bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of Iterative Network Uncertainty Quantification for Multicomponent System Qualification
Authors: Rojas Edward , Tencer John
Published: January 2022

In order to impact design decisions and realize the full promise of high-fidelity computational tools, simulation results must be integrated at the earliest stages in the design process. This is particularly challenging when dealing with uncertainty and optimizing for system-level performance metrics as full-system models (often notoriously expensive and time-consuming to develop) are generally required to propagate uncertainties to system-level quantities of interest. Methods for propagating parameter and boundary condition uncertainty in networks of interconnected components hold promise for enabling design under uncertainty in real-world applications. These methods preclude the need for time consuming mesh generation of full-system geometries when changes are made to components or subassemblies. Additionally, they explicitly tie full-system model predictions to component/subassembly validation data which is valuable for qualification. This is accomplished by taking advantage of the fact that many engineered systems are inherently modular, being comprised of a hierarchy of components and subassemblies which are individually modified or replaced to define new system designs. We leverage this hierarchical structure to enable rapid model development and the incorporation of uncertainty quantification and rigorous sensitivity analysis earlier in the design process.

The resulting formulation of the uncertainty propagation problem is iterative. We express the system model as a network of interconnected component models which exchange stochastic solution information at component boundaries. We utilize Jacobi iteration with Anderson acceleration to converge stochastic representations of system level quantities of interest through successive evaluations of component or subassembly forward problems. We publish our open-source tools for uncertainty propagation in networks remarking that these tools are extensible and can be used with any simulation tool (including arbitrary surrogate modeling tools) through the construction of a simple Python interface class. Additional interface classes for a variety of simulation tools are currently under active development.

The performance of the uncertainty quantification method is determined by the number of iterations needed to achieve a desired level of accuracy. Performance of these networks for simple canonical systems from both a heat transfer and solid mechanics perspective are investigated; the models are examined with thermal and mechanical Dirichlet and Neumann type boundary conditions separately imposed and the impact of varying governing equations and boundary condition type on the performance of the networks is analyzed. The form of the boundary conditions is observed to have a large impact on the convergence rate with Neumann-type boundary conditions corresponding to significant performance degradation compared to the Dirichlet boundary conditions. Nonmonotonicity is observed in the solution convergence in some cases.
Modelling Economic Life Cycle Investment in Natural Gas Pipelines and Power Plants Availability for a Nigerian National Gas Company
Authors: Abhulimen Kingsley E.
Published: January 2022

This paper presents an economic life cycle assessments based on the linear process model to justify investment opportunities in a National State Gas Pipelines and Power Plants Projects. The model predicts investments demand vectors of technology, human capital resource utilization, raw materials availability and environment impact categories. Thus the carbon foot print and acidification for each stage of the life cycle investment in the process design stages of economic capital resource decision matrix to the environment impact intervention matrix were simulated in a MATLAB and Excel spreadsheet environment. Therefore the economic capital utilization and environmental sustainability of the demands vectors of each stage were evaluated, categorized, ranked and correlated within targets retrospectively for investment in each stage of National Gas Company projects. The acidification (Nox, and Sox) pollution averaged 30.48ppm below the acceptable thresholds of 67.97ppm and the carbon foot prints were almost near negligible for all stages which signals an important landmark decision criteria for investments in the projects. The net impact value to shift in economic matrix demand vector sensitivity analysis using the statistical random simulations shows a correlation within 7% range deviation and the environmental impact categories were below the 25% threshold values.
Influence of Film Cooling Holes Partial Blockage on Cooling Effectiveness
Authors: Zhang Junhong , Dong Wenxin , Lin Jiewei , Dai Huwei , Wang Xibo
Published: January 2022

To study the effect of blockage on the film cooling performance, film cooling plate models with cylindrical hole, compound hole, and fan-shaped hole under the all-round blockage, leading-edge blockage, and trailing-edge blockage were established respectively. The anti-blockage performance of three kinds of the hole was compared. The result shows that the cooling performance of cylindrical holes is the worst due to the appearance of counter-rotating vortex pair (CRVP) under blockage. The cooling effectiveness decreases with the increase of the blockage ratio. With the re-attachment effect, the cooling effectiveness of downstream increases by 11% on the contrary. The cooling effectiveness of the compound hole decreases obviously with the all-round and trailing-edge blockages, meanwhile, the peak cooling effectiveness and the coolant coverage area decrease. However, the cooling effectiveness increases by 15% when the leading-edge is blocked. For fan-shaped hole, the change of velocity gradient affects the development of the anti-CRVP, which disappears under the all-round blockage and reduces the cooling effectiveness greatly. The change of cooling performance of leading-edge and trailing-edge is very slight no more than 5%. In conclusion, the fan-shaped hole shows the best anti-blockage capability under the trailing-edge blockage condition and the all-round blockage condition with a high blow ratio, while the compound hole performs better in other conditions.
Strain-Based Degradation Model With Application to Poly-L-Lactide Acid (PLLA) Artery Stent
Authors: Lin Shengmao , Dong Pengfei , Gu Linxia
Published: January 2022

The permanent implantation of stents with and without carrying drugs led to the unresolvable long-term complications such as restenosis and thrombosis. There are increasing interests in bioresorbable stents, which have the potential to resume the vessel tone and mitigate complications. The bioresorbable stent served as a temporary scaffold for an expected period of 6 to 12 months. The design of both polymeric material and stent structure is acknowledged to impact the mechanical integrity of bioresorbable stent. Poly-l-lactide (PLLA), a polymer-based material, is the most adopted bioresorbable stent materials due to its sufficient strength and degradation resistance. The mechanical performances of the PLLA stents need to be evaluated before it is considered to serve in the clinical application. Because of difficulty and time-consuming of physical tests, finite element method (FEM) has become an efficient way to solve the problem. However, the mechanical performances of PLLA stents during the degradation process could not be fully captured using the existing numerical models. A strain-based degradation numerical model with consideration of stent-artery interaction was proposed based on the previous published experimental data. In this model, the elongation fracture of the PLLA material was correlated to the degradation degree, a scalar factor controlled by the time and local strain. The degradation evolution process was then fully captured after the stent implantation using the derived material model. With continuously loss of mass in material, the degradation rates were not uniform in different locations along the stent structure. Severe degradation was observed at the higher strain regions of the stent, which locates at the outer surface of the stent, near the crowns of the ring stent strut. At first stage of degradation, the stent strut thinning was observed in the model which was also found in the previous experimental study. At second stage of degradation, the degradation happened at the connection region between the link strut and ring struts which resulted in the break of mechanical integrity. The diameter of the vessel has minor change during the first stage of the degradation process, while at the second stage, with the breakdown of the ring structure, the vessel recoiled to its original diameter in one month time. The two-staged degradation process showed a vision for the ideal stent design. The developed computational model provided more insights into the degradation process, which could complement the discrete experimental data for improving the design and clinical management of the bioresorbable vascular scaffold.
Optimization of Sustainable Machining of Ti6Al4V Alloy Using Genetic Algorithm for Minimized Carbon Emissions and Machining Costs, and Maximized Energy Efficiency and Human Health Benefits
Authors: Uysal Alper , Jawahir I. S.
Published: January 2022

Sustainable machining operations have in recent times become meaningful and viable options due to the need for significantly reducing the abundant and indiscriminate use of cutting fluids, especially petroleum-based. In this study, sustainable machining operations were performed on Ti6Al4V alloy under dry, minimum quantity lubrication (MQL), cryogenic (Liquid Nitrogen - LN2) machining and at two different hybrid cooling/lubricating conditions. In the orthogonal turning tests performed, three different cutting speeds and a constant undeformed chip thickness were used as cutting parameters. During orthogonal machining experiment, cutting force components were measured and used to calculate the consumed cutting power which was subsequently utilized to determine the carbon emissions, energy efficiency and machining costs. A multi-objective optimization algorithm was developed and used for sustainable machining of Ti6Al4V alloy to achieve minimized carbon emissions, improved energy efficiency and human health conditions, and reduced machining costs through Non-dominated Sorting Genetic Algorithm II (NSGA-II). Cutting parameters such as cutting speed, feed, depth of cut, and the cooling/lubricating methods which significantly affect the machining process were considered in the optimization of machining operations for maximizing the machining performance with minimized carbon emissions and machining costs, and maximized energy efficiency and human health benefits.
A Risk Assessment of Pathogen Transport During an Indoor Orchestra Performance
Authors: Joshi Vedant , Battaglia Francine
Published: January 2022

The COVID-19 pandemic has shown that airborne pathogens and viruses have a detrimental impact on the health and well-being of an individual in an indoor space. Respiratory particles are released as droplets of varying velocities and diameters, where smaller droplets (aerosols) linger in air for prolonged periods, increasing the infection risk of individuals in an enclosed space. The pandemic has raised concerns regarding the safety of musicians due to respiratory particles released through woodwind and brass instruments. A collaboration with the Buffalo Philharmonic Orchestra was pursued to assess the risk of infection and develop strategies to mitigate the spread of respiratory particles using computational fluid dynamics. A coupled Eulerian-Lagrangian modeling approach was employed to examine the airflow patterns and airborne particle pathogen transport induced by the musicians in the music hall. The investigation considered three brass instruments (trumpet, tuba, trombone), without and with a bell covering. It was observed that the dispersion of particles for each instrument depended on the bell design and orientation of the instrument. For example, the trumpet produced a higher concentration of respiratory particles compared to a tuba, which has its tubing wrapped. Additionally, the effect of using bell covers (cloth covering on the opening of the brass instruments) showed that the covers reduced the number of pathogens escaping the instruments by capturing large respiratory particles and reducing the escaping velocity of small particles. Reduced particle velocities at the instrument opening meant that the particles traveled shorter distances, which helped mitigate the spread of virus in the music hall. Moreover, the efficacy of using Plexiglas partitions on the sides and in front of the musicians limited the transmission of pathogens from one musician to another. Overall, the findings of this study helped strategize the location of musicians based on the type of instruments being played and the operating conditions in the music hall to decrease the airborne transmission of the novel Coronavirus.
Pinecone Harvesting Utilizing Combustion Engine Powered Tree Climbing Lift
Authors: Murphy Walker , Pate Keith , Heidarlou Mina Asghari , Breidi Farid
Published: January 2022

This work presents the design of a motorized tree climbing lift developed for pinecone farmers in Lebanon. The current process of harvesting pinecones in Lebanon consists of a two-person team; one person manually scales a sixty-foot-tall Pinus Pinea tree, using only a sling, to shear pinecones, while the other collects the fallen pinecones from the ground. While this technique is effective, the one-point contact between the sling and the tree can cause the user to slip on to the siliceous terrain, resulting in annual casualties. Furthermore, the sling is fixed to the tree by friction caused by the user’s weight, reducing mobility and reach. To provide a faster, safer, and more efficient method for harvesting pinecones, a motorized tree climbing lift was designed. The lift, with a mass of 55 kg, features a standing platform with safety rails for farmers to harness themselves to and provides a location to store harvested pinecones. The stand is fixed to a tree by three rollers: a drive roller and two guide rollers. The drive roller is directly connected to the front of the stand and is powered using a combustion engine, and the guide rollers are attached to the two retaining arms at the back side of the tree. A pneumatic actuator pushes the arms apart, pulling all three rollers and fixing the stand to the tree. The combustion engine drives a gearbox with a 15:1 gear ratio, allowing the stand to ascend and descend a 113 kg person at a maximum speed of 0.25 m/s. The retaining arms were modeled, out of Aluminum 6061-T4 Alloy, and analyzed in SolidWorks. The maximum Von Mises Stress in the arms occur where the pneumatic actuator anchors to the retaining arms and has a value of 4.214 × 107 N/m2. The yield strength of the selected aluminum alloy is 2.27 × 108 N/m2; therefore, the factor of safety is a value of 5.39. Additionally, an electrical equivalent circuit of the retaining arm is modeled in this work. This design allows the engineers to determine the maximum weight that the platform can hold and adjust the maximum speed accordingly. For a lighter person who stands on the platform, the simulation shows that the mechanical gear can be adjusted in a way that the maximum speed can be increased. This design promotes a safe alternative to the current methods of collecting pinecones in Lebanon and provides additional benefits of added storage while harvesting, reducing the need for having a two-person team.
Performance Analysis of the Direct Contact Membrane Distillation Using Sonication Effect
Authors: Ali Ussama , Sajjad Muhammad , Janajreh Isam
Published: January 2022

Direct contact membrane distillation (DCMD) for desalination often suffers from membrane fouling, scaling, low permeate water flux and pore wetting. This study focuses on the integration of sonication with DCMD to mitigate these problems by enhancing mass flux and reducing temperature polarization. A computational fluid dynamic model has been developed for the evaluation of temperature polarization through sonication enhanced DCMD. The computational domain consists of two channels, i.e., feed and permeate. It has a length of 20 mm, with a height of 1 mm for each channel, and a membrane thickness of 130 μm. Laminar flow at a low Reynolds number is considered (Re □ 10), with feed and permeate flowing in a counter-flow arrangement at the same inlet velocity but different temperatures. The employed numerical model is unsteady non-isothermal governed by Navier–Stokes equations which are conjugated thermally with the polymeric membrane. The model is subjected to different sonication frequencies and amplitudes. It employs dynamic mesh in conjunction with temporal sound application with a very small-time step to solve the governing equations associated with the sonication effect. A sensitivity study based on the effect of different parameters on the performance of the direct contact membrane distillation is conducted. The parameters studied include the effect of sonication wave (amplitude and frequency), feed flow rate and feed temperature on temperature polarization coefficient (TPC) and mass flux. Results show that sonication definitely can ameliorate the DCMD performance seen as a gain in both TPC and mass flux.
A Quantitative Approach to Assess the Likelihood of Supply Chain Shortages
Authors: Pandit Priyanka , Earthperson Arjun , Tezbasaran Alp , Diaconeasa Mihai A.
Published: January 2022

We define supply chains (SCs) as sequences of processes that link the demand and supply of goods or services within a network. SCs are prone to shortages in delivering their output goals due to several factors such as personnel undersupply, inefficient processes, policy failure, equipment malfunction, natural hazards, pandemic outbreaks, power outages, or economic crises. Recent notable supply-chain failures include the 2021 Texas power crisis, personal protection equipment shortages during the COVID-19 pandemic, and regional or global food chain shortages. The consequences of such shortages can range from negligible to devastating. The Texas power crisis resulted in the death of 70 people and left approximately 4.5 billion homes and businesses without power for multiple days.

In this paper, we presented a methodology to quantify the failure probability of the throughput of a supply chain. We divided the methodology into two major categories of steps. In the first step, we converted the given or assumed supply chain data into fault trees and quantify them. In the second step, we iterated the quantification of the fault tree to build a supply chain shortage risk profile. We introduced the notion of success criteria for the output from a facility, based on which we included or excluded the facility for quantification.

With the inclusion of relevant field data, we believe that our methodology can enable the stakeholders in the supply-chain decision-making process to detect vulnerable facilities and risk-inform prevention and mitigation actions. Applications for this methodology can include construction, inventory stocking, assessing manufacturing quantities, policy changes, personnel allocation, and financial investment for critical industries such as nuclear, pharmaceutical, aviation, etc.
Advances in Noninvasive Diagnosis Based on Body Sounds and Vibrations – A Review
Authors: Taebi Amirtahà , Khalili Fardin
Published: January 2022

This paper provides a brief overview of the advances in the area of early identification of different types of abnormalities and diseases, including respiratory illnesses and cardiovascular diseases, using noninvasive screening of biomedical acoustic signals. These signals include sounds and vibrations generated by different human body organs and systems that can be measured on the body surface using sensors such as stethoscopes and accelerometers. In this study, the measurement methods and signal processing algorithms for customized feature extraction and classification as well as clinical potentials, current limitations, and future directions are briefly reviewed and discussed.
High frequency viscoelasticity of soft particle glasses
Authors: Liu Tianfei , Khabaz Fardin , Cloitre Michel , Bonnecaze Roger T.
Published: January 2022

The storage and loss moduli for jammed soft particles are studied computationally for a variety of interparticle potentials and volume fractions. The qualitative behavior of the storage modulus is independent of the nature of the interparticle potential. The frequency dependence of the storage modulus computed in the simulations is described by a universal logistic formula exhibiting two plateaus at low and high frequencies. While the high-frequency modulus G∞ follows the prediction of the Zwanzig–Mountain expression, which depends on the pair distribution function and pairwise interparticle potential, no such formula exists for the low-frequency modulus G0. Here, we show that for jammed soft particles at a given volume fraction G0∼G∞/gmax, where gmax is the maximum in the pair distribution function. The qualitative nature of the loss modulus depends on the form of the near-field drag forces between the soft particles. At moderate to high frequency, the loss modulus increases with the frequency according to a power law whose exponent is related to the drag force expression between two sliding particles. Computational predictions of the storage and loss moduli match most experimental observations but some discrepancies are observed indicating behavior beyond pairwise particle interactions at high frequencies.
Hamsters Expressing Human Angiotensin-Converting Enzyme 2 Develop Severe Disease following Exposure to SARS-CoV-2
Authors: Golden Joseph W. , Li Rong , Cline Curtis R. , Zeng Xiankun , Mucker Eric M. , Fuentes-Lao Amadeo J. , Spik Kristin W. , Williams Janice A. , Twenhafel Nancy , Davis Neil , Moore Joshua L. , Stevens Stephen , Blue Eugene , Garrison Aura R. , Larson Deanna D. , Stewart Rebekah , Kunzler Madelyn , Liu Yanan , Wang Zhongde , Hooper Jay W.
Published: January 2022

The rapid emergence of SARS-CoV-2 has created a global health emergency. While most human SARS-CoV-2 disease is mild, some people develop severe, life-threatening disease.
Longitudinal Study after Sputnik V Vaccination Shows Durable SARS-CoV-2 Neutralizing Antibodies and Reduced Viral Variant Escape to Neutralization over Time
Authors: Gonzalez Lopez Ledesma María M. , Sanchez Lautaro , Ojeda Diego S. , Oviedo Rouco Santiago , Rossi Andrés H. , Varese Augusto , Mazzitelli Ignacio , Pascuale Carla A. , Miglietta Esteban A. , Rodríguez Pamela E. , Pallarés Horacio M. , Costa Navarro Guadalupe S. , Caramelo Julio J. , Rothlauf Paul W. , Liu Zhuoming , Bloyet Louis-Marie , Cornejo Pontelli Marjorie , Rasetto Natali B. , Wenker Shirley D. , Ramis Lila Y. , Bialer Magalí G. , de Leone María Jose , Hernando C. Esteban , Bianchimano Luciana , Ríos Antonella S. , Treffinger Cienfuegos María Soledad , Rodriguez García Diana R. , Longueira Yesica , Laufer Natalia , Alvarez Diego , Ceballos Ana , Ochoa Valeria , Monzani Cecilia , Turk Gariela , Salvatori Melina , Carradori Jorge , Prost Katherine , Rima Alejandra , Varela Claudia , Ercole Regina , Toro Rosana I. , Gutierrez Sebastian , Zubieta Martín , Acuña Dolores , Nabaes Jodar Mercedes S. , Torres Carolina , Mojsiejczuk Laura , Viegas Mariana , Velazquez Pilar , Testa Clarisa , Kreplak Nicolas , Yanovsky Marcelo , Whelan Sean , Geffner Jorge , Pifano Marina , Gamarnik Andrea V.
Published: January 2022

Vaccines have been produced in record time for SARS-CoV-2, offering the possibility of halting the global pandemic. However, inequalities in vaccine accessibility in different regions of the world create a need to increase international cooperation.
Candidalysins Are a New Family of Cytolytic Fungal Peptide Toxins
Authors: Richardson Jonathan P. , Brown Rhys , Kichik Nessim , Lee Sejeong , Priest Emily , Mogavero Selene , Maufrais Corinne , Wickramasinghe Don N. , Tsavou Antzela , Kotowicz Natalia K. , Hepworth Olivia W. , Gallego-Cortés Ana , Ponde Nicole O. , Ho Jemima , Moyes David L. , Wilson Duncan , D’Enfert Christophe , Hube Bernhard , Naglik Julian R.
Published: January 2022

Pathogenic fungi kill an estimated 1.5 million people every year. Recently, we discovered that the fungal pathogen
Candida albicans
secretes a peptide toxin called candidalysin during mucosal infection.
BrnQ-Type Branched-Chain Amino Acid Transporters Influence Bacillus anthracis Growth and Virulence
Authors: Dutta Soumita , Corsi Ileana D. , Bier Naomi , Koehler Theresa M.
Published: January 2022

Infection with
B. anthracis
can result in systemic disease with large numbers of the bacterium in multiple tissues. We found that branched-chain amino acid (BCAA) synthesis is insufficient for the robust growth of
B. anthracis
; access to BCAAs is necessary for the proliferation of the pathogen during culture and during infection in a murine model for anthrax.
B. anthracis
produces an unusually large repertoire of BCAA-related transporters.
Role of Earth-Moon rotational dynamics in the shaping of the surface of our planet
Authors: Borom* Marcus P.
Published: January 2022

The age of the Moon (1.55–1.78 b.y. old) as calculated from its regression as a function of geological time is much younger than the currently accepted age (ca. 4.52 Ga) determined by radiometric dating of lunar samples collected by Apollo astronauts. This discrepancy has posed a serious challenge for planetary scientists to account satisfactorily for the formation and subsequent breakup of Pangea. Conventional orbital models of the Earth-Moon system cannot explain why Pangea formed on only one hemisphere of Earth, whereas this study’s proposed two-stage rotation model can provide a plausible explanation. Calculations and a plot of the Earth-Moon separation distance against geologic age suggest that, during their first ~3.0 b.y., Earth and the Moon were mutually tidally locked, rotating as an integrated unit about a barycenter (designated as stage I rotation). Beginning 1.55 Ga, however, Earth disengaged from its tidal lock with the Moon and entered its current orbital mode (designated as stage II rotation). The dynamics associated with the two rotational modes of the Earth-Moon system throughout Earth’s history are hypothesized to constitute the driving forces for the migration and coalescence of landmasses during stage I rotation to create Pangea, and its ultimate breakup and drifting during stage II rotation.
Improving the experience of obtaining repeat complex paediatric prescriptions in the UK
Authors: Tse Yincent , Trivedi Ashifa , Mee Abigail , Santosh Paramala , Moss James , Batra Dushyant , Hawcutt Daniel B , Tomlin Stephen
Published: January 2022

In the UK, medicines for chronic conditions in children and young people (CYP) are typically initiated within secondary or tertiary care, with responsibility for ongoing supply often then passed to the child’s general practitioner (GP) and community pharmacist. The patient should then be reviewed in regular specialist clinics, with two-way communication for any changes in medications or clinical status undertaken between primary and secondary/tertiary care. This arrangement allows long-term medications to be obtained close to home.

Although this is what parents expect, the reality is often messy, with families regularly needing to source some medicines from the GPs and others via hospitals or homecare services. In addition, these arrangements are not uniform, they vary across different areas of the UK and depend on individual GP or hospital prescriber acceptance. When neither primary, secondary or tertiary care accepts it is their responsibility to prescribe, or patients are under multiple specialists, families often feel left to navigate this complex and variable supply system themselves. Obtaining a prescription is only the start of the process for families as dispensing from a community pharmacy can also be challenging.

In this article, we set out the barriers and potential solutions to this complex issue. We use the term specialist prescribers to include not only paediatricians but all other specialists looking after CYP including child and adolescent psychiatrists, ophthalmologists, dermatologists, surgeons, etc, as well as non-medical prescribers.
MRI-based brain volumes of preterm infants at term: a systematic review and meta-analysis
Authors: Romberg Julia , Wilke Marko , Allgaier Christoph , Nägele Thomas , Engel Corinna , Poets Christian F , Franz Axel
Published: January 2022

Background

MRI allows a detailed assessment of brain structures in preterm infants, outperforming cranial ultrasound. Neonatal MR-based brain volumes of preterm infants could serve as objective, quantitative and reproducible surrogate parameters of early brain development. To date, there are no reference values for preterm infants’ brain volumes at term-equivalent age.

Objective

Systematic review of the literature to determine reference ranges for MRI-based brain volumes of very preterm infants at term-equivalent age.

Methods

PubMed Database was searched on 6 April 2020 for studies reporting MR-based brain volumes on representative unselected populations of very preterm and/or very low birthweight infants examined at term equivalent age (defined as 37–42 weeks mean postmenstrual age at MRI). Analyses were limited to volumetric parameters reported in >3 studies. Weighted mean volumes and SD were both calculated and simulated for each parameter.

Results

An initial 367 publications were identified. Following application of exclusion criteria, 13 studies from eight countries were included for analysis, yielding four parameters. Weighted mean total brain volume was 379 mL (SD 72 mL; based on n=756). Cerebellar volume was 21 mL (6 mL; n=791), cortical grey matter volume 140 mL (47 mL; n=572) and weighted mean volume of unmyelinated white matter was 195 mL (38 mL; n=499).

Conclusion

This meta-analysis reports pooled data on several brain and cerebellar volumes which can serve as reference for future studies assessing MR-based volumetric parameters as a surrogate outcome for neurodevelopment and for the interpretation of individual or cohort MRI-based volumetric findings.
Impact of conditional and unconditional cash transfers on health outcomes and use of health services in humanitarian settings: a mixed-methods systematic review
Authors: van Daalen Kim Robin , Dada Sara , James Rosemary , Ashworth Henry Charles , Khorsand Parnian , Lim Jiewon , Mooney Ciaran , Khankan Yasmeen , Essar Mohammad Yasir , Kuhn Isla , Juillard Helene , Blanchet Karl
Published: January 2022

Background

Cash transfers, payments provided by formal or informal institutions to recipients, are increasingly used in emergencies. While increasing autonomy and being supportive of local economies, cash transfers are a cost-effective method in some settings to cover basic needs and extend benefits of limited humanitarian aid budgets. Yet, the extent to which cash transfers impact health in humanitarian settings remains largely unexplored. This systematic review evaluates the evidence on the effect of cash transfers on health outcomes and health service utilisation in humanitarian contexts.

Methods

Studies eligible for inclusion were peer reviewed (quantitative,qualitative and mixed-methods). Nine databases (PubMed, EMBAS, Medline, CINAHL, Global Health, Scopus, Web of Science Core Collection, SciELO and LiLACS) were searched without language and without a lower bound time restriction through 24 February 2021. The search was updated to include articles published through 8 December 2021. Data were extracted using a piloted extraction tool and quality was assessed using The Joanna Briggs Critical Appraisal Tool. Due to heterogeneity in study designs and outcomes, results were synthesised narratively and no meta-analysis was performed.

Results

30 673 records were identified. After removing duplicates, 17 715 were double screened by abstract and title, and 201 in full text. Twenty-three articles from 16 countries were included reporting on nutrition outcomes, psychosocial and mental health, general/subjective health and well-being, acute illness (eg, diarrhoea, respiratory infection), diabetes control (eg, blood glucose self-monitoring, haemoglobin A1C levels) and gender-based violence. Nineteen studies reported some positive impacts on various health outcomes and use of health services, 11 reported no statistically significant impact on outcomes assessed and 4 reported potential negative impacts on health outcomes.

Discussion

Although there is evidence to suggest a positive relationship between cash transfers and health outcomes in humanitarian settings, high-quality empirical evidence, that is methodologically robust, investigates a range of humanitarian settings and is conducted over longer time periods is needed. This should consider factors influencing programme implementation and the differential impact of cash transfers designed to improve health versus multipurpose cash transfers.

PROSPERO registration number

CRD42021237275.
Impact of the COVID-19 pandemic on children and adolescents with autism spectrum disorder and their families: a mixed-methods study protocol
Authors: Dekker Linda , Hooijman Linde , Louwerse Anneke , Visser Kirsten , Bastiaansen Dennis , Ten Hoopen Leontine , De Nijs Pieter , Dieleman Gwen , Ester Wietske , Van Rijen Susan , Truijens Femke , Van der Hallen Ruth
Published: January 2022

Background

The COVID-19 pandemic is a challenge for everyone, particularly for children and adolescents with autism spectrum disorder (ASD). ASD is a developmental disorder characterised by limitations in social communication, repetitive behavioural patterns, and limited interests, and activities. It is expected that many families with children with ASD will experience more problems due to the COVID-19 pandemic and the related public health restrictions. At the same time, some may experience improved functioning, due to fewer expectations and social demands.

Methods/design

In a mixed-method study to identify the impact of the COVID-19 pandemic, parents of children with ASD (ages 4–21) who were in care pre-COVID-19 at one of three large mental healthcare institutions in the region of Rotterdam participated (68 for T0, 57 for T1). The aims are (1) to investigate the impact of the COVID-19 pandemic on overall functioning and autistic symptoms of the child/adolescent with ASD, as well as parental and family functioning (QUANT-QUAL), in both the short term and longer term, and (2) to investigate risk and protective factors (in light of resilience) (QUANT-qual) and (3) to investigate care and informational needs (QUAL-quant). Pre-COVID-19 baseline data will be retrieved from clinical records. Participants will fill out two surveys (one during a COVID-19 peak—January–May 2021—and one thereafter). Survey participants were invited to participate in interviews (n=27). Surveys include measures thar were included pre-COVID-19 (ie, overall functioning and autism symptoms) as well as specific measures to identify family functioning and COVID-19 impact. The semistructured interviews focus on child, parent and family functioning and care—and informational needs.

Ethics and dissemination

The Medical Ethics Committee of the Erasmus MC has approved the study. Findings will be available to families of children with ASD, their care providers, the funders, autism societies, the government and other researchers.
Effectiveness of smart living environments to support older adults to age in place in their community: an umbrella review protocol
Authors: Tannou Thomas , Lihoreau Thomas , Gagnon-Roy Mireille , Grondin Myrian , Bier Nathalie
Published: January 2022

Introduction

Frailty is a vulnerable condition exposing older adults to incidental adverse health events that negatively impact their quality of life and increase health and social costs. Digital solutions may play a key role in addressing this global problem and in particular, smart living environments. Smart living environments involve a notion of measurement or collection of data via several sensors, capturing the person’s behaviours in the home or the person’s health status over a long period of time. It thus has great potential for home support for older adults. The objective of this umbrella review will be: (1) to document the effectiveness of smart living environments to support ageing in place for frail older adults and (2) among the reviews assessing the effectiveness of smart living environment, to gather evidence on what factors and strategies were identified as influencing the implementation process.

Methods and analysis

We will include systematic and scoping reviews of both quantitative and qualitative primary studies with or without meta-analysis focusing on assessing the effectiveness of interventions through smart living environments to support older adults in the community to age in place. The literature search will be done through the following biomedical, technological and sociological citation databases: MEDLINE, Embase, CINAHL, Web of Science and PsycINFO, and quality assessment of the reviews will be done thought AMSTAR2 checklist. The analysis of the results will be presented in narrative form.

Ethics and dissemination

Our review will rely exclusively on published data from secondary sources and will thus not involve any interactions with human subjects. The results will be presented at international conferences and publications.

PROSPERO registration number

CRD42021249849.
Cohort profile: Alliance for Quality Assessment in Healthcare-Dialysis (AQuAH-D) prospective cohort study of patients on haemodialysis in Japan
Authors: Shimizu Sayaka , Onishi Yoshihiro , Kabaya Koji , Wang Jui , Fukuma Shingo , Morinaga Jun , Hatakeyama Shingo , Kobayashi Shinya , Maeno Kazuyuki , Yamazaki Hajime , Fukuhara Shunichi
Published: January 2022

Purpose

The global burden of kidney failure is increasing, but the treatment of kidney failure varies widely between patients, between dialysis facilities and over time. The Alliance for Quality Assessment in Healthcare-Dialysis (AQuAH-D) aims to conduct efficient and timely cohort studies on associations between those variations and clinical and patient-reported outcomes.

Participants

Included are outpatients aged 20 years old or older who are undergoing haemodialysis and have consented to participate. A total of 2895 patients were enrolled from 25 facilities in Japan between August 2018 and July 2020 and are to be followed until 31 December 2026. Chart review and annual questionnaires are used to collect data on patient characteristics and on outcomes including quality of life. Data on medications, haemodialysis prescriptions and blood tests are obtained from existing electronic records. Data are collected retrospectively from 1 January 2017 to patient enrolment, and prospectively from patient enrolment until the end of December 2026.

Findings to date

To date, the mean age is 68.3 (SD 12.2) years and 35.2% are female. The most common cause of kidney failure is diabetic nephropathy (37.4%). In January 2020, the facilities’ median weekly doses of erythropoietin stimulating agent (ESA) and of intravenous vitamin D ranged from 1846 to 9692 IU (epoetin alfa equivalent) and 0.78 to 2.25 µg (calcitriol equivalent), respectively. The facilities’ percentages of patients to whom calcimimetics are prescribed varied from 19% to 79%. During the retrospective period (averaging 1.85 years per participant), the incidence rates of any hospitalisation and of hospitalisation due to cardiovascular disease were 67.2 and 12.0 per 100 person-years, respectively.

Future plans

AQuAH-D data will be updated every 6 months and will be available for studies addressing a wide range of research questions, using the advantages of granular data and quality-of-life measurement of ageing patients on haemodialysis.
Metaphors that shape parents’ perceptions of effective communication with healthcare practitioners following child death: a qualitative UK study
Authors: Turner Sarah , Littlemore Jeannette , Taylor Julie , Parr Eloise , Topping A E
Published: January 2022

Objectives

To offer an interpretation of bereaved parents’ evaluations of communication with healthcare practitioners (HCPs) surrounding the death of a child.

Design

Interpretative qualitative study employing thematic and linguistic analyses of metaphor embedded in interview data.

Setting

England and Scotland.

Participants

24 bereaved parents (21 women, 3 men).

Methods

Participants were recruited through the True Colours Trust website and mailing list, similar UK charities and word of mouth. Following interviews in person or via video-conferencing platforms (Skype/Zoom), transcripts first underwent thematic and subsequently linguistic analyses supported by NVivo. A focused analysis of metaphors used by the parents was undertaken to allow in-depth interpretation of how they conceptualised their experiences.

Results

The findings illuminate the ways parents experienced communication with HCPs surrounding the death of a child. Key findings from this study suggest that good communication with HCPs following the death of a child should acknowledge parental identity (and that of their child as an individual) and offer opportunities for them to enact this; taking account their emotional and physical experiences; and accommodate their altered experiences of time.

Conclusions

This study suggests that HCPs when communicating with bereaved parents need to recognise, and seek to comprehend, the ways in which the loss impacts on an individual’s identity as a parent, the ‘physical’ nature of the emotions that can be unleashed and the ways in which the death of a child can alter their metaphorical conceptions of time.
Hospital utilisation in home palliative care: caregiver health, preparedness and burden associations
Authors: Nguyen Huong Q , Haupt Eric C , Duan Lewei , Hou Anthony C , Wang Susan E , Mariano Jeffrey D , Lee Jung-Ah , McMullen Carmit
Published: January 2022

Background

Prior studies show that family caregiver factors influence patient outcomes. The purpose of this analysis was to determine the association between family caregiver self-rated health, perception of preparedness and burden at the time of patient admission to home palliative care (HomePal) with downstream patient hospital utilisation and time to hospice enrolment and death.

Methods

Data for this cohort study (n=441) were drawn from a trial testing two models of HomePal. Caregiver self-rated health, preparedness (Preparedness for Caregiving Scale, CPS) and burden (Zarit-12) were measured at admission to HomePal. Caregivers were categorised as having good/very good/excellent or fair/poor health, scoring above or below the CPS median score (23), or having no/mild (0–10), moderate (11-20) or high (>20) burden. Proportional hazard competing risk models assessed the association between caregiver factors with hospital utilisation (emergency department visits, observation and inpatient stays).

Results

Patients whose caregivers reported poor health and low preparedness received more visits by home health aides and social workers, respectively (both, p<0.05). Adjusted models showed that worse caregiver health (HR: 0.69 (95% CI 0.52 to 0.92), p=0.01), low preparedness (HR: 0.73 (95% CI 0.57 to 0.94), p=0.01) and high burden (HR: 0.77 (95% CI 0.56 to 1.06), p=0.10) were associated with lower risk for hospital utilisation. There were no significant associations between caregiver factors with time to patient enrolment in hospice or death in adjusted models (both, p>0.05).

Conclusion

Prospective studies are needed to understand how greater in-home supports for family caregivers with poor health could help achieve quality palliative care that aligns with families’ priorities.

Trial registration number

NCT03694431; ClinicalTrials.gov.
‘That is a Ministry of Health thing’: Article 5.3 implementation in Uganda and the challenge of whole-of-government accountability
Authors: Male Denis , Ralston Rob , Nyamurungi Kellen , Collin Jeff
Published: January 2022

Introduction

While Uganda has made legislative progress towards implementing Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC), ongoing challenges in minimising tobacco industry interference have not been adequately explored. This analysis focuses on understanding difficulties in managing industry engagement across government ministries and in developing effective whole-of-government accountability for tobacco control.

Methods

Interviews with Uganda government officials within the health sector and beyond, including in Ministries of Trade, Agriculture and Revenue.

Results

The findings indicate substantial variations in awareness of Article 5.3, its norm and practices across government sectors. The data suggest ambiguity and uncertainty about accountability for Article 5.3 implementation, with policy makers in departments beyond health often uncertain about obligations under the FCTC. Second, we highlight how responsibility for Article 5.3 implementation and the obligations incurred are widely seen as restricted to the Ministry of Health. Third, competing mandates and perceived difficulties in reconciling health goals with economic growth are shown to impact on accountability for tobacco control. Yet, importantly, the data also demonstrate enthusiasm in some unexpected parts of government for actively engaging with Article 5.3 and for promoting greater intersectoral coordination.

Conclusion

This paper demonstrates the intrinsic challenges of developing whole-of-government approaches, highlighting considerable uncertainty and ambiguity among decision makers in Uganda about tobacco control governance. The analysis points to the potential for Uganda’s national coordinating mechanism to help reconcile competing expectations and demonstrate the importance of Article 5.3 beyond health actors.
Institutional tensions, corporate social responsibility and district-level governance of tobacco industry interference: analysing challenges in local implementation of Article 5.3 measures in Karnataka, India
Authors: Kumar Praveen , Barry Rachel Ann , Kulkarni Muralidhar M , Kamath Veena Ganesh , Ralston Rob , Collin Jeff
Published: January 2022

Introduction

Accelerating progress on tobacco control will require Article 5.3 of the WHO Framework Convention on Tobacco Control to be systematically integrated into policies and practices of sectors beyond health at diverse government levels. However, no study has explored implementation challenges of Article 5.3 within multilevel systems such as India, where political decisions on tobacco control occur at diverse government levels, which may constrain action at local level.

Methods

Based on 33 semi-structured interviews with diverse government and civil society stakeholders across four districts in Karnataka, India (Mysore, Mangalore, Bengaluru (rural) and Udupi), this study examines challenges to implement Article 5.3 arising from competing agendas and policies of different actors at multiple levels.

Results

Our analysis reveals generally low levels of awareness of Article 5.3 and its guideline recommendations, even among those directly involved in tobacco control at district level. Efforts to implement Article 5.3 were also challenged by competing views on the appropriate terms of engagement with industry actors. Scope to reconcile tensions across competing health, agriculture and commercial agendas was further constrained by the policies and practices of the national Tobacco Board, thereby undermining local implementation of Article 5.3. The most challenging aspect of Article 5.3 implementation was the difficulties in restricting engagement by government officials and departments with tobacco industry corporate social responsibility initiatives given national requirements for such activities among major corporations.

Conclusions

Promoting effective implementation of Article 5.3 in Karnataka will require policymakers to work across policy silos and reconcile tensions across India’s national health and economic priorities.