bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Machine Learning Wall Modeling Approaches for Large Eddy Simulation of Gas Turbine Film Cooling Flows: An a Priori Study
Authors: Kumar Tadbhagya , Pal Pinaki , Wu Sicong , Nunno A. Cody , Owoyele Opeoluwa , Joly Michael M. , Tretiak Dima
Published: January 2024

In this work, a priori analysis of machine learning (ML) strategies is carried out with the goal of data-driven wall modeling for large eddy simulation (LES) of gas turbine film cooling flows. High-fidelity flow datasets are extracted from wall-resolved LES (WRLES) of flow over a flat plate interacting with the coolant flow supplied by a single row of 7-7-7 shaped cooling holes inclined at 30 degrees with the flat plate at different blowing ratios (BR). The WRLES are performed using the high-order Nek5000 spectral element computational fluid dynamics (CFD) solver. Light gradient boosting machine (LightGBM) is employed as the ML algorithm for the data-driven wall model. Parametric tests are conducted to systematically assess the influence of a wide range of input flow features (velocity components, velocity gradients, pressure gradients, and fluid properties) on the accuracy of ML wall model with respect to prediction of wall shear stress. In addition, the use of spatial stencil and time delay is also explored within the ML wall modeling framework. It is shown that features associated with gradients of the streamwise and spanwise velocity components have a major impact on the prediction fidelity of wall model, while the effect of gradients of wall-normal velocity component is found to be negligible. Moreover, adding flow feature information from an x-y-z spatial stencil significantly improves the ML model accuracy and generalizability compared to just using local flow features from the matching location. Overall, highest prediction accuracy is achieved when both spatial stencil and time delay features are incorporated within the data-driven wall modeling paradigm.
Effect of Impurities on the Compatibility of Steels in Supercritical CO2 at 450°–650°C
Authors: Pint Bruce A. , Lance Michael J. , Pillai Rishi , Keiser James R.
Published: January 2024

Direct-fired supercritical CO2 (sCO2) power cycles are a pathway to low-CO2 fossil energy but contain O2 and H2O in the sCO2 from combustion. The effect of impurities on structural steels was investigated at 450°–650 °C in 30 MPa sCO2. The test matrix included 9 and 12%Cr ferritic-martensitic (FM) steels and conventional and advanced austenitic steels exposed for 1000–2000 h with and without additions of 1%O2 and 0.1%H2O to simulate the cycle after water removal. For FM steels, the mass gains and scale thicknesses were similar with and without impurities with the formation of thick, duplex Fe-rich scales in all cases including the observation that Fe2O3 only formed with 1%O2. For the austenitic steels, higher mass gains were observed at all temperatures with increased formation of Fe-rich oxides when impurities were added. Carbon ingress was assessed by bulk combustion analysis, glow discharge optical emission spectroscopy (GDOES) and measuring postexposure room temperature tensile properties. Bulk C content was strongly increased at 650 °C but not at 450° or 550 °C.
Experimental Investigation of the Effect of the Burner Cap Geometry on the Performance of a Domestic Liquefied Petroleum Gas Stove
Authors: Ben Atia Warda , Boutar Zouhaier , Halloumi Anouar , Ennetta Ridha
Published: January 2024

Cooking is an important domestic activity that needs energy. Traditionally, solid fuels such as firewood and charcoal have been used. However, the combustion of solid fuels inside households causes internal pollution and harms the health of users and other occupants. Nowadays, gaseous fuels like natural gas (NG) and liquefied petroleum gas (LPG) are the most used for domestic cooking. Considering the limitation of fossil fuel resources, energy conservation issues, environmental problems, and the increase in demand for gaseous fuels, it is necessary to explore ways to improve the thermal efficiency and emission characteristics of existing cooking systems. Although the use of gaseous fuels reduces domestic air pollution, the earliest domestic gas burners have low heat performance with an efficiency value of approximately 40%. Continuous research and development in stove design and analysis has led to a significant improvement in the thermal performance of commercial gas burners, with efficiencies exceeding 60%. This study’s main objective is to improve an LPG domestic stove through the modification of the cap burner geometry. The effects of various inclination angles (between the top and the lateral cap faces) ranging from 0 deg to 90 deg have been experimentally investigated. Results demonstrated that the thermal efficiency of the burner increases with increasing inclination angle. The highest efficiency was obtained at an angle of 75 deg, and beyond this value, the efficiency dropped. Unfortunately, at this angle value, CO emissions were the highest.
Shock Wave Evaluation in Shell and Tube Heat Exchanger Tube Rupture Scenario
Authors: Terenzi Alessandro
Published: January 2024

Shell and Tube Heat Exchangers (STHEs) are commonly used in oil and gas plants to cool or heat process fluids. A possible issue when designing such systems is represented by the tube rupture scenario, when the internal HP (high-pressure) fluid is suddenly discharged to the LP (low-pressure) fluid in the shell. Since, usually, the tube and shell sides have different design pressures, this scenario must be analyzed to assess if the safety measures are fit to protect the weakest part of the system. The time evolution of this event is characterized by different phases; in the first one, a shock wave is generated and propagated very rapidly in the system, with a time scale in the order of a few ms. The phenomenon is so rapid that pressure relief devices are not effective. This kind of wave is normally not evaluated in the majority of available publications; however, it is deemed that it is of particular relevance for large-size SHTEs, due to their significant investment cost, and hence, a methodology has been developed in this work for the purpose. The main impact of such waves is expected in the LP piping connected to the exchanger. The amplitude of the shock wave at the source location, i.e., at the ruptured tube, is calculated based on the theory of the Riemann problem, with reference to different types of HP and LP fluids. Then, the relevant propagation up to the piping entrance is studied to estimate the wave damping and the effective wave amplitude impacting it. Both validation calculations and calculations referred to new design applications and existing installations are presented, and possible mitigation measures are proposed, if any.
Diffusion and magnetization of metal adatoms on single-layer molybdenum disulfide at elevated temperatures
Authors: Zarshenas Mohammad , Sangiovanni Davide G. , Sarakinos Kostas
Published: January 2024

The present work models temperature-dependent (500−1300K) diffusion dynamics of Ag, Au, and Cu adatoms on MoS2 as well as electronic and magnetic properties of adatom (Ag, Au, and Cu)/MoS2 systems. Modeling is done by means of ab initio molecular dynamics (AIMD) simulations that account for van der Waals corrections and electronic spin degrees of freedom in the framework of density functional theory. It is found that Ag and Au adatoms exhibit super-diffusive motion on MoS2 at all temperatures, while Cu adatoms follow a random walk pattern of uncorrelated surface jumps. The observed behavior is consistent with AIMD-calculated effective migration barriers Ea (EaAg=190±50meV, EaAu=67±7meV, and EaCu=300±100meV) and can be understood on the basis of the considerably flatter potential energy landscapes encountered by Ag and Au adatoms on the MoS2 surface (corrugation of the order of tens of meV), as compared to Cu adatoms (corrugation >100meV). Moreover, evaluation of the electronic and magnetic properties of AIMD configurations suggest that Ag, Au, and Cu monomer adsorption induces semimetallic features in at least one spin channel of the adatom/MoS2 electronic structure at elevated temperatures. The overall results presented herein may provide insights into fabricating 2D-material-based heterostructure devices beyond graphene.
Cathode spot dynamics in axial magnetic fields
Authors: Liang Jiongyu , Tsoutas Kostadinos , Bilek Marcela
Published: January 2024

Cathodic arcs (CA) are important across a wide range of applications including thin film deposition and solid fuel space propulsion. Understanding how cathode spots (CSs) move in magnetic fields has important implications for the deposition rates and thrust delivered as well as cathode/fuel usage efficiency. In this work, we investigated the dynamics of cathode spot (CS) motion in the presence of various axial magnetic fields (AMFs) in a high-current multi-spot CA system. Two photography techniques were used (i) long exposure and (ii) high-speed framing photography. The long-exposure images of cathode spots suggested that the cathode spots do not travel in spiral paths produced by Robson drift, as observed in previous vacuum interrupter system experiments. The reduced prevalence of Robson drift was found to be insufficiently explained considering only anodic plasma emission difference arising from the annular anode geometrical setup. High-speed framing images of cathode spots during discharges revealed a statistically significant reduction of the speed of cathode spot motion, as characterized by a decrease in K value as the applied AMF increases.
Entertaining audacious ideas
The Weirdness of the World
Eric Schwitzgebel
Princeton University Press, 2024. 376 pp.
Authors: Machery Edouard
Published: January 2024

Unbound by empiricism, a philosopher’s provocative musings inspire delight and vexation
A big-headed problem drives an ecological chain reaction
Authors: Gaynor Kaitlyn M.
Published: January 2024

Disruption of key species interactions reverberates across an African savanna
In Science Journals
Authors: Seale Madeleine , Funk Michael A. , Stajic Jelena , Olingy Claire , Scanlon Seth Thomas , Smith H. Jesse , Grocholski Brent , Czajka Caitlin , Yeston Jake S. , Alderton Gemma , Ash Caroline , Smith Keith T. , Lopez Bianca , Vignieri Sacha , Jiang Di , Foley John F.
Published: January 2024

Highlights from the
Science
family of journals
Strong medicine for Argentina’s beleaguered science
Authors: Orfila María de los Ángeles
Published: January 2024

Daniel Salamone, the country’s new science head, faces skepticism as he touts new priorities and entrepreneurship
SARS-CoV-2 sneezing explained
Authors: Leslie Mitch
Published: January 2024

Viral protein prods nerve cells, may be treatment target
Secretory leukocyte protease inhibitor protects against severe urinary tract infection in mice
Authors: Rosen Anne L. , Lint Michael A. , Voelker Dayne H. , Gilbert Nicole M. , Tomera Christopher P. , Santiago-Borges Jesús , Wallace Meghan A. , Hannan Thomas J. , Burnham Carey-Ann D. , Hultgren Scott J. , Kau Andrew L.
Published: January 2024

Annually, millions of people suffer from urinary tract infections (UTIs) and more than $3 billion are spent on work absences and treatment of these patients. While the early response to UTI is known to be important in combating urinary pathogens, knowledge of host factors that help curb infection is still limited. Here, we use a preclinical model of UTI to study secretory leukocyte protease inhibitor (SLPI), an antimicrobial protein, to determine how it protects the bladder against infection. We find that SLPI is increased during UTI, accelerates the clearance of bacteriuria, and upregulates genes and pathways needed to fight an infection while preventing prolonged bladder inflammation. In a small clinical study, we show SLPI is readily detectable in human urine and is associated with the presence of a uropathogen in patients without a previous history of UTI, suggesting SLPI may play an important role in protecting from bacterial cystitis.
Cross-protective HCoV immunity reduces symptom development during SARS-CoV-2 infection
Authors: Abela Irene A. , Schwarzmüller Magdalena , Ulyte Agne , Radtke Thomas , Haile Sarah R. , Ammann Priska , Raineri Alessia , Rueegg Sonja , Epp Selina , Berger Christoph , Böni Jürg , Manrique Amapola , Audigé Annette , Huber Michael , Schreiber Peter W. , Scheier Thomas , Fehr Jan , Weber Jacqueline , Rusert Peter , Günthard Huldrych F. , Kouyos Roger D. , Puhan Milo A. , Kriemler Susi , Trkola Alexandra , Pasin Chloé
Published: January 2024

Knowledge of the interplay between human coronavirus (HCoV) immunity and severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection is critical to understanding the coexistence of current endemic coronaviruses and to building knowledge potential future zoonotic coronavirus transmissions. This study, which retrospectively analyzed a large cohort of individuals first exposed to SARS-CoV-2 in Switzerland in 2020–2021, revealed several key findings. Pre-existing HCoV immunity, particularly mucosal antibody responses, played a significant role in improving SARS-CoV-2 immune response upon infection and reducing symptoms development. Mucosal neutralizing activity against SARS-CoV-2, although low in magnitude, retained activity against SARS-CoV-2 variants underlining the importance of maintaining local mucosal immunity to SARS-CoV-2. While the cross-protective effect of HCoV immunity was not sufficient to block infection by SARS-CoV-2, the present study revealed a remarkable impact on limiting symptomatic disease. These findings support the feasibility of generating pan-protective coronavirus vaccines by inducing potent mucosal immune responses.
Temporal genome-wide fitness analysis of
Mycobacterium marinum
during infection reveals the genetic requirement for virulence and survival in amoebae and microglial cells
Authors: Lefrançois Louise H. , Nitschke Jahn , Wu Huihai , Panis Gaël , Prados Julien , Butler Rachel E. , Mendum Tom A. , Hanna Nabil , Stewart Graham R. , Soldati Thierry
Published: January 2024

The emergence of biochemically and genetically tractable host model organisms for infection studies holds the promise to accelerate the pace of discoveries related to the evolution of innate immunity and the dissection of conserved mechanisms of cell-autonomous defenses. Here, we have used the genetically and biochemically tractable infection model system
Dictyostelium discoideum
/
Mycobacterium marinum
to apply a genome-wide transposon-sequencing experimental strategy to reveal comprehensively which mutations confer a fitness advantage or disadvantage during infection and compare these to a similar experiment performed using the murine microglial BV2 cells as host for
M. marinum
to identify conservation of virulence pathways between hosts.
Life in the Cambrian shallows: Exceptionally preserved arthropod and mollusk microfossils from the early Cambrian of Sweden
Authors: Slater Ben J.
Published: January 2024

Burgess Shale–type (BST) Lagerstätten record an exceptional variety of Cambrian soft-bodied fauna, yet these deposits are typically restricted to outboard depositional settings >1000 km from the paleocoastline. For shallow, well-oxygenated shelf environments, our knowledge of non-mineralized animals (the majority of diversity) is severely limited, giving rise to substantial bias in our perception of Cambrian biotas. An alternate means of detecting soft-bodied Cambrian fauna, independent of paleobathymetry, is to use acid maceration to extract microscopic organic remains of non-mineralized animals, known as “small carbonaceous fossils” (SCFs). Here, a hitherto unknown diversity of Cambrian arthropod and mollusk remains are reported from shallow-marine sediments (Cambrian Stage 3 Mickwitzia Sandstone, Sweden). These microfossils comprise a variety of arthropod cuticles preserving sub-micron-scale anatomy alongside abundant radular mouthparts from mollusks—among the oldest known arthropod and molluscan SCFs on record. Significantly, at least three distinct types of fossil radula are identifiable (uniseriate, distichous, and polystichous forms), revealing that substantial diversification of the basic molluscan radula had already taken place by the early Cambrian. These cryptic elements of the biota—otherwise undetectable in such deposits—offer novel insights into Cambrian primary consumers as well as aspects of the fauna that are absent from deeper-water BST deposits.
Erratum to: Endobiotic Ciliates from the Rumen of the European Bison Bison Bonasus (Linnaeus, 1758) from the Vologda Oblast of Russia
Authors: Kornilova O. A. , Chistyakova L. V. , Gusarov I. V.
Published: January 2024

An Erratum to this paper has been published: https://doi.org/10.1134/S0012496623050034
High-Frequency Shift and Extension of the Terahertz Radiation Spectrum up to 10 THz During Optical Rectification of High-Power Few-Cycle Near-Infrared Femtosecond Pump Radiation in a BNA Crystal
Authors: Rumiantsev B. V. , Zhidovtsev N. A. , Pushkin A. V. , Lobushkin E. A. , Shulyndin P. A. , Suleimanova D. Z. , Savel’ev-Trofimov A. B. , Potemkin F. V.
Published: January 2024

The generation of terahertz radiation in a BNA crystal pumped by 1.24-µm femtosecond laser radiation from a Cr:forsterite laser system with a pulse duration of 100 and 35 fs and a pump density of 10 mJ/cm2 has been realized. The achieved generation efficiency is 0.1%. It is found that a decrease in the pump pulse duration from 100 to 35 fs leads to the generation of high-frequency components in the ranges of 2.5–6.5 THz and 9‒10.5 THz in the generated radiation spectrum. Simulation of the terahertz radiation generation based on the solution of Maxwell’s equations by the finite-difference time-domain method has made it possible to adequately describe the measured spectra. The generation of broadband high-frequency terahertz radiation in the BNA crystal pumped by the Cr:forsterite laser system allows one to consider this schematic as an alternative to sources based on the BNA crystal pumped by a Ti:sapphire laser system.
Erratum to: The Trans-Baikal Parametric Borehole: First Evidence of the Deep Structure of the Borshchovochnyi Metamorphic Core Complex
Authors: Petrov O. V. , Kashubin S. N. , Gladkochub D. P. , Donskaya T. V. , Morozov A. F. , Kudryavtsev I. V. , Milshtein E. D. , Gorbachev V. I. , Narkisova V. V.
Published: January 2024

An Erratum to this paper has been published: https://doi.org/10.1134/S1028334X23060053
Erratum to: The First Record of a Representative of the Toarcian–Early Aalenian Belemnites in Kimberlites of the Obnazhennaya Pipe (Northeastern Siberian Platform)
Authors: Dzyuba O. S. , Grinenko V. S. , Oshchepkova M. G. , Shurygin B. N.
Published: January 2024

An Erratum to this paper has been published: https://doi.org/10.1134/S1028334X23060077
Erratum to: The First Discovery of Cambrian Volcanic Rocks and Plagiogranites in the Tekturmas Ophiolite Zone (Central Kazakhstan): Age and Composition
Authors: Degtyarev K. E. , Luchitskaya M. V. , Tretyakov A. A.
Published: January 2024

An Erratum to this paper has been published: https://doi.org/10.1134/S1028334X23060107
Erratum to: Sr-Isotopic Composition of Paleoocean Water 960 Ma Ago (according to the Data for the Nizhny Tunguska Formation of the Turukhansk Uplift, Siberian Platform)
Authors: Letnikova E. F. , Zhdanov A. A. , Ivanov A. V. , Maslov A. V. , Izokh A. E. , Letnikova A. F. , Soloshenko N. G.
Published: January 2024

An Erratum to this paper has been published: https://doi.org/10.1134/S1028334X23060144
Primary cerebral immunoglobulin light chain amyloidoma in a patient with multiple sclerosis
Authors: Traets Marissa J M , Chuwonpad Krisna , Leguit Roos J , Frequin Stephan T F M , Minnema Monique C
Published: January 2024

A man in his 60s, known with multiple sclerosis, presented with seizures and paresis of the left arm and leg. Brain imaging showed a white matter lesion, right parietal, which was progressive over the last 6 years and not typical for multiple sclerosis. Brain biopsy showed a B-cell infiltrate with IgA lambda monotypic plasma cell differentiation and amyloid deposits, typed as lambda immunoglobulin light chain (AL). Bone marrow biopsy and PET/CT ruled out a systemic lymphoma. Extended history taking, blood and urine testing (including cardiac biomarkers) identified no evidence of systemic amyloidosis-induced organ dysfunction.

Primary cerebral AL amyloidoma is a very rare entity where optimal treatment is difficult to assess. The patient was treated with locally applied volumetric modulated arc radiotherapy, 24 Gy, divided in 12 fractions. Afterwards, the paresis of the left arm partially resolved, and the function of the left leg improved. Seizures did not occur anymore.
Karate kick-induced myocardial contusion
Authors: Doornkamp Ruben N , van Winden Daniëlle FM , Josephus Jitta Djike , Buiten Maurits S
Published: January 2024

Myocardial contusion should be suspected in a selected patient group with blunt thoracic trauma, who have elevated troponin, ECG changes and/or haemodynamical instability. Echocardiography is useful for direct visualisation of possible complications. In stable conditions, MRI allows for good visualisation of the heart and can confirm a suspected myocardial contusion as well as demonstrate the extent of myocardial damage. Based on the present literature, the authors developed a diagram for the diagnostic approach of a patient with suspected myocardial contusion.
Subsequent development of Kawasaki disease following acute human adenovirus infection among siblings
Authors: Sankannaavr Ashwini , Puttalinga Divyashree , Bagalkot Praveen S
Published: January 2024

We report a middle-childhood girl presented with high-grade fever and headache for 4 days. Following this, the child developed mucocutaneous symptoms. She had a notable family history of autoimmune disease. Tests revealed increased inflammatory markers. On the sixth day of illness, a two-dimensonal echocardiogram showed an enlarged coronary artery, diagnosed as incomplete Kawasaki disease (KD) and treated with IVIG and aspirin.

Within a week, her younger sibling, an early-childhood girl presented with features of viral prodrome, developed mucocutaneous lesions and subcutaneous oedema of limbs. Her investigations also showed elevated inflammatory markers and echocardiographic changes, diagnosed as incomplete KD.

The subsequent development of KD in siblings, both showing initial viral symptoms and a family history of autoimmune disease, led to the suspicion of a potential viral trigger. This was confirmed through viral PCR studies for human adenovirus (type 3). These cases highlight an unusual occurrence of KD developing in siblings following acute adenoviral infection.
Association between antidepressant use during pregnancy and miscarriage: a systematic review and meta-analysis
Authors: Smith Sophie , Martin Flo , Rai Dheeraj , Forbes Harriet
Published: January 2024

Background

Literature surrounding the association between antidepressant use during pregnancy and miscarriage is conflicting. We aimed to conduct a systematic review and meta-analysis of studies among pregnant women regarding the association between exposure to antidepressants during pregnancy and the risk of miscarriage, compared with pregnant women not exposed to antidepressants.

Design

We conducted a systematic review and meta-analysis of non-randomised studies.

Data sources

We searched Medline, Embase and PsychINFO up to 6 August 2023.

Eligibility criteria and outcomes

Case-control, cohort and cross-sectional study designs were selected if they compared individuals exposed to any antidepressant class during pregnancy to comparator groups of either no antidepressant use or an alternate antidepressant.

Data extraction and synthesis

Effect estimates were extracted from selected studies and pooled using a random-effects meta-analysis. Risk of bias (RoB) was assessed using the Risk of Bias in Non-Randomised Studies of Interventions (ROBINS-I) tool, and heterogeneity assessed using the I2statistic. Subgroup analyses were used to explore antidepressant classes and the impact of confounding by indication.

Results

1800 records were identified from the search, of which 29 were included in the systematic review and meta-analysis. The total sample included 5 671 135 individuals. Antidepressant users initially appeared to have a higher risk of miscarriage compared with unexposed individuals from the general population (summary effect estimate: 1.24, 95% CI 1.18 to 1.31, I2=69.2%; number of studies (n)=29). However, the summary estimate decreased when comparing against unexposed individuals with maternal depression (1.16, 1.04 to 1.31; I2=58.6%; n=6), suggesting confounding by indication may be driving the association. 22 studies suffered from serious RoB, and only two of the 29 studies were deemed at moderate RoB.

Conclusions

After accounting for maternal depression, there is little evidence of any association between antidepressant use during pregnancy and miscarriage. Instead, the results indicate the biasing impact of confounding by indication.
Patients’ experiences with receiving sick leave certificates via remote consultations in Norway during the COVID-19 pandemic: a nationwide online survey
Authors: Zanaboni Paolo , Bergmo Trine S , Kristiansen Eli
Published: January 2024

Objectives

To explore patients’ experiences with receiving sick leave certificates via remote consultations during the COVID-19 pandemic and investigate whether there were differences among the types of remote consultation (telephone, video or text).

Design

A nationwide online patient survey consisting of quantitative data supplemented by qualitative opinions conducted in Norway.

Setting

Primary care.

Participants

Patients who received a sick leave certificate via remote consultation in the period from 16 November to 15 December 2020.

Results

Of the 5429 respondents, 3233 (59.6%) received a sick leave certificate via telephone consultation, 657 (12.1%) via video consultation and 1539 (28.3%) via text-based e-consultation. Most respondents (76.8%) were satisfied. Only 10% of the respondents thought that the doctor would have obtained more information through an office appointment. The majority of the respondents (59.6%) found that they had as much time to explain the problem as at an office appointment. Some patients also thought that it was easier to formulate the problem via a remote consultation (18.2%) and agree with the doctor on the sick leave (10.3%).

The users of text-based e-consultations were the most satisfied (79.3%, p<0.001) compared with those using telephone or video consultations. Among users of text-based e-consultations, there was a higher proportion of patients who thought that they had more time to explain the problem compared with an office appointment (p<0.001), it was easier to explain the problem (p<0.001) and agree with the doctor (p<0.001). Most respondents would use the same type of remote consultation if they were to contact the general practitioner (GP) for the same problem, with the highest proportion among the users of video consultations (62.1%, p<0.001).

Conclusions

Patients were satisfied with communicating and receiving sick leave certificates via remote consultations. Future studies should investigate patients’ and GPs’ use and experiences in a postpandemic setting.
Understanding aims, successes and challenges of palliative care and homelessness initiatives across the UK: an exploratory study
Authors: Crooks Jodie , Flemming Kate , Shulman Caroline , Hudson Briony
Published: January 2024

Background

Due to the recognition that people experiencing homelessness (PEH) often die young and unsupported, a growing number of initiatives focusing on palliative care and homelessness are emerging across the UK. However, there has been no systematic exploration of the nature and landscape of this work.

Aims

To understand the range, aims, successes and challenges of current initiatives within the field of palliative care and homelessness in the UK, by exploring existing projects and initiatives.

Method

An online survey was distributed to members of an Extension for Community Healthcare Outcomes network focusing on palliative care and homelessness for a mixed professional audience. The survey collated the aims, successes and challenges of initiatives aiming to improve palliative care for PEH. Responses were summarised using descriptive statistics, and free-text responses were analysed using thematic analysis.

Results

162 professionals completed the survey. Of these, 62% reported involvement in at least one palliative care and homelessness initiative. Initiatives focused on service delivery (59%), training (28%) and research (28%). Themes for success included improved service engagement, relationship formation, housing provision, honouring end-of-life wishes, upskilling staff and enabling safe hospital discharge. The main challenges included stigma around substance misuse, securing funding, staff capacity, equipment and facilities, and engaging communities.

Conclusion

The number and scope of initiatives aiming to support PEH with advanced ill health and palliative care needs across the UK is growing, with a range of professionals engaging in the field. Future research may benefit from exploring initiatives in more detail to understand the specific drivers of impact on PEH and the staff and services supporting them.
Quantifying the carbon footprint of clinical trials: guidance development and case studies
Authors: Griffiths Jessica , Fox Lisa , Williamson Paula R
Published: January 2024

Background

The urgency of the climate crisis requires attention from biomedical research, not least clinical trials which can involve significant greenhouse gas emissions. The Low Carbon Clinical Trials Working Group set out a strategy to reduce the emissions of clinical trials, starting with the development of a method to measure their carbon footprint (CO2e).

Methods

As a first step, we developed a process map defining clinical trial core activities. Corresponding emission factors were sourced to convert activity data into greenhouse gas emissions. The subsequent method was applied to two Cancer Research UK (CRUK)-funded trials (the international randomised sarcoma trial CASPS (ISRCTN63733470) and the UK cohort-based breast cancer trial PRIMETIME (ISRCTN41579286)). A guidance document defining the scope, method and assumptions was written to allow application to any publicly funded/investigator initiated clinical trial.

Results

Trial specific activities over and above routine care were grouped into 10 modules covering trial set up, conduct and closure. We identified emission factors for all trial activities within both trials and used them to estimate their total carbon footprint. The carbon footprint of CASPS, an international phase 2 trial of an investigational medicinal product with 47 participants, was 72 tonnes CO2e, largely attributable to clinical trials unit emissions and staff travel. PRIMETIME, a UK-based phase 3 non-investigational medicinal product trial with 1962 patients, produced 89 tonnes CO2e, largely attributable to trial-specific in-person participant assessments.

Conclusion

We have developed a method and guidance that trialists can use to determine the carbon footprint of clinical trials. The guidance can be used to identify carbon hotspots where alternative approaches to trial design and conduct could reduce a trial footprint, and where methodology research is required to investigate the potential impact of interventions taken to reduce carbon emissions. We will continue to refine the guidance to increase the potential application and improve usability.
The trajectory and influencing factors of disability acceptance in patients with hypertensive intracerebral haemorrhage: a protocol for prospective longitudinal cohort study in Heyuan City, China
Authors: Zhang Jia , Liu Xi , Zhang Zuolian
Published: January 2024

Introduction

China is one of the countries with the highest burden of hypertensive intracerebral haemorrhage (HICH), and its morbidity and mortality rates are almost twice the world average. Most survivors experience negative emotions such as anxiety and depression due to symptoms such as speech disorders, dysphagia, cognitive impairment, hemiplegia and ataxia. While evidence has emerged, supporting the acceptance of disability is a major factor in psychosocial adjustment of patients with disabilities. However, most relevant studies mainly focus on cross-sectional design, and the impact of disability on physical and mental health is a complex and comprehensive process, and its mechanism is still unclear. Therefore, we aimed to use the latent growth mixture model (LGMM) and the decision tree model to analyse the trajectory and predictors of disability acceptance in patients with HICH from stable hospitalisation to 2 years after discharge.

Methods and analysis

The objective of this prospective study will be to examine the 2-year trajectory of disability acceptance in a cohort of persons with HICH. 180 participants will be recruited, and baseline general data collection, disability acceptance, family caring index and self-efficacy of chronic disease will be conducted. All of them will be followed up at the stable hospitalisation period, 6 month, 1 year and 2 year after discharge using the same protocol. As a major result, disability acceptance trajectories and potential categories will be analysed using LGMM. Additionally, the independent variables with statistical significance will be included in the decision tree model, and the Classification And Regression Trees（CART） algorithm programme will be used to construct the prediction model of influencing factors of disability acceptance trajectory. The exploratory outcome will provide scientific basis for the optimal intervention time point and the formulation of rehabilitation measures for this population.

Ethics and dissemination

Ethical approval was obtained from the medical research ethics committee of Heyuan People’s Hospital (YXYJLL-2022S58). The results will be disseminated nationally and internationally through the publication of research papers.

Trial registration number

ChiCTR2300071778.
Etrolizumab as induction and maintenance therapy in patients with moderately to severely active ulcerative colitis: a protocol of systematic review and meta-analysis of placebo-controlled, randomised clinical trials
Authors: Qin Xuan , Wang Menghui , Zhang Wei , Liu Wenji , Shu Hongxin , Xiong Xiaowei
Published: January 2024

Introduction

Etrolizumab is a gut-targeted, anti-β7 integrin, monoclonal antibody. Recently, data from phase 2 and 3 trials presented different results in patients with moderately to severely active ulcerative colitis. The aim of this study is to summarise the latest published trials to analysis the role of etrolizumab in treatment of moderately to severely active ulcerative colitis during induction and maintenance phases.

Methods

Eligible randomised controlled trials (RCTs) will be retrieved from following databases: PubMed, Web of Science and the Cochrane Library. The last search time is May 2023. Two reviewers will independently identify RCTs according to inclusion and exclusion criteria. The primary outcome is clinical remission. The second outcomes are clinical response, endoscopic remission, endoscopic improvement, histological remission, any adverse event. The Grades of Recommendations, Assessment, Development and Evaluation tool will be established to estimate the evidence level of each outcome. All compute will be accomplished with Stata V.17.0 software.

Ethics and dissemination

This systematic review and meta-analysis will be disseminated through peer-reviewed journals. No ethical approval requirements are required because the results presented in this study are conducted based on published data.

PROSPERO registration number

CRD42023415369.
Patient organisations’ views, motivations and experiences on patient involvement in cancer research: a pilot study in Portugal
Authors: Roquette Constança , Crisóstomo Sofia , Milagre Tamara , Ribeiro Rute Simões , Pedro Ana Rita , Valente André
Published: January 2024

Objectives

To characterise Portuguese cancer-related patient organisations and analyse their views, motivations and experiences on patient involvement in cancer research.

Design

A multistakeholder group, comprising patient representatives and researchers, codesigned a questionnaire after a literature review, online sessions and collaborative mind maps. In May 2021, a survey was conducted among representatives of Portuguese cancer-related patient organisations, focusing on four dimensions: experience in cancer research; perception of its outcomes; motivations and expectations on patient involvement in research; and organisation characteristics.

Participants

Twenty-seven representatives from Portuguese cancer-related patient organisations responded to the questionnaire, corresponding to a 64% response rate.

Results

Among the surveyed organisations, 26% have participated in clinical studies. Their involvement occurred in few stages of the research process and, mostly, with low levels of engagement. They showed ‘great interest’ in participating in most research steps, although this is not reflected in a high perception of influence over these same steps. More than half claimed to have contributed to the increase in patient recruitment and to a better understanding of informed consent by patients involved. Ensuring that research results are more aligned with the true needs of patients is the greatest motivation. Also, our results suggest that the organisation’s number of employees and its integration into a European/International network play a relevant role in patient involvement in research.

Conclusions

This study provides the first in-depth characterisation of Portuguese cancer-related patient organisations and their views, motivations and experiences on patient involvement in cancer research. Most importantly, this study revealed that most of these organisations show great interest in being involved in different R&D stages to ensure that research results are aligned with patients’ needs. Their motivation should be turned into greater and more meaningful involvement in practice, so that the cancer community can benefit from the outcomes of truly patient-centred research.
Efficacy of photobiomodulation therapy combined with mobile health education in patients with head and neck cancer suffering from chronic xerostomia after radiotherapy: protocol for a three-arm, randomised, placebo-controlled, double-blinded study
Authors: Lopez-Garzon Maria , López-Fernández María Dolores , Ruíz-Martínez Alba Maria , Galván-Banqueri Pilar , Lozano-Lozano Mario , Tovar-Martín Isabel , Postigo-Martin Paula , Ariza-Vega Patrocinio , Artacho-Cordón Francisco , Fernández-Lao Carolina , Cantarero-Villanueva Irene , Fernández-Gualda Miguel Ángel , Arroyo-Morales Manuel , Ruíz-Villaverde Ricardo , Galiano-Castillo Noelia
Published: January 2024

Introduction

The role of photobiomodulation (PBM) therapy for oral tissue damage induced by cancer treatment is currently unclear, and there is low-quality to moderate-quality evidence supporting the use of this approach for treating xerostomia and/or hyposalivation. Consequently, patients with head and neck cancer increasingly turn to basic oral hygiene to alleviate salivary gland dysfunction, and their adherence can be improved by mobile health (mHealth) education. The primary objective of this study will be to analyse the effects of different doses of PBM therapy (7.5 J/cm2vs 3 J/cm2) plus mHealth education on quality of life (QoL), oral health, salivary secretion and salivary gland ultrasound assessment at postintervention and at the 6-month follow-up in patients with head and neck cancer after radiotherapy compared with those in control group.

Methods and analysis

A prospective, three-arm, randomised, placebo-controlled, double-blinded study will be conducted among patients with head and neck cancer suffering from chronic xerostomia. A total of 20 patients per arm will be included and randomly assigned to receive 7.5 J/cm2of PBM, 3 J/cm2of PBM or placebo therapy. PBM therapy will be applied during 24 sessions at 22 points extra and intraorally two times per week for 3 months, combined with a mobile application (https://www.laxer.es). The assessments will be recorded at the beginning of the study, at postintervention and at the 6-month follow-up. The primary outcomes will be QoL, oral health, salivary secretion and salivary gland ultrasound. The pain pressure threshold, functional performance, mood and sleep quality will be secondary indicators.

Ethics and dissemination

This study received ethics approval from the Andalusian Biomedical Research Ethics Portal (2402-N-21 CEIM/CEI Provincial de Granada) according to the Declaration of Helsinki for Biomedical Research. The results of this study will be presented at national and international conferences and published in peer-reviewed journals.

Trial registration number

ClinicalTrials.govNCT05106608.
Time-restricted eating and supervised exercise for improving hepatic steatosis and cardiometabolic health in adults with obesity: protocol for the TEMPUS randomised controlled trial
Authors: Camacho-Cardenosa Alba , Clavero-Jimeno Antonio , Martin-Olmedo Juan J , Amaro-Gahete Francisco , Cupeiro Rocío , Cejudo María Trinidad González , García Pérez Patricia Virginia , Hernández-Martínez Carlos , Sevilla-Lorente Raquel , De-la-O Alejandro , López-Vázquez Alejandro , Molina-Fernandez Marcos , Carneiro-Barrera Almudena , Garcia Federico , Rodríguez-Nogales Alba , Gálvez Peralta Julio Juan , Cabeza Rafael , Martín-Rodríguez José L , Muñoz-Garach Araceli , Muñoz-Torres Manuel , Labayen Idoia , Ruiz Jonatan R
Published: January 2024

Introduction

Metabolic dysfunction-associated steatotic liver disease is a major public health problem considering its high prevalence and its strong association with extrahepatic diseases. Implementing strategies based on an intermittent fasting approach and supervised exercise may mitigate the risks. This study aims to investigate the effects of a 12-week time-restricted eating (TRE) intervention combined with a supervised exercise intervention, compared with TRE or supervised exercise alone and with a usual-care control group, on hepatic fat (primary outcome) and cardiometabolic health (secondary outcomes) in adults with obesity.

Methods and analysis

An anticipated 184 adults with obesity (50% women) will be recruited from Granada (south of Spain) for this parallel-group, randomised controlled trial (TEMPUS). Participants will be randomly designated to usual care, TRE alone, supervised exercise alone or TRE combined with supervised exercise, using a parallel design with a 1:1:1:1 allocation ratio. The TRE and TRE combined with supervised exercise groups will select an 8-hour eating window before the intervention and will maintain it over the intervention. The exercise alone and TRE combined with exercise groups will perform 24 sessions (2 sessions per week+walking intervention) of supervised exercise combining resistance and aerobic high-intensity interval training. All participants will receive nutritional counselling throughout the intervention. The primary outcome is change from baseline to 12 weeks in hepatic fat; secondary outcomes include measures of cardiometabolic health.

Ethics and dissemination

This study was approved by Granada Provincial Research Ethics Committee (CEI Granada—0365-N-23). All participants will be asked to provide written informed consent. The findings will be disseminated in scientific journals and at international scientific conferences.

Trial registration number

NCT05897073.
Clinical characteristics and healthcare utilisation associated with undiagnosed cognitive impairment in elderly patients with diabetes in a primary care setting: a population-based cohort study
Authors: Merzon Eugene , Shpigelman Miriam , Vinker Shlomo , Golan Cohen Avivit , Green Ilan , Israel Ariel , Cukierman-Yaffe T , Eldor Roy
Published: January 2024

Objectives

The objective of this study is to report the prevalence, clinical characteristics and healthcare utilisation of patients with type 2 diabetes (T2DM) and previously undiagnosed cognitive impairment who were identified as having a low Montreal Cognitive Assessment (MoCA) score.

Design

A population-based cohort study comparing clinical characteristics, medications, outpatient and inpatient care of patients with a MoCA score <19 to MoCA >26 using descriptive statistics, linear regression and multivariate logistic regression.

Setting

Electronic medical records of a large health maintenance organisation in Israel.

Participants

350 patients, age >65 with T2DM who participated in a cognitive function screening initiative using MoCA, and had a follow-up visit during the 12 months after screening.

Results

130 (37.1%) had a MoCA score >26 and 68 (19.4%) <19. Patients with MoCA<19 had more diabetes-related complications, poorer glycaemic and lipid control, fewer visits to their main primary care physician (PCP; 3.9±3.2 vs 7.3±4.2 visits/year p=0.008), shorter duration of PCP visits (8.3±4.5 vs 4.0±3.5 min, p=0.007), fewer nutritionist and endocrinologist visits, and lower participation in diabetes or smoking cessation workshops. They were less likely to be treated with glucagon-like peptide-1 (GLP-1) agonists, dipeptidyl peptidase-4 inhibitor (DPP-4), or sodium-glucose transport protein 2 (SGLT-2) inhibitors and more likely to receive insulin or sulfonylurea. Moreover, they had more emergency room visits (ER; 15 (11.5%) vs 16 (23.5%), p=0.019), hospitalisations (8 (6.2%) vs 22 (32.4%), p=0.001), and longer hospital stays (4.3±3.2 vs 14.5±9.8, p=0.001). Using statistical models, MoCA<19 was identified as a risk factor for fewer and shorter PCP visits and more ER visits and hospitalisations.

Conclusions

This study highlights the high prevalence of undiagnosed severe cognitive impairment in elderly patients with T2DM and its association with poor outpatient care. Appropriate interventions are needed to improve outcomes and prevent hospitalisation in this high-risk population.
Association between travel distance and face-to-face consultations with general practitioners before an incident acute myocardial infarction: a nationwide register-based spatial epidemiological study
Authors: Kjærulff Thora Majlund , Bihrmann Kristine , Søndergaard Jens , Gislason Gunnar , Larsen Mogens Lytken , Ersbøll Annette Kjær
Published: January 2024

Objectives

This study examined the association between travel distance to the general practitioner’s (GP) office andnoface-to-face GP consultation within 1 year before an incident acute myocardial infarction (AMI).

Design

A prospective cohort study using multilevel spatial logistic regression analysis of nationwide register data.

Setting

Nationwide study including contacts to GPs in Denmark prior to an incident AMI in 2005–2017.

Participants

121 232 adults (≥30 years) with incident AMI were included in the study.

Primary and secondary outcomes measures

The primary outcome was odds of not having a face-to-face GP consultation within 1 year before an incident AMI.

Results

In total, 13 108 (10.8%) of the 121 232 individuals with incident AMI had no face-to-face consultation with the GP within 1 year before the AMI. Population density modified the association between travel distance andnoface-to-face GP consultation. Increased odds ofnoface-to-face GP consultation was observed for medium (25th–75th percentile/1123–5449 m) and long (>75th percentile/5449 m) compared with short travel distance (<25th percentile/1123 m) among individuals living in small cities (OR (95% credible intervals) of 1.19 (1.10 to 1.29) and 1.19 (1.06 to 1.33), respectively) and rural areas (1.46 (1.26 to 1.68) and 1.48 (1.29 to 1.68), respectively). No association was observed for individuals living in large cities and the capital.

Conclusions

Travel distance above approximately 1 km was significantly associated withnoface-to-face GP consultation before an incident AMI among individuals living in small cities and rural areas. The structure of the healthcare system should consider the importance of geographical distance between citizens and the GP in remote areas.