bluuebunny/crossref_metadata_2025 huggingface dataset:
Random Grid-Based DIC Analysis of Plastic Flow Near Interfaces in Deformation Processing
Authors: Gupta Deepika , Viswanathan Koushik
Published: September 2022

Digital Image Correlation (DIC), an in situ analysis technique, has gained widespread popularity within the mechanics community over the past two decades. Despite this, accurate computation of strain and displacement fields, especially at interfaces and free surfaces, remains a central challenge. This problem is particularly acute since material flow near free surfaces and interfaces is paramount for understanding the mechanics of several deformation processing configurations, such as machining and forming. Two common DIC implementations exist, and they exploit either local or global information about the deformation. Local techniques suffer from a lack of continuity across subsets, while global methods, despite ensuring continuity, fail to estimate fields at interfaces accurately. Furthermore, global DIC necessitates grid refinement to capture heterogeneous deformation and can often be computationally expensive. Both local and global methods finally use interpolation schemes to obtain continuous displacement fields, along with a finite difference scheme to compute strains. However, these present additional limitations, such as spurious strains at interfaces and loss of experimental data. In this work, we present a random grid-based scheme that uses local correlation search, while simultaneously exploiting global information. Our algorithm is based on a forward 6-parameter (displacement and its first order derivatives) Newton-Raphson (N-R) search. An underlying random grid is first generated and serves to locate subset centers for the correlation scheme. Second derivatives are then computed using a triangulation method. Multiple random grid realizations enable averaging with minimal data loss, thereby eliminating the need for post-processing. The use of second-order derivatives ensures continuous strain fields, which will otherwise need a twelve-parameter (displacement, its first and second derivatives) based correlation search. We establish the validity of our scheme using standard test cases derived from synthetic non-homogeneous displacement fields and demonstrate its utility in practical machining and deformation processing applications.
Digital Twin-Based Tool State Prognosis Model for Drilling Machines
Authors: Dayam Sunidhi , Desai K. A.
Published: September 2022

Digital Twin technology can be effectively employed for prognosis and predictive maintenance tasks by establishing interconnections between manufacturing equipment and its virtual counterpart. This paper presents the Tool State Prognosis (TSP) model based on Digital Twin philosophy to perceive the state of a twist drill during the drilling operation. The TSP model estimates the state of a twist drill viz. initial, intermediate, or worn during the operation rather than obtaining the precise wear value. The Digital Twin collects input information as time-series data by establishing an appropriate connection protocol with a drilling machine using vibration and acoustic emission sensors. The Root Mean Square (RMS) approach and Quadratic Support Vector Machine (QSVM) are employed for feature extraction and recognizing the twist drill status with Remaining Useful Life (RUL) prediction from the time-series data. The model also includes integrating a Human Machine Interface (HMI) unit for displaying tool status and RUL information to assist operators in tool replacement decisions. The developed model can be integrated as an edge-level solution with manual and CNC drilling machines without significant hardware changes for perceiving the status of a twist drill. The prediction abilities of the digital twin are corroborated by performing a set of drilling experiments for various cutting tool-workpiece combinations. The confusion matrices demonstrated the effectiveness and generalization abilities of the developed model by comparing predicted and actual classes for each combination. The developed Digital Twin model can quickly respond to tool status and failure with enhanced man-machine interactions and improved prognosis abilities for the drilling machines.
Experimental Study of Microscopic Morphology and Material Property for Recycled Polyamide 12 Powder in Selective Laser Sintering
Authors: Al Amin Mohammad Aman Ullah , Yang Yiran , Kobir Md Humaun , Di Lei
Published: September 2022

Selective laser sintering has become one of the most popular additive manufacturing technologies owing to its great capability of fabricating complex structures with reduced or even eliminated need for the support structure. Meanwhile, an average of 50% to 70% of the consumed powder materials is not directly used for part fabrication. To reduce material waste and enhance material usage efficiency, research studies have been conducted to facilitate the recycling and/or reusing of the waste powder in selective laser sintering. In this research, polyamide 12 powders are studied including virgin powder, waste powder, recycled powder, and mixed powder (with a 30% refresh rate) in terms of their microscopic morphology and material properties. In addition, the location of the powder sampled from the build chamber is also studied for its impact on the powder size and shape. Experimental results show that the average particle size does not change much in different samples, but the standard deviation increases in waste powder. Furthermore, the averaged ultimate tensile strength of test specimens fabricated with virgin powder is around 25% higher than specimens made with mixed powder (30% virgin powder and 70% recycled powder), showing a clear mechanical degradation.
Numerical Studies on Cold Spray Particle Deposition Using a Rectangular Nozzle
Authors: Gabor Ted , Akin Semih , Tsai Jung-Ting , Jo Seunghwan , Al-Najjar Feraas , Jun Martin Byung-Guk
Published: September 2022

Cold spray additive manufacturing (CSAM) is an emerging technique for scalable and rapid deposition of thick metallic coatings on various substrates. Despite great promises, CSAM with no upper limit of coating thickness remains challenging due to the stochastic nature of cold spray (CS) deposition. In particular, using axisymmetric nozzles (i.e., circular supersonic nozzles) lead to a quasi-Gaussian shaped particle distribution on the target surface, which limits the CSAM due to the formation of triangular-shaped (i.e., peak/valley-shaped) coating morphology. Recently, rectangular cold spray nozzles have been applied to CS particle deposition, and found to be promising for CSAM owing to its more uniform particle distribution and wider spray beam. In these studies, however, process-structure properties of cold spray deposition with a rectangular nozzle have not been sufficiently elucidated. Practical expansion of rectangular nozzles in CSAM strictly depends on uncovering process-structure properties of CS deposition phenomenon. To this end, we investigate cold spray deposition of microscale particles using a rectangular nozzle through three-dimensional discrete-phase turbulent flow modeling. The numerical modeling results are experimentally justified using a dual disc anemometer setup. The influence of operating gas conditions on critical particle deposition parameters is studied. An experimental case study of cold spray particle deposition on a polymer (ABS) substrate is also conducted to show the potential of rectangular nozzle in cold-spray based polymer metallization. The results suggest that cold spraying using a rectangular nozzle is beneficial for a more uniform, compact, and higher precision particle distribution on the target surface.
Fused Deposition Modeling of Carbon Fiber Reinforced High-Density Polyethylene: Effects on Microstructure and Mechanical Properties
Authors: Pandit Partha Pratim , Liu Chang , Corti Giancarlo , Hu Yingbin
Published: September 2022

Owing to its superior durability, good biocompatibility, and high recycling capability, high-density polyethylene (HDPE) has been widely applied into making prosthetic implants, liquid permeable membranes, corrosion-resistant pipes, etc., and gains its popularity in packaging, consumer goods, and chemical industries. Injection molding and blow molding are two most common conventional processes of making HDPE products. These conventional processes, however, are considered time-consuming and labor-intensive since molds are usually needed prior to fabricating parts. Moreover, manufacturing complex-structured parts (such as lattice and cellular structures) is a challenge for these conventional manufacturing processes. Facing these problems, it is crucial to find a time- and labor-saving process, which can be used to manufacture complicated structures in a cost-effective way. Additive manufacturing (AM) is such a process that needs no mold and is more affordable to create complex and highly customized parts. Among all types of AM processes, fused deposition modeling (FDM), which is primarily designed for thermoplastic materials, seemed to be a benevolent process for fabricating HDPE parts. Based on reported publications, however, it is difficult to print HDPE materials using FDM due to the problems of warping, shrinking, and weak bonding between printed HDPE parts and the substrate. In addition, the FDM-printed HDPE parts can demonstrate defects of porosities and delamination. To improve the printability of FDM, we conducted preliminary experiments and optimized processing parameters. For the first time, we added carbon fiber (CF) into HDPE to make CF-reinforced HDPE composites (CF-HDPE) using FDM and investigated the effects of CF on part quality, microstructure characteristics, and mechanical properties (including tensile properties and dynamic mechanical properties) of CF-reinforced HDPE composites. Experimental results show that the addition of CF was beneficial for not only improving the printability of FDM and quality of printed composite parts, but also for enhancing mechanical properties (such as Young’s Modulus and ultimate tensile strength) of the parts.
Fluidized-bed plasma enhanced atomic layer deposition of Pd catalyst for low-temperature CO oxidation
Authors: Wang Dongyuan , Zhou Tian , Tang Shouxian , Tian Di , Zhang Haibao , Chen Qiang , Liu Zhongwei
Published: September 2022

A fluidized-bed plasma-enhanced atomic layer deposition (FP-ALD) process is reported to fabricate Pd nanoparticles using palladium hexafluoroacetylacetonate and H2 plasma. The process successfully deposits Pd nanoparticles over porous γ-Al2O3 (30 wt. %), amorphous aluminum silicate (50 wt. %), and molecular sieve (20 wt. %) (ASM) powders. Pd loading on ASM is increased linearly with increasing the number of FP-ALD cycle with a growth rate of 0.34 mg/1 g ASM/cycle. Transmission electron microscopy reveals that high-density Pd nanoparticles are uniformly distributed over the entire ASM powders and the average Pd particle size is sensitive to the number of FP-ALD cycle. By increasing the number of FP-ALD cycles from 25 to 150, the average Pd particle size rises from 0.9 to 5.8 nm, indicating the particle size can be tuned easily by varying the number of FP-ALD cycles. The catalytic activities of different particle sizes and Pd loading samples are evaluated for CO oxidation. With the metal loading amount of 2% for Pd and the average particle size of 2.9 nm, the deposited Pd/ASM sample shows an excellent catalytic activity for the oxidation of CO. Under the condition of a gas mixture of 0.5 vol. % CO and 21 vol. % O2 balanced with N2, and gas hourly space velocity of 24 000 h−1, 100% CO conversion temperature is as low as 140 °C.
Regulation of autoimmune disease progression by Pik3ip1 through metabolic reprogramming in T cells and therapeutic implications
Authors: Xie Wenqiang , Fang Juan , Shan Zhongyan , Guo Junyi , Liao Yuan , Zou Zhaolei , Wang Jun , Wen Shuqiong , Yang Lisa , Zhang Yanshu , Lu Huanzi , Zhao Hang , Kuang Dong-Ming , Huang Peng , Chen Qianming , Wang Zhi
Published: September 2022

Metabolic alterations could profoundly affect immune functions and influence the progression and outcome of autoimmune diseases. However, the detailed mechanisms and their therapeutic potential remain to be defined. Here, we show that phosphatidylinositide 3-kinase interacting protein 1 (Pik3ip1), a newly identified negative immune regulator, is notably down-regulated in several major autoimmune diseases through a previously unidentified mechanism mediated by interleukin-21/p38 mitogen-activated protein kinase/a disintegrin and metalloprotease-17 (ADAM17) pathway. Down-regulation of Pik3ip1 in T cells causes a major metabolic shift from oxidative phosphorylation toward aerobic glycolysis, leading to their overactivation and aggressive disease progression in experimental autoimmune encephalomyelitis (EAE) mouse model. Suppression of hypoxia-inducible factor 1α (Hif1α) or pharmacologic inhibition of glycolysis could reverse these phenotypes and largely mitigate EAE severity. Our study reveals a previously unrecognized role of Pik3ip1 in metabolic regulation that substantially affects the inflammatory loop in the autoimmune setting and identifies the Pik3ip1/Hif1α/glycolysis axis as a potential therapeutic target for treatment of autoimmune diseases.
Astrocytic NDRG2-PPM1A interaction exacerbates blood-brain barrier disruption after subarachnoid hemorrhage
Authors: Feng Dayun , Zhou Jinpeng , Liu Haixiao , Wu Xun , Li Fei , Zhao Junlong , Zhang Yu , Wang Lei , Chao Min , Wang Qiang , Qin Huaizhou , Ge Shunnan , Liu Qiang , Zhang Jian , Qu Yan
Published: September 2022

Blood-brain barrier (BBB) injury critically exacerbates the poor prognosis of patients with subarachnoid hemorrhage (SAH). The massively increased matrix metalloproteinases 9 (MMP-9) plays a deleterious role in BBB. However, the main source and mechanism of MMP-9 production after SAH remain unclear. We reported that the increased MMP-9 was mainly derived from reactive astrocytes after SAH.
Ndrg2
knockout in astrocytes inhibited MMP-9 expression after SAH and attenuated BBB damage. Astrocytic
Ndrg2
knockout decreased the phosphorylation of Smad2/3 and the transcription of MMP-9. Notably, cytoplasmic NDRG2 bound to the protein phosphatase PPM1A and restricted the dephosphorylation of Smad2/3. Accordingly, TAT-QFNP12, a novel engineered peptide that could block the NDRG2-PPM1A binding and reduce Smad2/3 phosphorylation, decreased astrocytic MMP-9 production and BBB disruption after SAH. In conclusion, this study identified NDRG2-PPM1A signaling in reactive astrocytes as a key switch for MMP-9 production and provided a novel therapeutic avenue for BBB protection after SAH.
Catalytic deconstruction of waste polyethylene with ethylene to form propylene
Authors: Conk Richard J. , Hanna Steven , Shi Jake X. , Yang Ji , Ciccia Nicodemo R. , Qi Liang , Bloomer Brandon J. , Heuvel Steffen , Wills Tyler , Su Ji , Bell Alexis T. , Hartwig John F.
Published: September 2022

The conversion of polyolefins to monomers would create a valuable carbon feedstock from the largest fraction of waste plastic. However, breakdown of the main chains in these polymers requires the cleavage of carbon–carbon bonds that tend to resist selective chemical transformations. Here, we report the production of propylene by partial dehydrogenation of polyethylene and tandem isomerizing ethenolysis of the desaturated chain. Dehydrogenation of high-density polyethylene with either an iridium-pincer complex or platinum/zinc supported on silica as catalysts yielded dehydrogenated material containing up to 3.2% internal olefins; the combination of a second-generation Hoveyda-Grubbs metathesis catalyst and [PdP(
t
Bu)
3
(μ-Br)]
2
as an isomerization catalyst selectively degraded this unsaturated polymer to propylene in yields exceeding 80%. These results show promise for the application of mild catalysis to deconstruct otherwise stable polyolefins.
2022 Golden Goose Award honors serendipitous science
Authors: Korte Andrea
Published: September 2022

Ceremony recognizes unexpected breakthroughs on pain relievers, microscopes, and laser surgery
Clash of the titans
Authors: Cho Adrian
Published: September 2022

The United States and Japan are embarking on ambitious efforts to wring a key secret of the universe from the subatomic phantoms known as neutrinos
Fraud charges crumble in China Initiative cases
Authors: Mervis Jeffrey
Published: September 2022

Judges reject claims that defendants defrauded agencies by not disclosing China ties
Neuropilin-1 Facilitates Pseudorabies Virus Replication and Viral Glycoprotein B Promotes Its Degradation in a Furin-Dependent Manner
Authors: Chen Meng , Wang Meng-Hang , Shen Xue-Gang , Liu Hao , Zhang Yu-Yuan , Peng Jin-Mei , Meng Fandan , Wang Tong-Yun , Bai Yuan-Zhe , Sun Ming-Xia , Tian Zhi-Jun , Yin Xin , Cai Xue-Hui , Tang Yan-Dong
Published: September 2022

Recent studies have shown accelerated PRV cross-species spillover and that PRV poses a potential threat to humans. PRV infection in humans always manifests as a high fever, tonic-clonic seizures, and encephalitis.
Complete Genome Sequences of Cluster A Mycobacteriophages Kenmech and Peterson and Cluster F Mycobacteriophage Rockne
Authors: Nsa Imade Y. , Odunsi Ayodeji A. , Bamisaye Seun D. , Kamselem Hauwa J. , Abidoye Shina O. , Jegede Abisola C. , Ayodele John O. ,   University of Lagos SEA-PHAGES Annotators, Egwuatu Tenny O. G. , Oyetibo Ganiyu O. , Ilori Matthew O. ,   University of Lagos SEA-PHAGES Annotators: Kenmech, Abina Yewande T. , Abulude Michael I. , Ademilola Adebimpe O. , Akala Anthony A. , Akingbade Adetutu G. , Akinsola Whaliat M. , Akintobi Moyinoluwa E. , Akintola Aisha A. , Ejiofor Ezichukwu E. , Iyamu Ehivbuema A. , Olubiyo Victor O. , Stephen Samuel , Sulaimon Olawale F. ,   Peterson:, Aaron Daniel B. , Adepoju Sunday B. , Adeboyejo Oluwanifemi J. , Aofolaju Boluwatife A. , Bamimosu Omoniyi A. , Evbuoma Efosa D. , Fiyai Prere A. , Kene Favour E. , Latunde Comfort A. , Osuji Williams I. , Oyetunji Daniel A. , Yusuf Yasiroh M. ,   Rockne:, Abubakar Muhammed A. , Adeayo Praise S. , Afuape Esther O. , Mustapha Olalekan A. , Oloko Ameenat O. , Oluwalanke Eunice O. , Osadolor Amenze O.
Published: September 2022

Kenmech, Peterson, and Rockne are bacteriophages that infect
Mycobacterium smegmatis
mc
2
155. Both Kenmech and Peterson genomes are ~52 kbp long and contain 1 tRNA as well as 92 and 89 protein-coding genes, respectively. Rockne has a 56,704-bp genome with 108 protein-coding genes and no tRNA.
Why Did Lord Novgorod the Great Fall? The Novgorod Republic and Its Neighbors in 1470–1471
Authors: Lukin P. V. , Polekhov S. V.
Published: September 2022

This article is devoted to the last decades of the existence of the independent Novgorod Republic and its fall. The events of 1470–1471, namely, the attempts to call into service a prince from Lithuania, to conclude an alliance with Lithuania and with the Teutonic Order in Livonia, and the campaign of Ivan III and the military defeat of Lord Novgorod the Great, have been considered on a wide background of social and political development of Novgorod the Great throughout the fifteenth century, in the context of the history of its foreign relations and the position of its neighbors, the organization of its armed forces, with a comprehensive account of a variety of sources (not only chronicles but also charters, epistolary and literary sources, etc.) and a rich research literature. In contrast to the approaches widespread in historiography, emphasis has been placed on contemporary reliable sources rather than on later ideological interpretations. Analysis of the chronicles also involves textual criticism. The authors have come to the conclusion that the defeat of the Novgorod Republic was caused not only by social, particularly religious, conflicts that were emphasized by the Moscow side but rather by the complex international situation, which the military and political organization of Novgorod was no longer consistent with, and the inability of the opposing pro-Moscow and pro-Lithuanian parties to offer a convincing ideological line and, consequently, strategy of action in these circumstances.
The Agony of the “Yoke”: The Great Horde as a Fading Threat to Muscovite Rus
Authors: Trepavlov V. V.
Published: September 2022

The last period of the existence of the Golden Horde and its relations with Muscovite Rus and the Polish–Lithuanian state have been considered, and the gradual degradation of the Horde statehood has been shown, including the change in the relations of the Tatar rulers with former Russian tributaries.
Britain’s Sanctions Policy: Institutional Design and Targeting Russia
Authors: Timofeev I. N.
Published: September 2022

Britain is one of the key initiators of sanctions against Russia. It is pursuing an independent policy of restrictive measures against Russia since its withdrawal from the European Union. However, both the institutional design and practice of the UK’s sanctions policy remain poorly covered by the academic literature. These gaps generate a number of questions that are central to this article. What are the institutional characteristics of the contemporary UK policy of sanctions? What are the trends in comparison with other players like the United States, the European Union, and others? In what way are these institutional and practical features implemented in relation to Russia? Three assumptions follow. (i) the UK institutional design provides considerable autonomy to the executive branch to implement sanctions, although the instruments used are standard and similar to the ones applied by other Western countries (including blocking sanctions and export control); (ii) Britain is quite active in using sanctions. Although the UK applies sanctions less actively than the US or the EU, it uses them far more actively than China and Russia; (iii) Russia is becoming a priority target for London both in terms of the number of sanctions imposed and the variety of methods used. These assumptions are tested in this article based on the analysis of legal and official documents, as well as the Sanctions Events Database (SED) designed by the Russian International Affairs Council (RIAC).
Intrathecal haematoma after an epidural blood patch
Authors: Ito Yoshimi , Bhagwat Amit
Published: September 2022

This case demonstrates a rare but potentially serious complication of an epidural blood patch (EBP). Intrathecal haematoma is a rare complication after an EBP and anaesthetists should be able to promptly identify and manage these patients to prevent long-term damage. This case also highlights the importance of informed consent according to the principles of the Montgomery judgement/principle of consent.
Genetic and clinical landscape ofARR3-associated MYP26: the most common cause of Mendelian early-onset high myopia with a unique inheritance
Authors: Wang Yingwei , Xiao Xueshan , Li Xueqing , Yi Zhen , Jiang Yi , Zhang Fengsheng , Zhou Lin , Li Shiqiang , Jia Xiaoyun , Sun Wenmin , Wang Panfeng , Zhang Qingjiong
Published: September 2022

Aims

To elucidate genetic background of early-onset high myopia (eoHM) and characteristics ofARR3-associated MYP26.

Methods

Variants in 14 genes reported to contribute to eoHM, includingARR3, were selected from exome sequencing data set and classified into different categories following American College of Medical Genetics and Genomics guidelines based on in silico prediction, associated phenotypes, confirmation and cosegregation analysis. The available clinical data of individuals were summarised.

Results

Pathogenic and likely pathogenic variants in three of 14 genes were identified in 52 of 928 families with eoHM, including 29 inARR3, 22 inOPN1LWand 1 inLRPAP1. ForARR3, 24 pathogenic variants (16 truncation and 8 missense) were identified in 66 women and 12 men, in whom 64 women and 4 men had eoHM by X-linked female-limited inheritance. Refraction ranged from −5.00 to −28.75 diopter (−12.58±4.83). Mild-to-moderately reduced cone responses were recorded in 76.9% (10/13) of patients with electroretinogram recordings. Most patients (75.9%, 41/54) had mild myopic fundus changes (C0 to C1). Genotype–phenotype analysis suggested that the myopic retinopathy degree was correlated with age and the variant’s nature. Peripheral retinal degeneration was observed in 38.5% (5/13) patients using wide-field examinations.

Conclusion

This study revealsARR3as the most frequently implicated gene for Mendelian eoHM. Truncations and highly scored missense variants inARR3are pathogenic. Myopia due toARR3mutations is transmitted in X-linked female-limited inheritance, manifests with mild cone impairment and slowly progresses to pathologic myopia. Identification of the most common cause for Mendelian eoHM provides a valuable starting point into the molecular mechanism of myopia.
Effectiveness of a behavioural intervention delivered by text messages (safetxt) on sexually transmitted reinfections in people aged 16-24 years: randomised controlled trial
Authors: Free Caroline , Palmer Melissa J , McCarthy Ona L , Jerome Lauren , Berendes Sima , Knight Megan , Carpenter James R , Morris Tim P , Jamal Zahra , Dhaliwal Farandeep , French Rebecca S , Hickson Ford Colin Ian , Gubijev Anasztazia , Wellings Kaye , Baraitser Paula , Roberts Ian , Bailey Julia V , Clayton Tim , Devries Karen , Edwards Phil , Hart Graham , Michie Susan , Macgregor Louis , Turner Katy M E , Potter Kimberley
Published: September 2022

Objective

To quantify the effects of a series of text messages (safetxt) delivered in the community on incidence of chlamydia and gonorrhoea reinfection at one year in people aged 16-24 years.

Design

Parallel group randomised controlled trial.

Setting

92 sexual health clinics in the United Kingdom.

Participants

People aged 16-24 years with a diagnosis of, or treatment for, chlamydia, gonorrhoea, or non-specific urethritis in the past two weeks who owned a mobile phone.

Interventions

3123 participants assigned to the safetxt intervention received a series of text messages to improve sex behaviours: four texts daily for days 1-3, one or two daily for days 4-28, two or three weekly for month 2, and 2-5 monthly for months 3-12. 3125 control participants received a monthly text message for one year asking for any change to postal or email address. It was hypothesised that safetxt would reduce the risk of chlamydia and gonorrhoea reinfection at one year by improving three key safer sex behaviours: partner notification at one month, condom use, and sexually transmitted infection testing before unprotected sex with a new partner. Care providers and outcome assessors were blind to allocation.

Main outcome measures

The primary outcome was the cumulative incidence of chlamydia or gonorrhoea reinfection at one year, assessed by nucleic acid amplification tests. Safety outcomes were self-reported road traffic incidents and partner violence. All analyses were by intention to treat.

Results

6248 of 20 476 people assessed for eligibility between 1 April 2016 and 23 November 2018 were randomised. Primary outcome data were available for 4675/6248 (74.8%). At one year, the cumulative incidence of chlamydia or gonorrhoea reinfection was 22.2% (693/3123) in the safetxt arm versus 20.3% (633/3125) in the control arm (odds ratio 1.13, 95% confidence interval 0.98 to 1.31). The number needed to harm was 64 (95% confidence interval number needed to benefit 334 to ∞ to number needed to harm 24) The risk of road traffic incidents and partner violence was similar between the groups.

Conclusions

The safetxt intervention did not reduce chlamydia and gonorrhoea reinfections at one year in people aged 16-24 years. More reinfections occurred in the safetxt group. The results highlight the need for rigorous evaluation of health communication interventions.

Trial registration

ISRCTN registry
ISRCTN64390461
.
Testing strategies to detect acute and prevalent HIV infection in adult outpatients seeking healthcare for symptoms compatible with acute HIV infection in Kenya: a cost-effectiveness analysis
Authors: Babigumira Joseph B , Agutu Clara A , Hamilton Deven T , van der Elst Elise , Hassan Amin , Gichuru Evanson , Mugo Peter Mwangi , Farquhar Carey , Ndung'u Thumbi , Sirengo Martin , Chege Wairimu , Goodreau Steven M , Sanders Eduard J , M Graham Susan
Published: September 2022

Background

Detection of acute and prevalent HIV infection using point-of-care nucleic acid amplification testing (POC-NAAT) among outpatients with symptoms compatible with acute HIV is critical to HIV prevention, but it is not clear if it is cost-effective compared with existing HIV testing strategies.

Methods

We developed and parametrised a decision tree to compare the cost-effectiveness of (1) provider-initiated testing and counselling (PITC) using rapid tests, the standard of care; (2) scaled-up provider-initiated testing and counselling (SU-PITC) in which all patients were tested with rapid tests unless they opted out; and (3) opt-out testing and counselling using POC-NAAT, which detects both acute and prevalent infection. The model-based analysis used data from the Tambua Mapema Plus randomised controlled trial of a POC-NAAT intervention in Kenya, supplemented with results from a stochastic, agent-based network model of HIV-1 transmission and data from published literature. The analysis was conducted from the perspective of the Kenyan government using a primary outcome of cost per disability-adjusted life-year (DALY) averted over a 10-year time horizon.

Results

After analysing the decision-analytical model, the average per patient cost of POC-NAAT was $214.9 compared with $173.6 for SU-PITC and $47.3 for PITC. The mean DALYs accumulated per patient for POC-NAAT were 0.160 compared with 0.176 for SU-PITC and 0.214 for PITC. In the incremental analysis, SU-PITC was eliminated due to extended dominance, and the incremental cost-effectiveness ratio (ICER) comparing POC-NAAT to PITC was $3098 per DALY averted. The ICER was sensitive to disability weights for HIV/AIDS and the costs of antiretroviral therapy.

Conclusion

POC-NAAT offered to adult outpatients in Kenya who present for care with symptoms compatible with AHI is cost-effective and should be considered for inclusion as the standard of HIV testing in this population.

Trial registration number

Tambua Mapema (“Discover Early”) Plus study (NCT03508908) conducted in Kenya (2017–2020) i.e., Post-results.
Local area public sector spending and nutritional anaemia hospital admissions in England: a longitudinal ecological study
Authors: Jenkins Rosemary , Vamos Eszter P , Mason Kate E , Daras Konstantinos , Taylor-Robinson David , Bambra Clare , Millett Christopher , Laverty Anthony A
Published: September 2022

Introduction

Reductions in local government spending may have impacts on diets and health which increase the risk of hospital admissions for nutritional anaemias. Mechanisms include potential impacts of changes to local authority (LA) services (eg, housing services) on personal resources and food access, availability and provision. We therefore investigated the association between changes in LA spending and nutritional anaemia-related hospital admissions. Specifically, we address whether greater cuts to LA spending were linked to increased hospital admissions for nutritional anaemias.

Design

Longitudinal analysis of LA panel data using Poisson fixed effects regression models.

Setting

312 LAs in England (2005–2018).

Main exposure

Total LA service expenditure per capita per year.

Main outcome

Principal and total nutritional anaemia hospital admissions, for all ages and stratified by age (0–14, 15–64, 65+ years).

Results

LA service expenditure increased by 9% between 2005 and 2009 then decreased by 20% between 2010 and 2018. Total nutritional anaemia hospital admissions increased between 2005 and 2018 from 173 to 633 admissions per 100 000 population. A £100 higher LA service spending was associated with a 1.9% decrease in total nutritional anaemia hospital admissions (adjusted incidence rate ratio (aIRR): 0.98, 95% CI: 0.96 to 0.99). When stratified by age, this was seen only in adults. A £100 higher LA service spending was associated with a 2.6% decrease in total nutritional anaemia hospital admissions in the most deprived LAs (aIRR: 0.97, 95% CI: 0.95 to 1.0).

Conclusion

Increased LA spending was associated with reduced hospital admissions for nutritional anaemia. Austerity-related reductions had the opposite effect, increasing admissions, with greater impacts in more deprived areas. This adds further evidence to the potential negative impacts of austerity policies on health and health inequalities. Among other impacts, re-investing in LA services may prevent hospital admissions associated with nutritional anaemias.
Protocol for a pragmatic feasibility randomised controlled trial of peer coaching for adults with long-term conditions: PEER CONNECT
Authors: Dennett Rachel , Thompson Tom , Clyne Wendy , Straukiene Agne , Davies-Cox Helen , Hosking Joanne , Bones Krystina , Weight Olivia , Elston Julian
Published: September 2022

Introduction

Patients with low levels of knowledge, skills and confidence to manage their health and well-being (activation) are more likely to have unmet health needs, delay seeking healthcare and need emergency care. National Health Service England estimates that this may be applicable to 25%–40% of patients with long-term health conditions. Volunteer peer coaching may support people to increase their level of activation. This form of intervention may be particularly effective for people with low levels of activation.

Methods and analysis

This single site, two-arm randomised controlled trial has been designed to assess the feasibility of conducting a definitive trial of volunteer peer health and well-being coaching for people with long-term health conditions (multiple sclerosis, rheumatic diseases or chronic pain) and low activation. Feasibility outcomes include recruitment and retention rates, and intervention adherence. We will measure patient activation, mental health and well-being as potential outcomes for a definitive trial. These outcomes will be summarised descriptively for each time point by allocated group and help to inform sample size calculation for the definitive trial. Criteria for progression to a full trial will be used.

Ethics and dissemination

Ethical approval has been granted by the London - Surrey Research Ethics Committee, reference 21/LO/0715. Results from this feasibility trial will be shared directly with participants, presented at local, regional and national conferences and published in an open-access journal.

Trial registration number

ISRCTN12623577.
Study protocol: primary healthcare transformation through patient-centred medical homes—improving access, relational care and outcomes in an urban Aboriginal and Torres Strait Islander population, a mixed methods prospective cohort study
Authors: Butler Danielle , Clifford-Motopi Anton , Mathew Saira , Nelson Carmel , Brown Renee , Gardner Karen , Turner Lyle , Coombe Leanne , Roe Yvette , Gao Yu , Ward James
Published: September 2022

Introduction

For over 40 years, Aboriginal and Torres Strait Islander Community-Controlled Health Services (ACCHS) in Australia have led strategic responses to address the specific needs of Aboriginal and Torres Strait Islander populations. Globally, there has been rapid growth in urban Indigenous populations requiring an adaptive primary healthcare response. Patient-centred medical homes (PCMH) are an evidenced-based model of primary healthcare suited to this challenge, underpinned by principles aligned with the ACCHS sector—relational care responsive to patient identified healthcare priorities. Evidence is lacking on the implementation and effectiveness of the PCMH model of care governed by, and delivered for, Aboriginal and Torres Strait Islander populations in large urban settings.

Method and analysis

Our multiphased mixed-methods prospective cohort study will compare standard care provided by a network of ACCHS to an adapted PCMH model of care. Phase 1 using qualitative interviews with staff and patients and quantitative analysis of routine primary care health record data will examine the implementation, feasibility and acceptability of the PCMH. Phase 2 using linked survey, primary care and hospitalisation data will examine the impact of our adapted PCMH on access to care, relational and quality of care, health and wellbeing outcomes and economic costs. Phase 3 will synthesise evidence on mechanisms for change and discuss their implications for sustainability and transferability of PCMHs to the broader primary healthcare system

Ethics and dissemination

This study has received approval from the University of Queensland Human Research Ethics Committee (2021/HE00529). This research represents an Aboriginal led and governed partnership in response to identified community priorities. The findings will contribute new knowledge on how key mechanisms underpinning the success and implementation of the model can be introduced into policy and practice. Study findings will be disseminated to service providers, researchers, policymakers and, most importantly, the communities themselves.
Global evidence on falls and subsequent social isolation in older adults: a scoping review
Authors: Thomas Sonia M , Parker Amanda , Fortune Jennifer , Mitchell Gary , Hezam Areej , Jiang Ying , de Groh Margaret , Anderson Kerry , Gauthier-Beaupré Amélie , Barker Joan , Watt Jennifer , Straus Sharon E , Tricco Andrea C
Published: September 2022

Background

Falls are a leading cause of injury-related hospitalizations among adults aged 65 years and older and may result in social isolation.

Objective

To summarise evidence on falls and subsequent social isolation and/or loneliness in older adults through a scoping review.

Eligibility criteria

Studies were eligible for inclusion if the population had a mean age of 60 years or older, they examined falls and subsequent social isolation, loneliness, fear of falling or risk factors and were primary studies (eg, experimental, quasi-experimental, observational and qualitative).

Sources of evidence

MEDLINE, CINAHL, Embase, Ageline and grey literature from inception until 11 January 2021.

Charting methods

A screening and charting form was developed and pilot-tested. Subsequently, two reviewers screened citations and full-text articles, and charted the evidence.

Results

After screening 4993 citations and 304 full-text articles, 39 studies were included in this review. Participants had a history of falling (range: 11% to 100%). Most studies were conducted in Europe (44%) and North America (33%) and were of the cross-sectional study design (66.7%), in the community (79%). Studies utilised 15 different scales. Six studies examined risk factors for social isolation and activity restriction associated with fear of falling. Six studies reported mental health outcomes related to falls and subsequent social isolation.

Conclusions

Consistency in outcome measurement is recommended, as multiple outcomes were used across the included studies. Further research is warranted in this area, given the ageing population and the importance of falls and social isolation to the health of older adults.

Scoping review registration number

10.17605/OSF.IO/2R8HM.
Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for type 2 diabetes remission (ORDER): protocol of a multicentre, randomised controlled, open-label, superiority trial
Authors: Li Mengyi , Liu Yang , Lee Wei-Jei , Shikora Scott A , Robert Maud , Wang Weu , Wong Simon Kin Hung , Kong Yuanyuan , Tong Daniel King Hung , Tan Chun Hai , Zeng Na , Zhu Shaihong , Wang Cunchuan , Zhang Pin , Gu Yan , Bai Rixing , Meng Fanqiang , Mao Zhongqi , Zhao Xiangwen , Wu Liangping , Liu Yanjun , Zhang Songhai , Zhang Peng , Zhang Zhongtao
Published: September 2022

Introduction

Previous studies have demonstrated that one anastomosis gastric bypass (OAGB) is not inferior to Roux-en-Y gastric bypass (RYGB) in treating obesity. However, high level evidence comparing the efficacy and safety of both procedures in type 2 diabetes (T2D) treatment is still lacking, which is another main aim of bariatric surgery. The presented trial has been designed to aim at investigating the superiority of OAGB over the reference procedure RYGB in treating T2D as primary endpoint. And diabetes-related microvascular and macrovascular complications, cardiovascular comorbidities, weight loss, postoperative nutritional status, quality of life and overall complications will be followed up for 5 years as secondary endpoints.

Methods and analysis

This prospective, multicentre, randomised superiority open-label trial will be conducted in patients of Asian descent. A total of 248 patients (BMI≥27.5 kg/m2) who are diagnosed with T2D will be randomly assigned (1:1) to OAGB or RYGB with blocks of four. The primary endpoint is the complete diabetes remission rate defined as HbA1c≤6.0% and fasting plasma glucose≤5.6 mmol/L without any antidiabetic medications at 1 year after surgery. All secondary endpoints will be measured at different follow-up visit points, which will start at least 3 months after enrolment, with a continuous annual follow-up for five postoperative years in order to provide solid evidence on the efficacy and safety of OAGB in patients with T2D.

Ethics and dissemination

The study has been approved by the ethics committee of leading centre (Beijing Friendship Hospital, Capital Medical University, no. 2021-P2-037-03). The results generated from this work will be disseminated to academic audiences and the public via publications in international peer-reviewed journals and conferences. The data presented will be imported into a national data registry. Findings are expected to be available in 2025, which will facilitate clinical decision-making in the field.

Trial registration number

NCT05015283.
Perceived stress and associated factors among pregnant women during COVID-19 pandemic period in Northwest Ethiopia, 2020: a cross-sectional study
Authors: Biresaw Mengesha Srahbzu , Takelle Girmaw Medfu , Gebeyehu Enguday Tirfeneh
Published: September 2022

Objective

This study aimed to determine the prevalence and associated factors of perceived stress among pregnant women during the COVID-19 pandemic period in Northwest Ethiopia.

Method

A cross-sectional study.

Setting

University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia.

Participants

A total of 415 pregnant women were recruited by using a systematic random sampling technique from 28 April 2020 to 12 June 2020.

Measurement

The required data were collected through face-to-face interviews. The Perceived Stress Scale was used to assess perceived stress. The Edinburgh Postnatal Depression Scale and Oslo Social Support Scale 3 were used for associated factors. The data were analysed by using SPSS V.20. We also included sociodemographic, obstetrical and gynaecology, substance use and intimate partner-related factors. Logistic regression analysis was used to identify associated factors with perceived stress. Bivariate and multivariable logistic regression analyses were used to identify the effect of each independent variable with the outcome variable. A p value of less than 0.05 was considered to be statistically significant.

Results

A total of 415 pregnant women participated in the study with response rate of 98.57%. The prevalence of perceived stress is found to be 13.7% (95% CI=10.4% to 17.1%). According to the multivariable logistic regression result, being a student (adjusted OR (AOR)=9.67, 95% CI=2.739 to 34.183), being at the first and third trimesters of gestational age (AOR=3.56, 95% CI=1.065 to 11.885; AOR=4.80, 95% CI=1.851 to 14.479, respectively), and having antenatal depression (AOR=3.51, 95% CI=1.628 to 7.563) were factors positively associated with perceived stress.

Conclusion

The prevalence of perceived stress among pregnant people was relatively high. This study recommends that all pregnant people should be screened and treated for perceived stress particularly during the first and third trimesters. Emphasis should be given to early detection and treatment of antenatal depression. Pregnant students must be strongly evaluated and intervened for perceived stress.
Study protocol: a mixed-methods study to evaluate which health visiting models in England are most promising for mitigating the harms of adverse childhood experiences
Authors: Woodman Jenny , Mc Grath-Lone Louise , Clery Amanda , Weatherly Helen , Jankovic Dina , Appleton Jane V , Kirman Jennifer , Barlow Jane , Kendall Sally , Bennett Samantha , Gilbert Ruth , Harron Katie
Published: September 2022

Introduction

Exposure to adverse childhood experiences (ACEs) is associated with poorer health outcomes throughout life. In England, health visiting is a long-standing, nationally implemented service that aims to prevent and mitigate the impact of adversity in early childhood, including for children exposed to ACEs. A range of health visiting service delivery practices exist across England (from the minimum five recommended contacts to tailored intensive interventions), but there is a lack of evidence on who receives what services, how this varies across local authorities (LAs) and the associated outcomes.

Methods and analysis

This study will integrate findings from analysis of individual-level, deidentified administrative data related to hospital admissions (Hospital Episode Statistics (HES)) and health visiting contacts (Community Services Data Set (CSDS)), aggregate LA-level data, in-depth case studies in up to six LAs (including interviews with mothers), a national survey of health visiting services, and workshops with stakeholders and experts by experience. We will use an empirical-to-conceptual approach to develop a typology of health visiting service delivery in England, starting with a data-driven classification generated from latent class analysis of CSDS-HES data, which will be refined based on all other available qualitative and quantitative data. We will then evaluate which models of health visiting are most promising for mitigating the impact of ACEs on child and maternal outcomes using CSDS-HES data for a cohort of children born on 1 April 2015 to 31 March 2019.

Ethics and dissemination

The University College London Institute of Education Research Ethics Committee approved this study. Results will be submitted for publication in a peer-reviewed journal and summaries will be provided to key stakeholders including the funders, policy-makers, local commissioners and families.
Visual acuity outcome of stable proliferative diabetic retinopathy following initial complete panretinal photocoagulation
Authors: Fu Dun Jack , Thottarath Sridevi , Faes Livia , Balaskas Konstantinos , Keane Pearse A , Sim Dawn , Sivaprasad Sobha
Published: September 2022

Background

Recent clinical trials on proliferative diabetic retinopathy (PDR) show that presenting visual acuity can be stabilised with panretinal photocoagulation (PRP) within 2 years despite the need for supplementary PRP or anti-vascular endothelial growth factor therapy for concomitant diabetic macular oedema (DMO). It is unclear whether similar results can be obtained in daily clinical practice. Here, we query the probability of vision loss in patients with treatment-naïve PDR who have attained stability after PRP and its predictors.

Methods

Retrospective cohort study at a tertiary eye centre between 01 January 2015 and 31 December 2019, wherein 2336 eyes met study criteria with first record of stable PRP-treated PDR in at least one eye. Kaplan-Meier and Cox proportional hazards modelling were used to report the probability of vision loss of at least five Early Treatment Diabetic Retinopathy Study (ETDRS) letters.

Results

The probability of losing at least five ETDRS letters was 50% at 3.32 (95% CI, 2.94 to 3.78) years after achieving first stability post PRP in treatment-naïve PDR. The mean decrease at this event was 14.2 (SD 13.0) ETDRS letters irrespective of the presence of DMO. The strongest risk factor for vision loss was a history of DMO at baseline (HR 1.62 (95% CI, 1.34 to 1.95), p<0.001).

Discussion

One in two patients with stable treated PDR lose a line of vision by 3.5 years. This resulted in 15% of patients losing their eligibility to drive. Notably, 13% of the cohort died during the follow-up period.