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The current European fleet of vehicles is ageing and lifetime mileages are rising proportionally. Consequently, a substantial fraction of the vehicle fleet is currently operating at mileages well beyond current durability legislation (≤ 160,000 km). Emissions inventories and models show substantial increases in emissions with increasing mileage, but knowledge of the effect of emissions control system deterioration at very high mileages is sparse. Emissions testing has been conducted on matched pairs (or more) of diesel and gasoline (and CNG) vehicles, of low and high mileage, supplementing the results with in-house data, in order to explore high mileage emission deterioration factors (DF). The study isolated, as far as possible, the effect of emissions deterioration with mileage, by using nominally identical vehicle models and controlling other variables. Several emissions species were considered, including pollutants under consideration for control at Euro 7, with measurements made and data included from chassis dynamometer testing (WLTC and real driving emissions cycles) and from driving on the road using portable emissions measurement systems (PEMS). In addition to specific vehicle measurements, Remote Sensing Detection (RSD) data was used to help select vehicle pairs for testing, to interrogate Euro 5 single vehicle-model emissions deterioration across the full mileage spectrum for a historical perspective, and to evaluate pooled (similar) vehicle types for mileage-related emissions control deterioration. Data was analysed to identify emissions DF in two ways: firstly, to look at the differences between pairs at high and low mileages and secondly, to determine the deterioration gradient with mileage according to fuel type and test cycle. These deterioration gradients were cross validated against similar gradients determined from a large RSD database. Results showed increases in emissions control deterioration from 160,000km to 200,000km and further deterioration out to 240,000km for several pollutants; diesel DF were generally higher than gasoline DF for the same pollutants, and DF determined from RDE tended to be higher than DF determined from WLTC testing.

Emissions from passenger cars are one of major sources that deteriorate urban air quality. This study presents characterization of real-drive emissions from three Euro 6 emission level passenger cars (two gasoline and one diesel) in terms of fresh particles and secondary aerosol formation. The gasoline vehicles were also characterized by chassis dynamometer studies. In the real-drive study, the particle number emissions during regular driving were 1.1–12.7 times greater than observed in the laboratory tests (4.8 times greater on average), which may be caused by more effective nucleation process when diluted by real polluted and humid ambient air. However, the emission factors measured in laboratory were still much higher than the regulatory value of 6 × 1011 particles km−1. The higher emission factors measured here result probably from the fact that the regulatory limit considers only non-volatile particles larger than 23 nm, whereas here, all particles (also volatile) larger than 3 nm were measured. Secondary aerosol formation potential was the highest after a vehicle cold start when most of the secondary mass was organics. After the cold start, the relative contributions of ammonium, sulfate and nitrate increased. Using a novel approach to study secondary aerosol formation under real-drive conditions with the chase method resulted mostly in emission factors below detection limit, which was not in disagreement with the laboratory findings. publishedVersion

Surgical site infections (SSI) following total hip arthroplasty (THA) have a significantly adverse impact on patient outcomes and pose a great challenge to the treating surgeon. Therefore, timely recognition of those patients at risk for this complication is very important, as it allows for adopting measures to reduce this risk. This review discusses literature reported risk factors for SSI after THA. These can be classified into patient-related factors (age, gender, obesity, comorbidities, history of infection, primary diagnosis, and socioeconomic profile), surgery-related factors (allogeneic blood transfusion, DVT prophylaxis and coagulopathy, duration of surgery, antibiotic prophylaxis, bearing surface and fixation, bilateral procedures, NNIS index score, and anesthesia type), and hospital-related factors (duration of hospitalization, institution and surgeon volume, and admission from a healthcare facility). All these factors are discussed with respect to potential measures that can be taken to reduce their effect and consequently the overall risk for infection.

We report the case of a patient with giant cell tumor of the L5 vertebra. A 35-year-old female patient with giant cell tumor of the L5 vertebra was subjected to a combined treatment. Three years after treatment, there is no recurrence of the disease and no increase in the residual tumor’s size. Giant cell tumor of the L5 vertebra requires careful planning of treatment and close follow-up of the patient.

Study Design. This study is a case report. Objective. To report a case of a patient with paraplegia and low back pain, who was diagnosed with acute infrarenal aortic thrombosis. Summary of Background Data. There have been few reports in the literature regarding acute aortic thrombosis presenting with paraplegia. Methods. A 56-year-old man was referred to our emergency department with flaccid paraplegia and low back pain. Clinical examination and imaging revealed acute infrarenal aortic thrombosis, with lower limb ischemia. The patient underwent transcutaneous embolectomy. Results. Despite successful revascularization, the patient finally died because of development of revascularization syndrome. Conclusion. Acute aortic occlusion is a catastrophic event and may present with paraplegia, because of acute spinal cord ischemia. This can mislead the clinician to a wrong diagnosis and delay initiation of definite treatment.

Background: Total scapulectomy and intra-articular resection of the glenohumeral joint indicates the Malawer Type III shoulder girdle resection. Materials and Methods: The modified Tikhoff-Linberg total scapulectomy and constrained reverse total shoulder reconstruction for a Ewing’s sarcoma of the scapula is presented. A combined approach has been used. The deltoid, trapezius, rhomboids, levator scapulae, latissimus dorsi, and serratus anterior were preserved. the tumor was removed en bloc by disarticulation of the acromioclavicular and the glenohumeral joints. The scapular prosthesis was suspended by the muscles. A constrained reverse humeral prosthesis was implanted after osteotomy of the humeral head. Results: There were no intraoperative or postoperative complications; surgical margin, were clear. At 12 months postoperatively, the patient has a stable and painless shoulder. Conclusion: The goal of shoulder reconstructions is to provide a stable and painless joint that allows positioning of the arm and hand in space. Compared to those patients left without a scapula reconstruction, prosthetic replacement of the scapula and shoulder partially restores abduction and external rotation and improves cosmesis. J. Surg. Oncol. 2009;100:611-615. (C) 2009 Wiley-Liss, Inc.