tests (step test; 30 s sit and stand test; 40 m accelerated walk test). The Global Rating of Change Scale (GRC) will also be applied to quantify the volunteers’ perceived change.Ethics and disseminationThe project was approved by the Human Research Ethics Committee of the Federal University of São Carlos, São Paulo, Brazil (3955692). The results will be published in peer-reviewed journals.Trial registration numberNCT04724902.
Implementation and outcomes of a system-wide women’s health ‘team goal’ to reduce maternal morbidity for black women: a prospective quality improvement study
Authors: Hamm Rebecca Feldman , Howell Elizabeth , James Abike , Faizon Robert , Bloemer Tina , Cohen Jennifer , Srinivas Sindhu K 
Published: November 2022

ObjectiveIn response to the unacceptable racial disparities in US obstetric outcomes, our health system established a formal goal to reduce maternal morbidity for black women. Here, we describe our process for meeting this equity-focused goal in the context of diverse implementation climates at 5 inpatient sites.Study designTo meet the system goal, we established a collaborative of multidisciplinary, site-based teams. The validated 18-question Implementation Climate Scale (ICS) was distributed to site clinicians at baseline. Sites focused on haemorrhage, performing case reviews of black women meeting morbidity criteria. Comparing cases by site, site-specific areas for improvement in haemorrhage risk assessment, prevention and management emerged. Evidence-based practices (EBPs) were then selected, tailored and implemented by site. Monthly system-wide team meetings included (1) metric tracking and (2) site presentations with discussions around barriers/facilitators to EBP implementation. Maternal morbidity rates among black women were compared the year before goal development (1 July 2019–30 June 2020) to the year after (1 July 2020–30 June 2021).ResultsMean ICS scores for inpatient obstetric units differed by site (p=0.005), with climates more supportive of implementation at urban/academic hospitals. In response to case reviews, sites reported implementing 2 to 8 EBPs to meet the goal. Despite different ICS scores, this process was associated with significant reductions in maternal morbidity for black women from pregoal to postgoal development overall and at sites 1, 2 and 3, with non-statistically significant reductions at sites 4 and 5 (overall: −29.4% reduction, p<0.001).ConclusionsA health system goal of reducing maternal morbidity for black women led to a data-driven, collaborative model for implementing site-tailored interventions. If health systems prioritise equity-focused goals, sites can be supported in implementing EBPs that improve care.
Emergent readmission and long-term mortality risk after incident atrial fibrillation hospitalisation
Authors: Weber Courtney , Hung Joseph , Hickling Siobhan , Li Ian , Murray Kevin , Briffa Tom 
Published: November 2022

ObjectiveTo assess the frequency and predictors of unplanned readmissions after hospitalisation for incident atrial fibrillation (AF) and the association of readmissions with mortality over 2 years.MethodsWe performed a retrospective cohort study using Western Australian morbidity and mortality data to identify all patients, aged 25–94 years, who survived incident (first-ever) hospitalisation for AF (principal diagnosis), between 2001 and 2015. Ordinal logistic models determined the covariates independently associated with unplanned readmission(s), and Cox proportional hazards models with time-varying exposures determined the hazard ratios (HR) of one or more readmissions for mortality over 2 years after incident AF.ResultsOf 22 956 patients, 57.7% male, mean age 67.9 (SD 13.8) years, 44.0% experienced 22 053 unplanned readmissions within 2 years, 50.6% being cardiovascular-related. All-cause death occurred in 8.0% of the cohort, and the multivariable-adjusted mortality HR of 1 (vs 0) readmission was 2.9 (95% CI 2.6 to 3.3), increasing to 5.6 (95% CI 5.0 to 6.5) for 3+ readmissions. First emergent readmission for AF, stroke, heart failure or myocardial infarction was independently associated with an increased hazard for mortality. Coexistent cardiovascular and other comorbidities were independently associated with increased readmission and mortality risk, whereas AF ablation was associated with reduced risk.ConclusionThis study highlights the large burden of unplanned all-cause and cardiovascular-specific readmissions within 2 years after being hospitalised for incident AF and their associated adverse impact on mortality. Concomitant comorbidities are independently associated with unplanned hospitalisations and mortality, which supports integrated multidisciplinary management of comorbidities, along with AF-targeted treatments, to improve long-term outcomes in patients with AF.
Investigating the impact of a 20 miles per hour speed limit intervention on road traffic collisions, casualties, speed and volume in Belfast, UK: 3 year follow-up outcomes of a natural experiment
Authors: Hunter Ruth F , Cleland Claire L , Busby John , Nightingale Glenna , Kee Frank , Williams Andrew James , Kelly Paul , Kelly Michael P , Milton Karen , Kokka Kelly , Jepson Ruth 
Published: November 2022

BackgroundEvidence regarding the effectiveness of 20 miles per hour (mph) speed limit interventions is limited, and rarely have long-term outcomes been assessed. We investigate the effect of a 20 mph speed limit intervention on road traffic collisions, casualties, speed and volume at 1 and 3 years post-implementation.MethodsAn observational, repeated cross-sectional design was implemented, using routinely collected data for road traffic collisions, casualties, speed and volume. We evaluated difference-in-differences in collisions and casualties (intervention vs control) across three different time series and traffic speed and volume pre-implementation, at 1 and 3 years post-implementation.ResultsSmall reductions in road traffic collisions were observed at year 1 (3%; p=0.82) and year 3 post-implementation (15%; p=0.31) at the intervention site. Difference-in-differences analyses showed no statistically significant differences between the intervention and control sites over time for road traffic collisions. There were 16% (p=0.18) and 22% (p=0.06) reductions in casualty rates at years 1 and 3 post-implementation, respectively, at the intervention site. Results showed little change in mean traffic speed at year 1 (0.2 mph, 95% CI −0.3 to 2.4, p=0.14) and year 3 post-implementation (0.8, 95% CI −1.5 to 2.5, p=0.17). For traffic volume, a decrease in 57 vehicles per week was observed at year 1 (95% CI –162 to −14, p<0.00) and 71 vehicles at year 3 (95% CI −213 to 1, p=0.05) post-implementation.ConclusionA 20 mph speed limit intervention implemented at city centre scale had little impact on long-term outcomes including road traffic collisions, casualties and speed, except for a reduction in traffic volume. Policymakers considering implementing 20 mph speed limit interventions should consider the fidelity, context and scale of implementation.
Reduced BDNF expression in the auditory cortex contributed to neonatal pain-induced hearing impairment and dendritic pruning deficiency in mice
Authors: Li Nanqi , Chen Bing , Jia Gaogan , Xu Rui , Xia Ying , Lai Chuijin , Li Gang , Li Wenxian , Han Yuan 
Published: November 2022

IntroductionProcedural pain in neonates is associated with impaired neurodevelopment. Whether hearing development is impaired, however, remains unknown. This study examined potential cause-and-effect relationship between neonatal pain and subsequent hearing loss in mice.MethodsMale C57BL/6J mouse pups received an intra-plantar injection of complete Freund’s adjuvant on postnatal day 7 or repetitive needle prick stimuli from postnatal days 0–7. Mechanical and thermal pain thresholds were tested between postnatal days 14 and 49. The auditory brainstem response test was used to determine hearing thresholds. The inner ear structures and dendritic morphology in auditory cortex were assessed using immunofluorescence and Golgi-staining. The effects of oxycodone, tropomyosin receptor kinase B agonists and antagonists were tested.ResultsNeonatal pain resulted in impaired hearing in adulthood of both pain models No damage or synapse loss was found in the cochlea but increased dendritic spine density and reduced brain-derived neurotrophic factor level were found in auditory cortex in neonatal pain group. Oxycodone attenuated hearing loss and the associated changes in dendritic spine density and brain-derived neurotrophic factor changes in auditory cortex. A tropomyosin receptor kinase B agonist reversed neonatal pain-induced hearing impairment and decreased caspase 3 expression in auditory cortex. Administration of tropomyosin receptor kinase B antagonist in naïve mouse pups impaired hearing development suppressed phosphorylated-AKT, and increased caspase 3 expression.ConclusionChronic pain during the neonatal period resulted in impaired hearing in adulthood in mice, possibly via the brain-derived neurotrophic factor signaling pathway and dendritic spine pruning deficiency in auditory cortex.
Primary palliative care in Japan: needs estimation and projections – national database study with international comparisons
Authors: Ito Masami , Aoyama Maho , Murtagh Fliss E M , Miyashita Mitsunori 
Published: November 2022

ObjectivesWe aimed to estimate the potential population that requires palliative care, clarify the relationship between this population and the rate of ageing in Japan, and compare these trends with those of other countries.DesignWe used the national death registration data and population projections for Japan to estimate the population in need of palliative care using the minimal estimate method developed by Murtaghet al. Linear regression was used to create a model of mortality using sex, age at intervals of 5 years, and each major disease classification. We calculated the future population in need of palliative care until 2040 and compared the ageing data to those of other countries.Setting/participantsAll adults in Japan who died from 1980 to 2040 at intervals of 5 years.ResultsThe number of people who might need palliative care from 2020 to 2040 will also increase linearly from 1 059 000 to 1 405 000. The proportion of Alzheimer’s, dementia and senility of the total need for palliative care will increase to 43.4% in 2040. The correlation coefficient between the proportion of the population in need of palliative care and the rate of ageing was 0.24 in developed countries.ConclusionIn Japan, the population requiring palliative care in 2040 will be 1.5 times that in 2015. Palliative care needs to be provided urgently for people with Alzheimer’s disease, dementia and senility. The proportion of patients in need of palliative care may not change, although the number of patients requiring such gradually increases in developed countries.