bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Thermal Residual Stresses on Polymer/Metal Interfacial Adhesion
Authors: Yao Qizhou , Qu Jianmin
Published: December 2021

In this study, the apparent fracture toughness of the interfaces of several epoxy-based polymeric adhesives and metal (aluminum) substrate is experimentally measured. Double layer specimens with initial interfacial cracks are made for four-point bending tests. Thermal residual stresses exist on the interface due to the coefficient of thermal expansion (CTE) mismatch between the underfill and aluminum. Silica fillers are used to modify the CTE of the epoxy-based adhesives so that various levels of interface thermal residual stresses are achieved. Finite element analysis is also performed to quantify the effects of CTE mismatch as well as the elastic mismatch across the interface. It is found that the apparent interfacial toughness is significantly affected by the thermal residual stress, while the effect of elastic mismatch is negligible. In general thermal residual stress undermines the resistance to an interfacial crack. In some cases the residual stress is sufficient to result in adhesive and/or cohesive failure.
Application of High Frequency Dielectric Spectroscopy for the Assessment of Durability of Adhesively Bonded Composite Structures
Authors: Boinard P. , Pethrick R. A. , Banks W. M.
Published: December 2021

Composites materials, especially adhesively bonded structures are being used in a wide range of applications, including situations where they become exposed to high levels of moisture. Ingress of moisture into a polymeric material will in general lead to changes in its mechanical properties usually associated with plasticisation effects. In bonded composite structures, water ingress can influence not only the mechanical properties of the matrix but also those of the matrix-fibre and adhesive-adherent interfaces.

Over the last ten years, the application of high-frequency dielectric techniques to the characterisation of the integrity and durability of adhesively bonded metallic structures has been extensively investigated by the coauthors.

In general, a bonded structure resembles a wave-guide in which the adhesive layer is the dielectric. Changes in the characteristics as a function of time of exposure to the environment can be used to monitor the ageing of such structures. This paper discusses the application of the principles to the study of carbon fibre reinforced plastics (CFRP) adhesively bonded composite structures. Carbon fibre is in general less conductive than aluminium material. However, it is sufficiently conductive to sustain the propagation of high-frequency dielectric signals. The effect of changes in the surface alignment and subsequent bulk orientation of carbon fibres on the dielectric propagation has been investigated. The ingress of moisture in the raw materials and in the joint structure is presented. The high-frequency time domain response (TDR) analysis allows the integrity of the structure to be explored and a good correlation is shown between TDR analysis and gravimetric results.

This study indicates that the success obtained in the application of high frequency dielectric measurements to adhesively bonded aluminium structures is also applicable to CFRP bonded structures. The dielectric study not only indicates a new way to assess the state of such a structure but is also producing new insights into the application of TDR measurement to non-isotropic materials.
Blade Loading and Numerical Slip Factor of Centrifugal Compressor Impellers
Authors: Oh JongSik
Published: December 2021

Through the state-of-the-art CFD approach, the Eckardt radial bladed and backswept impellers were analyzed to investigate the effect of blade loadings from blade design shape on the slip factor variation for the change of the flow rate. In addition, a new design of the blade profile was arbitrarily attempted to generate a center-loading pattern in the Eckardt backswept impeller. Three dimensional compressible turbulent flow analysis was applied, with the Baldwin-Lomax turbulence model adopted, to get the numerical slip factor, using the mass-averaged concept, at the discharge plane of each impeller. The numerical slip factors are in good agreement with the experimental ones, and the Wiesner’s slip factors are found to deviate further from the numerical and experimental ones, especially in the two backswept impellers. The deviation angles and the blade loadings in the meridional channel are found in no direct relation with the trend of change of the slip factors. Blade-to-blade loadings in midspan location are, however, found in direct relation, especially at the sections where maximum loadings are to be expected. That information can be utilized in establishing an improved expression for slip factor in the future.
Development of a Temperature Profile Measurement Technique Based on Molecular Tagging Velocimetry
Authors: Thomson Scott L.
Published: December 2021

The development of a new laser-based temperature measurement technique is explained. The technique is based on molecular tagging velocimetry (MTV), an established, non-intrusive method of obtaining velocity profiles throughout a fluid. MTV works by dissolving a photoluminescent chemical in water and directing an ultraviolet laser beam into the solution. The intensity of the light emitted by the chemical upon excitation by the UV beam is inversely related to the temperature of the fluid. Recent research has been directed towards quantifying this temperature-intensity relationship. The method of obtaining temperature measurements, including equipment setup and image analysis, is explained, and a summary of results is given.
A Modified Model for Predicting Flow Regime Transitions in Horizontal Gas-Liquid Flow
Authors: Mostafa N. H. , El Mitwally E. S. , El Desoky A. A.
Published: December 2021

A Theoretical model for identifying the flow regime transition of air-water two-phase flow in a horizontal pipe is presented. In this work, when mapping the two-phase flow, the nonuniform liquid-to-wall shear stress around the pipe circumference and the interfacial shear stress were taken into consideration. This model was found in agreement with the experimental map of Mandhane et al. (1974) and the Modified Baker map (Ball et al. 1970) for mapping the two-phase flow. The proposed model is plotted for different pipe diameters. The superficial liquid velocity was found to increase four times in the stratified and bubble flow regimes when the pipe diameter was increased from 2.5 to 5 cm. This model enables for any user for working in different diameters.
A Modular Finite Element Parallel Fluid Applications Simulator
Authors: Wong K. L. , Baker A. J.
Published: December 2021

With the rapid advances in high-performance computing technology in recent years, researchers at the University of Tennessee have initiated a collaborative project to address the theoretical, algorithmic, and numerical implementation issues of computational mechanics simulations. To meet the challenge, a Parallel Interoperable Computational Mechanics Simulator System (PICMSS) has been established. Such effort entails the development of a modular finite element platform capable of admitting diverse CFD formulations, as well as closure models for physics phenomena, as required/derived by the users operating on supercomputers and networks of PC clusters. Incompressible Navier Stokes Benchmark solutions via a velocity-vorticity formulation are proposed to examine the integrity and scalability of PICMSS.
Full Vehicle Flow Simulation Using a Hybrid Mesh
Authors: Johnson James P. , Karlsson Silvia H. , Lim Jerry C. , Makowski Francis T. , Malan Paul
Published: December 2021

Computational Fluid Dynamics (CFD) simulations of wind tunnel tests to determine the aerodynamic performance of a motor vehicle with respect to drag and lift have matured to the point where results are available early enough in the design process to provide guidance to vehicle shape decisions. The technical advances that have led to this point now bring strong demands on solution accuracy and turnaround time in order for this technology to be included in mainstream design processes. This paper addresses accuracy issues and presents numerical results for a simulation of a production vehicle test in the General Motors full scale aerodynamic wind tunnel. A comparison to experimental data is presented. Computational solutions were obtained using a hybrid grid CFD model with the Fluent UNS solver running in parallel processing mode. The static pressure gradient was used as the error indicator to perform solution adaptive grid refinement.
Multithreading Parallelization of CFD Problems Under Microsoft Windows NT
Authors: Nicolescu Bogdan , Golubovici Gabriel , Oanta Emil M.
Published: December 2021

We present a method of parallelization for computationally extensive problems on multiprocessor machines using a multitasking operating system and a regular compiler. The idea is to divide a process into independent tasks that represent as many execution threads distributed among the available processors. For the distribution of threads on different processors we offer two solutions one in which the operating system is doing this task and one in which it is the programmer’s job to specify which thread runs on which processor. As a model we choose the unsteady flow of an incompressible, viscous fluid through a channel with an obstacle inside. For an easy understanding of the method and for the purpose of outlining the general principles of such flows we considered the simplest geometry: a straight tube with an obstacle inside parallel to its walls.
Fluids Engineering Division Conferences: Revisited
Authors: Morrow Thomas B.
Published: December 2021

The ASME Fluids Engineering Division (FED) sponsors technical sessions at the FED Summer Meeting (FEDSM) and at the International Mechanical Engineering Congress and Exhibition (IMECE). This paper describes the way in which these conferences are organized, publicized and presented. The first version of this paper was presented at IMECE’97 in Dallas, TX. This version updates the Dallas paper by including attendance information from FEDSM’98 and ’99.
A necessary condition for double-decay envelopes in stringed instruments
Authors: Woodhouse Jim
Published: December 2021

Measurements of body vibration characteristics of five different stringed musical instruments have been used to address the question of whether and when they might be expected to produce transient response featuring a “double decay” sound profile. The phenomenon has been well documented and studied in the context of the piano but has not been systematically studied for other instruments. The results show considerable variation among instruments. The piano is indeed predicted to show double decays over most of its range. In the tested guitar, by contrast, double decays are likely to be confined to a few notes near strong body resonances. Other instruments fall between these extremes. The lute and the mandolin, both normally strung with double strings, should both exhibit double decays over much of their playing range, especially towards the higher end. The banjo is single-strung but is also predicted to show strong double decays, especially for higher notes in its range.
Atomic-scale visualization of topological spin textures in the chiral magnet MnGe
Authors: Repicky Jacob , Wu Po-Kuan , Liu Tao , Corbett Joseph P. , Zhu Tiancong , Cheng Shuyu , Ahmed Adam S. , Takeuchi N. , Guerrero-Sanchez J. , Randeria Mohit , Kawakami Roland K. , Gupta Jay A.
Published: December 2021

Peeking into magnetic textures

Topological spin textures hold promise as robust carriers of information and have been observed in bulk materials with a specific crystal structure. One of these materials, manganese germanide (MnGe), exhibits unusual textures in bulk form. Repicky
et al
. used spin-polarized scanning tunneling microscopy to study surface magnetism in thin films of MnGe. Achieving high spatial resolution, the researchers observed stripe-like features consistent with a helical state. In regions where the film was slightly curved due to strain, the intersection of domain walls led to characteristic closed patterns that could be manipulated with current/voltage pulses. —JS
Pangenomics enables genotyping of known structural variants in 5202 diverse genomes
Authors: Sirén Jouni , Monlong Jean , Chang Xian , Novak Adam M. , Eizenga Jordan M. , Markello Charles , Sibbesen Jonas A. , Hickey Glenn , Chang Pi-Chuan , Carroll Andrew , Gupta Namrata , Gabriel Stacey , Blackwell Thomas W. , Ratan Aakrosh , Taylor Kent D. , Rich Stephen S. , Rotter Jerome I. , Haussler David , Garrison Erik , Paten Benedict
Published: December 2021

Giraffe pangenomes

Genomes within a species often have a core, conserved component, as well as a variable set of genetic material among individuals or populations that is referred to as a “pangenome.” Inference of the relationships between pangenomes sequenced with short-read technology is often done computationally by mapping the sequences to a reference genome. The computational method affects genome assembly and comparisons, especially in cases of structural variants that are longer than an average sequenced region, for highly polymorphic loci, and for cross-species analyses. Siren
et al
. present a bioinformatic method called Giraffe, which improves mapping pangenomes in polymorphic regions of the genome containing single nucleotide polymorphisms and structural variants with standard computational resources, making large-scale genomic analyses more accessible. —LMZ
Readout of spin quantum beats in a charge-separated radical pair by pump-push spectroscopy
Authors: Mims David , Herpich Jonathan , Lukzen Nikita N. , Steiner Ulrich E. , Lambert Christoph
Published: December 2021

Quantum oscillations in radical pairs

The spin dynamics of photoinduced radical pairs, involving an interconversion between singlet and triplet spin states, plays an important role in nature, for example, in avian magnetoreception. The spin interconversion is a truly quantum process with characteristic coherent oscillations (quantum beats) that should be reflected in the reaction kinetics. However, their experimental observation has remained challenging. Mims
et al
. developed an optical readout technique that can directly monitor the singlet-triplet interconversion quantum beats, as demonstrated for a photoinduced, charge-separated state of an electron donor–acceptor dyad (see the Perspective by Hore). The present work opens a new way to monitor the spin evolution in radical pairs, which will be important not only in biological physics but also in organic solar cells and other practical applications. —YS
COVID-19 impact on infant and adolescent vaccine supplies
Authors: Cernuschi Tania , Malvolti Stefano , Downham Matthew , Maugeais Dominique , Robinson David , Cravioto Alejandro
Published: December 2021

Vaccine production is quadrupling rapidly, creating supply chain challenges
Proteins, proteins everywhere
Authors: Thorp H. Holden
Published: December 2021

The first protein structures were determined by x-ray crystallography in 1957 by John C. Kendrew and Max F. Perutz. As a bioinorganic chemist, I was delighted that the structures were myoglobin and hemoglobin, both heme proteins with big, beautiful iron atoms. It must have been an extraordinary experience to stare at a physical model of the structures and see something that had previously only been imagined. Not long afterward, Christian B. Anfinsen Jr. proposed that the structure of a protein was thermodynamically stable. It seemed possible that the three-dimensional structure of a protein could be predicted based on the sequence of its amino acids. This “protein-folding problem,” as it came to be known, baffled scientists until this year, when the papers we’ve deemed the 2021 Breakthrough of the Year were published.
Complete Genome Sequences of Two Nosocomiicoccus ampullae Strains and a Growth-Adapted Mutant
Authors: Schuster Christopher F. , Sommer Frank , Strommenger Birgit , Werner Guido , Layer Franziska
Published: December 2021

Here, we present the circular and complete genome sequences of the
Nosocomiicoccus ampullae
isolate 19-00310 and type strain DSM 19163. To our knowledge, these represent the first complete, circular chromosomes in the entire genus. Sequencing of a growth-adapted mutant suggests iron availability as a factor for growth improvement.
Draft Genome Sequence of Bacillus pacificus KVCMST-8A-12, Isolated from a Marine Sediment Sample from the Kanyakumari Coast, India
Authors: Santhi Asha , Subramanian Venkatesh , Muthan Krishnaveni
Published: December 2021

A DNase-producing
Bacillus pacificus
strain was isolated, and the whole-genome sequence is reported in this paper. The draft genome sequence of
Bacillus pacificus
KVCMST-8A-12 constitutes 2.4 Gbp of raw reads, with a GC content of 35.24%. In total, 5,661 protein-coding genes, 64 tRNA genes, and 4 rRNA genes were predicted.
octoFLUshow: an Interactive Tool Describing Spatial and Temporal Trends in the Genetic Diversity of Influenza A Virus in U.S. Swine
Authors: Arendsee Zebulun W. , Chang Jennifer , Hufnagel David E. , Markin Alexey , Janas-Martindale Alicia , Vincent Amy L. , Anderson Tavis K.
Published: December 2021

Influenza A virus (IAV) is passively surveilled in swine in the United States through a U.S. Department of Agriculture-administered surveillance system. We present an interactive Web tool to visualize and explore trends in the genetic and geographic diversity of IAV derived from the surveillance system.
Early Earth zircons formed in residual granitic melts produced by tonalite differentiation
Authors: Laurent Oscar , Moyen Jean-François , Wotzlaw Jörn-Frederik , Björnsen Jana , Bachmann Olivier
Published: December 2021

The oldest geological materials on Earth are Hadean (>4 Ga) detrital zircon grains. Their chemistry and apparently low Ti-in-zircon temperatures (≤700 °C) are considered to be inconsistent with crystallization in a magma of the tonalite-trondhjemite-granodiorite (TTG) suite, although these are the dominant Archean (4.0–2.5 Ga) silicic rocks. Using a new data set of trace element contents in zircons from Paleoarchean Barberton TTGs (South Africa) and thermodynamic modeling, we show that these zircons have crystallized at near-solidus conditions from a compositionally uniform granitic melt. This melt is residual from the crystallization of a less evolved (tonalitic) parent and thereby shows major and trace element compositions different from bulk TTG rocks. A global compilation reveals that most Hadean detrital and Archean TTG-hosted grains share a peculiar zircon trace element signature that is distinct from the chemical trends defined by Phanerozoic zircons. Our model shows that the low Ti contents of early Earth zircons reflect crystallization at higher temperatures (720–800 °C) than initially inferred due to lower modeled TiO2 activity in the melt relative to previous estimates. We therefore propose that near-solidus zircon crystallization from a chemically evolved melt in a TTG-like magmatic environment was the dominant zircon-forming process on the early Earth.
Giving science the finger—is the second-to-fourth digit ratio (2D:4D) a biomarker of good luck? A cross sectional study
Authors: Smoliga James M , Fogaca Lucas K , Siplon Jessica S , Goldburt Abigail A , Jakobs Franziska
Published: December 2021

Objectives

To explore whether random chance, weak research methodology, or inappropriate reporting can lead to claims of statistically significant (yet, biologically meaningless) biomarker associations, using as a model the relation between a common surrogate of prenatal testosterone exposure, second-to-fourth digit ratio (2D:4D), and a random indicator of good luck.

Design

Cross sectional study.

Setting

University sports performance laboratory in the United States. Data were collected from May 2015 to February 2017.

Participants

176 adults (74 women, 102 men), including university students, faculty, and staff with no history of injuries, disease, or medical conditions that would affect digit length.

Main outcome measures

2D:4D, body composition parameters potentially influenced by androgens (bone mineral content, bone mineral density, body fat percentage), and good luck (using poker hands from randomly selected playing cards as a surrogate).

Results

2D:4D significantly correlated with select body composition parameters (Spearman’srsrange −0.26 to 0.23; P<0.05), but the correlations varied by sex, participant hand measured, and the method of measuring 2D:4D (by photocopy or radiography). However, the strongest correlation observed was between right hand 2D:4D in men measured by radiograph and poker hand rank (rs=0.28, P=0.004).

Conclusions

Greater prenatal exposure to testosterone, as estimated by a lower 2D:4D, significantly increases good luck in adulthood, and also modulates body composition (albeit to a lesser degree). While these findings are consistent with a wealth of research reporting that 2D:4D is related to many seemingly disparate outcomes, they are not meant to provide confirmatory evidence that 2D:4D is a universal biomarker of nearly everything. Instead, the associations between 2D:4D and good luck are simply due to chance, and provide a “handy” example of the reproducibility crisis within medical and scientific research. Biologically sound hypotheses, pre-registration of trials, strong methodological and statistical analyses, transparent reporting of negative results, and unbiased interpretation of data are all necessary for biomarker studies and other areas of clinical research.
Innovative Telemonitoring Enhanced Care Programme for Chronic Heart Failure (ITEC-CHF) to improve guideline compliance and collaborative care: protocol of a multicentre randomised controlled trial
Authors: Ding Hang , Jayasena Rajiv , Maiorana Andrew , Dowling Alison , Chen Sheau Huey , Karunanithi Mohan , Layland Jamie , Edwards Iain
Published: December 2021

Introduction

Chronic heart failure (CHF) is a life-threatening chronic disease characterised by periodic exacerbations and recurrent hospitalisations. In the management of CHF, patient compliance with evidence-based clinical guidelines is essential, but remains difficult practically. The objective of this study is to examine whether an Innovative Telemonitoring Enhanced Care Programme for CHF (ITEC-CHF) improves patients’ compliance, and associated health and economic outcomes.

Methods and analysis

An open multicentre randomised controlled trial has been designed. Patients will be recruited and randomised to receive either ITEC-CHF (n=150) or usual care CHF (n=150) for at least 6 months. ITEC-CHF combines usual care and an additional telemonitoring service including remote weight monitoring, structured telephone support and nurse-led collaborative care. The primary outcomes are the compliance rates with the best-practice guidelines for daily weight monitoring. The secondary outcomes include the compliance with other guideline recommendations (health maintenance, medication, diet and exercise), health (health-related quality of life, risk factors, functional capacity and psychological states) and economic outcomes related to the use of healthcare resources such as hospital readmissions and general practitioner/emergency department visits.

Ethics and dissemination

The clinical trial has been approved by Peninsula Health Human Research Ethics Committee (HREC Reference: HREC/14/PH/27), Royal Perth Hospital Human Research Ethics Committee (Reference: 15-081) and the Curtin University Human Research Ethics Committee (Reference: HR 181/2014). We will disseminate the final results to the public via conferences and journal publications. A final study report will also be provided to the ethics committees.

Trial registration number

Registered with Australian New Zealand Clinical Trial Registry (ACTRN12614000916640).
Predictive validity of A-level grades and teacher-predicted grades in UK medical school applicants: a retrospective analysis of administrative data in a time of COVID-19
Authors: McManus I C , Woolf Katherine , Harrison David , Tiffin Paul A , Paton Lewis W , Cheung Kevin Yet Fong , Smith Daniel T
Published: December 2021

Objectives

To compare in UK medical students the predictive validity of attained A-level grades and teacher-predicted A levels for undergraduate and postgraduate outcomes. Teacher-predicted A-level grades are a plausible proxy for the teacher-estimated grades that replaced UK examinations in 2020 as a result of the COVID-19 pandemic. The study also models the likely future consequences for UK medical schools of replacing public A-level examination grades with teacher-predicted grades.

Design

Longitudinal observational study using UK Medical Education Database data.

Setting

UK medical education and training.

Participants

Dataset 1: 81 202 medical school applicants in 2010–2018 with predicted and attained A-level grades. Dataset 2: 22 150 18-year-old medical school applicants in 2010–2014 with predicted and attained A-level grades, of whom 12 600 had medical school assessment outcomes and 1340 had postgraduate outcomes available.

Outcome measures

Undergraduate and postgraduate medical examination results in relation to attained and teacher-predicted A-level results.

Results

Dataset 1: teacher-predicted grades were accurate for 48.8% of A levels, overpredicted in 44.7% of cases and underpredicted in 6.5% of cases. Dataset 2: undergraduate and postgraduate outcomes correlated significantly better with attained than with teacher-predicted A-level grades. Modelling suggests that using teacher-estimated grades instead of attained grades will mean that 2020 entrants are more likely to underattain compared with previous years, 13% more gaining the equivalent of the lowest performance decile and 16% fewer reaching the equivalent of the current top decile, with knock-on effects for postgraduate training.

Conclusions

The replacement of attained A-level examination grades with teacher-estimated grades as a result of the COVID-19 pandemic may result in 2020 medical school entrants having somewhat lower academic performance compared with previous years. Medical schools may need to consider additional teaching for entrants who are struggling or who might need extra support for missed aspects of A-level teaching.
Systematic review of patient-engagement interventions: potentials for enhancing person-centred care for older patients with multimorbidity
Authors: Søgaard Mathilde Bendix , Andresen Katrine , Kristiansen Maria
Published: December 2021

Introduction

Person-centred care based on systematic and comprehensive patient-engagement is gaining momentum across healthcare systems. Providing care that is responsive to the needs, values and priorities of each patient is important for patients, relatives and providers alike, not least for the growing population of older patients living with multi-morbidity and associated complex care trajectories.

Objectives

The aim of this systematic review is to investigate the effects of patient engagement interventions for older patients with multimorbidity.

Methods

Systematic review conducted in August 2021. Two reviewers independently screened the international databases Embase and PubMed. Reviewers carried out duplicate and independent data extraction and assessment of study quality. Grading of Recommendations Assessment, Development and Evaluation was used to assess the quality of the evidence for each study.

Results

We included twelve studies from primary care setting and hospitals. The included studies were heterogeneous in terms of characteristics of populations, types of interventions to enhance patient-engagement, outcome measures and length of follow-up. Nine of the 12 included studies found significant improvements in health and patient-reported outcomes such as higher quality-adjusted life-years, fewer hospital visits and disease specific symptoms. Quality of the included studies was of low to moderate.

Conclusion

This review identifies potential beneficial effects of interventions to enhance patient-engagement in older adults with multimorbidity. Nevertheless, the limited and very diverse evidence-based calls for more robust studies into efficient approaches to engaging older adults with multimorbidity in care trajectories.
‘It’s always in the back of my mind’: understanding the psychological impact of recovery following pancreaticoduodenectomy for cancer: a qualitative study
Authors: Taylor Anna Kathryn , Chang David , Chew-Graham Carolyn Anne , Rimmer Lara , Kausar Ambareen
Published: December 2021

Objectives

Ten per cent of patients diagnosed with pancreatic cancer undergo pancreaticoduodenectomy. There is limited previous research focusing on psychological well-being; unmet support needs impact negatively on quality of life. This paper reports the psychological impact of a pancreatic cancer diagnosis and subsequent pancreaticoduodenectomy, exploring how patients’ lives alter following surgery and how they seek support.

Design

Inductive qualitative study involving in-depth semistructured interviews with 20 participants who had undergone pancreaticoduodenectomy for pancreatic or distal biliary duct cancer. Interviews were audiorecorded, transcribed and anonymised, and thematic analysis used principles of constant comparison.

Setting

Single National Health Service Trust in Northwest England.

Participants

Patients were eligible for inclusion if they had had pancreaticoduodenectomy for head of pancreas cancer, periampullary cancer or distal cholangiocarcinoma between 6 months and 6 years previously, and had completed adjuvant chemotherapy.

Results

Analysis identified the following main themes: diagnosis and decision making around surgery; recovery from surgery and chemotherapy; burden of monitoring and ongoing symptoms; adjusting to ‘a new normal’; understanding around prognosis; support-seeking. Participants seized the chance to have surgery, often without seeming to absorb the risks or their prognosis. They perceived that they were unable to control their life trajectory and, although they valued close monitoring, experienced anxiety around their appointments. Participants expressed uncertainty about whether they would be able to return to their former activities. There were tensions in their comments about support-seeking, but most felt that emotional support should be offered proactively.

Conclusions

Patients should be made aware of potential psychological sequelae, and that treatment completion may trigger the need for more support. Clinical nurse specialists (CNSs) were identified as key members of the team in proactively offering support; further training for CNSs should be encouraged. Understanding patients’ experience of living with cancer and the impact of treatment is crucial in enabling the development of improved support interventions.
Assessment of patient-reported outcomes after polytrauma – instruments and methods: a systematic review
Authors: Ritschel Michaela , Kuske Silke , Gnass Irmela , Andrich Silke , Moschinski Kai , Borgmann Sandra Olivia , Herrmann-Frank Annegret , Metzendorf Maria-Inti , Wittgens Charlotte , Flohé Sascha , Sturm Johannes , Windolf Joachim , Icks Andrea
Published: December 2021

Objectives

We (1) collected instruments that assess health-related quality of life (HRQoL), activities of daily living (ADL) and social participation during follow-up after polytrauma, (2) described their use and (3) investigated other relevant patient-reported outcomes (PROs) assessed in the studies.

Design

Systematic Review using the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline.

Data sources

MEDLINE, Embase, CINAHL, PsycINFO, CENTRAL, as well as the trials registers ClinicalTrials.gov and WHO ICTRP were searched from January 2005 to April 2018.

Eligibility criteria

All original empirical research published in English or German including PROs of patients aged 18–75 years with an Injury Severity Score≥16 and/or an Abbreviated Injury Scale≥3. Studies with defined injuries or diseases (e.g. low-energy injuries) and some text types (e.g. grey literature and books) were excluded. Systematic reviews and meta-analyses were excluded, but references screened for appropriate studies.

Data extraction and synthesis

Data extraction, narrative content analysis and a critical appraisal (e.g. UK National Institute for Health and Care Excellence) were performed by two reviewers independently.

Results

The search yielded 3496 hits; 54 publications were included. Predominantly, HRQoL was assessed, with Short Form-36 Health Survey applied most frequently. ADL and (social) participation were rarely assessed. The methods most used were postal surveys and single assessments of PROs, with a follow-up period of one to one and a half years. Other relevant PRO areas reported were function, mental disorders and pain.

Conclusions

There is a large variation in the assessment of PROs after polytrauma, impairing comparability of outcomes. First efforts to standardise the collection of PROs have been initiated, but require further harmonisation between central players. Additional knowledge on rarely reported PRO areas (e.g. (social) participation, social networks) may lead to their consideration in health services provision.

PROSPERO registration number

CRD42017060825.
Living conditions, HIV and gender affirmation care pathways of transgender people living with HIV in France: a nationwide, comprehensive, cross-sectional, community-based research protocol (ANRS Trans&HIV)
Authors: Mora Marion , Rincon Giovanna , Bourrelly Michel , Maradan Gwenaëlle , Freire Maresca Anaenza , Michard Florence , Rouveix Elisabeth , Pannetier Julie , Leriche Diane , Alain Tristan , Yazdanpanah Yazdan , Michels David , Spire Bruno
Published: December 2021

Introduction

Transgender identity is poorly accepted in France, and data on living conditions and the daily difficulties transgender people encounter are scarce. This lack of data reinforces their invisibility in social life, contributes to their stigmatisation and probably increases the burden of HIV infection, especially for HIV-positive transgender people (TRHIV). The main objective of the community-based research study ANRS Trans&HIV is to identify personal and social situations of vulnerability in TRHIV, the obstacles they encounter in terms of access to and retention in medical care, and their gender affirmation and HIV care needs.

Methods and analysis

ANRS Trans&HIV is a national, comprehensive, cross-sectional survey of all TRHIV currently being followed in HIV care units in France. TRHIV women are exclusively included in the quantitative component, and TRHIV men in the qualitative component. Data are collected by community-based interviewers and will be analysed to explore patient care pathways and living conditions in the TRHIV population with regard to gender affirmation and HIV. Data collection began in October 2020 and should be completed in December 2021. The statistical analyses techniques used will be adapted to each of the study’s objectives and to the type of data collected (cross-sectional (questionnaires) and retrospective (biographical trajectory)). The study’s results will provide a greater understanding of TRHIV health needs in order to suggest possible national recommendations for comprehensive HIV and gender affirmation medical care.

Ethics and dissemination

ANRS Trans&HIV was approved by Inserm’s Ethical Evaluation Committee (no 20-694 on 12 May 2020) and is registered with the National Commission on Informatics and Liberty under number 2518030720. Potential participants are informed about the study through an information note provided by their attending HIV physician. All results published in peer-reviewed journals will be disseminated to the HIV transgender community, institutional stakeholders and healthcare providers.

Trial registration number

NCT04849767.
Cohort profile: demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe
Authors: Gerritsen Suzanne E , Maras Athanasios , van Bodegom Larissa S , Overbeek Mathilde M , Verhulst Frank C , Wolke Dieter , Appleton Rebecca , Bertani Angelo , Cataldo Maria G , Conti Patrizia , Da Fonseca David , Davidović Nikolina , Dodig-Ćurković Katarina , Ferrari Cecilia , Fiori Federico , Franić Tomislav , Gatherer Charlotte , De Girolamo Giovanni , Heaney Natalie , Hendrickx Gaëlle , Kolozsvari Alfred , Levi Flavia Micol , Lievesley Kate , Madan Jason , Martinelli Ottaviano , Mastroianni Mathilde , Maurice Virginie , McNicholas Fiona , O'Hara Lesley , Paul Moli , Purper-Ouakil Diane , de Roeck Veronique , Russet Frédérick , Saam Melanie C , Sagar-Ouriaghli Ilyas , Santosh Paramala J , Sartor Anne , Schandrin Aurélie , Schulze Ulrike M E , Signorini Giulia , Singh Swaran P , Singh Jatinder , Street Cathy , Tah Priya , Tanase Elena , Tremmery Sabine , Tuffrey Amanda , Tuomainen Helena , van Amelsvoort Therese A M J , Wilson Anna , Walker Leanne , Dieleman Gwen C
Published: December 2021

Purpose

The presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports.

Participants

Seven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at.

Findings to date

This cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be ‘markedly ill’, ‘severely ill’ or ‘among the most extremely ill’ by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year.

Future plans

Analysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared.

Trial registration number

NCT03013595.
Novel longitudinal Multiple Overall Toxicity (MOTox) score to quantify adverse events experienced by patients during chemotherapy treatment: a retrospective analysis of the MRC BO06 trial in osteosarcoma
Authors: Spreafico Marta , Ieva Francesca , Arlati Francesca , Capello Federico , Fatone Federico , Fedeli Filippo , Genalti Gianmarco , Anninga Jakob , Gelderblom Hans , Fiocco Marta
Published: December 2021

Objectives

This study aims at exploring and quantifying multiple types of adverse events (AEs) experienced by patients during cancer treatment. A novel longitudinal score to evaluate the Multiple Overall Toxicity (MOTox) burden is proposed. The MOTox approach investigates the personalised evolution of high overall toxicity (high-MOTox) during the treatment.

Design

Retrospective analysis of the MRC-BO06/EORTC-80931 randomised controlled trial for osteosarcoma.

Setting

International multicentre population-based study.

Participants

A total of 377 patients with resectable high-grade osteosarcoma, who completed treatment within 180 days after randomisation without abnormal dosages (+25% higher than planned).

Interventions

Patients were randomised to six cycles of conventional versus dose-intense regimens of doxorubicin and cisplatin. Non-haematological toxicity data were collected prospectively and graded according to the Common Terminology Criteria for Adverse Events (CTCAE).

Main outcome measures

The MOTox score described the overall toxicity burden in terms of multiple toxic AEs, maximum-severity episode and cycle time-dimension. Evolution of high-MOTox was assessed through multivariable models, that investigated the impact of personalised characteristics (eg, achieved chemotherapy dose, previous AEs or biochemical factors) cycle-by-cycle.

Results

A cycle-by-cycle analysis identifies different evolutions of MOTox levels during treatment, detecting differences in patients’ health. Mean MOTox values and percentages of patients with high-MOTox decreased cycle-by-cycle from 2.626 to 1.953 and from 57.8% to 36.6%, respectively. High-MOTox conditions during previous cycles were prognostic risk factors for a new occurrence (ORs range from 1.522 to 4.439), showing that patient’s history of toxicities played an important role in the evolution of overall toxicity burden during therapy. Conventional regimen may be preferred to dose-intense in terms of AEs at cycles 2–3 (p<0.05).

Conclusions

The novel longitudinal method developed can be applied to any cancer studies with CTCAE-graded toxicity data. After validation in other studies, the MOTox approach may lead to improvements in healthcare assessment and treatment planning.

Trial registration number

ISRCTN86294690; Post-results.
Cannabis and cannabidiol use among autistic and non-autistic adults in the UK: a propensity score-matched analysis
Authors: Hua Daniel Ying-Heng , Lees Rachel , Brosnan Mark , Freeman Tom P
Published: December 2021

Objectives

To assess whether autistic and non-autistic adults differ in their cannabis and cannabidiol (CBD) use, their perceptions of cannabinoid products and their cannabinoid-related support-seeking behaviours.

Design

Cross-sectional survey.

Participants

Respondents to an online survey, who self-reported an autism-spectrum disorder diagnosis (autistic participants) or no issues relating to autism (controls). Exclusion criteria were: related/subclinical issues relating to autism, non-UK residence, under 16 years old. Propensity score matching was used to match autistic participants and controls on age, gender and ethnicity. The full-sample analysis included 269 participants and the propensity-matched sample analysis included 166 participants. Propensity-matched analysis was used for primary analysis and was considered robust if supported by triangulation with full-sample analysis.

Results

Autistic participants were more likely to have used CBD in the past 12 months compared with controls (OR=3.52, 95% CI 1.57 to 7.87, p=0.002). They used CBD on more days in the past 12 months (M=34, SD=93) compared with controls (M=17, SD=69, p=0.002). Autistic participants reported trusting the news and doctors less as sources of cannabinoid-related information than controls (p=0.024 and p=0.003, respectively). Autistic participants endorsed the following barriers to cannabinoid-related support seeking more than controls: ‘worrying they won’t understand me’ (OR=3.25, 95% CI 1.67 to 6.33, p<0.001), ‘going somewhere unfamiliar’ (OR=5.29, 95% CI 2.62 to 10.67, p<0.001) and ‘being in a crowded or chaotic place’ (OR=9.79, 95% CI 4.18 to 22.89, p<0.001).

Conclusion

Results indicate a higher prevalence and frequency of CBD use, but not cannabis use, among autistic individuals compared with controls. Findings also suggest appropriate methods to disseminate cannabinoid-related support to autistic individuals, and indicate differences in the potential barriers autistic and non-autistic individuals may face when seeking cannabinoid-related support.
Bronchial Thermoplasty Global Registry (BTGR): 2-year results
Authors: Torrego Alfons , Herth Felix J , Munoz-Fernandez Ana M , Puente Luis , Facciolongo Nicola , Bicknell Stephen , Novali Mauro , Gasparini Stefano , Bonifazi Martina , Dheda Keertan , Andreo Felipe , Votruba Praha , Langton David , Flandes Javier , Fielding David , Bonta Peter I , Skowasch Dirk , Schulz Christian , Darwiche Kaid , McMullen Edmund , Grubb G. Mark , Niven Robert
Published: December 2021

Objectives

Bronchial thermoplasty (BT) is a device-based treatment for subjects ≥18 years with severe asthma not well controlled with inhaled corticosteroids and long-acting beta-agonists. The Bronchial Thermoplasty Global Registry (BTGR) collected real-world data on subjects undergoing this procedure.

Design

The BTGR is an all-comer, prospective, open-label, multicentre study enrolling adult subjects indicated for and treated with BT.

Setting

Eighteen centres in Spain, Italy, Germany, the UK, the Netherlands, the Czech Republic, South Africa and Australia

Participants

One hundred fifty-seven subjects aged 18 years and older who were scheduled to undergo BT treatment for asthma. Subjects diagnosed with other medical conditions which, in the investigator’s opinion, made them inappropriate for BT treatment were excluded.

Primary and secondary outcome measures

Baseline characteristics collected included demographics, Asthma Quality of Life Questionnaire (AQLQ), Asthma Control Test (ACT), medication usage, forced expiratory volume in one second and forced vital capacity, medical history, comorbidities and 12-month baseline recall data (severe exacerbations (SE) and healthcare utilisation). SE incidence and healthcare utilisation were summarised at 1 and 2 years post-BT.

Results

Subjects’ baseline characteristics were representative of persons with severe asthma. A comparison of the proportion of subjects experiencing events during the 12 months prior to BT to the 2-year follow-up showed a reduction in SE (90.3% vs 56.1%, p<0.0001), emergency room visits (53.8% vs 25.5%, p<0.0001) and hospitalisations (42.9% vs 23.5 %, p=0.0019). Reductions in asthma maintenance medication dosage were also observed. AQLQ and ACT scores improved from 3.26 and 11.18 at baseline to 4.39 and 15.54 at 2 years, respectively (p<0.0001 for both AQLQ and ACT).

Conclusions

The BTGR demonstrates sustained improvement in clinical outcomes and reduction in asthma medication usage 2 years after BT in a real-world population. This is consistent with results from other BT randomised controlled trials and registries and further supports improvement in asthma control after BT.

Trial registration number

NCT02104856.