bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Temperature Distribution on Radial Growth of Compressor Disks
Authors: Luberti Dario , Tang Hui , Scobie James A. , Pountney Oliver J. , Owen J. Michael , Lock Gary D.
Published: March 2020

For the next generation of aero-engines, manufacturers are planning to increase the overall compressor pressure ratio from the existing values around 50:1 to values of 70:1. The requirement to control the tight clearances between the blade tips and the casing overall engine-operating conditions is a challenge for the engine designer attempting to minimize tip-clearances losses. Accurate prediction of the tip clearance requires an accurate prediction of the radial growth of the compressor rotor, which depends on the temperature distribution of the disk. The flow in the rotating cavities between adjacent disks is buoyancy-driven, which creates a conjugate heat transfer problem: the disk temperature depends on the radial distribution of the Nusselt number, which in turn depends on the radial distribution of disk temperature. This paper focuses on calculating the radial growth of a simplified compressor disk in isolation from the other components. Calculations were performed using steady one-dimensional (1D) theoretical and two-dimensional numerical computations (2D finite element analysis (FEA)) for overall pressure ratios (OPRs) of 50:1, 60:1, and 70:1. At each pressure ratio, calculations were conducted for five different temperature distributions; the distribution based on an experimentally validated buoyancy model was used as the datum case, and the results from this were compared with those from linear, quadratic, cubic, and quartic power laws. The results show that the assumed distribution of disk temperature has a significant effect on the calculated disk growth, whereas the pressure ratio has only a relatively small effect. Good agreement between the growth calculated by the 1D theoretical model and the FEA suggests that the 1D model should be useful for design purposes. Although the results were obtained for steady-state conditions, a method is outlined for calculating the growth under transient conditions.
Atomic layer deposition of high-quality Pt thin film as an alternative interconnect replacing Cu
Authors: Han Seung-Min , Nandi Dip K. , Joo Yong-Hwan , Shigetomi Toshiyuki , Suzuki Kazuharu , Nabeya Shunichi , Harada Ryosuke , Kim Soo-Hyun
Published: March 2020

High-quality Pt thin films are prepared by atomic layer deposition (ALD) using metal-organic precursors dimethyl-(N,N-dimethyl-3-butene-1-amine-N) platinum (C8H19NPt) and with diluted molecular oxygen (O2) as a reactant. The films are grown at a relatively low temperature of 225 °C on a thermally grown SiO2 substrate, and the process shows all the necessary qualities of an ideal ALD such as self-limiting growth characteristics and a well-defined ALD temperature window between 200 and 250 °C. Noticeably, the current ALD-Pt process shows a very high growth per cycle of 0.167 nm without an incubation period at 225 °C, and perfect conformality is obtained at a dual trench structure (top and bottom width: 40 and 15 nm) with an aspect ratio of around 6.3. The resistivity of the ALD-Pt film at ∼39 nm in thickness deposited at 225 °C is almost the same (∼10.8 μΩ cm) as its bulk resistivity (10.6 μΩ cm), and it is as low as ∼12 μΩ cm at 25 nm in thickness. Comprehensive analyses using x-ray photoelectron spectroscopy, x-ray diffractometry, transmission electron microscopy (TEM), and x-ray reflectance indicate that the extremely low resistivity of ALD-Pt is due to the formation of highly pure and polycrystalline films with high density (∼21.04 g/cm3) and large grain size (∼48 nm for 25 nm thick film). For comparison, ALD-Ru is deposited at the same equipment and deposition temperature, 225 °C, using (ethylbenzene)(1,3-butadiene)Ru(0) (C12H16Ru) and diluted O2 as the reactant. The higher resistivity of ∼20 μΩ cm at a similar thickness (∼23.5 nm) with ALD-Pt is obtained, which is much higher than its bulk value (7.6 μΩ cm). TEM analysis suggests that the formation of relatively smaller-sized grains of ALD-Ru is the main reason for it.
Fluid Mechanics Education Using Japanese Anime: Examples from “Castle in the Sky” by Hayao Miyazaki
Authors: Ryu Sangjin , Zhang Haipeng , Peteranetz Markeya , Daher Tareq
Published: March 2020

Current K-12 and undergraduate students have grown up with constant exposure to visual popular culture (e.g., movies, TV programs, graphic novels, etc.). Because youth find pop culture references in the classroom to be engaging, many science and engineering instructors have shown that examples found in visual pop culture can be used to teach science and engineering concepts. One recent study on the efficacy of using pop culture for instruction found that high school students learning from graphic-novel style comics acquired deeper understanding of complex subject matter and reported higher engagement with the instructional materials as compared to students learning from traditional text materials. Furthermore, the increased engagement with the instructional comics was even greater for students who were less likely to self-identify as a “science person.”
A Hair-Raising Demonstration
Authors: Greenslade Thomas B.
Published: March 2020

This note is about 1000 words in length. We have been taught that this much information is contained in a single picture. But, Fig. 1 is so rich that four separate ideas can be obtained from it! The figure appears in The Boy’s Playbook of Science by John Henry Pepper. Pepper tells us that this shows an “assistant standing on the insulating stool and touching the disk of the electroscope while being struck with a dry handkerchief.”
Incorporating the Stern-Gerlach delayed-choice quantum eraser into the undergraduate quantum mechanics curriculum
Authors: Courtney William F. , Vieira Lucas B. , Julienne Paul S. , Freericks James K.
Published: March 2020

As “Stern-Gerlach first” becomes increasingly popular in the undergraduate quantum mechanics curriculum, we show how one can extend the treatment found in conventional textbooks to cover some exciting new quantum phenomena. Namely, we illustrate how one can describe a delayed choice variant of the quantum eraser which is realized within the Stern-Gerlach framework. Covering this material allows the instructor to reinforce notions of changes in basis functions, quantum superpositions, quantum measurements, and the complementarity principle as expressed in whether we know “which-way” information or not. It also allows the instructor to dispel common misconceptions of when a measurement occurs and when a system is in a superposition of states.
Angular momentum in the fractional quantum Hall effect
Authors: van Enk S. J.
Published: March 2020

Suppose a classical electron is confined to move in the xy plane under the influence of a constant magnetic field in the positive z direction. It then traverses a circular orbit with a fixed positive angular momentum Lz with respect to the center of its orbit. It is an underappreciated fact that the quantum wave functions of electrons in the ground state (the so-called lowest Landau level) have an azimuthal dependence ∝ exp (−imϕ) with m≥0, seemingly in contradiction with the classical electron having positive angular momentum. We show here that the gauge-independent meaning of that quantum number m is not angular momentum, but that it quantizes the distance of the center of the electron's orbit from the origin, and that the physical angular momentum of the electron is positive and independent of m in the lowest Landau levels. We note that some textbooks and some of the original literature on the fractional quantum Hall effect do find wave functions that have the seemingly correct azimuthal form ∝ exp (+imϕ) but only on account of changing a sign (e.g., by confusing different conventions) somewhere on the way to that result.
Stirling engine operating at low temperature difference
Authors: Romanelli Alejandro
Published: March 2020

This paper develops the dynamics and thermodynamics of Stirling engines that run with temperature differences below 100 °C. The working gas pressure is analytically expressed using an alternative thermodynamic cycle. The shaft dynamics is studied using its rotational equation of motion. It is found that the initial volumes of the cold and hot working gas play a non-negligible role in the functioning of the engine.
Inversion of head waves in ocean acoustic ambient noise
Authors: Li Jie , Gerstoft Peter , Siderius Martin , Fan Jun
Published: March 2020

The virtual head wave is produced through cross-correlation processing of signals containing the real, acoustic head wave. The virtual head wave has the same phase speed as the head wave, but the travel time is offset, thus the term virtual. The virtual head wave, like the real head wave, propagates in a direction corresponding to the seabed critical angle. The virtual head wave travel time varies with array depth and water column depth. However, in a refracting environment, the travel time is also dependent on the depth-dependent sound speed profile. Previously, the virtual head wave was shown as observable from measurements of ocean ambient noise, and the arrival angle was used to estimate the seabed sound speed. By also using the virtual head wave travel times, it is possible to invert for array depth and water column depth. The previous analysis was limited to the assumption of a Pekeris waveguide, which is a special case of the more realistic refracting waveguide. In this paper, the virtual head wave and the inversion method are considered in environments having refracting sound speeds. The theoretical framework and the inversion method are presented along with illustrative simulations and application to the Boundary'03 data.
Unrest imperils India's census
Authors: Chandrashekhar Vaishnavi
Published: March 2020

Opposition to citizenship policies could lead to undercount.
Technology Feature | Democratizing cryo-EM: Broadening access to an expanding field
Authors: Tachibana Chris
Published: March 2020

Cryo-electron microscopy (cryo-EM) yields atomic-level structures of megacomplexes and tiny compounds. How can your lab get access to this versatile method?
Response to Comment on “Amphibian fungal panzootic causes catastrophic and ongoing loss of biodiversity”
Authors: Scheele Ben C. , Pasmans Frank , Skerratt Lee F. , Berger Lee , Martel An , Beukema Wouter , Acevedo Aldemar A. , Burrowes Patricia A. , Carvalho Tamilie , Catenazzi Alessandro , De la Riva Ignacio , Fisher Matthew C. , Flechas Sandra V. , Foster Claire N. , Frías-Álvarez Patricia , Garner Trenton W. J. , Gratwicke Brian , Guayasamin Juan M. , Hirschfeld Mareike , Kolby Jonathan E. , Kosch Tiffany A. , La Marca Enrique , Lindenmayer David B. , Lips Karen R. , Longo Ana V. , Maneyro Raúl , McDonald Cait A. , Mendelson Joseph , Palacios-Rodriguez Pablo , Parra-Olea Gabriela , Richards-Zawacki Corinne L. , Rödel Mark-Oliver , Rovito Sean M. , Soto-Azat Claudio , Toledo Luís Felipe , Voyles Jamie , Weldon Ché , Whitfield Steven M. , Wilkinson Mark , Zamudio Kelly R. , Canessa Stefano
Published: March 2020

Lambert
et al
. question our retrospective and holistic epidemiological assessment of the role of chytridiomycosis in amphibian declines. Their alternative assessment is narrow and provides an incomplete evaluation of evidence. Adopting this approach limits understanding of infectious disease impacts and hampers conservation efforts. We reaffirm that our study provides unambiguous evidence that chytridiomycosis has affected at least 501 amphibian species.
Latitudinal effect of vegetation on erosion rates identified along western South America
Authors: Starke J. , Ehlers T. A. , Schaller M.
Published: March 2020

Erosion-vegetation interactions

The impact of vegetation on erosion rates is hard to gauge. Although vegetation can hold soils in place mechanically, root systems can also loosen soils or even help to fracture rock. These processes can increase erosion, especially because areas of heavy vegetation tend to be in areas with high precipitation rates. Starke
et al.
tackled this issue using a large set of observations that span 3500 km of the Andes mountain range. They found a complex set of interactions where increasing vegetation decreases erosion in more arid regions but can accelerate erosion in vegetation dense regions.

Science
, this issue p.
1358
Structural basis of G
s
and G
i
recognition by the human glucagon receptor
Authors: Qiao Anna , Han Shuo , Li Xinmei , Li Zhixin , Zhao Peishen , Dai Antao , Chang Rulve , Tai Linhua , Tan Qiuxiang , Chu Xiaojing , Ma Limin , Thorsen Thor Seneca , Reedtz-Runge Steffen , Yang Dehua , Wang Ming-Wei , Sexton Patrick M. , Wootten Denise , Sun Fei , Zhao Qiang , Wu Beili
Published: March 2020

Choosing a partner that fits

G protein–coupled receptors (GPCRs) are responsible for transducing diverse signals from outside to inside cells. This process requires specificity both in ligand binding to GPCRs and in coupling between GPCRs and their intracellular partners, G proteins. Qiao
et al.
determined the structure of the human glucagon receptor (GCGR), a type B GPCR, bound to glucagon and one of two heterotrimeric G proteins, G
s
or G
i1
. GCGR signals mainly through G
s
, and the structures provide a basis for this specificity. Conformational changes in GCGR, relative to the inactive state, create a binding cavity for the G proteins. The pocket is opened sufficiently to accommodate a bulky binding motif in G
s
. G
i1
can still bind but the pocket does not close around it, so there is a smaller interaction interface.

Science
, this issue p.
1346
Neuron-targeted electrical modulation
Authors: Otto Kevin J. , Schmidt Christine E.
Published: March 2020

Engineering neurons to make conductive polymers enables cell type–specific behaviors
Better late than never
Authors: Thorp H. Holden
Published: March 2020

Among the questions that have come up quite often during my first few months as Editor-in-Chief of Science are those that concern the Retrospectives that we publish on prominent scientists who have passed away. Does a Retrospective serve as a tribute? Do we run Retrospectives on individuals who made important contributions to science but had other well-known personal drawbacks? Why can't we feature more diverse members of the scientific community in Retrospectives? These have been passionate inquiries that made me wonder about whether we should just stop publishing these pieces to avoid any strife.
The Als3 Cell Wall Adhesin Plays a Critical Role in Human Serum Amyloid A1-Induced Cell Death and Aggregation in Candida albicans
Authors: Gong Jiao , Bing Jian , Guan Guobo , Nobile Clarissa J. , Huang Guanghua
Published: March 2020

Antimicrobial peptides and proteins play critical roles in the host defense against invading pathogens. We recently discovered that recombinantly expressed human and mouse serum amyloid A1 (rhSAA1 and rmSAA1, respectively) proteins have potent antifungal activities against the major human fungal pathogen
Candida albicans
. At high concentrations, rhSAA1 disrupts
C. albicans
membrane integrity and induces rapid fungal cell death. In the present study, we find that rhSAA1 promotes cell aggregation and targets the
C. albicans
cell wall adhesin Als3.
Double hit: Evans syndrome after malignant thymoma treatment and parvovirus B19 infection
Authors: Xie John , Chaaya Gerard , Jetly-Shridhar Rachna , Atkinson Thomas Stewart
Published: March 2020

Malignancies are often associated with autoimmune diseases, which are addressed by treating the underlying cancer. However, there are rare malignancies that can cause autoimmune diseases even after appropriate treatment. Our patient is a 39-year-old Hispanic man with a malignant thymoma recently treated with chemotherapy and radiation who presented with syncope and dyspnoea. He was found to be both anaemic and thrombocytopenic. His labs were consistent with autoimmune haemolytic anaemia (AIHA), except his reticulocyte count was unexpectedly low. Bone marrow biopsy supported a diagnosis of Evans syndrome, a rare autoimmune condition characterised by (AIHA) combined with immune thrombocytopenia. He was also found to have an acute parvovirus B19 infection. He was treated with steroids and RBC transfusion. His blood counts gradually returned to baseline, with improvement in symptoms. This patient’s thymoma treatment and active parvovirus B19 infection likely both played a role in the development of Evans syndrome.
Air pollution and gestational diabetes mellitus: evidence from cohort studies
Authors: Tang Xingyao , Zhou Jian-Bo , Luo Fuqiang , Han Yipeng , Heianza Yoriko , Cardoso Marly Augusto , Qi Lu
Published: March 2020

Exposure to different air pollutants has been linked to type 2 diabetes mellitus, but the evidence for the association between air pollutants and gestational diabetes mellitus (GDM) has not been systematically evaluated. We systematically retrieved relevant studies from PubMed, Embase, and the Web of Science, and performed stratified analyses and regression analyses. Thirteen studies were analyzed, comprising 1 547 154 individuals from nine retrospective studies, three prospective studies, and one case–control study. Increased exposure to particulate matter ≤2.5 µm in diameter (PM2.5) was not associated with the increased risk of GDM (adjusted OR 1.03, 95% CI 0.99 to 1.06). However, subgroup analysis showed positive correlation of PM2.5exposure in the second trimester with an increased risk of GDM (combined OR 1.07, 95% CI 1.00 to 1.13). Among pollutants other than PM2.5, significant association between GDM and nitrogen dioxide (NO2) (OR 1.05, 95% CI 1.01 to 1.10), nitrogen oxide (NOx) (OR 1.03, 95% CI 1.01 to 1.05), and sulfur dioxide (SO2) (OR 1.09, 95% CI 1.03 to 1.15) was noted. There was no significant association between exposure to black carbon or ozone or carbon monoxide or particulate matter ≤10 µm in diameter and GDM. Thus, systematic review of existing evidence demonstrated association of exposure to NO2, NOx, and SO2, and the second trimester exposure of PM2.5with the increased risk of GDM. Caution may be exercised while deriving conclusions from existing evidence base because of the limited number and the observational nature of studies.
Patients’ perspectives on the barriers to referral after telescreening for diabetic retinopathy in communities
Authors: Zhu Xiaofeng , Xu Yi , Lu Lina , Zou Haidong
Published: March 2020

Objective

To understand the referral completion and explore the associated barriers to the referral after telescreening for diabetic retinopathy (DR) among people with vision-threatening DR (VTDR).

Research design and methods

All participants with VTDR after DR telescreening in the communities completed the self-reported questionnaires to assess referral completion and their perspectives on referral barriers. Sociodemographic characteristics and perceived barriers related to incomplete referrals were identified by conducting univariate analysis and multiple logistic regression model. The final model was then built to predict incomplete referral.

Results

Of the 3362 participants, 46.1% had incomplete referral. Old age and lower education level showed significant association with incomplete referral. Almost all participants had at least one barrier during the referral process. Knowledge-related and attitude-related barriers, including ‘Too old to want any more treatment’, ‘Difficulty in getting time to referral’, ‘No serious illness requiring treatment at present’, ‘My eyes are okay’, ‘Distrust the recommended hospital’ and ‘Have not been diagnosed or treated before’, and logistics-related barrier ‘Mobility or transportation difficulties’ showed significant association with incomplete referral.

Conclusions

The issue of incomplete referral after DR telescreening is serious among individuals with VTDR, particularly in the elder and low education level population. The negativity of knowledge-related and attitude-related factors might be more prominent than logistic barriers in predicting incomplete referral. Therefore, new strategies to improve the compliance with referral assist in optimizing the referral accessibility, and the ongoing educational support to improve the awareness of disease and increase the effectiveness of physician-patient communication.
Knowledge, attitude and prevalence of hepatitis B virus among healthcare workers: a cross-sectional, hospital-based study in Bamenda Health District, NWR, Cameroon
Authors: Akazong W Etheline , Tume Christopher , Njouom Richard , Ayong Lawrence , Fondoh Victor , Kuiate Jules-Roger
Published: March 2020

Introduction

Hepatitis B virus (HBV) is a bloodborne virus which can be transmitted via percutaneous and mucocutaneous exposure to infected body fluid. Healthcare workers (HCWs) who are continuously exposed to different body fluids are at an increased risk of contracting and transmitting this virus. It is thus important to evaluate the knowledge and attitude of HCWs towards HBV and the prevalence of HBV infection among them.

Methods

This cross-sectional study was carried out between April and September 2017. Overall, 398 HCWs were recruited for this study. Knowledge on the route of HBV transmission and attitude towards HBV were evaluated using a well-structured questionnaire. Hepatitis B surface antigen (HBsAg) positivity was obtained using the Monolisa HBsAg ULTRA kit (Bio-Rad). Data were analysed using SPSS V.20.

Results

Among the HCWs who participated in this study, 338 (84.9%) had heard of HBV, and 269 (67.6%) of them had adequate knowledge on the route of HBV transmission. Medical doctors were the most knowledgeable among biomedical workers and students (76.5%). The rate of stigma was highest among nurses (87, 38.8%). The prevalence of HBsAg positivity was high (42, 10.6%) given that there is an efficient and available vaccine. Overall, over 70% of HCWs invited to participate in this study responded.

Conclusion

Knowledge on the route of HBV transmission was fair, and the level of stigmatisation of HBV-infected patients and the prevalence of HBV infection were high in this study. A sensitisation campaign should be carried out to educate HCWs on HBV, thus reducing the level of stigma associated with HBV as well as the probability of contracting HBV as a nosocomial infection.
Patients’ views about screening for atrial fibrillation (AF): a qualitative study in primary care
Authors: Lown Mark , Wilcox Christopher R , Hughes Stephanie , Santer Miriam , Lewith George , Moore Michael , Little Paul
Published: March 2020

Objectives

There has been increased interest in screening for atrial fibrillation (AF) with commissioned pilot schemes, ongoing large clinical trials and the emergence of inexpensive consumer single-lead ECG devices that can be used to detect AF. This qualitative study aimed to explore patients’ views and understanding of AF and AF screening to determine acceptability and inform future recommendations.

Setting

A single primary care practice in Hampshire, UK.

Participants

15 participants (11 female) were interviewed from primary care who had taken part in an AF screening trial. A semistructured interview guide was used flexibly to enable the interviewer to explore any relevant topics raised by the participants. Interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis.

Results

Participants generally had an incomplete understanding of AF and conflated it with other heart problems or with raised blood pressure. With regards to potential drawbacks from screening, some participants considered anxiety and the cost of implementation, but none acknowledged potential harms associated with screening such as side effects of anticoagulation treatment or the risk of further investigations. The screening was generally well accepted, and participants were generally in favour of engaging with prolonged screening.

Conclusions

Our study highlights that there may be poor understanding (of both the nature of AF and potential negatives of screening) among patients who have been screened for AF. Further work is required to determine if resources including decision aids can address this important knowledge gap and improve clinical informed consent for AF screening.

Trial registration number

ISRCTN 17495003.
Low-value injury care in the adult orthopaedic trauma population: a protocol for a rapid review
Authors: Bérubé Mélanie , Moore Lynne , Leduc Stéphane , Farhat Imen , Lesieur Martin , Lamontagne Jean , Pelet Stéphane , Berry Gregory , Tardif Pier-Alexandre , Côté Caroline , Paquet Jérôme
Published: March 2020

Introduction

Orthopaedic injuries affect almost 90% of trauma patients. A previous scoping review and expert consultation survey identified 15 potential low-value intra-hospital practices in the adult orthopaedic trauma population. Limiting the frequency of such practices could reduce adverse events, improve clinical outcomes and free up resources. The aim of this study is to synthesise the evidence on intra-hospital practices for orthopaedic injuries, previously identified as potentially of low value.

Methods and analysis

We will search Medline, Excerpta Medica Database (EMBASE), the Cochrane Central Register of Controlled Trials and Epistemonikos to identify systematic reviews, randomised controlled trials (RCTs), quasi-RCTs, cohort studies and case–control studies that evaluate selected practices according to a priori PICOS statements (Population–Intervention–Comparator–Outcome–Study design) . We will evaluate the methodological quality for systematic reviews using the Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR-2). Risk of bias in original studies will be evaluated with the Cochrane revised tool for RCTs (RoB2) and with the risk of bias in non-randomised studies of interventions (ROBINS-I) tool. If for a given practice, more than two original studies on our primary outcome are identified, we will conduct meta-analysis using a random effects model and assess heterogeneity using the I2index. We will assess credibility of evidence (I–IV) based on statistical significance, sample size, heterogeneity and bias as per published criteria.

Ethics and dissemination

Ethics approval is not required as original data will not be collected. Knowledge users from three level I trauma centres are involved in the design and conduct of the study in accordance with an integrated knowledge translation approach. Findings related to the rapid review will be available in May 2020. They will be presented to key stakeholders to inform discussions and raise awareness on low-value injury care. In addition, results will be disseminated in a peer-reviewed journal, at national and international scientific meetings and to healthcare associations.
Quantification and visualisation methods of data-driven chronic care delivery pathways: protocol for a systematic review and content analysis
Authors: Siqueira do Prado Luiza , Allemann Samuel , Viprey Marie , Schott Anne-Marie , Dediu Dan , Dima Alexandra L
Published: March 2020

Introduction

Chronic conditions require long periods of care and often involve repeated interactions with multiple healthcare providers. Faced with increasing illness burden and costs, healthcare systems are currently working towards integrated care to streamline these interactions and improve efficiency. To support this, one promising resource is the information on routine care delivery stored in various electronic healthcare databases (EHD). In chronic conditions, care delivery pathways (CDPs) can be constructed by linking multiple data sources and extracting time-stamped healthcare utilisation events and other medical data related to individual or groups of patients over specific time periods; CDPs may provide insights into current practice and ways of improving it. Several methods have been proposed in recent years to quantify and visualise CDPs. We present the protocol for a systematic review aiming to describe the content and development of CDP methods, to derive common recommendations for CDP construction.

Methods and analysis

This protocol followed the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols. A literature search will be performed in PubMed (MEDLINE), Scopus, IEEE, CINAHL and EMBASE, without date restrictions, to review published papers reporting data-driven chronic CDPs quantification and visualisation methods. We will describe them using several characteristics relevant for EHD use in long-term care, grouped into three domains: (1) clinical (what clinical information does the method use and how was it considered relevant?), (2) data science (what are the method’s development and implementation characteristics?) and (3) behavioural (which behaviours and interactions does the method aim to promote among users and how?). Data extraction will be performed via deductive content analysis using previously defined characteristics and accompanied by an inductive analysis to identify and code additional relevant features. Results will be presented in descriptive format and used to compare current CDPs and generate recommendations for future CDP development initiatives.

Ethics and dissemination

Database searches will be initiated in May 2019. The review is expected to be completed by February 2020. Ethical approval is not required for this review. Results will be disseminated in peer-reviewed journals and conference presentations.

PROSPERO registration number

CRD42019140494.
Carers’ experience of using assistive technology for dementia care at home: a qualitative study
Authors: Sriram Vimal , Jenkinson Crispin , Peters Michele
Published: March 2020

Objective

Assistive technology (AT) can help carers (family, friends and neighbours) and people with dementia to stay well and safely at home. There are important gaps in what we know about experience of using AT from the perspective of carers of persons with dementia. This study investigates carers’ experience of using AT in supporting and caring for persons with dementia who live at home.

Design

Qualitative phenomenological study with semi-structured interviews to achieve data saturation and thematic analysis to identify key themes.

Setting

Community-based within the UK.

Participants

Twenty-three (14 women, 9 men) adult carers of persons with dementia who have used at least one AT device.

Results

All participants reported benefiting to varying degrees from using AT. There were 5 themes and 18 subthemes that highlighted reasons for using AT and use of AT over time. Providing care for a person with dementia, motivation for using AT, changes to roles and routines, carer knowledge and skills for using AT and social, environmental and ethical considerations were the main themes. This study showed that AT can provide reassurance and support for carers of persons with dementia but there are difficulties with acquiring and continued use of AT as dementia progresses.

Conclusions

Carers consider AT as an adjunct to care they provided in caring for a person with dementia. Use of AT should be considered in the personal, social and environmental context of persons with dementia and their carers. Further research and policy interventions are needed to address best use of resources and guidance on data sharing and data protection while using AT.
Linking administrative data sets of inpatient infectious diseases diagnoses in far North Queensland: a cohort profile
Authors: Eisen Damon P , McBryde Emma S , Vasanthakumar Luke , Murray Matthew , Harings Miriam , Adegboye Oyelola
Published: March 2020

Purpose

To design a linked hospital database using administrative and clinical information to describe associations that predict infectious diseases outcomes, including long-term mortality.

Participants

A retrospective cohort of Townsville Hospital inpatients discharged with an International Classification of Diseases and Related Health Problems 10th Revision Australian Modification code for an infectious disease between 1 January 2006 and 31 December 2016 was assembled. This used linked anonymised data from: hospital administrative sources, diagnostic pathology, pharmacy dispensing, public health and the National Death Registry. A Created Study ID was used as the central identifier to provide associations between the cohort patients and the subsets of granular data which were processed into a relational database. A web-based interface was constructed to allow data extraction and evaluation to be performed using editable Structured Query Language.

Findings to date

The database has linked information on 41 367 patients with 378 487 admissions and 1 869 239 diagnostic/procedure codes. Scripts used to create the database contents generated over 24 000 000 database rows from the supplied data. Nearly 15% of the cohort was identified as Aboriginal or Torres Strait Islanders. Invasive staphylococcal, pneumococcal and Group A streptococcal infections and influenza were common in this cohort. The most common comorbidities were smoking (43.95%), diabetes (24.73%), chronic renal disease (17.93%), cancer (16.45%) and chronic pulmonary disease (12.42%). Mortality over the 11-year period was 20%.

Future plans

This complex relational database reutilising hospital information describes a cohort from a single tropical Australian hospital of inpatients with infectious diseases. In future analyses, we plan to explore analyses of risks, clinical outcomes, healthcare costs and antimicrobial side effects in site and organism specific infections.
Assessment of the implementation fidelity of a strategy to scale up integrated care in five European regions: a multimethod study
Authors: Grooten Liset , Fabbricotti Isabelle Natalina , Devroey Dirk , Vrijhoef Hubertus J M
Published: March 2020

Objective

The SCaling IntegRated Care in COntext (SCIROCCO) project tested a step-based scaling up strategy to explore what and how to scale up integrated care initiatives in five European regions. To gain a profound understanding of which factors influence the implementation of this strategy, the objective of this study was to assess the extent to which the SCIROCCO strategy was implemented as planned.

Design

Multimethod study.

Methods

The extended version of the conceptual framework for implementation fidelity was used to evaluate what factors influence the implementation of the scaling up strategy. Data were collected in the five participating European regions during the intervention period. Data collection methods included: key informant interviews, focus groups, questionnaire studies and project documents.

Results

All three main steps of the scaling up strategy were implemented with acceptable fidelity. Variations were observed in the duration of implementing the steps in the regions. Also, variations were observed in the coverage of experts to participate in the steps of the strategy. Several factors were observed to influence the implementation: facilitation conditions (ie, good coordination for implementation) and participant responsiveness (ie, a positive experience of participants in the organised study visits). Factors that may have moderated adherence to the original plan of the strategy were found in facilitating conditions (ie, in the flexible approach), participant recruitment factors (ie, adaptions of the procedure by the regions) and contextual factors (ie, the level of development of integrated care).

Conclusion

This was the first study to assess implementation fidelity of a European project that used a step-based scaling up strategy in five European regions. Similar European projects that are based on collaboration between several European regions can learn from the lessons captured in SCIROCCO and can become more aware of the facilitating factors and pitfalls of implementing such projects.
Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description
Authors: Archibald Mandy , Lawless Michael , Ambagtsheer Rachel C , Kitson Alison
Published: March 2020

Objectives

Despite growing interest in frailty as a significant public health challenge, comparatively little is known about how older adults perceive and experience frailty, limiting the effectiveness of strategies to improve frailty management and prevention. The objective of this study was to understand how older people, including frail older persons in residential aged care, perceive and understand frailty through an interpretive–descriptive qualitative study.

Setting

Aged care facility, community-based university for older persons and an aged care auxiliary care group in a large metropolitan centre in South Australia.

Participants

39 non-frail, prefrail, frail and very frail South Australian older adults.

Methods

Seven focus groups were conducted. Participants completed one of two frailty instruments depending on setting and indicated whether they self-identified as frail. Data were analysed inductively and thematically by two independent investigators.

Results

Frailty was described according to three schemas of (1) the old and frail: a static state near the end of life; (2) frailty at any age: a disability model; and (3) frailty as a loss of independence: control, actions and identity. In addition, a theme was identifying linking mindset, cognition and emotion to frailty. The term frailty was viewed negatively and was often implicated with personal choice. There was little correlation between frailty assessments and whether participants self-identified as frail.

Conclusions

Aside from a disability model, views of frailty as unmodifiable permeated older persons’ diverse perspectives on frailty and are likely to impact health behaviours. To our knowledge, this is among the largest qualitative studies examining consumer perceptions of frailty and contributes a clinically relevant schema linking age, prevention and modifiability from a consumer perspective.
Achieving Control of Asthma in Children in Africa (ACACIA): protocol of an observational study of children’s lung health in six sub-Saharan African countries
Authors: Mosler Gioia , Oyenuga Victoria , Addo-Yobo Emmanuel , Adeyeye Olayinka Olufunke , Masekela Refiloe , Mujuru Hilda Angela , Nantanda Rebecca , Rylance Sarah , Ticklay Ismail , Grigg Jonathan
Published: March 2020

Introduction

Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Africa, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.

Methods and analysis

Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.

Ethics and dissemination

The ACACIA study has been reviewed by the Queen Mary University of London Ethics of Research Committee in the UK. All African centres have received local ethical approval for this study. Study results will be published in academic journals and at conferences. Study outputs will be communicated to the public via newsfeeds on the ACACIA website and Twitter, and through news media outlets and other local dissemination.

Trial registration number

269211.
Maximising trichiasis surgery success (MTSS) trial: rationale and design of a randomised controlled trial to improve trachomatous trichiasis surgical outcomes
Authors: Bayissasse Belay , Sullivan Kristin M , Merbs Shannath L , Munoz Beatriz , Keil Alexander , Sisay Alemayehu , Singer Alison , Gower Emily W
Published: March 2020

Introduction

Trachomatous trichiasis (TT) is a condition in which the eyelid turns inward and eyelashes abrade the front part of the eye. To prevent eventual blindness, surgery is recommended. Two surgical procedures are commonly used, bilamellar tarsal rotation (BLTR) and posterior lamellar tarsal rotation (PLTR). Evidence suggests that incision height and surgery type may affect the risk of postoperative TT (PTT) and other surgical outcomes. However, these studies have not prospectively compared the impact of incision height on surgical outcomes.

Methods and analysis

Maximising trichiasis surgery Success (MTSS) is a three-arm, randomised clinical trial being conducted in Ethiopia. Participants will be randomly assigned on a 1:1:1 basis to BLTR with a 3 mm incision height, BLTR with a 5 mm incision height, or PLTR 3 mm incision height. Patients are eligible for the trial if they have previously unoperated upper eyelid TT. Follow-up visits will be conducted by trained eye examiners at 1 day, 2 weeks, 6 weeks and 12 months after surgery. The primary outcome is incident PTT within 1 year following surgery. Logistic regression will be used in an intention-to-treat analysis to assess outcome incidence by surgical approach.

Ethics and dissemination

The University of North Carolina and Johns Hopkins School of Medicine institution review boards, Ethiopian National Research Ethics Review Committee and Ethiopian Food, Medicine, Healthcare and Administration and Control Authority provided ethics approval for the trial. On completion, trial results will be disseminated at local and international meetings and in peer-reviewed journals.

Trial registration number

NCT03100747.
International Mind, Activities and Urban Places (iMAP) study: methods of a cohort study on environmental and lifestyle influences on brain and cognitive health
Authors: Cerin Ester , Barnett Anthony , Chaix Basile , Nieuwenhuijsen Mark J , Caeyenberghs Karen , Jalaludin Bin , Sugiyama Takemi , Sallis James F , Lautenschlager Nicola T , Ni Michael Y , Poudel Govinda , Donaire-Gonzalez David , Tham Rachel , Wheeler Amanda J , Knibbs Luke , Tian Linwei , Chan Yih-kai , Dunstan David W , Carver Alison , Anstey Kaarin J
Published: March 2020

Introduction

Numerous studies have found associations between characteristics of urban environments and risk factors for dementia and cognitive decline, such as physical inactivity and obesity. However, the contribution of urban environments to brain and cognitive health has been seldom examined directly. This cohort study investigates the extent to which and how a wide range of characteristics of urban environments influence brain and cognitive health via lifestyle behaviours in mid-aged and older adults in three cities across three continents.

Methods and analysis

Participants aged 50–79 years and living in preselected areas stratified by walkability, air pollution and socioeconomic status are being recruited in Melbourne (Australia), Barcelona (Spain) and Hong Kong (China) (n=1800 total; 600 per site). Two assessments taken 24 months apart will capture changes in brain and cognitive health. Cognitive function is gauged with a battery of eight standardised tests. Brain health is assessed using MRI scans in a subset of participants. Information on participants’ visited locations is collected via an interactive web-based mapping application and smartphone geolocation data. Environmental characteristics of visited locations, including the built and natural environments and their by-products (e.g., air pollution), are assessed using geographical information systems, online environmental audits and self-reports. Data on travel and lifestyle behaviours (e.g., physical and social activities) and participants’ characteristics (e.g., sociodemographics) are collected using objective and/or self-report measures.

Ethics and dissemination

The study has been approved by the Human Research Ethics Committee of the Australian Catholic University, the Institutional Review Board of the University of Hong Kong and the Parc de Salut Mar Clinical Research Ethics Committee of the Government of Catalonia. Results will be communicated through standard scientific channels. Methods will be made freely available via a study-dedicated website.

Trial registration number

ACTRN12619000817145.
Selfing and correlated paternity in relation to pollen management in western red cedar seed orchards
Authors: Ritland Kermit , Miscampbell Allyson , Van Niejenhuis Annette , Brown Patti , Russell John
Published: March 2020

We used microsatellite genetic markers to evaluate the mating system of western red cedar (Thuja plicata Donn ex D. Don) under various seed orchard pollen management schemes. We primarily examined whether supplemental mass pollination (SMP) can reduce the observed selfing rates. Pollen blowing and “hooding” were also examined in smaller tests. Only SMP was consistently effective in reducing the selfing rate, from 30% to 20%. The correlation of paternity was quite high (60%–90%) in two of three orchards, and in these two orchards the application of SMP reduced this correlation by about 10% as well. The correlation of paternity is the fraction of full-sibling vs. half-sibling progeny, and unbiased estimates can be obtained with few loci, even single loci, in contrast to other types of paternity analysis. We also find the microsatellite amplicon sizes should be pooled into “bins” of 2–4 nucleotides, owing to unintended errors of assay; otherwise the estimates are biased. This new feature of mating system estimation was incorporated into the computer program MLTR.
Updating plots to improve the precision of small-area estimates: the example of the Lorraine region, France
Authors: Fortin Mathieu
Published: March 2020

The sampling intensity of a national forest inventory is usually low. Forest dynamics models can be used to update plots from past inventory campaigns to enhance the precision of the estimate on smaller areas. By doing this, however, the inference relies not only on the sampling design, but also on the model. In this study, the contribution of model predictions to the variance of enhanced small-area estimates was assessed through a case study. The French national forest inventory provided different annual campaigns for a particular region and department of France. Three past campaigns were updated using a forest dynamics model, and estimates of the standing volumes were obtained through two methods: a modified multiple imputation and the Bayesian method. The update greatly increased the precision of the estimate, and the gain was similar between the two methods. The sampling-related variance represented the largest share of the total variance in all cases. This study suggests that plot updating provides more precise estimates as long as (i) the forest dynamics model exhibits no systematic lack of fit and was fitted to a large data set and (ii) the sampling-related variance clearly outweighs the model-related variance.