Truck frontal underride protection - compatibility factors influencing passenger car safety

Frontal collisions between passenger cars and trucks are the severest vehicle-to-vehicle collisions observed in accident statistics. Regulation 93 was developed to reduce the risk of fatal injury by preventing passenger cars from underriding heavy truck structures. The regulation does not fully address the higher energy of content in these collisions where passenger car structures cannot be expected to have sufficient energy-absorbing capacity. The performance of a front underrun protective device (FUPD) incorporated into a finite element truck model was evaluated and compared with earlier studies by the authors. In particular, structural interaction of the car with the truck structures was investigated. The packing of the FUPD and truck structures was a critical factor for the FUPD performance. It was found that when the vertical offset between the FUPD and truck frame rails is too small, the efficiency of the FUPD is decreased. Incorporating deformable truck frame elements is only beneficial if the offset is at least 220 mm

FIMCAR XII: Influence on Other Impact Types

The objective of this deliverable is to describe the expected influence of the candidate test procedures developed in FIMCAR for frontal impact on other impact types. The other impact types of primary interest are front-to-side impacts, collisions with road restraint systems (e.g. guardrails), and heavy goods vehicle impacts. These collision types were chosen as they involve structures that can be adapted to improve safety. Collisions with vulnerable road users (VRU) were not explicitly investigated in FIMCAR. It is expected that the vehicle structures of interest in FIMCAR can be designed into a VRU friendly shell. Information used for this deliverable comes from simulations and car-to-car crash tests conducted in FIMCAR or review of previous research. Three test configurations (full width, offset, and moving deformable barriers) were the input to the FIMCAR selection process. There are three different types of offset tests and two different full width tests. During the project test procedures could be divided into three groups that provide different influences or outcomes on vehicle designs: 1. The ODB barrier provides a method to assess part of the vehicles energy absorption capabilities and compartment test in one test 2. The FWRB and FWDB have similar capabilities to control structural alignment, further assess energy absorption capabilities, and promote the improvements in the occupant restraint system for high deceleration impacts. 3. The PDB and MPDB can be used to promote better load spreading in the vehicle structures, in addition to assessing energy absorption and occupant compartment strength in an offset configuration. The consortium selected the ODB and FWDB as the two best candidates for short term application in international rulemaking. The review of how all candidates would affect vehicle performance in other impacts (beside front-to-front vehicle or frontal impacts with fixed obstacles) however is reported in this deliverable to support the benefit analysis reported in FIMCAR. The grouping presented above is used to discuss all five test candidates using similarities between certain tests and thereby simplify the discussion

Flexible working: the experiences of women knowledge workers.

Removed at author's reques

FIMCAR II: Accident Analysis

For the assessment of vehicle safety in frontal collisions compatibility (which consists of self and partner protection) between opponents is crucial. Although compatibility has been analysed worldwide for years, no final assessment approach has been defined to date. Taking into account the European Enhanced Vehicle safety Committee (EEVC) compatibility and frontal impact working group (WG15) and the EC funded FP5 VC-COMPAT project activities, two test approaches have been identified as the most promising candidates for the assessment of compatibility. Both are composed of an off-set and a full overlap test procedure. In addition another procedure (a test with a moving deformable barrier) is getting more attention in today’s research programmes. The overall objective of the FIMCAR project is to complete the development of the candidate test procedures and propose a set of test procedures suitable for regulatory application to assess and control a vehicle’s frontal impact and compatibility crash safety. In addition an associated cost benefit analysis should be performed. The specific objectives of the work reported in this deliverable were: • Determine if previously identified compatibility issues are still relevant in current vehicle fleet o Structural interaction o Frontal force matching o Compartment strength in particular for light cars • Determine nature of injuries and injury mechanisms o Body regions injured o Injury mechanism ▪ Contact with intrusion ▪ Contact ▪ Deceleration / restraint induced The main data sources for this report were the CCIS and Stats 19 databases from Great Britain and the GIDAS database from Germany. The different sampling and reporting schemes for the detailed databases (CCIS & GIDAS) sometimes do not allow for direct comparisons of the results. However the databases are complementary – CCIS captures more severe collisions highlighting structure and injury issues while GIDAS provides detailed data for a broader range of crash severities. The following results represent the critical points for further development of test procedures in FIMCAR

Adeno-associated virus 2 infection in children with non-A–E hepatitis

Funding Information: We wish to acknowledge the contribution of the participating children and their parents who agreed to participate in the ISARIC CCP-UK and DIAMONDS studies, and the research teams who recruited the patients; S. Bennett-Slater from NHS Greater Glasgow and Clyde for assisting with sample location and testing; the histopathology team, Veterinary Diagnostic, University of Glasgow, for excellent technical assistance; P. Murcia for providing resources and advice; P. Olmo for administrative assistance; and E. J. Kremer from the Institut de Génétique Moléculaire de Montpellier, Université de Montpellier and A. Baker, University of Edinburgh, for advice. The work was funded by Public Health Scotland, the National Institute for Health Research (NIHR; award CO-CIN-01) and the Medical Research Council (MRC; grants MR/X010252/1, MC_UU_1201412, MC_UU_12018/12, MC_PC_19059, MC_PC_19025 and MC_PC_22004). DIAMONDS is funded by the European Union Horizon 2020 programme; grant 848196). M.P. acknowledges funding support from the Wellcome Trust (206369/Z/17/Z). M.G.S. acknowledges funding support from The Pandemic Institute, Liverpool and the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool, and UK Health Security Agency. J.K.B. acknowledges funding support from a Wellcome Trust Senior Research Fellowship (223164/Z/21/Z), and MC_PC_20029, Sepsis Research (Fiona Elizabeth Agnew Trust), a BBSRC Institute Strategic Programme Grant to the Roslin Institute (BB/P013732/1, BB/P013759/1), and the Intensive Care Society of the United Kingdom. We acknowledge the support of Baillie Gifford and the Baillie Gifford Science Pandemic Hub at the University of Edinburgh. Parts of this research has been conducted using the UK Biobank Resource under project 788 and we would like to acknowledge the assistance of A. Tenesa in making this possible. Additional replication was also conducted using the UK Biobank Resource (Project 26041). This research was also funded by the National Institute for Health and Care Research (CO-CIN-01) and jointly by NIHR and UK Research and Innovation (CV220-169, MC_PC_19059). The views expressed in this article are those of the author(s) and not necessarily those of UKRI, the NIHR, or the Department of Health and Social Care. We also acknowledge the support of NHS Research Scotland (NRS) Greater Glasgow and Clyde Biorepository team. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Funding Information: We wish to acknowledge the contribution of the participating children and their parents who agreed to participate in the ISARIC CCP-UK and DIAMONDS studies, and the research teams who recruited the patients; S. Bennett-Slater from NHS Greater Glasgow and Clyde for assisting with sample location and testing; the histopathology team, Veterinary Diagnostic, University of Glasgow, for excellent technical assistance; P. Murcia for providing resources and advice; P. Olmo for administrative assistance; and E. J. Kremer from the Institut de Génétique Moléculaire de Montpellier, Université de Montpellier and A. Baker, University of Edinburgh, for advice. The work was funded by Public Health Scotland, the National Institute for Health Research (NIHR; award CO-CIN-01) and the Medical Research Council (MRC; grants MR/X010252/1, MC_UU_1201412, MC_UU_12018/12, MC_PC_19059, MC_PC_19025 and MC_PC_22004). DIAMONDS is funded by the European Union Horizon 2020 programme; grant 848196). M.P. acknowledges funding support from the Wellcome Trust (206369/Z/17/Z). M.G.S. acknowledges funding support from The Pandemic Institute, Liverpool and the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool, and UK Health Security Agency. J.K.B. acknowledges funding support from a Wellcome Trust Senior Research Fellowship (223164/Z/21/Z), and MC_PC_20029, Sepsis Research (Fiona Elizabeth Agnew Trust), a BBSRC Institute Strategic Programme Grant to the Roslin Institute (BB/P013732/1, BB/P013759/1), and the Intensive Care Society of the United Kingdom. We acknowledge the support of Baillie Gifford and the Baillie Gifford Science Pandemic Hub at the University of Edinburgh. Parts of this research has been conducted using the UK Biobank Resource under project 788 and we would like to acknowledge the assistance of A. Tenesa in making this possible. Additional replication was also conducted using the UK Biobank Resource (Project 26041). This research was also funded by the National Institute for Health and Care Research (CO-CIN-01) and jointly by NIHR and UK Research and Innovation (CV220-169, MC_PC_19059). The views expressed in this article are those of the author(s) and not necessarily those of UKRI, the NIHR, or the Department of Health and Social Care. We also acknowledge the support of NHS Research Scotland (NRS) Greater Glasgow and Clyde Biorepository team. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: © 2023, The Author(s), under exclusive licence to Springer Nature Limited.An outbreak of acute hepatitis of unknown aetiology in children was reported in Scotland 1 in April 2022 and has now been identified in 35 countries2. Several recent studies have suggested an association with human adenovirus with this outbreak, a virus not commonly associated with hepatitis. Here we report a detailed case–control investigation and find an association between adeno-associated virus 2 (AAV2) infection and host genetics in disease susceptibility. Using next-generation sequencing, PCR with reverse transcription, serology and in situ hybridization, we detected recent infection with AAV2 in plasma and liver samples in 26 out of 32 (81%) cases of hepatitis compared with 5 out of 74 (7%) of samples from unaffected individuals. Furthermore, AAV2 was detected within ballooned hepatocytes alongside a prominent T cell infiltrate in liver biopsy samples. In keeping with a CD4+ T-cell-mediated immune pathology, the human leukocyte antigen (HLA) class II HLA-DRB1*04:01 allele was identified in 25 out of 27 cases (93%) compared with a background frequency of 10 out of 64 (16%; P = 5.49 × 10−12). In summary, we report an outbreak of acute paediatric hepatitis associated with AAV2 infection (most likely acquired as a co-infection with human adenovirus that is usually required as a ‘helper virus’ to support AAV2 replication) and disease susceptibility related to HLA class II status.Peer reviewe

Ferumoxytol MR angiography vs Duplex ultrasound for vascular mapping before arteriovenous fistula surgery for hemodialysis

Ferumoxytol-enhanced68 MR angiography was superior to duplex US in the detection of central vein stenosis and arterial disease that correlated with outcomes of arteriovenous fistula surgery for hemodialysis. Background: Duplex US is performed routinely for vascular mapping prior to arteriovenous fistula (AVF) creation for hemodialysis but cannot demonstrate the central vasculature. Ferumoxytol, an iron oxide nanoparticle, provides an alternative to gadolinium contrast material for MR angiography for safe use in chronic kidney disease (CKD). Purpose: To assess the clinical utility of ferumoxytol-enhanced MR angiography compared with duplex US for vascular mapping before upper limb AVF creation in participants with CKD. Materials and Methods: In a prospective comparative study (ClinicalTrials.gov: NCT02997046) from December 2016 to August 2018, participants with CKD underwent ferumoxytol-enhanced MR angiography and duplex US. Two independent readers evaluated vessels for diameter, stenosis or occlusion, arterial disease, and central stenosis. Intraclass correlation coefficients (ICCs) and Bland-Altman plots were used to assess intra- and interreader variability. On the basis of accepted standards for AVF creation, an algorithm was developed to predict AVF outcome based on imaging findings. Multivariable regression models used AVF success as the dependent variable and age, sex, and duplex US or ferumoxytol-enhanced MR angiography findings as independent variables. Results: Fifty-nine participants with CKD (mean age, 59 years ± 13 [standard deviation]; 30 women) were evaluated. A total of 51 fistulas were created, of which 24 (47%) were successful. Ferumoxytol-enhanced MR angiography showed excellent inter- and intrareader repeatability (ICC, 0.84–0.99) for all variables assessed. In addition to revealing 15 central vasculature stenoses, ferumoxytol-enhanced MR angiography resulted in characterization of 88 of 236 (37%) of the arterial sections examined as unsuitable for AVF creation compared with 61 of 236 (26%) sections with duplex US (P = .01). Ferumoxytol-enhanced MR angiography independently predicted AVF success in models including (odds ratio, 6.5; 95% confidence interval: 1.7, 25; P = .006) and those excluding (odds ratio, 4.6; 95% confidence interval: 1.3, 17; P = .02) the central vasculature. Conclusion: In addition to enabling identification of central vessel pathologic features, ferumoxytol-enhanced MR angiography revealed peripheral arterial disease not recognized with duplex US and was more predictive than duplex US of the outcome of arteriovenous fistula surgery

Rapid feedback on hospital onset SARS-CoV-2 infections combining epidemiological and sequencing data.

BACKGROUND: Rapid identification and investigation of healthcare-associated infections (HCAIs) is important for suppression of SARS-CoV-2, but the infection source for hospital onset COVID-19 infections (HOCIs) cannot always be readily identified based only on epidemiological data. Viral sequencing data provides additional information regarding potential transmission clusters, but the low mutation rate of SARS-CoV-2 can make interpretation using standard phylogenetic methods difficult. METHODS: We developed a novel statistical method and sequence reporting tool (SRT) that combines epidemiological and sequence data in order to provide a rapid assessment of the probability of HCAI among HOCI cases (defined as first positive test >48 hr following admission) and to identify infections that could plausibly constitute outbreak events. The method is designed for prospective use, but was validated using retrospective datasets from hospitals in Glasgow and Sheffield collected February-May 2020. RESULTS: We analysed data from 326 HOCIs. Among HOCIs with time from admission ≥8 days, the SRT algorithm identified close sequence matches from the same ward for 160/244 (65.6%) and in the remainder 68/84 (81.0%) had at least one similar sequence elsewhere in the hospital, resulting in high estimated probabilities of within-ward and within-hospital transmission. For HOCIs with time from admission 3-7 days, the SRT probability of healthcare acquisition was >0.5 in 33/82 (40.2%). CONCLUSIONS: The methodology developed can provide rapid feedback on HOCIs that could be useful for infection prevention and control teams, and warrants further prospective evaluation. The integration of epidemiological and sequence data is important given the low mutation rate of SARS-CoV-2 and its variable incubation period. FUNDING: COG-UK HOCI funded by COG-UK consortium, supported by funding from UK Research and Innovation, National Institute of Health Research and Wellcome Sanger Institute.COG-UK HOCI funded by COG-UK consortium, supported by funding from UK Research and Innovation, National Institute of Health Research and Wellcome Sanger Institute

"If we use the strength of diversity among researchers we can only improve the quality and impact of our research": Issues of equality, diversity, inclusion, and transparency in the process of applying for research funding

This paper sets out the recommendations that have emerged from a six-month-long exploration and discussion of the processes that take place before research is submitted for funding: the ‘pre-award’ environment. Our work concentrated on how this environment is experienced by researchers at all career stages and from a variety of backgrounds, demographics, and disciplines, as well as by research managers and research support professionals. In the later stages of our exploration, representatives from research funders were also involved in the discussions. The primary component of this project was an analysis of pre-award activities and processes at UK universities, using information collated from workshops with researchers and research management and support staff. The findings of this analysis were presented as a workflow diagram, which was then used to surface issues relating to equality, diversity, inclusion, and transparency in context. The workflow diagram and the issues highlighted by it were used to structure discussions at a symposium for a range of research stakeholders, held in Bristol, UK, in January 2023. The recommendations set out in this paper are drawn from discussions that took place at that event. This paper is not an exhaustive landscape analysis, nor a review of existing research and practice in the area of pre-award processes or of recent thinking on the topics of equality, diversity, and inclusion (EDI). Instead, it aims to summarise and encapsulate the suggestions put forward by the stakeholders during the symposium. These recommendations, from experienced professionals working in the field, are based on their encounters with the issues raised in the project. They do not solely relate to those working on pre-award processes, but may also apply to funders, policymakers, university leaders, and professional associations, since many of the challenges flagged in our research are systemic and cultural, and reach far beyond the research office

Future and potential spending on health 2015-40 : development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

Background The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. Methods We extracted GDP, government spending in 184 countries from 1980-2015, and health spend data from 1995-2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted. Findings We estimated that global spending on health will increase from US$9.21 trillion in 2014 to$24.24 trillion (uncertainty interval [UI] 20.47-29.72) in 2040. We expect per capita health spending to increase fastest in upper-middle-income countries, at 5.3% (UI 4.1-6.8) per year. This growth is driven by continued growth in GDP, government spending, and government health spending. Lower-middle income countries are expected to grow at 4.2% (3.8-4.9). High-income countries are expected to grow at 2.1% (UI 1.8-2.4) and low-income countries are expected to grow at 1.8% (1.0-2.8). Despite this growth, health spending per capita in low-income countries is expected to remain low, at $154 (UI 133-181) per capita in 2030 and$195 (157-258) per capita in 2040. Increases in national health spending to reach the level of the countries who spend the most on health, relative to their level of economic development, would mean $321 (157-258) per capita was available for health in 2040 in low-income countries. Interpretation Health spending is associated with economic development but past trends and relationships suggest that spending will remain variable, and low in some low-resource settings. Policy change could lead to increased health spending, although for the poorest countries external support might remain essential.Peer reviewe