bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrating Multivariate Signal Processing and Machine Learning for Optimal Control of Prosthetic Hands
Authors: Pirouz Mortaza , Tadesse Yonas
Published: November 2023

Control systems for prosthetic hands, actuated with muscle-like actuators face challenges in achieving natural and intuitive movement. The utilization of electromyography (EMG) has the potential to control wearable devices and establish a connection between the human body and smart devices. Although this holds a great promise, there are still challenges to be addressed. Accurately replicating control signals from nerve and muscle sources is significant due to the complexity of signals and the high noise-to-signal ratio. This must be effectively addressed to ensure precise control of the robotic hand, prior to implementing artificial intelligence for the creation of smart devices. To address these challenges, we utilized EMG dataset comprising 8 channels, having 15 different hand motions, with 24 trials (8 individuals with 3 repeated measurements), and 20 seconds of data for each trial. The dataset was sampled at a rate of 4000 samples per second. We used Generalized Eigendecomposition (GED) technique to isolate and distinguish various sources of naturally occurring signals in the human arm, simultaneously reducing the noise ratio. Subsequently, these processed signals are then employed to train machine learning models for movement recognition, imitation learning, and adaptive control. Our machine learning algorithms trained using GED achieved exceptional accuracy in recognizing unprocessed EMG signals. For individual data, we achieved 100% accuracy, while for combined training and testing data from multiple individuals, the accuracy reached over 83%. Notably, our approach outperformed convolutional neural network models on the same dataset in terms of both speed and accuracy. These results highlight the effectiveness of employing multivariate signal processing techniques, such as GED, in improving accuracy, reducing overfitting, and enhancing the robustness and reliability of predictions. These findings have significant implications for optimizing the control of prosthetic hands.
Design Optimisation of a Planar Electromagnetic Energy Harvester Suitable for Low Frequency Vibrations
Authors: Ghafoor Nouman , Punch Jeff , Nico Valeria
Published: November 2023

Nowadays, most of the wireless sensor nodes (WSNs) used in Internet of Things (IoT) applications are powered by batteries. Despite the convenience of battery usage, the need for frequent battery replacement contributes to both direct and indirect environmental pollution. Vibrational energy harvesting using electromagnetic vibrational energy harvesters (EM-VEHs) is a more sustainable alternative to batteries as it harnesses the kinetic energy from ambient vibrations. Usually, the form factors of these devices render them difficult to integrate with printed circuit board and energy storage technologies since coils and magnets are generally arranged in a cylindrical form factor. Arranging coils and magnets in a planar configuration can result in a more compact device and improved integration.

In this paper, an innovative planar EM-VEH design is proposed for harvesting kinetic energy from low frequency (10 Hz to 20 Hz), in-plane vibrations. The structure comprises three fixed-free beams, each of which is fixed on one side to the housing of the harvester while their free ends are attached to a single mass that acts as a magnet holder. Compared to previous studies where the beams are straight (90° to the mass and to the fixed ends), the proposed fixed-free beams form an angle (86°) to the mass and at the fixed end. Coils can be placed on top and bottom of the magnets or, in case of a Halbach array, coils can be placed on top or bottom of the magnets. In-plane excitations induce oscillations of the beams in the in-plane direction and, hence, relative movement of magnets and coils.

Finite element analysis (FEA) using the stress and frequency analysis modules in SolidWorks was carried out to investigate and optimise different geometrical parameters of the design in order to increase the output power for low amplitude (up to 0.5 g, g = 9.81 m/s2) and low frequency (up to 20 Hz) vibrations. In particular, geometrical dimensions of the beams are optimised in terms of: (1) stress at the fixed end of the beam; (2) vertical deflection of the mass at free end; and (3) the movement of the magnet holder.

The FEA results show a resonant frequency of 16.8 Hz, and relative displacements in x-axis of coil and magnet of 4.3 mm, 6.5 mm, 8.7mm and 10.8 mm at acceleration levels of 0.2 g, 0.3 g, 0.4 g, and 0.5 g, respectively.
SMA Micro-Wire Bundle With High Cyclic Actuation Frequency
Authors: Kirsch Susanne-Marie , Welsch Felix , Seelecke Stefan , Motzki Paul
Published: November 2023

Shape memory alloys (SMAs) are an attractive technology in actuators and sensors because of their versatile geometry, low weight, high energy density, and low cost. The design of an SMA actuator system is generally tuned to the desired application criteria during development. Due to the thermal actuation, SMA applications are currently only considered in the frequency ranges below 10 Hz. Replacing cross-sectionally ‘thick’ SMA elements can achieve higher actuation frequencies. The concept of using ‘thin’ elements, thus improving the surface-to-volume ratio, is known from the literature and was translated into applications.

Such a system’s efficient and reliable operation requires the precise combination of the used SMA elements in one system. Replacing the time-consuming and error-prone adjustment process of single SMA elements, a novel bundle concept is developed and presented. One continuous SMA wire is used to build the hole antagonistic system and reaches a cyclic actuation frequency of up to 20 Hz.

This work presents the investigation of the improved bundle concept. Massively reducing the surface-to-volume ratio using very thin SMA wires with a diameter of 25 μm enables the cyclic actuation of up to 66 Hz. In detail, different actuation parameters are discussed to evaluate the cyclic actuation performance.
Soft Actuators From Flexible Auxetic Metamaterials and Shape Memory Alloys Springs
Authors: Woo Janghoon , Abel Julianna
Published: November 2023

Soft robots composed of elastic materials can exhibit nonlinear behaviors, such as variable stiffness and adaptable deformation, that are favorable to cooperation with humans. These characteristics enable soft robots to be used in multiple applications, ranging from minimally invasive surgery and search and rescue in emergency or hazardous environments to marine or space exploration and assistive devices for people with musculoskeletal disorders. Although soft actuators composed of smart materials have been proposed as a control strategy for soft robots, most studies have focused on traditional actuators using hydraulic or pneumatic pressure. Over the years, these have made a lot of progress, but they have not been able to overcome the limitations of the complex configuration of the system and the expansion of the cross-section of the actuator when contracted. This paper merges the actuator design methodology for smart materials with the mechanical analysis of auxetic structures to present an electrically driven soft actuator architecture that achieves reliable actuation displacements. This novel soft actuator, constructed with contractile SMA springs and flexible auxetic metamaterials (FAM), has a spontaneous recovery of the shape after a contraction, a negative Poisson’s ratio, and over 90% of consistency with the performance predictions at the design stage. Our research presents a methodology for the design of a new electrically driven soft actuator, describes the manufacture of SMA springs and FAM, and concludes with the validation of the design by experimental analysis using the 2D planar soft actuator prototype. Finally, our study revealed that the application of the extraordinary characteristics of smart materials and structures together into a single architecture can be a strategy to overcome the limitations of existing soft actuator studies.
Development of Numerical Models Based on Experimental Tests for the Design of Active Vibration Controllers
Authors: Silva Tarcisio , Balasubramanian Prabakaran , Ferrari Giovanni , Hameury Celia , Buabdulla Abdulaziz , Franchini Giulio , Amabili Marco
Published: November 2023

Active Vibration Control (AVC) of electromechanical systems has been an active field of research for decades. One main challenge in AVC techniques is the design of the control laws. In most cases, the design is entirely based on numerical models, thus making high-fidelity models greatly desirable. However, analytical or finite element models are intrinsically onerous and rarely consider imperfections of real-life structures. To overcome this drawback, this work presents a method to obtain a high-fidelity numerical model for electromechanical systems built upon the collection of a set of experimental data. From the experimental responses, the modal mass, damping, stiffness, and electromechanical coupling matrices are determined by using the least square method technique and error minimization. After building the model, the design of a Multiple Input Multiple Output (MIMO) Positive Position Feedback (PPF) control law is presented to mitigate vibrations on a composite panel equipped with 8 non co-located piezoelectric materials and free-free boundary conditions. The tuning of the MIMO controller is carried out completely on the numerical model. Once the tuning is completed, the resulting parameters of the controller are experimentally tested for validation. Experimental results show that the MIMO PPF efficiently reduces vibrations of several modes for both systems, with an overall reduction of nearly 50% compared to the uncontrolled case. In addition, the frequency bandwidth spans more than 150Hz with negligible spillover.
Self-Healing of Fibre-Reinforced Delaminated Composites
Authors: Lanzara Giulia , Porrari Alessandro
Published: November 2023

Taking inspiration from nature allows to engineer materials that possess improved performance, durability and reliability. For instance, living systems repair themselves spontaneously when their biological tissues are injured. Similarly, a material that self-heals when cracked or damaged has the potential to significantly augment its life-time and at the same reduce environmental impact (higher sustainability).

This work is focused on the fabrication of a fibre-reinforced composite, whose aggregating matrix is a thermosetting epoxy resin that is here demonstrated to possess self-healing capability. The composite is designed in such a way to follow the “Close Then Heal” strategy, as for human skin. The chemical and mechanical characterization of the material is discussed, first by studying the bare resin, and then by investigating self-healing of the carbon fiber composite once artificially damaged and re-healed. The study focuses in particular to the most critical failure mode of fibre-reinforced composites: i.e. delamination, which is known to be catastrophic. The results show that the composite self-repairs for a limited number of cycles and that the recovery of the mechanical properties, assessed by comparing the response of the composite before and after cyclic failures/repairs, decreases gradually with the subsequent cycles. The study also shows that the application of pressure allows to reach a more efficient repair, while the microscopic investigation highlights the great potential also in terms of morphological distribution of the fibers within the hosting matrix. The morphology of the re-healed samples is found to be fully recovered with respect to the initial undamaged samples.
An Innovative Multi-Layer System for Thermally Activated Switching Actions
Authors: Hausherr Ginevra , Lanzara Giulia
Published: November 2023

Smart and shape-changing materials are entering a wide range of disciplines including the autonomous activation of devices. Here, a novel thermally driven multifunctional material that works as switch that independently reconfigures itself to trigger an electrical circuit, is presented.

The material consists of multiple polymeric layers that are capable to spontaneously adapt their shape, as a system, when exposed to specific thermal gradients. The multi-layer system hosts in itself an electrically conductive layer. In particular, the film is flat at low temperature and is curved at higher temperature. In this case study the rolled configuration corresponds to the closed circuit (current flow) while the flat configuration corresponds to the opened circuit. The shape changing capability of the film is given by its unique structure which comprises multiple layers (PE and PET) characterized by specific and indeed opposite glass transition temperatures. A key feature of this design is that the material can be “educated” to reach both the desired shape at a specific set temperature, the desired degree and speed of shape change. Moreover, and most importantly, such morphing actions are cyclic without the need of re-educating the material. The study highlights the possibility to fine-tune with repeatability and precision, the shape of the film as a function of temperature.
Effect of Multiple Combination Modes of Reactive Components on the Response of Electromagnetic Vibration Energy Harvester
Authors: Zhong Rui , Thein Chung Ket , Halim Dunant , Xu John
Published: November 2023

As reactive components, capacitors and inductors play an important role in the tuning of energy harvesters, but only a few monotonic connection modes between reactive components and load resistors are usually considered. The impact of diverse connection modes between reactive components and load resistor on energy harvester is worth exploring. In this work, an accurate equivalent circuit model for a specific vibration energy harvester is established. Using this model, the fact that different connection modes have an impact on the response of the energy harvester has been proved. This work provides a reference for setting capacitor and inductor values to maximize load power at fixed applied frequencies. Visual simulation results demonstrate that specific connection modes will cause relatively large load power within a larger range of reactive component parameter settings. At the same time, it is verified that specific connection modes will perform better than other modes under variable applied frequencies, giving reasonable suggestions for the selection of connection modes in this situation.
Design Approach to Particulate-Based Multifunctional Polymer Composite Materials
Authors: Collet Robin , Lynch Christopher S.
Published: November 2023

This paper presents a study on the effect of electrostatic interactions between adjacent dielectric particles. Multifunctional polymer composite materials include a low permittivity matrix material, typically polymer, with dielectric (piezoelectric/ferroelectric) inclusions dispersed throughout. The high permittivity of the inclusions leads to an electric field concentration in the matrix. Interparticle electrostatic interactions arise due to the presence of charged particles in the matrix. These interactions affect the overall properties of the composite. This issue has led to an increasing interest in the electrical properties of multifunctional polymer composite materials. Based on closed-form solution for single inclusion geometries, Finite Element Method (FEM) models are validated. Additional particles of the same geometry are introduced. The electrostatic interactions between particles and the electric field distribution in the composite are studied. Different configurations of particles are presented as well as different particles sizes to assess the effect on the electric field within the particles.
A Hybrid Piezoelectric-Hydraulic Actuator Model and Prototype With Large Stroke and Force Parameters
Authors: Borden Yan , Inman Daniel
Published: November 2023

This paper reports the development of a hybrid piezohydraulic actuator. Piezoelectric stacks provide quick and precise response, when used as actuators. However, their small stroke limits their use to micro- and nano-actuation systems. Mechanical levers are most commonly used to amplify the displacement of a piezo stack, but they sacrifice a significant amount of the blocked force. For the research presented here, a hydraulic system is used to magnify the displacement of piezoelectric stacks, while generating a large blocked force (on the order of kN). This allows the actuator to achieve displacements on the scale of tens of millimeters. Seven piezo stacks push on a piston that moves a hydraulic fluid through a narrowing, which amplifies the stroke of the stacks by the ratio of the wide channel area to the narrow channel area. Since this process decreases the output blocking force by the same ratio, multiple high-force piezo stacks are required to obtain a kN-range blocking force. Hysteresis of the piezo stacks is modeled using a non-symmetrical Bouc-Wen model. A Simulink model of the actuator is constructed and verified using a small-scale prototype. Simulated response characteristics of the proposed actuator as well as drawbacks are also discussed.
Monitoring Volumetric Defects in 3D Bioprinting Using Video-Based Vibrometry
Authors: Taylor Rayanne , Kim Jinki
Published: November 2023

Additive manufacturing technologies have the potential to revolutionize the manufacturing industry by making it easier to fabricate complex structures, high value, and low volume parts in various contexts. Bio-additive manufacturing is particularly promising, as it has enabled the 3D printing of human organs. Researchers have made progress by developing novel materials and printing strategies for additively manufacturing complicated mission-critical geometries. On the other hand, assessing the structural integrity of these bio-printed structures has been challenging, as destructive contact-based approaches may interfere with the manufacturing process and affect the original dynamics and quality of the bio-prints, due to the relatively soft and lightweight nature of bio-prints. Furthermore, the repeatability of measurement is significantly dependent on the quality of how the sensor is attached to the part. Non-contact methods, such as laser and X-ray based techniques, can provide measurements without adding mass to the part. However, lasers may produce inaccuracies due to reflection and absorption in translucent materials, which are often found in bio-constructs. Although there have been significant advances in non-contact methods for reliably identifying damages in bio-printed structures, particularly embedded defects, implementing these approaches in a straightforward way has been challenging. To advance the state-of-the-art, this study proposes a novel method that can reliably assess the damage properties without contact by using video-based vibrometry. Vibration signals can provide a comprehensive response of the target structure, including material properties and geometry changes due to embedded defects in bioprinting. By analyzing the phase shift of the pixel intensity in the video, the vibration characteristics that indicate surface and/or embedded defects can be assessed for the entire structure captured in the camera angle, without the need for multiple sensors to be installed on the structure. This research focuses on analyzing the vibration characteristics of a cube that was manufactured by an extrusion-based bio-printer with pneumatic dispensing using sodium alginate based bioink. A high-speed camera and phase-based motion estimation technique are used to obtain experimental data on the vibration characteristics of the cube. Volumetric defects introduced by extrusion pressure irregularity and scaffolds with voids and their severities are identified by monitoring the vibration characteristics. These findings suggest that the proposed method could be utilized to effectively verify the structural integrity of additively manufactured organs during fabrication, which could enhance process optimization and operation safety. Future works include incorporating finite element model to compare its response characteristics for healthy and damaged models with the experimentally obtained results and identifying the detection sensitivity and limit with respect to parameters such as damage type and location.
Juglone, a plant-derived 1,4-naphthoquinone, binds to hydroxylamine oxidoreductase and inhibits the electron transfer to cytochrome
c
554
Authors: Akutsu Yukie , Fujiwara Takaaki , Suzuki Rintaro , Nishigaya Yuki , Yamazaki Toshimasa
Published: November 2023

Nitrification is an essential biological process that converts ammonia into nitrate via nitrite. In the initial phase of nitrification, ammonia-oxidizing bacteria convert ammonia to hydroxylamine and subsequently to nitrite. The electrons generated in this process provide energy for cellular growth. In this study, we observed the inhibitory effects of plant-derived 1,4-naphthoquinones, including juglone, plumbagin, and 1,4-naphthoquinone, on nitrification in
Nitrosomonas europaea
, a typical nitrifying bacterium. These compounds disrupted the transfer of electrons produced during hydroxylamine oxidation to cytochrome
c
554
, a physiological electron acceptor.
In vitro
electron transfer experiments confirmed the function of these three 1,4-naphthoquinones as electron acceptors in hydroxylamine oxidation. The results indicate that these compounds interfere with electron transfer to cytochrome
c
554
during the ammonia oxidation process leading to nitrification inhibition. Remarkably, lawsone, an isomer of juglone, exhibited no effect on the activity of hydroxylamine oxidoreductase, implying a correlation between the redox potential of each 1,4-naphthoquinone and their ability to hinder canonical electron transfer. Furthermore, X-ray crystallographic analysis revealed that juglone resides in close proximity to the catalytic heme P460 in hydroxylamine oxidoreductase. The hydrophobic environment surrounding the binding cavity appears critical for the selectivity of 1,4-naphthoquinones.

IMPORTANCE

Nitrification, the microbial conversion of ammonia to nitrate via nitrite, plays a pivotal role in the global nitrogen cycle. However, the excessive use of ammonium-based fertilizers in agriculture has disrupted this cycle, leading to groundwater pollution and greenhouse gas emissions. In this study, we have demonstrated the inhibitory effects of plant-derived juglone and related 1,4-naphthoquinones on the nitrification process in
Nitrosomonas europaea
. Notably, the inhibition mechanism is elucidated in which 1,4-naphthoquinones interact with hydroxylamine oxidoreductase, disrupting the electron transfer to cytochrome
c
554
, a physiological electron acceptor. These findings support the notion that phytochemicals can impede nitrification by interfering with the essential electron transfer process in ammonia oxidation. The findings presented in this article offer valuable insights for the development of strategies aimed at the management of nitrification, reduction of fertilizer utilization, and mitigation of greenhouse gas emissions.
Comparative pathogenomic analysis reveals a highly tetanus toxin-producing clade of
Clostridium tetani
isolates in Japan
Authors: Shitada Chie , Sekizuka Tsuyoshi , Yamamoto Akihiko , Sakamoto Chiyomi , Hashino Masanori , Kuroda Makoto , Takahashi Motohide
Published: November 2023

Clostridium tetani
is the etiological agent of the disease tetanus, resulting in various symptoms, including neck tension, tongue-twisting, a decline in walking ability, and death in severe cases. To date, publicly available genome sequences of
C. tetani
are limited.
C. tetani
was isolated from soil in Kumamoto Prefecture, Japan, between 2020 and 2022. Subsequently, bacteriological, biochemical, genetic, and immunological tests were conducted. Among the 46 soil sampling sites, 151
C
.
tetani
strains were isolated from 33 sites, with a 71.7% positivity rate. Comparative genomic analysis subdivided clade 1 into clades 1-1, 1-2, and 1-3. The enzyme-linked immunosorbent assay revealed that partial clade 1-3 strains produced over sevenfold more tetanus neurotoxin (TeNT) than the reference strain (first isolate of
C. tetani
KHSU-154301-001). RNA-Seq analysis supported this elevated tetanus toxin
tetX
gene expression. Additionally,
tetX
-negative strains were isolated from the clade, indicating that TeNT may not be essential for ensuring the survival of their offspring without its representative toxin-causing tetanus. Five strains acquired the tetracycline resistance gene
tet
(M) in the
tetX
plasmid, resulting in significantly reduced susceptibility to tetracycline. In conclusion, although we investigated
C. tetani
isolates from a specific region of the Kumamoto Prefecture, we demonstrated that these isolates exhibit variable genomic features, toxin productivity, and substantial acquired antimicrobial resistance. These findings indicate that multiple
C. tetani
lineages have successfully adapted to the soil in Japan, as evidenced by the additional genome information and toxin productivity assays in this study.

IMPORTANCE

C. tetani
is a spore-forming, anaerobic bacterium that produces a toxin causing muscle stiffness and paralysis. Tetanus is preventable with the toxoid vaccine, but it remains a significant public health threat in regions with low vaccine coverage. However, there are relatively few isolates and limited genomic information available worldwide. In Japan, about 100 cases are reported each year, but there have been no nationwide surveys of isolates, and no genomic information from Japanese isolates has been published. In our study, we analyzed the genomes of 151 strains from a limited survey of soil in Kumamoto, Japan. Our findings revealed a high degree of genetic diversity, and we also identified a subset of strains that produced significantly more toxin, which provides new insights into the pathogenesis of tetanus. Our findings lay the foundation for future studies to investigate the distribution and evolution of
C. tetani
in Japan and neighboring countries.
Supplemental Material: Magma-carbonate interactions drive CO2 production and metal enrichment in shallow dikes and sills at volcanic arcs
Authors: Morris Rebecca , al. et
Published: November 2023

 Supplementary figures and methods. 
Supplemental Material: Permian–Triassic magmatism above a slab window in the Eastern Tianshan: Implications for the evolution of the southern Altaids
Authors: Muhtar M.N. , et al.
Published: November 2023

Text S1: Analytical methods. Table S1: U-Pb dating results for zircons from the Huangshandong gabbro and Shuangchagou Complex. Table S2: Major- and trace element composition of the Shuangchagou Complex and Huangshandong gabbro. Table S3: Hf isotope composition of zircon grains from the Huangshandong gabbro and Shuangchagou Complex. Table S4: Bulk rock Sr-Nd isotope composition of the Shuangchagou Complex and Huangshandong gabbro.
Nanoobjects for the Luminescence Determination of Fluoroquinolones
Authors: Shtykov S. N. , Smirnova T. D. , Rusanova T. Yu.
Published: November 2023

Fluoroquinolones are the most successful antibiotics, which also show antiviral and antitumor activity. The widespread use of fluoroquinolones in medicine, pharmaceutical chemistry, veterinary medicine and in animal, poultry, and fish feeds requires continuous improvement of methods for their determination in various samples. Sensitized fluorescence based on resonance electronic excitation energy transfer (RET) during the formation of chelates with terbium and europium ions is a promising and highly sensitive method for the determination of fluoroquinolones. This review analyzes the use of two types of nanoobjects—liquid micellar nanosystems and quantum dots based on the nanoparticles of silver, gold, and semiconductors and carbon, magnetic, and other nanomaterials—for increasing the efficiency of energy transfer and the sensitivity of the determination of fluoroquinolones in various samples. The terminology used in the inductive-resonance and exchange-resonance mechanisms of energy transfer is considered, and the fundamental difference in RET between liquid and solid types of nanoobjects is shown. Linear dynamic ranges of determined concentrations, limits of detection, and examples of practical application of sensitized fluorescence to the determination of fluoroquinolones in real samples with the use of nanoparticles and micellar nanosystems are tabulated.
Bronchopulmonary dysplasia: temporal trend from 2010 to 2019 in the Brazilian Network on Neonatal Research
Authors: Stolz Camila , Costa-Nobre Daniela Testoni , Sanudo Adriana , Ferreira Daniela Marques de Lima Mota , Sales Alves José Mariano , dos Santos Julia Paula , Miyoshi Milton Harumi , Silva Nathalia Moura de Mello , Melo Fernanda Pegoraro de Godoi , da Silva Regina Vieira Cavalcanti , Barcala Dafne , Vale Marynea Silva , de Souza Rugolo Ligia Maria Suppo , Diniz Edna Maria Albuquerque , Ribeiro Manoel , Marba Sérgio T M , Cwajg Silvia , Duarte José Luiz Muniz Bandeira , Gonçalves Ferri Walusa Assad , Procianoy Renato S , Anchieta Leni Marcia , de Andrade Lopes José Maria , de Almeida Maria Fernanda B , Guinsburg Ruth
Published: November 2023

Objective

To evaluate the temporal trend of bronchopulmonary dysplasia (BPD) in preterm infants who survived to at least 36 weeks’ post-menstrual age (PMA) and BPD or death at 36 weeks’ PMA, and to analyse variables associated with both outcomes.

Design

Retrospective cohort with data retrieved from an ongoing national registry.

Setting

19 Brazilian university public hospitals.

Patients

Infants born between 2010 and 2019 with 23–31 weeks and birth weight 400–1499 g.

Main outcome measures

Temporal trend was evaluated by Prais-Winsten model and variables associated with BPD in survivors or BPD or death were analysed by logistic regression.

Results

Of the 11 128 included infants, BPD in survivors occurred in 22%, being constant over time (annual per cent change (APC): −0.80%; 95% CI: −2.59%; 1.03%) and BPD or death in 45%, decreasing over time (APC: −1.05%; 95% CI: −1.67%; −0.43%). Being male, small for gestational age, presenting with respiratory distress syndrome, air leaks, needing longer duration of mechanical ventilation, presenting with treated patent ductus arteriosus and late-onset sepsis were associated with an increase in the chance of BPD. For the outcome BPD or death, maternal bleeding, multiple gestation, 5-minute Apgar <7, late-onset sepsis, necrotising enterocolitis and intraventricular haemorrhage were added to the variables reported above as increasing the chance of the outcome.

Conclusion

The frequency of BPD in survivors was constant and BPD or death decreased by 1.05% at each study year. These results show some improvement in perinatal care in Brazilian units which resulted in a reduction of BPD or death, but further improvements are still needed to reduce BPD in survivors.
Perianaesthetic management on a child with Lennox-Gastaut Syndrome for vagus nerve stimulation (VNS) placement
Authors: Yeap Tat Boon , Koo Thai Hau , Ang Song Yee , Ab Mukmin Laila
Published: November 2023

Vagus nerve stimulation (VNS) is a neurostimulatory modality in treating patients with medically resistant epilepsy (MRE). It was introduced in 1997 and has been proven to reduce patients’ dependency on antiepileptic drugs and seizure frequency. However, the usage of VNS in children with MRE has been limited, especially those with Lennox Gastaut Syndrome (LGS). Our teenage boy with this syndrome developed MRE and successfully underwent VNS placement. We discuss the perianaesthetic challenges, a brief description of VNS and the reported successes in patients with LGS.
Atrial myxoma: A cause for concern in multiple cerebral infarctions in absence of cardiac symptoms
Authors: Ale Pramol , Gurung Abinas , Hargroves David , Omojowolo Olubunmi
Published: November 2023

Ischaemic cerebral infarct is the most common neurological manifestation of myxomas. We present a mid-70s man who was brought to the stroke unit with sudden onset right hemiparesis and dysarthria. Although he had risk factors for developing stroke like hypertension, hypercholesterolaemia, history of prostate cancer and new paroxysmal atrial flutter on admission, clinical suspicion and detailed investigations in the absence of cardiac symptoms revealed a 9 cm myxoma causing severe mitral stenosis. He underwent successful surgical resection with good functional recovery. This also highlights the need for thorough clinical examination especially in the absence of cardiac symptoms.
Ocular inflammatory events following COVID-19 vaccination: reporting of suspected adverse drug reactions to regulatory authorities in the UK
Authors: Testi Ilaria , Soomro Taha , Pavesio Carlos , Solebo Ameenat Lola
Published: November 2023

Background/aims

The UK Medicines and Healthcare products Regulatory Agency (MHRA) has published suspected adverse drug reactions to vaccines against COVID-19. Ocular inflammatory events following COVID-19 vaccination have been reported worldwide.

Methods

We analysed MHRA data on spontaneous reports of suspected ocular inflammatory events following COVID-19 vaccination between January 2021 and September 2022.

Results

The MHRA received 300 UK spontaneous suspected reports of ocular inflammatory events following COVID-19 vaccination, with a calculated prevalence of 6.6 events per 1 000 000 vaccinated individuals. Anterior uveitis was the most common phenotype (58.3%), followed by optic neuritis in 39.3%. Median number of days between vaccination and onset was 8 days. Resolution of the event was seen in 52.3%.

Conclusion

Ocular inflammatory events following COVID-19 vaccination have a very rare prevalence in the UK. There is no increase in the reporting rate of uveitis, optic neuritis and scleritis following COVID-19 vaccination when compared with the range of incidence in the UK population. The Yellow Card System represents a vital instrument within the domain of pharmacovigilance, empowering patients and healthcare professionals to contribute to the ongoing monitoring of medication safety.
Tuberculosis infection control practice among healthcare workers in Ethiopia: a protocol for systematic review and meta-analysis
Authors: Tiruneh Misganaw Guadie , Anagaw Tadele Fentabil , Fenta Eneyew Talie
Published: November 2023

Background

Tuberculosis (TB) is a main concern of health care workers in sub-Saharan Africa. Healthcare workers have the potential to have contact with TB patients and are the main stakeholders in healthcare settings to implement TB infection control, and the poor practice of TB infection control may increase the risk of transmission of TB in healthcare settings. However, there is no consistent conclusion on the TB infection control practice among healthcare workers in Ethiopia. Thus, this study aimed to determine the pooled magnitude of TB infection control practice and associated factors among healthcare workers in Ethiopia.

Methods

This systematic review and meta-analysis will be done by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The following databases will be used to search for articles: PubMed, Cochrane Library, Google Scholar and grey literatures. The quality of studies will be assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. The data from included studies will be extracted using Microsoft Excel V.2016, and the extracted data will be analysed using STATA V.16. Forest plot and I2statistics will be done for heterogeneity. A funnel plot and Egger’s regression test will be conducted to check for publication bias. Potential sources of bias will be identified by subgroup analysis and meta-regression. Any type of study design conducted in Ethiopia and in English language will be included.

Ethics and dissemination

Ethics approval is not required, and the findings will be published in peer-reviewed journal.

PROSPERO registration number

CRD42023393580.
Optimising HIV care using information obtained from PROMs: protocol for an observational study
Authors: Moody Kevin , Nieuwkerk Pythia T , Bedert Maarten , Nellen Jeannine F , Weijsenfeld Annouschka , Sigaloff Kim C E , Laan Laura , Bruins Claire , van Oers Hedy , Haverman Lotte , Geerlings Suzanne E , Van der Valk Marc
Published: November 2023

Introduction

Successful antiviral therapy has transformed HIV infection into a chronic condition, where optimising quality of life (QoL) has become essential for successful lifelong treatment. Patient-reported outcome measures (PROMs) can signal potential physical and mental health problems related to QoL. This study aims to determine whether PROMs in routine clinical care improve quality of care as experienced by people with HIV (PWH).

Methods and analysis

We report the protocol of a multicentre longitudinal cohort studying PWH at Amsterdam University Medical Centres in the Netherlands. PROMs are offered annually to patients via the patient portal of the electronic health record. Domains include anxiety, depression, fatigue, sleep disturbances, social isolation, physical functioning, stigma, post-traumatic stress disorder, adherence, drug and alcohol use and screening questions for sexual health and issues related to finances, housing and migration status. Our intervention comprises (1) patients’ completion of PROMs, (2) discussion of PROMs scores during annual consultations and (3) documentation of follow-up actions in an individualised care plan, if indicated. The primary endpoint will be patient-experienced quality of care, measured by the Patient Assessment of Chronic Illness Care, Short Form (PACIC-S). Patients will provide measurements at baseline, year 1 and year 2. We will explore change over time in PACIC-S and PROMs scores and examine the sociodemographical and HIV-specific characteristics of subgroups of patients who participated in all or only part of the intervention to ascertain whether benefit has been achieved from our intervention in all subgroups.

Ethics and dissemination

Patients provide consent for the analysis of data collected as part of routine clinical care to the AIDS Therapy Evaluation in the Netherlands study (ATHENA) cohort through mechanisms described in Boenderet al. Additional ethical approval for the analysis of these data is not required under the ATHENA cohort protocol. The results will be presented at national and international academic meetings and submitted to peer-reviewed journals for publication.
Increasing the reach of evidence-based interventions for weight management and diabetes prevention among Medicaid patients: study protocol for a pilot Sequential Multiple Assignment Randomised Trial
Authors: Schlechter Chelsey R , Del Fiol Guilherme , Jones Dusti R , Orleans Brian , Gibson Bryan , Nahum-Shani Inbal , Maxfield Ellen , Locke Amy , Cornia Ryan , Bradshaw Richard , Wirth Jennifer , Jaggers Shanna J , Lam Cho Y , Wetter David W
Published: November 2023

Introduction

Over 40% of US adults meet criteria for obesity, a major risk factor for chronic disease. Obesity disproportionately impacts populations that have been historically marginalised (eg, low socioeconomic status, rural, some racial/ethnic minority groups). Evidence-based interventions (EBIs) for weight management exist but reach less than 3% of eligible individuals. The aims of this pilot randomised controlled trial are to evaluate feasibility and acceptability of dissemination strategies designed to increase reach of EBIs for weight management.

Methods and analysis

This study is a two-phase, Sequential Multiple Assignment Randomized Trial, conducted with 200 Medicaid patients. In phase 1, patients will be individually randomised to single text message (TM1) or multiple text messages (TM+). Phase 2 is based on treatment response. Patients who enrol in the EBI within 12 weeks of exposure to phase 1 (ie, responders) receive no further interventions. Patients in TM1 who do not enrol in the EBI within 12 weeks of exposure (ie, TM1 non-responders) will be randomised to either TM1-Continued (ie, no further TM) or TM1 & MAPS (ie, no further TM, up to 2 Motivation And Problem Solving (MAPS) navigation calls) over the next 12 weeks. Patients in TM+ who do not enrol in the EBI (ie, TM+ non-responders) will be randomised to either TM+Continued (ie, monthly text messages) or TM+ & MAPS (ie, monthly text messages, plus up to 2 MAPS calls) over the next 12 weeks. Descriptive statistics will be used to characterise feasibility (eg, proportion of patients eligible, contacted and enrolled in the trial) and acceptability (eg, participant opt-out, participant engagement with dissemination strategies, EBI reach (ie, the proportion of participants who enrol in EBI), adherence, effectiveness).

Ethics and dissemination

Study protocol was approved by the University of Utah Institutional Review Board (#00139694). Results will be disseminated through study partners and peer-reviewed publications.

Trial registration number

clinicaltrials.gov;NCT05666323.
Quasi-experimental study finding no localised gun crime or call reduction after gun buybacks in Philadelphia
Authors: Ratcliffe Jerry H , Huffer Marc
Published: November 2023

Introduction

Gun buyback programmes have been popular in the USA since the 1970s. Studies show that they have no effect on citywide gun crime rates, but more microlevel examinations around gun buyback locations have not been conducted. This study tests for local effects of 34 Philadelphia, PA buyback events at 30 locations between 2019 and 2021.

Methods

We analysed all gun-related crime events and gun-related calls for service attended by the police from 2019 to 2021. Multilevel models with an autoregressive residual structure were estimated on weekly gun crime and call event intensity (inverse distance weighted) totals across a range of distances (4000–8000 feet). Impacts of a gun buyback event were estimated for 1–4 weeks postevent.

Results

Statistically significant weekly increases in gun event intensity are associated with seasonality and after the murder of George Floyd. Gun event intensity was not significantly affected by gun buybacks. Across 20 sensitivity tests of different distances and time periods (4000–8000 feet and between 1 and 4 weeks), gun buybacks were not statistically associated with any localised reduction in the intensity of gun crimes and calls.

Conclusions

Extant research has failed to uncover any effect of gun buybacks on citywide gun crime rates. The current results now contribute a lack of evidence at the local level to this literature. While gun buybacks remain popular with politicians and the public, this study adds to the ongoing question of whether buyback funds could be better spent more effectively.
QRISK3 underestimates the risk of cardiovascular events in patients with COPD
Authors: Amegadzie Joseph Emil , Gao Zhiwei , Quint Jennifer K , Russell Richard , Hurst John R , Lee Tae Yoon , Sin Don D , Chen Wenjia , Bafadhel Mona , Sadatsafavi Mohsen
Published: November 2023

Background

Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease (CVD). The extent to which the excess CVD risk is captured by risk factors in QRISK, a widely used CVD risk scoring tool, is not well studied.

Methods

We created an incidence cohort of diagnosed COPD patients from the United Kingdom (UK) Clinical Practice Research Datalink GOLD database (January 1998–July 2018). The outcome was a composite of fatal or non-fatal CVD events. Sex-specific age-standardised incidence ratios (SIR) were compared with values for the UK primary-care population. The observed 10-year CVD risk was derived using the Kaplan-Meier estimator and was compared with predicted 10-year risk from the QRISK3 tool.

Results

13 208 patients (mean age 64.9 years, 45% women) were included. CVD incidence was 3.53 events per 100 person-years. The SIR of CVD was 1.71 (95% CI 1.61 to 1.75) in women and 1.62 (95%CI 1.54–1.64) in men. SIR was particularly high among patients younger than 65 years (women=2.13 (95% CI 1.94 to 2.19); men=1.86 (95% CI 1.74 to 1.90)). On average, the observed 10-year risk was 52% higher than QRISK predicted score (33.5% vs 22.1%). The difference was higher in patients younger than 65 years (observed risk 82% higher than predicted).

Conclusion

People living with COPD are at a significantly heightened risk of CVD over and beyond their predicted risk. This is particularly the case for younger people whose 10-year CVD risk can be >80% higher than predicted. Risk scoring tools must be validated and revised to provide accurate CVD predictions in patients with COPD.
Efficacy and safety of fenofibrate in combination with phototherapy for the treatment of neonatal hyperbilirubinemia: A systematic review and meta-analyses.
Authors: Abdellatif Mohammed , Abozaid Ali Ahmed Fouad , Shah Prakesh S , Dhouibi Nacir , Nguyen-Khac Thuan , Khleif Rafeef , Luu Mai Ngoc , Quyen Dinh Kim , Mohareb Anton , Vaghela Gladson , Khan Zeeshan Ali , Pham Hoang Nhat , Makram Abdelrahman M , Huy Nguyen Tien
Published: November 2023

Phototherapy is the standard treatment for neonatal jaundice. We aimed to review the efficacy and safety of fenofibrate as an adjunct therapy. Twelve databases were searched and a systematic review and meta-analysis were conducted. Mean change (MC), mean difference (MD), and risk ratios (RR) with a 95% confidence interval (CI) were calculated using a random effects model. The GRADE approach was used to evaluate the evidence's certainty. Nine randomized trials were included. The MC of total serum bilirubin (mg/dl) (TSB) was significant at 12, 24, 36, 48 and 72 hours with respective MC (95% CI) values of -0.46 (-0.61, -0.310), -1.10 (-1.68, -0.52), -2.06 (-2.20, -1.91), -2.15 (-2.74, -1.56), and -1.13 (-1.71, -0.55). The FEN+PT group had a shorter duration of phototherapy (MD -14.36 hours; 95% CI -23.67, -5.06) and a shorter hospital stay (MD: -1.40 days; 95% CI: -2.14, -0.66). There was no significant difference in the risk of complications (RR: 0.89; 95% CI: 0.54, 1.46) or the need for exchange transfusion (RR: 0.58; 95% CI: 0.12, 2.81). The certainty of the evidence was very low for all outcomes. In conclusion, fenofibrate might be a safe adjunct to neonatal phototherapy. Larger RCTs are needed for confirmation of these results.
A computational description of time-dependent transport of a water-based nanofluid with hybrid nanocomposite Cu–Al2O3 over a parabolic surface by Keller-box scheme: A modified Buongiorno model
Authors: Rajput Sohita , Bhattacharyya Krishnendu , Sharma Dimpal , Pandey Amit Kumar , Chamkha Ali J.
Published: November 2023

This paper discusses the high heat transfer demand from application prospects. Hybrid nanofluid is a well-known liquid with higher heat transfer capabilities. Here, the time-dependent flow of hybrid nanocomposite, by hybridizing the metal (Cu) and metallic oxide (Al2O3) and inserting them into water-based nanofluid, is examined. The flow takes place over the upper half of a parabolic surface. The modified Buongiorno model is used to express the physical phenomenon in mathematical equations form. The governing system of partial differential equations (PDEs) is reduced to a system of ordinary differential equations (ODEs) by applying certain transformations. Computation of the final equations has been done by a numerical scheme, known as the Keller-box method. The significance of dimensionless flow causing physical parameters is shown through graphs and tables. The findings reveal that among the hybrid nanofluids with two types of nanoparticles varying from 0% to 5%, a nanofluid having 5% of both nanoparticles is the one with the maximum surface drag force and heat transport rate, which are 41.8% and 22.7% higher to water, respectively. A higher amount of Al2O3 than Cu results in a suitable hybrid combination for application purposes to produce higher cooling rate with less surface drag. Also, the thickness of the surface, unsteadiness, nanoparticles suspension and power index of wall temperature enhance the heat transfer rate. Thin parabolic surfaces experience less drag and have larger boundary layer thicknesses (momentum, thermal and concentration) as compared to thicker parabolic surfaces. Also, the addition of copper slows down the hybrid fluid flow field, but alumina magnifies the mobility of hybrid fluid.