bluuebunny/crossref_metadata_2025 huggingface dataset:
STEP-NC Process Planning for Powder Bed Fusion Additive Manufacturing
Authors: Milaat Fahad Ali , Witherell Paul , Hardwick Martin , Yeung Ho , Ferrero Vincenzo , Monnier Laetitia , Brown Matthew
Published: October 2022

Powder bed fusion (PBF) is an additive manufacturing (AM) technology that uses high-power beams to fuse powder material into layers of scanned patterns, thus producing parts with great geometric complexity. For PBF, the selection of appropriate process parameters, environmental control, and machine functions play critical roles in maintaining fabrication consistency and reducing potential part defects such as cracks and pores. However, poor data representations in the form of approximated geometry and incoherent process plans can negatively impact the relationship between the selected parameters. To address this issue, the Standard for the Exchange of Product model data Numerical Control (STEP-NC) recently added standardized data entities and attributes specifically for AM applications. Yet, the current STEP-NC data representations for AM do not have definitions for process parameters and scan strategies that are commonly used in PBF processes. Therefore, there is a need for defining data models that link process parameters with process control. To bridge this gap, in this paper, an amended STEP-NC compliant data representation for PBF in AM is proposed. Specifically, the characteristics of the interlayer relationships in PBF, along with the technology and scan strategy controls, are defined. Simulation results demonstrate the feasibility of granular process planning control and the potential for producing high-quality parts that meet geometric requirements and tight tolerances. The contributions of this paper highlight the importance of information models in AM, promoting data representations as key enablers of the AM technology and supporting the neutrality and interoperability of data across AM systems.
Buoyancy-Induced Instability of a Power-Law Fluid Saturating a Vertical Porous Slab
Authors: Lazzari Stefano , Celli Michele , Vayssière Brandão Pedro , Barletta Antonio
Published: October 2022

Many engineering applications involve porous media and rely on non-Newtonian working fluids. In this paper, the seepage flow of a non-Newtonian fluid saturating a vertical porous layer is studied. The buoyant flow is thermally driven by the boundaries of the porous layer, which are permeable surfaces kept at different temperatures. In order to model the seepage flow of both shear-thinning (pseudoplastic) and shear-thickening (dilatant) fluids, reference is made to the Ostwald-de Waele rheological model implemented via the power-law extended form of Darcy's law. The basic stationary flow is parallel to the vertical axis and shows a single-cell pattern, where the cell has infinite height and can display a core-region of enhanced/inhibited flow according to the fluid's rheological behavior. By applying small perturbations, a linear stability analysis of the basic flow is performed to determine the onset conditions for a multicellular pattern. This analysis is carried out numerically by employing the shooting method. The neutral stability curves and the values of the critical Rayleigh number are computed for different pseudoplastic and dilatant fluids. The behavior of a Newtonian fluid is also obtained as a limiting case.
Experimental Study of Impact of In-Service Deterioration on Thermal Performance of High-Pressure Nozzle Guide Vanes
Authors: Michaud Mathias , Chowdhury Nafiz H. K. , Povey Thomas
Published: October 2022

In this paper, we analyze the impact of in-service deterioration on the overall thermal performance (metal effectiveness) of heavily cooled high-pressure nozzle guide vanes of a design typical of large civil jet engines. We study 15 deteriorated parts (increased surface roughness, thermal barrier coating spallation and sintering, damaged film cooling holes, and trailing edge burn-back) from operational engines and compare their thermal performance to that of equivalent new parts. A companion paper focuses on the aerodynamic impact of in-service deterioration. Overall cooling effectiveness measurements were performed in the Engine Component AeroThermal (ECAT) Facility at the University of Oxford, at engine-representative conditions of Mach number, Reynolds number, coolant-to-mainstream pressure ratio, and turbulence intensity. We characterize the degradation of overall cooling effectiveness with service time. This is an important result for whole-life modeling. Changes in overall cooling effectiveness were greatest on the pressure surface and early suction surface of the parts. Area-averaged differences in overall cooling effectiveness of −1.83% and −10.41% were measured on the pressure surfaces of mid-life and end-of-life vanes, respectively. In the analysis, we attempt to decouple the contributions from independent deterioration effects and compare the philosophy of this top-down approach to the bottom-up approach in which effects are studied in isolation and then superposed in modeling.
The Influence of Boundary Layer State and Trailing Edge Wedge Angle on the Aerodynamic Performance of Transonic Turbine Blades
Authors: Rossiter A. D. , Pullan G. , Melzer A. P.
Published: October 2022

Trailing edge loss typically accounts for a third of the profile loss of a transonic turbine blade. In this paper, two dominant influencing factors—boundary layer state and trailing edge wedge angle—are quantified using a combined experimental (single airfoil transonic tests) and computational (wall-resolved LES) approach. Three key findings are reported. First, the switch between two flow regimes—detached vortex shedding and transonic vortex shedding—as the Reynolds number is increased, is identified and explained. It is shown that the transition of the pressure surface boundary layer drives the switch from the former to the latter; this change is associated with a jump in loss of close to 100%. The switch is also shown to affect the base pressure distribution around the trailing edge, changing it from uniform, with an isobaric dead-air region, to non-uniform. Second, the influence of the trailing edge wedge angle is explored. It is found that higher wedge angles can offer performance benefits in both loss and base pressure—with a change from 8 deg to 14 deg geometry providing up to a 29% reduction in an overall loss for the geometry tested. Finally, as these findings are the result of changes to the unsteady flow phenomena around the trailing edge, they would not be picked up by current low-fidelity, steady design tools. A method is proposed to use data, such as that presented in this paper, to improve low-fidelity modeling.
Direct Numerical Simulation of Partial Fuel Stratification Assisted Lean Premixed Combustion for Assessment of Hybrid G-Equation/Well-Stirred Reactor Model
Authors: Xu Chao , Ameen Muhsin , Pal Pinaki , Som Sibendu
Published: October 2022

Partial fuel stratification (PFS) is a promising fuel injection strategy to stabilize lean premixed combustion in spark-ignition (SI) engines. PFS creates a locally stratified mixture by injecting a fraction of the fuel, just before spark timing, into the engine cylinder containing homogeneous lean fuel/air mixture. This locally stratified mixture, when ignited, results in complex flame structure and propagation modes similar to partially premixed flames and allows for faster and more stable flame propagation than a homogeneous lean mixture. This study focuses on understanding the detailed flame structures associated with PFS-assisted lean premixed combustion. First, a two-dimensional direct numerical simulation (DNS) is performed using detailed fuel chemistry, experimental pressure trace, and realistic initial conditions mapped from a prior engine large-eddy simulation (LES), replicating practical lean SI operating conditions. DNS results suggest that the conventional triple flame structure is prevalent during the initial stage of flame kernel growth. Both premixed and nonpremixed combustion modes are present with the premixed mode contributing dominantly to the total heat release. Detailed analysis further reveals the effects of flame stretch and fuel pyrolysis on flame displacement speed. Based on the DNS findings, the accuracy of a hybrid G-equation/well-stirred reactor (WSR) combustion model is assessed for the PFS-assisted lean operation in the LES context. It is found that the G-equation model qualitatively captures the premixed branches of the triple flame, while the WSR model predicts the nonpremixed branch of the triple flame. Finally, potential needs for improvements to the hybrid G-equation/WSR modeling approach are discussed.
Broadening Band Gaps of Bragg Scattering Phononic Crystal With Graded Supercell Configuration
Authors: Ye Yuanyuan , Mei Chaosheng , Li Li , Wang Xuelin , Ling Ling , Hu Yujin
Published: October 2022

A new phononic crystal with the graded supercell configuration is proposed to broaden the Bragg scattering band gaps. The graded structural design can merge adjacent multiple band gaps into an extremely broad one. The proposed phononic crystal is made up of a periodic arrangement of supercells, and the supercells are composed of unit cells with graded structural parameters. The mechanical model of the graded phononic crystals is established based on the transfer matrix method to investigate in-plane elastic waves propagating and band structures of the periodic system. Modal analysis shows that the mechanism for the broadening of band gap is that the graded supercell configuration breaks some symmetries of the phononic crystal, resulting in the opening of the Dirac cone and creation of new band gaps. The effects of the main structural parameters related to graded supercell design on band gap broadening are studied by simulation and verified by the experiment. The present study is beneficial to the design of new functional materials with broadband vibration isolation performance.
A Fenestrated Balloon Expandable Stent System for the Treatment of Aortoiliac Occlusive Disease
Authors: Cashin John L. , Wirtz Alex J. , Genin Guy M. , Zayed Mohamed
Published: October 2022

In aortoiliac occlusive disease, atherosclerotic plaques can occlude the distal aortic bifurcation and proximal bilateral iliac artery and thus cause ischemia in the lower extremity. This is typically treated by restoring patency with balloon expandable stents. Stents are typically deployed in a “kissing stent” configuration into the bilateral iliac arteries and into the distal aortic bifurcation lumen to restore antegrade arterial flow. However, these stents typically become re-occluded by plaques. To understand the reasons for this and look for solutions, we simulated flow dynamics in the aortic bifurcation in the presence and absence of stents using computational fluid dynamics. Results demonstrated that the kissing stent configuration was associated with high levels of vorticity and flow constriction. These prothrombotic variables were alleviated in an alternative, aortoiliac fenestrated (AIFEN), tapered, and balloon-expandable stent design. Our findings suggest that stent design can be tailored to improve flow fields for aortoiliac stenting.
Mechatronic Model of a Powertrain With Half Toroidal Continuously Variable Transmission
Authors: Padilla-García Erick Axel , Cervantes-Culebro Héctor , Mendoza-Trejo Omar
Published: October 2022

This paper presents a mechatronic model of a powertrain with a half toroidal continuously variable transmission. In this model, the actuator, the load on the output shaft, and the mechanical, electrical, and control dynamics are simultaneously considered. A reduced mathematical model is stated for the half toroidal transmission, where a time-variant transmission ratio is considered to drive different input/output dynamic torques of the powertrain. The dynamic performance of the mechatronic model is shown through three case studies with different inertial/dynamic loads at the output shaft. Simulation results are performed for fixed and automatic transmission ratio changes. The model and simulation results presented in this article extend the options to design, control, and drive mechatronic systems that include a half toroidal continuously variable transmission.
Experimental Determination of Blade Tip Rub Forces in a Multiblade System
Authors: Reifsnyder Robin , Keener Christopher , Mathison Randall , D'Souza Kiran
Published: October 2022

As improved efficiency goals require ever smaller gaps between rotating turbomachinery blade tips and stationary outer casings, it becomes more important to understand the physics of what happens when a blade tip rubs against the casing. A key piece of information to be determined is the force exerted on the blade tip during the rub event. This paper presents a method of extracting the blade tip rub forces from experiments conducted at The Ohio State University Gas Turbine Laboratory. To identify the forces during the rub, three multi-axis load cells are mounted behind a segment of the casing to measure the forces exerted on the casing during the rub event. Recovering blade tip forcing from this load cell data requires creating an appropriate model that can relate the measured data at the load cells to the high-speed rotating blade loads. The continuous, repeated nature of the rubs in the experiment makes this a challenge. This paper discusses the creation and performance of a state-space realization model developed from stationary ping test data that is used to address these challenges. The model is augmented with information on the angular position of the blades from a rotary encoder and information on the angular span of the rub, which increases with rub depth. Challenges and solutions related to finding tangential frequency responses, simultaneous blade rubs, and irregularities in the experimental data are also discussed. This paper aims to summarize the process and effectiveness of this approach for finding blade tip forces, as well as lessons learned along the way.
Critical role of lncEPAT in coupling dysregulated EGFR pathway and histone H2A deubiquitination during glioblastoma tumorigenesis
Authors: Li Linlin , Zhou Aidong , Wei Yanjun , Liu Feng , Li Peng , Fang Runping , Ma Li , Zhang Sicong , Wang Longqiang , Liu Jinze , Richard Hope T. , Chen Yiwen , Wang Hengbin , Huang Suyun
Published: October 2022

Histone 2A (H2A) monoubiquitination is a fundamental epigenetics mechanism of gene expression, which plays a critical role in regulating cell fate. However, it is unknown if H2A ubiquitination is involved in EGFR-driven tumorigenesis. In the current study, we have characterized a previously unidentified oncogenic lncRNA (lncEPAT) that mediates the integration of the dysregulated EGFR pathway with H2A deubiquitination in tumorigenesis. LncEPAT was induced by the EGFR pathway, and high-level lncEPAT expression positively correlated with the glioma grade and predicted poor survival of glioma patients. Mass spectrometry analyses revealed that lncEPAT specifically interacted with deubiquitinase USP16. LncEPAT inhibited USP16’s recruitment to chromatin, thereby blocking USP16-mediated H2A deubiquitination and repressing target gene expression, including
CDKN1A
and
CLUSTERIN
. Depletion of lncEPAT promoted USP16-induced cell cycle arrest and cellular senescence, and then repressed GBM cell tumorigenesis. Thus, the EGFR-lncEPAT-ubH2A coupling represents a previously unidentified mechanism for epigenetic gene regulation and senescence resistance during GBM tumorigenesis.
A bioresorbable peripheral nerve stimulator for electronic pain block
Authors: Lee Geumbee , Ray Emily , Yoon Hong-Joon , Genovese Sabrina , Choi Yeon Sik , Lee Min-Kyu , Şahin Samet , Yan Ying , Ahn Hak-Young , Bandodkar Amay J. , Kim Joohee , Park Minsu , Ryu Hanjun , Kwak Sung Soo , Jung Yei Hwan , Odabas Arman , Khandpur Umang , Ray Wilson Z. , MacEwan Matthew R. , Rogers John A.
Published: October 2022

Local electrical stimulation of peripheral nerves can block the propagation of action potentials, as an attractive alternative to pharmacological agents for the treatment of acute pain. Traditional hardware for such purposes, however, involves interfaces that can damage nerve tissue and, when used for temporary pain relief, that impose costs and risks due to requirements for surgical extraction after a period of need. Here, we introduce a bioresorbable nerve stimulator that enables electrical nerve block and associated pain mitigation without these drawbacks. This platform combines a collection of bioresorbable materials in architectures that support stable blocking with minimal adverse mechanical, electrical, or biochemical effects. Optimized designs ensure that the device disappears harmlessly in the body after a desired period of use. Studies in live animal models illustrate capabilities for complete nerve block and other key features of the technology. In certain clinically relevant scenarios, such approaches may reduce or eliminate the need for use of highly addictive drugs such as opioids.
The linker domain of the initiator DnaA contributes to its ATP binding and membrane association in
E. coli
chromosomal replication
Authors: Hou Yanqi , Kumar Pankaj , Aggarwal Monika , Sarkari Farzad , Wolcott Karen M. , Chattoraj Dhruba K. , Crooke Elliott , Saxena Rahul
Published: October 2022

DnaA, the initiator of
Escherichia coli
chromosomal replication, has in its adenosine triphosphatase (ATPase) domain residues required for adenosine 5′-triphosphate (ATP) binding and membrane attachment. Here, we show that D118Q substitution in the DnaA linker domain, a domain known to be without major regulatory functions, influences ATP binding of DnaA and replication initiation in vivo. Although initiation defective by itself, overexpression of DnaA(D118Q) caused overinitiation of replication in
dnaA46
ts cells and prevented cell growth. The growth defect was rescued by overexpressing the initiation inhibitor, SeqA, indicating that the growth inhibition resulted from overinitiation. Small deletions within the linker showed another unexpected phenotype: cellular growth without requiring normal levels of anionic membrane lipids, a property found in DnaA mutated in its ATPase domain. The deleted proteins were defective in association with anionic membrane vesicles. These results show that changes in the linker domain can alter DnaA functions similarly to the previously shown changes in the ATPase domain.
A green and sustainable strategy toward lithium resources recycling from spent batteries
Authors: Xu Jing , Jin Yang , Liu Kai , Lyu Nawei , Zhang Zili , Sun Bin , Jin Qianzheng , Lu Hongfei , Tian Huajun , Guo Xin , Shanmukaraj Devaraj , Wu Hui , Li Meicheng , Armand Michel , Wang Guoxiu
Published: October 2022

Recycling lithium from spent batteries is challenging because of problems with poor purity and contamination. Here, we propose a green and sustainable lithium recovery strategy for spent batteries containing LiFePO
4
, LiCoO
2
, and LiNi
0.5
Co
0.2
Mn
0.3
O
2
electrodes. Our proposed configuration of “lithium-rich electrode || LLZTO@LiTFSI+P3HT || LiOH” system achieves double-side and roll-to-roll recycling of lithium-containing electrode without destroying its integrity. The LiTFSI+P3HT-modified LLZTO membrane also solves the H
+
/Li
+
exchange problem and realizes a waterproof protection of bare LLZTO in the aqueous working environment. On the basis of these advantages, our system shows high Li selectivity (97%) and excellent Faradaic efficiency (≥97%), achieving high-purity (99%) LiOH along with the production of H
2
. The Li extraction processes for spent LiFePO
4
, LiNi
0.5
Co
0.2
Mn
0.3
O
2
, and LiCoO
2
batteries is shown to be economically feasible. Therefore, this study provides a previously unexplored technology with low energy consumption as well as high economic and environmental benefits to realize sustainable lithium recycling from spent batteries.
Nef Suppresses LINE-1 Retrotransposition through Two Distinct Mechanisms
Authors: Wang Yu , Zhao Ke , Zhao Yifei , Zhao Zihan , Wang Shaohua , Du Juan
Published: October 2022

Human immunodeficiency viruses are pathogens of AIDS that were first discovered almost 40 years ago and continue to threaten human lives to date. While currently used anti-HIV drugs are sufficient to suppress viral loads in HIV-infected patients, both drug-resistant HIV strains and adverse side effects triggered by the long-term use of these drugs highlight the need to develop novel anti-HIV drugs targeting different viral proteins and/or different steps in viral replication.
Supplemental Material: The Pondosa fault zone: A distributed dextral-normal-oblique fault system in northeastern California
Authors: Jobe J. Thompson , al. et
Published: October 2022

Contains bedrock orientation, geochronology, and thermochronology data, shapefiles of fault and lineament mapping, and field observations.  
Surface Imaging in Applied Research
Authors: Pytskii I. S. , Kuznetsova E. S. , Buryak A. K.
Published: October 2022

The possibilities of mass spectrometric visualization in new areas of research are considered. It is shown that surface mass spectrometry can be used to study structural materials and monitor surfaces for corrosion damage, process contamination, and damage. The possibility of studying non-metallic materials is shown for the first time. It is found that studying the low molecular weight part of polymer films helps to detect technological impurities and irreversible deformation of the film surface. It is established this can be used to authenticate handwritten documents, make corrections to them, and successfully compete with the classical means of such research.
Pharmacy services at the Tokyo 2020 Olympic and Paralympic Games: perspectives of the pharmacy workforce
Authors: Kasashi Kumiko , Sato Ayaka , Stuart Mark , Thomas Trudy , Kim Sung Hwa , Jang Da Mi , File Hayley , Suzuki Satomi , Rhie Sandy Jeong
Published: October 2022

Objectives

To evaluate the awareness of the volunteer pharmacy workforce of medication use and their satisfaction with the pharmacy services of the Tokyo 2020 Olympic and Paralympic Games from a pharmacist’s perspective.

Methods

A questionnaire was developed from related articles in published peer-reviewed journals and modified prior to distribution to the whole population of pharmacists serving at the Tokyo 2020 Olympic and Paralympic Games. Validity tests were conducted based on expert opinions and Cronbach’s alpha (0.79). The questionnaire consisted of demographics (11 questions), knowledge of medication use in sports (8 questions) and satisfaction on the provision of the service (5 questions). Responses using a 5-point-Likert scale, from strongly agree (5) to strongly disagree (1), and two free text questions were analysed with descriptive statistics.

Results

The response rate was 86% (n=32/37). Overall, the pharmacists reported a high awareness of medication use. Specifically, questions on the prohibited list of medications (mean 4.0±SD 0.7), COVID-19 policy (3.8±0.9), use of alternative non-prohibited medications (3.6±1.0) and therapeutic use exemptions (3.5±0.9). Moreover, they rated high satisfaction with the pharmacy service they provided. However, rates were ≤3 for knowledge of the International Olympic Committee Needle Policy (2.6±1.0), Medication Importation Declaration (2.9±1.0) and communication skills (3.0±1.0).

Conclusion

Pharmacists were confident and satisfied with the pharmacy service at the games. The study confirms the importance of prior training and education. Game-specific policies and strategies to improve communication skills should be included in the pharmacy education for future Games.
Artificial intelligence and opioid use: a narrative review
Authors: Gadhia Seema , Richards Georgia C , Marriott Tracey , Rose James
Published: October 2022

Background

Opioids are strong pain medications that can be essential for acute pain. However, opioids are also commonly used for chronic conditions and illicitly where there are well-recognised concerns about the balance of their benefits and harms. Technologies using artificial intelligence (AI) are being developed to examine and optimise the use of opioids. Yet, this research has not been synthesised to determine the types of AI models being developed and the application of these models.

Methods

We aimed to synthesise studies exploring the use of AI in people taking opioids. We searched three databases: the Cochrane Database of Systematic Reviews, Embase and Medline on 4 January 2021. Studies were included if they were published after 2010, conducted in a real-life community setting involving humans and used AI to understand opioid use. Data on the types and applications of AI models were extracted and descriptively analysed.

Results

Eighty-one articles were included in our review, representing over 5.3 million participants and 14.6 million social media posts. Most (93%) studies were conducted in the USA. The types of AI technologies included natural language processing (46%) and a range of machine learning algorithms, the most common being random forest algorithms (36%). AI was predominately applied for the surveillance and monitoring of opioids (46%), followed by risk prediction (42%), pain management (10%) and patient support (2%). Few of the AI models were ready for adoption, with most (62%) being in preliminary stages.

Conclusions

Many AI models are being developed and applied to understand opioid use. However, there is a need for these AI technologies to be externally validated and robustly evaluated to determine whether they can improve the use and safety of opioids.
Person-centred support programme (RESPECT intervention) for women with breast cancer treated with endocrine therapy: a feasibility study
Authors: Ahlstedt Karlsson Susanne , Henoch Ingela , Olofsson Bagge Roger , Wallengren Catarina
Published: October 2022

Objective

The peRson-cEntred Support Programme EndoCrine Therapy intervention is a complex intervention encompassing a person-centred support programme for patients with breast cancer being treated with endocrine therapy (ET). The aim of this study was to explore the feasibility of the trial design and patient acceptability of the intervention and outcome measures and to provide data to estimate the parameters required to design the final intervention.

Design

A controlled before-and-after design following the Consolidated Standards of Reporting Trials 2010 statement for feasibility trials.

Setting

A surgical outpatient clinic in Sweden.

Participants

Forty-one patients (aged 47–85) with breast cancer who were treated with ET.

Interventions

Eligible patients were assigned to the control group or intervention group, which included individual education material, an individualised learning plan and a personalised reminder letter using a person-centred approach. The intervention could be delivered as a telephone or digital follow-up during a 12-week follow-up.

Outcome measures

The aims were to determine the recruitment rate, assess the rate of retention, explore whether the intervention was delivered according to the protocol, assess the preferred form of educational support, rate of education sessions, length per education session and length between each education session, determine the distribution of education materials and assess completion rates of patient-reported instruments, including the General Self-efficacy Scale, the Quality of Care from the Patient’s Perspective Questionnaire and the Memorial Symptom Assessment Scale.

Results

Eighty-six per cent of the patients in the intervention group completed the intervention and questionnaires 3 months after their inclusion. The call attendance was 90%. During the intervention, the contact nurse complied with the intervention protocol. For self-efficacy, symptoms and quality of care, there were no differences in effect size between the control and intervention groups.

Conclusions

This intervention seems to be feasible and acceptable among patients.
How do high ambient temperatures affect infant feeding practices? A prospective cohort study of postpartum women in Bobo-Dioulasso, Burkina Faso
Authors: Part Chérie , Filippi Véronique , Cresswell Jenny A , Ganaba Rasmané , Hajat Shakoor , Nakstad Britt , Roos Nathalie , Kadio Kadidiatou , Chersich Matthew , Lusambili Adelaide , Kouanda Seni , Kovats Sari
Published: October 2022

Objective

To examine the effects of high ambient temperature on infant feeding practices and childcare.

Design

Secondary analysis of quantitative data from a prospective cohort study.

Setting

Community-based interviews in the commune of Bobo-Dioulasso, Burkina Faso. Exclusive breastfeeding is not widely practised in Burkina Faso.

Participants

866 women (1:1 urban:rural) were interviewed over 12 months. Participants were interviewed at three time points: cohort entry (when between 20 weeks’ gestation and 22 weeks’ postpartum), three and nine months thereafter. Retention at nine-month follow-up was 90%. Our secondary analysis focused on postpartum women (n=857).

Exposure

Daily mean temperature (°C) measured at one weather station in Bobo-Dioulasso. Meteorological data were obtained from publicly available archives (TuTiempo.net).

Primary outcome measures

Self-reported time spent breastfeeding (minutes/day), exclusive breastfeeding of infants under 6 months (no fluids other than breast milk provided in past 24 hours), supplementary feeding of infants aged 6–12 months (any fluid other than breast milk provided in past 24 hours), time spent caring for children (minutes/day).

Results

The population experienced year-round high temperatures (daily mean temperature range=22.6°C–33.7°C). Breastfeeding decreased by 2.3 minutes/day (95% CI -4.6 to 0.04, p=0.05), and childcare increased by 0.6 minutes/day (0.06 to 1.2, p=0.03), per 1°C increase in same-day mean temperature. Temperature interacted with infant age to affect breastfeeding duration (p=0.02), with a stronger (negative) association between temperature and breastfeeding as infants aged (0–57 weeks). Odds of exclusive breastfeeding very young infants (0–3 months) tended to decrease as temperature increased (OR=0.88, 0.75 to 1.02, p=0.09). There was no association between temperature and exclusive breastfeeding at 3–6 months or supplementary feeding (6–12 months).

Conclusions

Women spent considerably less time breastfeeding (~25 minutes/day) during the hottest, compared with coolest, times of the year. Climate change adaptation plans for health should include advice to breastfeeding mothers during periods of high temperature.
What should be included in case report forms? Development and application of novel methods to inform surgical study design: a mixed methods case study in parastomal hernia prevention
Authors: Murkin Charlotte , Rooshenas Leila , Smart Neil , Daniels I R , Pinkney Tom , Shabbir Jamshed , Rockall Timothy , Bennett Joanne , Torkington Jared , Randall Jonathan , Brandsma H T , Reeves Barnaby , Blazeby Jane , Blencowe Natalie S
Published: October 2022

Objectives

To describe the development and application of methods to optimise the design of case report forms (CRFs) for clinical studies evaluating surgical procedures, illustrated with an example of abdominal stoma formation.

Design

(1) Literature reviews, to identify reported variations in surgical components of stoma formation, were supplemented by (2) intraoperative qualitative research (observations, videos and interviews), to identify unreported variations used in practice to generate (3) a ‘long list’ of items, which were rationalised using (4) consensus methods, providing a pragmatic list of CRF items to be captured in the Cohort study to Investigate the Prevention of parastomal HERnias (CIPHER) study.

Setting

Two secondary care surgical centres in England.

Participants

Patients undergoing stoma formation, surgeons undertaking stoma formation and stoma nurses.

Outcome measures

Successful identification of key CRF items to be captured in the CIPHER study.

Results

59 data items relating to stoma formation were identified and categorised within six themes: (1) surgical approach to stoma formation; (2) trephine formation; (3) reinforcing the stoma trephine with mesh; (4) use of the stoma as a specimen extraction site; (5) closure of other wounds during the procedure; and (6) spouting the stoma.

Conclusions

This study used multimodal data collection to understand and capture the technical variations in stoma formation and design bespoke CRFs for a multicentre cohort study. The CIPHER study will use the CRFs to examine associations between the technical variations in stoma formation and risks of developing a parastomal hernia.

Trial registration number

ISRCTN17573805.
Protocol for establishing and evaluating a public and patient panel for organisation science and management principles in healthcare
Authors: Harnett Claire , Ryan Nuala , Hynes Briga
Published: October 2022

Introduction

Patient and public involvement (PPI) has not been used to its full potential when examining the organisational science and management principles side of healthcare. With more and more acknowledgement of the relationship between management tools and patient outcomes, having meaningful engagement with the patient and the public in conducting research with the potential to enhance the patient experience, has never been more important. This study aims to outline the process in identifying members for a PPI for the organisational science and management principles side of healthcare, as well as providing guidelines for the establishment of PPIs in this nascent field. In addition, it aims to produce a charter for the panel, by and with the panel members, ensuring they are involved at every stage of research.

Methods and analysis

A hybrid of both a priority-setting and partnership approach to PPI will provide guidance on identifying, recruiting and establishing a PPI for research on the organisational science and management principles in healthcare. The panel will consist of approximately 20 members including patients, members of the public and researchers. A World Café approach to panel workshops will be adopted to produce a charter for the group. An assessment of panel engagement will be conducted through analysis of records of the meetings/workshops, as well as one-to-one interviews with all panel members at key points in time. Assessment criteria will be agreed with all members of the PPI panel. Data will be transcribed and managed using NVivo through a thematic analysis.

Ethics and dissemination

Ethical approval for the evaluation of the PPI has been received from the Kemmy Business School’s Ethics Committee. Papers outlining the process in establishing a PPI in the area of organisational science and management principles of healthcare, and the results of the assessment of the panel’s engagement will be published in journals.
Fever among preschool-aged children: a cross-sectional study assessing Lebanese parents’ knowledge, attitudes and practices regarding paediatric fever assessment and management
Authors: Sakr Fouad , Toufaili Zeinab , Akiki Zeina , Akel Marwan , Malaeb Diana , Dabbous Mariam , Salameh Pascale
Published: October 2022

Objectives

This study investigated parental knowledge, attitudes and practices towards fever in preschool children to help address gaps in public health and provide information with the aim of supporting clinical reports for parental education.

Design

A cross-sectional study design was used to explore parental experiences with fever.

Setting

Participants were recruited randomly from schools all over Lebanon targeting the preschool divisions.

Participants

Parents of children aged 5 years or less.

Interventions

An electronic self-administered questionnaire was sent to the parents through the schools’ emails and e-learning mobile applications.

Primary and secondary outcomes

The primary outcome measure was to assess parental knowledge about the precise definition of fever, correct use of medications and to evaluate the impact of sociodemographic factors on this knowledge. The secondary outcome measures were to assess parental attitudes and practices of fever management, sources of information and reasons to seek primary medical attention.

Results

A total of 733 parents were included in the study. Only 44% identified fever correctly according to the recognised definition by international guidelines. A significant association between parents’ knowledge of antibiotics and years of parenting experience was found (adjusted OR, ORa=4.23, 95% CI 1.41 to 12.68, p=0.01). Other sociodemographic factors that were significantly associated with parents’ knowledge of antibiotics were age (ORa=3.42, 95% CI 1.09 to 10.73, p=0.036) and education level (ORa=7.99, 95% CI 3.71 to 17.23, p<0.001). Greater than 75% usually give their children antipyretics without consulting a doctor. Approximately one-quarter of parents (26.3%) consulted different doctors at the same time, of which more than half (58.4%) had received different medical information.

Conclusions

This research determines deficiencies in parents’ knowledge of fever with some malpractices in its management particularly regarding antipyretic use. It provides insight for healthcare providers to empower parental experiences by offering the necessary information to enhance general outcomes of febrile sickness.
Transcutaneous auricular vagus nerve stimulation in poststroke cognitive impairment: protocol for a randomised controlled trial
Authors: Li Zhen-Dong , Qiu Hang-Jian , Wang Xiao-Qian , Zhang Cheng-Cheng , Zhang Yue-Juan
Published: October 2022

Background

As one of the most common stroke sequelae, poststroke cognitive impairment significantly impacts 17.6%–83% of survivors, affecting their rehabilitation, daily living and quality of life. Improving cognitive abilities among patients in stroke recovery is therefore critical and urgent. Transcutaneous auricular vagus nerve stimulation (TAVNS) is a non-invasive, safe, cost-effective treatment with great potential for improving the cognitive function of poststroke patients. This clinical research will evaluate the effectiveness, and help elucidate the possible underlying mechanisms, of TAVNS for improving poststroke cognitive function.

Methods and analysis

A single-centre, parallel-group, allocation concealment, assessor-blinded randomised controlled clinical trial. We will allocate 88 recruited participants to the TAVNS or sham group for an intervention that will run for 8 weeks, 5 days per week with twice daily sessions lasting 30 min each. Blood tests will be performed and questionnaires issued at baseline and 8-week and 12 week follow-ups. Primary outcomes will be changes in cognitive function scores. Secondary outcomes will be changes in activities of daily living, quality of life and serum oxidative stress indicators.

Ethics and dissemination

The Ethics Committee of the First Affiliated Hospital of Hunan University of Chinese Medicine has approved the protocol (No. HN-LL-YJSLW-2022200). Findings will be published in peer-reviewed academic journals and presented at scientific conferences.

Trial registration number

ChiCTR2200057808.
Impacts of economic inequality on healthcare worker safety at the onset of the COVID-19 pandemic: cross-sectional analysis of a global survey
Authors: Harrigan Sean P , Tsang Vivian W L , Yassi Annalee , Zungu Muzimkhulu , Spiegel Jerry M
Published: October 2022

Objectives

To assess the extent to which protection of healthcare workers (HCWs) as COVID-19 emerged was associated with economic inequality among and within countries.

Design

Cross-sectional analysis of associations of perceptions of workplace risk acceptability and mitigation measure adequacy with indicators of respondents’ respective country’s economic income level (World Bank assessment) and degree of within-country inequality (Gini index).

Setting

A global self-administered online survey.

Participants

4977 HCWs and healthcare delivery stakeholders from 161 countries responded to health and safety risk questions and a subset of 4076 (81.2%) answered mitigation measure questions. The majority (65%) of study participants were female.

Results

While the levels ofriskbeing experienced at the pandemic’s onset were consistently deemed as unacceptable across all groupings, participants from countries with less income inequality were somewhat less likely to report unacceptable levels of risk to HCWs regarding both workplace environment (OR=0.92, p=0.012) and workplace organisational factors (OR=0.93, p=0.017) compared with counterparts in more unequal national settings. In contrast, considerable variation existed in the degree to whichmitigationmeasures were considered adequate. Adjusting for other influences through a logistic regression analysis, respondents from lower middle-income and low-income countries were comparatively much more likely to assess both occupational health and safety (OR=10.91, p≤0.001) and infection prevention and control (IPC) (OR=6.61, p=0.001) protection measures as inadequate, despite much higher COVID-19 rates in wealthier countries at the time of the survey. Greater within-country income inequality was also associated with perceptions of less adequate IPC measures (OR=0.94, p=0.025). These associations remained significant when accounting for country-level differences in occupational and gender composition of respondents, including specifically when only female care providers, our study’s largest and most at-risk subpopulation, were examined.

Conclusions

Economic inequality threatens resilience of health systems that rely on health workers working safely to provide needed care during emerging pandemics.
Risk factors for the prevalence of poor sleep quality in lecturers during COVID-19 pandemic in Ethiopia: an institution-based cross-sectional study
Authors: Hailu Tesfaye Amensisa , Alemayehu M , Abere Giziew , Kabito Gebisa Guyasa
Published: October 2022

Objective

This study was conducted to assess the prevalence and risk factors of poor sleep quality (SQ) among the academic staff at the University of Gondar, Northwestern Ethiopia.

Design

An institution-based cross-sectional study was conducted from March to April 2021. A validated, self-administered, standardised Pittsburgh Sleep Quality Index (PSQI) was used to quantify the amount of self-reported poor SQ. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14 software. Binary logistic regressions were computed to determine the association between variables. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05.

Setting

The study was conducted at the University of Gondar, Northwestern Ethiopia.

Participants

A total of 607 lecturers participated in this study.

Outcome measures

The primary outcome is the prevalence of poor SQ, which was measured using the PSQI.

Results

Overall response rate was 95.60% (N=607). The age of the participants ranges from 21 to 70 with a mean of 32.39 (SD±6.80) years. The magnitude of poor SQ during the COVID-19 pandemic in the last month was 60.30% (95% CI (56.28% to 64.21%)). Working greater than 10 hours per day (AOR=2.19, 95% CI (1.16 to 4.27)), electronic device use before bedtime (AOR=1.53, 95% CI (1.04 to 2.27)), high-risk perception of COVID-19 infections (AOR=1.60, 95% CI (1.04 to 2.46)) and perceived job stress (AOR=2.15 (95% CI (1.50 to 3.08)) were risk factors for poor SQ.

Conclusion

The study revealed that the prevalence of poor SQ was high during the COVID-19 pandemic. The finding highlights the importance of optimising the working hours per day, minimising electronic device use before bedtime, promoting risk perception toward COVID-19 infection and developing workplace coping strategies for stress, which play a substantial role in minimising poor SQ.
Peer-support interventions for women with cardiovascular disease: protocol for synthesising the literature using an evidence map
Authors: Parry Monica , Visintini Sarah , Johnston Amy , Colella Tracey JF , Kapur Deeksha , Liblik Kiera , Gomes Zoya , Dancey Sonia , Liu Shuangbo , Goodenough Catherine , Hay Jacqueline L , Noble Meagan , Adreak Najah , Robert Helen , Tang Natasha , O'Hara Arland , Wong Anice , Mullen Kerri-Anne
Published: October 2022

Introduction

The leading cause of death for women is cardiovascular disease (CVD), including ischaemic heart disease, stroke and heart failure. Previous literature suggests peer support interventions improve self-reported recovery, hope and empowerment in other patient populations, but the evidence for peer support interventions in women with CVD is unknown. The aim of this study is to describe peer support interventions for women with CVD using an evidence map. Specific objectives are to: (1) provide an overview of peer support interventions used in women with ischaemic heart disease, stroke and heart failure, (2) identify gaps in primary studies where new or better studies are needed and (3) describe knowledge gaps where complete systematic reviews are required.

Methods and analysis

We are building on previous experience and expertise in knowledge synthesis using methods described by the Evidence for Policy and Practice Information (EPPI) and the Coordinating Centre at the Institute of Education. Seven databases will be searched from inception: CINAHL, Embase, MEDLINE, APA PsycINFO, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials, and Scopus. We will also conduct grey literature searches for registered clinical trials, dissertations and theses, and conference abstracts. Inclusion and exclusion criteria will be kept broad, and studies will be included if they discuss a peer support intervention and include women, independent of the research design. No date or language limits will be applied to the searches. Qualitative findings will be summarised narratively, and quantitative analyses will be performed using R.

Ethics and dissemination

The University of Toronto’s Research Ethics Board granted approval on 28 April 2022 (Protocol #42608). Bubble plots (ie, weighted scatter plots), geographical heat/choropleth maps and infographics will be used to illustrate peer support intervention elements by category of CVD. Knowledge dissemination will include publication, presentation/public forums and social media.
Contribution of sex, sports and activity types and curriculum load distribution to intracurricular injury risk in physical education teacher education: a cohort study
Authors: Barendrecht Maarten , Tak Igor , Barten Carl , Verhagen Evert
Published: October 2022

Objectives

To investigate the influence of sports/activity types and their distribution over the curriculum years on intracurricular injury risk differences between curriculum years and sexes in Physical Education Teacher Education (PETE) studies.

Methods

In a cohort study over 14 years (2000–2014), injuries reported at the medical facility of a Dutch vocational institute by PETE students who completed their full curriculum were registered. Intracurricular injury rates (IR) per 1000 hours and 95% CIs were calculated per sport, sex and curriculum year and compared with injury rate ratios (RR) and 95% CI. Exposure times per sports category per curriculum year were compared with the χ2test.

Results

Intracurricular IR was highest for gymnastics, team ball sports and track and field (0.76–1.23, 95% CI 0.65 to 1.45). IRs were higher for female compared with male students (RR 2.38, 95% CI 1.97 to 2.87). Comparisons for all individual sports and for all three curriculum years showed the same pattern. IR for the first year was higher than for the second (RR 1.79, 95% CI 1.45 to 2.21) and third year (RR 2.74, 95% CI 2.13 to 3.54) with similar patterns for all sports categories. Over the curriculum years, exposure time distributions per sport showed small differences (p<0.001, Cramer’s V=0.07).

Conclusion

Curriculum year, sex and sports types are risk factors to be independently targeted for preventive and rehabilitative measures in PETE studies. The nature and aetiology of injuries in mixed sports, and the adaption to increased loads in first-year and female PETE students, need further investigation.