bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Students’ Learning Through Reflection on Doing Based on Sentiment Analysis
Authors: Wu Yupeng , Ming Zhenjun , Allen Janet K. , Mistree Farrokh
Published: December 2022

In this paper, we address the following question: How can instructors leverage assessment instruments used to process information gleaned from design, build, and test courses to simultaneously improve student outcomes and assess student learning well enough to improve the course in the future? A take-away is unstructured text written by students in AME4163: Principles of engineering design to record what they understand by reflecting on authentic and immersive experiences that occur throughout the semester. The immersive experiences include lectures, assignments, reviews, building, testing, and post-analysis for the design of an electro-mechanical system to address a given customer need. In the context of a take-away, a student then writes a learning statement that is a structured sentence written as a triple, i.e., (Experience—Learning—Value). Between 2019 and 2021, we collected about 10,000 take-aways and learning statements from almost 400 students. In this paper, we address the question from the perspective of students’ feelings and use dictionary-based sentiment analysis to evaluate students’ subjective feelings toward what they are learning. Through quantitative results, we get an overview of students’ sentiments, analyze the underlying reasons, and provide evidence-based guidance to instructors on how to improve the delivery of the course in the future. Our focus in this paper is on explaining the method using data from AME4163, which is general and can be extended to other courses.
Artificial Intelligence Impersonating a Human: The Impact of Design Facilitator Identity on Human Designers
Authors: Zhang Guanglu , Raina Ayush , Brownell Ethan , Cagan Jonathan
Published: December 2022

Advances in artificial intelligence (AI) offer new opportunities for human–AI cooperation in engineering design. Human trust in AI is a crucial factor in ensuring an effective human–AI cooperation, and several approaches to enhance human trust in AI have been explored in prior studies. However, it remains an open question in engineering design whether human designers have more trust in an AI and achieve better joint performance when they are deceived into thinking they are working with another human designer. This research assesses the impact of design facilitator identity (“human” versus AI) on human designers through a human subjects study, where participants work with the same AI design facilitator and they can adopt their AI facilitator’s design anytime during the study. Half of the participants are told that they work with an AI, and the other half of the participants are told that they work with another human participant but in fact they work with the AI design facilitator. The results demonstrate that, for this study, human designers adopt their facilitator’s design less often on average when they are deceived about the identity of the AI design facilitator as another human designer. However, design facilitator identity does not have a significant impact on human designers’ average performance, perceived workload, and perceived competency and helpfulness of their design facilitator in the study. These results caution against deceiving human designers about the identity of an AI design facilitator in engineering design.
Extending Timoshenko Beam Theory for Large Deflections in Compliant Mechanisms
Authors: Wu Ke , Zheng Gang , Chen Guimin
Published: December 2022

Compliant mechanisms (CMs) have presented its inherently advantageous properties due to the fact that CMs utilize elastic deformation of the elementary flexible members to transfer motion, force, and energy. Previously, the classic Euler–Bernoulli beam theory is the most used theory in terms of modeling large beam deflections in CMs. However, it has some assumptions that may decrease the modeling accuracy, such as ignoring the shear strain and the axial strain of cross sections. In this article, to take into account the shear and axial strains, we adopt the Timoshenko beam theory along with some modifications to consider the axial elongation. To simplify the complexity of the proposed governing boundary value problem (BVP), we transform the BVP into an explicit formulation and use weighted residual methods to numerically approximate the solution. We first focus on the single-beam deflection of a straight beam and an initially curved beam (ICB) using Euler–Bernoulli beam theory, Timoshenko beam theory, and solid mechanics to analyze the contributions of the influences of shear and axial strains in beam deflections. Then, we prove the feasibility of the proposed modeling strategy via mechanism synthesis for a bi-stable mechanism and an ICB-based parallelogram mechanism. Finally, the deduction of the mathematical model and the numerical results are provided along with brief analysis on the mechanical performances of the studied CMs.
Design of a Novel Flexible Robotic Laparoscope Using a Two Degrees-of-Freedom Cable-Driven Continuum Mechanism With Major Arc Notches
Authors: Wang Zhengyu , Bao Shiyang , Wang Daoming , Qian Sen , Zhang Jianxi , Hai Mingxin
Published: December 2022

This article presents the design, development, and motion control of a novel flexible robotic laparoscope (FRL). The main structure of the FRL includes a two degrees-of-freedom (DOFs) continuum mechanism driven by two pairs of cable-pulley-driven systems, which are actuated by four miniature linear actuators. A constant-curvature model is employed on the kinematics modeling and analysis of the continuum mechanism with designed major arc notches. The bending control strategy of the continuum mechanism is proposed and realized based on its kinematics model and a feedforward compensation method considering its nonlinearity motion calibration with a suitable initial tension of the driven cables. Besides, the continuum mechanism is made of elastic nylon material through 3D printing technology. An experimental prototype is developed to test the effectiveness and feasibility of the FRL. The experimental results indicate that the FRL has good positioning accuracy and motion performance with potential applications in robot-assisted laparoscopic surgery.
Interlayer Slidable Friction Structures on Soft-Substrate
Authors: Sun Bo-Hua , Dang Wen , Guo Xiao-Lin
Published: December 2022

In this paper, we consider the interlayer slidable friction structures on soft-substrate as the hardcover book-like-laminated-plates with internal friction on the Winkler foundation. For a quasi-static problem, a detailed analysis of the bending response and energy dissipation is carried out for a three-point-supported layered plate on the Winker foundation. Our numerical investigations show that the hardcover, friction, and substrate have a great influence on bending response, and in particular, the friction can cause a considerable amount of energy dissipation within per loading–unloading cycle. The study is not only to predict the mechanical interactions behavior in-between of geometry, friction, elasticity, and substrate but also as a representative case to help finding some clue on the universal behaviors of interlayer slidable friction structures on soft-substrate.
Research on Start-Stop Performance of Journal Bearing Based on an Isothermal and Mixed Lubrication Model With Different Acceleration and Deceleration Forms in Consideration
Authors: Gu Chunxing , Dai Li , Zhang Di
Published: December 2022

In order to explore the influence of different acceleration and deceleration forms on the bearing performance during acceleration and deceleration, an isothermal and mixed lubrication model for journal bearings was established. In this model, the fluid mechanics was solved by the Reynolds equation with mass conservation boundary condition, while the contact mechanics was predicted by Greenwood and Tripp (GT) contact model. By the developed model and using different functions of the shaft speed, the start-stop performances of the journal-bearing system under different acceleration scenarios were analyzed. The effects of working conditions, lubrication oil temperature, and bearing structure parameters on the start-stop performance of the journal-bearing system were studied. It was found that the larger starting acceleration can help the journal-bearing system enter the hydrodynamic lubrication faster in the acceleration phase. In the deceleration phase, slow deceleration helps the journal-bearing system maintain hydrodynamic lubrication for a longer time. The higher final speed, lower lubrication oil temperature, and lower bearing clearance can make the journal-bearing system have a better performance in the start-stop process.
Analysis of a Moored and Articulated Multibody Offshore System in Steep Waves
Authors: Jiang Changqing , Xu Peng , el Moctar Ould , Zhang Guiyong
Published: December 2022

Wave-induced motions and loads on a moored and articulated multibody offshore structure are numerically analyzed, where a coupled mooring–joint–viscous flow solver is used to count for mooring dynamics, joint restrictions, nonlinear rigid body motions, and viscous flow effects. The considered concepts consist of two modular floating structures (MFSs) connected by two types of connections, namely, a rigid joint and a flexible joint, and positioned by four symmetrical catenary mooring lines. The analyzed responses comprised multibody motions as well as associated forces acting in the hinged joints and the mooring lines. Results indicate that surge motions of articulated bodies are almost identical to each other, whereas the effects of the joint on heave motions are not pronounced. However, highly dynamic pitch motions between two hinged MFSs are observed. Apart from motion responses, forces acting on the hinged joint and the mooring lines are estimated. The importance of wave nonlinearity and higher order components is identified by studying waves with different steepness. The coupled mooring–joint–viscous flow solver demonstrates its capability to predict wave-induced motions and loads on a moored multibody offshore structure articulated by various types of joints.
Development of Liquid Film Thickness Measurement Considering Effect of Curved Gas-Liquid Interface Based on Optical Waveguide Film
Authors: Furuichi Hajime , Kawada Shunya , Mizushima Yuki , Sanada Toshiyuki
Published: December 2022

This study aims at developing a liquid film sensor with an optical waveguide film (OWF-based sensor) that provides accurate measurements of liquid film thickness. The OWF measurement principle employs detection of light reflected at the liquid film surface with high spatial resolution. Since the curved surface of the liquid film reflects the light and increases measurement error, we proposed a signal processing method to remove the error factor in calculation of the time-averaged thickness. This method requires knowing an appropriate range for the thickness measurement and predicting the surface curvature. We experimentally simulated a liquid film curved surface with a metal test piece, and the test piece was moved with a constant velocity in an acrylic water vessel. We found that an output signal from the OWF-based sensor peaked when the wave passed above the sensor. We calculated the output signal with our 3D ray-tracing simulator of the OWF-based sensor. The simulation results showed that the effect of the curved surface up to the surface curvature of 5.0 mm−1 was negligible based on the good agreement of the liquid film thickness with that of the flat liquid film surface within 6 % difference. Furthermore, we found the surface curvature in the range of 0.1–20.0 mm−1 was able to be predicted using a characteristic of the output signal peak. Consequently, we confirmed the effectiveness of the developed sensor with the OWF-based sensor.
An Assessment of Utilities Locating Practices and Excavation Damage
Authors: Farrag Khalid , Guerrero Merino Marta
Published: December 2022

Excavation damage to underground utilities is caused by three main root causes, namely: One-call notifications were not made or not sufficient, unsuccessful locating practices, and excavation practices not sufficient.

This paper investigates the root-causes of excavation damage and the effect of various site characteristics and locating practices on the success of locating belowground utilities. Excavation damage incidents were reviewed from the National Transportation Safety Board (NTSB) pipeline incident reports and Pipeline and Hazardous Materials Safety Administration (PHMSA) records of natural gas distribution (GD), gas transmission (GT), and hazardous liquid (HL) lines from 1970 to 2019. These records were stored in an SQL database and a web-based data management program was developed for displaying the distributions and relationships between the root causes and incidents’ parameters.

The incidents’ data analysis was performed using a Bayesian Network (BN) approach for the evaluation of the probabilities of locating failures under variable parameters. BN provides the flexibility of updating the probabilities when performing risk and sensitivity analysis under various conditions. The means by which BN is processed enables performing the sensitivity analysis quantitatively as well as ranking the significance of the risk factors.

The paper presents the relationships and causality of the parameters affecting the performance of Electromagnetic (EM) and Ground Penetrating Radar (GPR) Locators. A parametrical study was performed to evaluate the effect of site conditions (such as soil type and moisture), pipe attributes (material, size, and depth), and locating practices (such as equipment type and frequency) on the probability of a successful locating. The results demonstrate the significance of the pipe diameter to depth ratio and device frequency on the probability of detection.
Balancing Hydrogen Networks Safely: A Method for Calculating Linepack Potential Without Causing Integrity Risk Due to Hydrogen-Enhanced Fatigue
Authors: Wesselink Onno , Krom Alfons , van Agteren Martin
Published: December 2022

The hydrogen economy is about to shift towards a large-scale decarbonization solution, a transition in which green hydrogen will take the stage. An increasing share of green hydrogen means that supply and demand will be more widely spread, in terms of distance as well as timing. Transport system operators see a temporary role for themselves in solving this issue of imbalance. Gasunie will have developed a ‘hydrogen backbone’ by 2030, approximately 1200 km in length, of which 80% will consist of re-used natural gas pipelines with 36–48 inch diameters. Hydrogen pipeline networks can efficiently accommodate temporal imbalances via their linepack.

However, there is a downside to using linepack this way. Highly volatile production volumes of green hydrogen, caused by volatile wind and solar profiles, will result in frequent significant pressure fluctuations in the pipelines. This is worrying because pipeline crack-like defects in contact with hydrogen gas grow about ten times faster compared to natural gas under the same pressure fluctuations. This effect is known as hydrogen-enhanced fatigue defect growth. Increasing the frequency and amplitude of pressure fluctuations for balancing using linepack will lead to even higher defect growth rates, compared to a more constant pressure regime.

Enhanced fatigue can be prevented by controlling the pressure fluctuations, but this limits the maximum available linepack. This difficult choice between commercial interests and pipeline integrity justifies performing a quantitative analysis of market-driven pressure fluctuations in hydrogen networks and their effect on defect growth and lifetimes of these hydrogen networks. This paper describes an integrated simulation model that can calculate dynamic network behaviour for hydrogen transport networks and give an indication of the corresponding defect growth risks that come with this network behaviour.

By using this integrated simulation model, safe margins can be calculated for providing sufficient linepack without risking increased hydrogen-enhanced fatigue defect growth, which can undermine the integrity of a pipeline and reduce the lifetime of this asset. Insights from this model are applied by Gasunie to maximize security of supply and minimize integrity risks. This is essential in the start-up phase of the hydrogen economy due to the absence of sufficient flexibility in production and storage.
Safe Repurposing of Vintage Pipelines for Hydrogen in North America
Authors: Sandana Daniel , Gallon Neil , Burkinshaw Ollie , Bhatia Arti
Published: December 2022

Hydrogen has been championed as a vital player in the future energy mix needed to achieve net-zero carbon emissions. The deployment of hydrogen at an industrial scale will require pipelines for transportation, and given the many obstacles to new pipeline construction, it appears inevitable that a large proportion of the future hydrogen pipeline network will consist of repurposed existing infrastructure.

Conversion strategies require that retrofit pipelines remain operationally safe under the new mode of transportation. From an integrity perspective, the conversion exercise will require understanding the line pipe material’s “DNA” (e.g. grades, hard spots) and assessing the impact of hydrogen on key pipeline mechanical properties (e.g. fracture toughness) and on the tolerance of integrity threats. These threats include those that may already exist from previous hydrocarbon service (e.g. stress-corrosion cracking), those that are directly related to the conversion to hydrogen (e.g. fatigue) and those that are an integral part of a pipeline life cycle (e.g. third-party damages, geohazards). There is currently a lack of clarity within the industry about how to quantify and manage these threats to hydrogen pipelines. How, if at all, should an integrity management strategy for a hydrogen pipeline differ from that of a natural gas pipeline?

In order to define the boundaries of the existing North American pipeline network and the starting point for conversion, this paper will conduct an Exploratory Data Analysis (EDA) of (i) the pipeline network’s “DNA” (e.g. diameters, thicknesses, grades, fracture toughness, hard spots, age), and (ii) the pipeline threat and condition attributes (e.g. pre-existing crack threats, crack distribution). This paper will take advantage of the knowledge derived from the ROSEN Integrity Data Warehouse (IDW), a global repository of ILI results and Integrity Management, in order to quantify the characteristics specific to North America.

A pragmatic approach to safely repurposing existing pipelines to hydrogen service will be then presented in recognition of the identified regional ‘DNA’ and integrity peculiarities, and in respect to applicable local codes and regulations.
Role of Axial Stress in Pipeline Integrity Management
Authors: Zhang Ken , Chune Ron , Wang Rick , Kania Richard
Published: December 2022

In pipeline integrity management, axial stress solely can be a detrimental condition, and it may play an important role in assessment of other threats. Current practice for the assessment of integrity features such as external metal loss, deformation and stress corrosion cracking (SCC) are based on methods validated by burst testing that primarily consider hoop stress to be the maximum principal stress which governs. Observations during recent integrity management practice, however, indicate that axial stress plays an important role in pipeline failures when interacting with integrity features under certain circumstances, and should be carefully considered in integrity engineering assessment.

Multiple real-life case studies are described to illustrate the importance of proper consideration of axial stress in integrity management, including: 1) axial compressive stress induced global buckling, 2) yielding of small radius fitting under axial stress, 3) ductile overloading due to axial tensile stress interacting with circumferentially oriented corrosion feature, 4) axial tensile stress and its relationship with formation of circumferential stress corrosion cracking. The details of the case studies, results and findings are summarized in this paper.

Determining axial stress for integrity assessment can be critical, depending on site-specific conditions and nature of the loading. In this paper, a multi-level method for calculating axial stress based on finite element analysis (FEA) using various elements and techniques, combined with bending strain measured by in-line inspection (ILI) is described. In addition, a simplified approach for interacting threat analysis with continuum FEA and a simplified assessment based on empirical equations are proposed and discussed.
Magnetic properties and magnetocaloric effect of (Fe70Ni30)96Mo4 thin films grown by molecular beam epitaxy
Authors: Saqat Raghad S. H. , Forbes Andrew W. , Bhattarai Niraj , Pegg Ian L. , Philip John
Published: December 2022

Thin films of ferromagnetic (Fe70Ni30)96Mo4 were grown via molecular beam epitaxy. Their magnetic properties and magnetocaloric effects were investigated. X-ray diffraction and vibrating sample magnetometry measurements confirmed the crystalline ferromagnetic (Fe70Ni30)96Mo4 phase, with a Curie point near room temperature. To determine the suitability of this material for magnetocaloric applications, we observed a large magnetic entropy change with a large temperature span as well as high relative cooling power near Curie temperature comparable to rare-earth-based materials operating near room temperature.
Evaluation of dry stored disposable sensor strip on rapid SARS-CoV-2 detection platform
Authors: Chiang Chao-Ching , Chiu Chan-Wen , Ren Fan , Tsai Cheng-Tse , Liao Yu-Te , Esquivel-Upshaw Josephine F. , Pearton Stephen J.
Published: December 2022

This study investigated a SARS-CoV-2 virus detection mechanism using dry-stored disposable strips. The accuracy of this sensing platform is as good as polymerase chain reaction (PCR) with a detection time of fewer than 30 s. SARS-CoV-2 antibodies were biofunctionalized on disposable strips similar to glucose detection strips to detect the presence and concentrations of SARS-CoV-2 in saliva samples. Eight 1 ms electric pulses were sent through the sensor strip with a saliva sample in its microfluidic chamber. A circuit board embedded with MOSFET was also employed to amplify the detected signals and convert the signal to digital readings displayed on an LCD screen. The COV-antibody functionalized disposable strips were stored in a dry condition for at least one day before analyzing clinical human saliva samples with known cycling threshold (Ct) values confirmed with conventional PCR tests. Results demonstrate our system is capable of showing qualitative positive or negative results within 30 s and providing quantitative SARS-CoV-2 concentrations in terms of Ct values in 5 min.
Measurement of Physical Activity Using Accelerometry in Persons With Multiple Sclerosis
Authors: Motl Robert W.
Published: December 2022

The consequences of multiple sclerosis (MS), particularly gait and walking dysfunction, may obfuscate (i.e., make unclear in meaning) the measurement of physical activity using body-worn motion sensors, notably accelerometers. This paper is based on an invited keynote lecture given at the 8th International Conference on Ambulatory Monitoring of Physical Activity and Movement, June 2022, and provides an overview of studies applying accelerometers for the measurement of physical activity behavior in MS. The overview includes initial research uncovering a conundrum with the interpretation of activity counts from accelerometers as a measure of physical activity. It then reviews research on calibration of accelerometer output based on its association with energy expenditure in yielding a biologically based metric for studying physical activity in MS. The paper concludes with other applications and lessons learned for guiding future research on physical activity measurement using accelerometry in MS and other populations with neurological diseases and conditions.
Validation and Application of Long-Read Whole-Genome Sequencing for Antimicrobial Resistance Gene Detection and Antimicrobial Susceptibility Testing
Authors: Weinmaier Thomas , Conzemius Rick , Bergman Yehudit , Lewis Shawna , Jacobs Emily B. , Tamma Pranita D. , Materna Arne , Weinberger Johannes , Beisken Stephan , Simner Patricia J.
Published: December 2022

Next-generation sequencing applications are increasingly used for detection and characterization of antimicrobial-resistant pathogens in clinical settings. Oxford Nanopore Technologies (ONT) sequencing offers advantages for clinical use compared with other sequencing methodologies because it enables real-time basecalling, produces long sequencing reads that increase the ability to correctly assemble DNA fragments, provides short turnaround times, and requires relatively uncomplicated sample preparation.
Update on Novel Taxa and Revised Taxonomic Status of Bacteria Isolated from Nondomestic Animals Described in 2018 to 2021
Authors: Lawhon Sara D. , Burbick Claire R. , Munson Erik , Zapp Amanda , Thelen Elizabeth , Villaflor Maia
Published: December 2022

Revisions and new additions to bacterial taxonomy can have a significant widespread impact on clinical practice, infectious disease epidemiology, veterinary microbiology laboratory operations, and wildlife conservation efforts. The expansion of genome sequencing technologies has revolutionized our knowledge of the microbiota of humans, animals, and insects.
Antigenic Landscape Analysis of Individuals Vaccinated with a Universal Influenza Virus Vaccine Candidate Reveals Induction of Cross-Subtype Immunity
Authors: Meade Philip , Strohmeier Shirin , Bermúdez-González Maria Carolina , García-Sastre Adolfo , Palese Peter , Simon Viviana , Krammer Florian
Published: December 2022

The development of a universal influenza virus vaccine that protects against seasonal drifted, zoonotic, or emerging pandemic influenza viruses would be an extremely useful public health tool. Here, we test a technology designed to measure the breadth of antibody responses induced by this new class of vaccines.
Activity, Template Preference, and Compatibility of Components of RNA Replicase of Eastern Equine Encephalitis Virus
Authors: Lello Laura Sandra , Miilimäe Agneta , Cherkashchenko Liubov , Omler Ailar , Skilton Rachel , Ireland Rachel , Ulaeto David , Merits Andres
Published: December 2022

Infection of EEEV in humans can cause serious neurologic disease with an approximately 30% fatality rate. Although human infections are rare, a record-breaking number was documented in 2019.
Molecular Engineering of a Mammarenavirus with Unbreachable Attenuation
Authors: Sakabe Saori , Cubitt Beatrice , Martinez-Sobrido Luis , de la Torre Juan C.
Published: December 2022

Several mammarenaviruses cause severe disease in humans and pose important public health problems in their regions of endemicity. Currently, no FDA-licensed mammarenavirus vaccines are available, and anti-mammarenaviral therapy is limited to an off-label use of ribavirin whose efficacy is controversial.
An Ascovirus Utilizes Different Types of Host Larval Regulated Cell Death Mechanisms To Produce and Release Vesicles
Authors: Yu Huan , Xiao Hua-Yan , Li Ni , Yang Chang-Jin , Huang Guo-Hua
Published: December 2022

Viruses and other pathogens can interrupt host cellular apoptosis to gain benefits, such as sufficient resources and a stable environment that enables them to complete their replication and assembly. It is unusual for viruses to code proteins with homology to caspases, which are commonly recognized as apoptosis regulators.
Dysbiosis of Gut Microbiota Contributes to Uremic Cardiomyopathy via Induction of IFNγ-Producing CD4
+
T Cells Expansion
Authors: Han Bin , Zhang Xiaoqian , Wang Ling , Yuan Weijie
Published: December 2022

Uremic cardiomyopathy (UCM) correlates tightly with increased mortality in patients with chronic kidney disease (CKD), yet the pathogenesis of UCM remains incompletely understood, limiting therapeutic approaches. Our study proposed that a Gut Microbiota-Gut-Kidney-Heart axis could play a critical role in understanding etiology of UCM.
Antiviral Activity of Nitrosonium Cations against SARS-CoV-2 on a Syrian Hamster Model
Authors: Shipovalov A. V. , Vanin A. F. , Pyankov O. V. , Bagryanskaya E. G. , Mikoyan V. D. , Tkachev N. A. , Asanbaeva N. A. , Popkova V. Ya.
Published: December 2022

The antiviral action of binuclear dinitrosyl iron complexes with glutathione along with diethyldithiocarbamate against the SARS-CoV-2 virus has been demonstrated on a Syrian hamster model after aerosol exposure of SARS-CoV-2-infected animals to the solutions of said compounds. EPR assays in analogous experiments on intact hamsters have demonstrated that the iron complexes and diethyldithiocarbamate are predominantly localized in lung tissues. These results have been compared with similar measurements on intact mice, which have shown the equal localization of these agents in both the lungs and liver. We assume that the release of the nitrosonium cations from the binuclear dinitrosyl iron complexes with glutathione occurs during their contact with diethyldithiocarbamate in the animal body. These cations caused S-nitrosation of host and viral cell proteases, leading to suppression of SARS-CoV-2 infection.
Barriers to paediatric penicillin allergy de-labelling in UK secondary care: a regional survey
Authors: Maduemem Kene , Clark Hannah , Sohal Iseult , Dawson Tom , Makwana Niten
Published: December 2022

Background

Incorrect penicillin allergy labels result in the use of inappropriately broad-spectrum antibiotics. De-labelling inaccurate penicillin allergy promotes antimicrobial stewardship and optimises prescribing practices. The objectives were to evaluate paediatric clinicians’ knowledge and understanding of penicillin allergy and to identify barriers in tackling incorrect penicillin allergy labels.

Methods

Paediatric clinicians from across the West Midlands of the UK were surveyed using an online, anonymised questionnaire between 1 August and 30 September 2021. Domains explored were (1) approach to penicillin allergy clinical vignettes, (2) knowledge of the impact of penicillin allergy labels, (3) frequency of allergy-focused history questions and (4) barriers in tackling incorrect penicillin allergy.

Results

Responses were received from 307 paediatric clinicians across 12 hospitals. Sixty-one per cent would not prescribe a penicillin-based antibiotic if a family history of penicillin allergy was reported. There was an overall deficit in taking an allergy-focused history with only 36.5% inquiring about diagnostic confirmation. Absence, or lack of awareness of a referral pathway for antibiotic allergy evaluation (58.6%) and unfamiliarity of the indications for oral provocation testing (55%) were the most common reported barriers to penicillin allergy de-labelling. Fifty-one per cent would rather ‘play it safe’ than explore penicillin allergy confirmation as it is felt that alternative treatments were readily available.

Conclusions

The deficiency in antibiotic allergy-focused history among paediatric clinicians highlights the need for better allergy education across all clinical grades. Pragmatic algorithms and clear referral pathways could address barriers faced by non-allergists in de-labelling incorrect penicillin allergy.
Laparoscopic choledochoscopy for choledocholithiasis is possible in the anatomical anomaly of left gallbladder
Authors: Kaldas Peter , Goh Su Kah , Weinberg Laurence , Hodgson Russell
Published: December 2022

Laparoscopic cholecystectomy (LC) is more challenging in the anatomical variation of left-sided gallbladder with the anomaly also highly related to biliary anomalies. Therefore, there has been a reluctance to operate close to the common bile duct (CBD) in left gallbladder patients, and thus choledocholithiasis is usually treated with endoscopic retrograde cholangiopancreatography (ERCP). There is emerging evidence that single stage LC and CBD exploration for choledocholithiasis may be superior to two stage LC and ERCP in terms of short-term and long-term morbidity, cost and length of stay. With the re-emergence of laparoscopic choledochoscopy, the purpose of this case report is to demonstrate the feasibility of this approach for choledocholithiasis.
COVID-19-associated parotitis and sublingual gland sialadenitis
Authors: Maegawa Kazuki , Nishioka Hiroaki
Published: December 2022

The COVID-19 mainly affects the respiratory system; however, a variety of atypical manifestations of this disease have been also reported. Herein, we report a case of a man in his late 50s with severe COVID-19 presenting with parotitis and sublingual gland sialadenitis. Six days after admission, swelling in the bilateral preauricular and lower jaw areas developed. CT demonstrated parotid and sublingual gland enlargement with surrounding fat stranding, indicating sialadenitis. This case suggests that, in the present COVID-19 pandemic, COVID-19 should be included in the differential diagnosis of sialadenitis and prompt isolation should be considered to reduce the spread of infection.
Cohort profile of the Sloane Project: methodology for a prospective UK cohort study of >15 000 women with screen-detected non-invasive breast neoplasia
Authors: Clements Karen , Dodwell David , Hilton Bridget , Stevens-Harris Isabella , Pinder Sarah , Wallis Matthew G , Maxwell Anthony J , Kearins Olive , Sibbering Mark , Shaaban Abeer M , Kirwan Cliona , Sharma Nisha , Stobart Hilary , Dulson-Cox Joanne , Litherland Janet , Mylvaganam Senthurun , Provenzano Elena , Sawyer Elinor , Thompson Alastair M
Published: December 2022

Purpose

The introduction of breast screening in the UK led to an increase in the detection of non-invasive breast neoplasia, predominantly ductal carcinoma in situ (DCIS), a non-obligatory precursor of invasive breast cancer. The Sloane Project, a UK prospective cohort study of screen-detected non-invasive breast neoplasia, commenced in 2003 to evaluate the radiological assessment, surgical management, pathology, adjuvant therapy and outcomes for non-invasive breast neoplasia. Long-term follow-up and accurate data collection are essential to examine the clinical impact. Here, we describe the establishment, development and analytical processes for this large UK cohort study.

Participants

Women diagnosed with non-invasive breast neoplasia via the UK National Health Service Breast Screening Programme (NHSBSP) from 01 April 2003 are eligible, with a minimum age of 46 years. Diagnostic, therapeutic and follow-up data collected via proformas, complement date and cause of death from national data sources. Accrual for patients with DCIS ceased in 2012 but is ongoing for patients with epithelial atypia/in situ neoplasia, while follow-up for all continues long term.

Findings to date

To date, patients within the Sloane cohort comprise one-third of those diagnosed with DCIS within the NHSBSP and are representative of UK practice. DCIS has a variable outcome and confirms the need for longer-term follow-up for screen-detected DCIS. However, the radiology and pathology features of DCIS can be used to inform patient management. We demonstrate validation of follow-up information collected from national datasets against traditional, manual methods.

Future plans

Conclusions derived from the Sloane Project are generalisable to women in the UK with screen-detected DCIS. The follow-up methodology may be extended to other UK cohort studies and routine clinical follow-up. Data from English patients entered into the Sloane Project are available on request to researchers under data sharing agreement. Annual follow-up data collection will continue for a minimum of 20 years.
Outcome Monitoring After Cardiac Surgery (OMACS): a single-centre prospective cohort study of cardiac surgery patients
Authors: Walker-Smith Terrie , Joyce Katherine , Maishman Rachel , Smartt Helena , Hopkins Emma , Brierley Rachel , Reeves Barnaby C , Rogers Chris A , Angelini Gianni D , Culliford Lucy
Published: December 2022

Introduction

More than 30 000 cardiac surgery procedures are performed in the UK each year, however, postoperative complications and long-term failure of interventions are common, leading to repeated surgeries. This represents a significant burden on the patient and health service.

Routinely, patients are discharged to their general practitioner 6 weeks postoperatively and research studies typically only report short-term outcomes up to 1 year after surgery, together this makes long-term outcomes of cardiac surgery difficult to monitor. Further, traditional research methods have yet to advance understanding of what causes early complications and why surgical interventions fail.

Methods and analysis

This prospective cohort study will characterise participants undergoing cardiac surgery at baseline, describe short-term, medium-term and long-term health outcomes postoperatively and collect tissue samples.

All eligible adult patients undergoing cardiac surgery at the Bristol Heart Institute, UK will be approached for consent. Recruitment is expected to continue for up to 10 years resulting in the largest cohort of cardiac patients reported to date. Blood, urine and waste tissue samples will be collected during admission. Samples, along with anonymised data, will be used to investigate outcomes and inform predictive models of complications associated with cardiac surgery.

Data about the surgical admission will be obtained from hospital databases and medical notes. Participants may be monitored up to 5 years postoperatively using data obtained from NHS digital. Participants will complete health questionnaires 3 months and 12 months postoperatively.

The analysis of data and tissue samples to address specific research questions will require separate research protocols and ethical approval.

Ethics and dissemination

This study was approved by the East Midlands Nottingham 2 Research Ethics Committee.

Findings will be disseminated through peer-reviewed publications and presentation at national and international meetings. Participants will be informed of results in annual newsletters.

Trial registration number

ISRCTN90204321.
Study protocol: ‘a large cohort study of postnatal events in a not-for-profit referral centre in Vellore, South India’
Authors: R Grace Mano , Pricilla Ruby Angeline , Kurian Suja , Benjamin Santosh Joseph , Rathore Swati , Yenuberi Hilda , Minz Shanti dani , Kumar Manish , Ross Benjamin Jeyanth , Vijayaselvi Reeta , Abraham Anuja , Prasanthi Annie , Mani Thenmozhi , Abraham Sunil George , Ebenezer Emily Divya , George Anne , Mittal Rohin , Jeyaseelan Lakshmanan , Mathews Jiji Elizabeth
Published: December 2022

Introduction

In a large developing country, with diverse population characteristics and differential access to healthcare, it is important to identify factors that influence postnatal health. This knowledge will help frame recommendations to enhance universal postnatal care.

Methods and analysis

A prospective cohort study will be conducted by recruiting all participants who deliver in a referral centre in South India during a 1-year period after written consent is obtained from them. In addition to clinical information pertaining to their delivery and demographics, details of physical health, mental health socioeconomic status and emotional support will also be collected. Every participant will be followed up physically and/or by telephonic consultation at 3, 9 and 18 months of their postnatal period to reassess their status and that of their babies. As there are several independent and dependent variables requiring multivariate analysis, a sample size of 10 000 is considered adequate. Any unplanned visits to a health facility will be enquired into and documented for analysis.

During data analysis, the effect of Caesarean section, high-risk characteristics and gestational age of the baby at delivery on various outcome measures and postnatal status will be evaluated. Interpretation of the large volume of collected data will help frame recommendations to improve postnatal care

Ethics and dissemination

The study is approved by the Institutional Review Boards (Research and Ethics Committees) of Christian Medical College, Vellore, Tamil Nadu, India (IRB 12178 date 24 June 2020).

Women are provided with a detailed information sheet and written consent is obtained. They are reassured that their care will not be compromised if they do not consent to the study. Data will be available on the clinical trial portal to assist in the dissemination of results after the project is published.

Trial registration number

CTRI/2022/03/041343.
Effects of housing environments on COVID-19 transmission and mental health revealed by COVID-19 Participant Experience data from the All of Us Research Program in the USA: a case–control study
Authors: Luo Wenting , Baldwin Edwin , Jiang Anna Yi , Li Shujuan , Yang Bo , Li Haiquan
Published: December 2022

Objectives

To examine the association between housing types and COVID-19 infection (or mental health) during the early stages of the pandemic by using the large-scale individual-levelAll of UsResearch Program COVID-19 Participant Experience (COPE) survey data. We hypothesise that housing types with a shared component are associated with elevated COVID-19 infection and subsequent mental health conditions.

Design

A retrospective case–control study.

Setting

Secondary analysis of online surveys conducted in the USA.

Participants

62 664 participant responses to COPE from May to July 2020.

Primary and secondary outcome measures

Primary outcome measure is the self-reported COVID-19 status, and the secondary outcome measures are anxiety or stress. Both measures were applied for matched cases and controls of the same race, sex, age group and survey version.

Results

A multiple logistic regression analysis revealed that housing types with a shared component are significantly associated with COVID-19 infection (OR=1.19, 95% CI 1.1 to 1.3; p=2×10−4), anxiety (OR=1.26, 95% CI 1.1 to 1.4; p=1.1×10−6) and stress (OR=1.29, 95% CI 1.2 to 1.4; p=4.3×10−10) as compared with free-standing houses, after adjusting for confounding factors. Further, frequent optional shopping or outing trips, another indicator of the built environment, are also associated with COVID-19 infection (OR=1.36, 95% CI 1.1 to 1.8; p=0.02), but not associated with elevated mental health conditions. Confounding factors are controlled in the analysis such as ethnicity, age, social distancing behaviour and house occupancy.

Conclusion

Our study demonstrates that houses with a shared component tend to have an increased risk of COVID-19 transmission, which consequently leads to high levels of anxiety and stress for their dwellers. The study also suggests the necessity to improve the quality of the built environment such as residential housing and its surroundings through planning, design and management, ensuring a more resilient society that can cope with future pandemics.
Opportunities and challenges to non-communicable disease (NCD) research and training in Pakistan: a qualitative study from Pakistan
Authors: Almas Aysha , Awan Safia , Bloomfield Gerald , Nisar Muhammad Imran , Siddiqi Sameen , Ahmed Asma , Ali Asad , Shafqat Saad Hameed , Bhutta Zulfiqar Ahmed , Mark Daniel Benjamin , Douglas Pamela , Bartlett John , Jafar Tazeen H , Samad Zainab
Published: December 2022

Introduction

Most of the global non-communicable disease (NCD)-related death burden is borne by low and middle-income countries (LMICs). In LMICs like Pakistan, however, a major gap in responding to NCDs is a lack of high-quality research leading to policy development and implementation of NCDs. To assess institutional opportunities and constraints to NCD research and training we conducted a situational analysis for NCD research and training at Aga Khan University Pakistan.

Methods

We conducted a descriptive exploratory study using grounded theory as a qualitative approach: semistructured interviews of 16 NCD stakeholders (three excluded) and two focus group discussions with postgraduate and undergraduate trainees were conducted. A simple thematic analysis was done where themes were identified, and then recurring ideas were critically placed in their specific themes and refined based on the consensus of the investigators.

Results

The major themes derived were priority research areas in NCDs; methods to improve NCD research integration; barriers to NCD research in LMICs like Pakistan; design of NCD research programme and career paths; and NCD prevention at mass level, policy and link to the government. In general, participants opined that while there was an appetite for NCD research and training, but few high-quality research training programmes in NCDs existed, such programmes needed to be established. The ideal NCD research and training programmes would have in-built protected time, career guidance and dedicated mentorship. Most participants identified cardiovascular diseases as a priority thematic area and health information technology and data science as key methodological approaches to be introduced into research training.

Conclusion

We conclude from this qualitative study on NCD research and training that high-quality research training programmes for NCDs are rare. Such programmes need to be established with in-built protected time, career guidance and mentorship for the trainees to improve their research capacity in Pakistan.
Relationship between serum chloride and prognosis in non-ischaemic dilated cardiomyopathy: a large retrospective cohort study
Authors: Li Xinyi , Zhang Xiaonan , Liu Yaoxin , Shu Fen , Shao Sisi , Tan Ning , Jiang Lei
Published: December 2022

Objectives

Serum chloride has a unique homeostatic role in modulating neurohormonal pathways. Some studies have reported that hypochloremia has potential prognostic value in cardiovascular diseases; thus, we aimed to investigate the association of baseline serum chloride with clinical outcomes in elderly patients with non-ischaemic dilated cardiomyopathy (NIDCM).

Design

Retrospective study.

Setting and participant

A total of 1088 patients (age ≥60 years) diagnosed with NIDCM were enrolled from January 2010 to December 2019.

Results

Logistic regression analyses showed that serum chloride was significantly associated with in-hospital death. Receiver operating characteristic (ROC) curve analyses showed that serum chloride had excellent prognostic ability for in-hospital and long-term death (area under the curve (AUC)=0.690 and AUC=0.710, respectively). Kaplan-Meier survival analysis showed that the patients with hypochloremia had worse prognoses than those without hypochloremia (log-rank χ2=56.69, p<0.001). After adjusting for age, serum calcium, serum sodium, left ventricular ejection fraction, lg NT-proBNP and use of diuretics, serum chloride remained an independent predictor of long-term death (HR 0.934, 95% CI 0.913 to 0.954, p<0.001).

Conclusions

Serum chloride concentration was a prognostic indicator in elderly patients with NIDCM, and hypochloremia was significantly associated with both in-hospital and long-term poor outcomes.