bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Role of Microgrid Topology for Decentralized Model-Based Control
Authors: Chu Cheong Matthew K. , Chen Dongmei , Du Pengwei
Published: November 2019

This paper identifies how the topology of a microgrid, particularly with respect to localized power injections, can affect the overall stability of the system. Microgrids are smaller-scale power networks that can disconnect from, and operate independently to, the main grid if necessary; accordingly, distributed and local generation is much more common in these systems. Of these local power sources, a significant proportion interface with the microgrid via inverters, and therefore lack physical inertia. This absence of physical inertia exacerbates the control challenge in a microgrid. These issues motivate the question of how to best control distributed generators to realize grid-wide improvements to power quality. We outline how the placement of controlled distributed generators can result in varying degrees of improved transient behavior, following disturbances to a microgrid. In this resulting simulations and analysis, we find that when the power sources in a microgrid are of varying capacity or rating, then the network topology can have a significant effect on transient performance deterioration. Notably, we find that if even a single a lower rated power source is ‘near’ or adjacent to a grid disturbance, then the microgrid may experience severe harmonic disturbances. In addition, we show that if such sources are controlled with a decentralized optimal controller, rather than a typical droop mechanism, then the overall microgrid performance is significantly improved.
An Improved Small-Scale Connected Autonomous Vehicle Platform
Authors: Wu Xihui , Eskandarian Azim
Published: November 2019

This paper introduces a small-scale platform for Connected Autonomous Vehicle (CAV) research that outperforms currently available commercial options in several important benchmarks. The platform is built around a Radio-Control (RC) car utilizing high-performance brushless DC motors allowing the vehicle to reach a maximum speed of 70mph, expanding the possibilities for higher speed research applications. Furthermore, this platform (named after our lab, ASIMcar, for brevity in this article) is equipped with a robust sensor suite and features a state-of-the-art embedded GPU unit for onboard computation, allowing for real-time control over a wide range of challenging operations. For demonstration and comparison, lane keeping as an Advanced Driving Assistance System (ADAS) function was implemented and evaluated using the platform. The commercially available mobile robots are expensive, offer limited capabilities, are harder to modify for various research needs, are more difficult to interface with other robots (cars), and could have proprietary software/hardware features which render them less flexible and less adaptable to specific research needs. The developed ASIMcar overcomes these limitations and provides a highly flexible and cost-effective alternative for automated/autonomous and connected vehicle research and development projects. This paper provides an in-depth description for the development of this car and lists significant features which will assist other researchers to easily and rapidly duplicate them and create a similar platform for their research.
Analysis of Reference Shaping Control for Improved Yaw Stability in a Steer-by-Wire Vehicle
Authors: Srinivasan Srivatsan , Schmid Matthias J. , Krovi Venkat N.
Published: November 2019

Incorporation of electronic yaw stabilization in on-road vehicles can take many forms. Although the most popular ones are differential braking and torque distribution, a potentially better alternative would be the inclusion of a controller into the steering process. However, this is not often pursued in mechanically-coupled steering systems since the controller could work against the driver’s intentions creating potential challenges to safety. The growing adoption of steer-by-wire (SbW) systems now in autonomous/semi-autonomous vehicles offers an opportunity to simplify the incorporation of such steering-controller based assistance. Most current steering-assistance systems focus either on adaptive steering control (adaptive power steering and gear ratios) or on total steering control in autopilot functions (lane keeping control). Such steering-controllers (incorporated via SbW modality) can improve driving performance and maneuverability and contribute to the overall suite of active-safety vehicle systems. In this study, we introduce a new pure-feedforward (open loop) controller for the steer-by-wire system based on the concept of reference shaping control aimed at reducing the vibration/oscillation caused in vehicles during fast (evasive) maneuvers.
Observer-Based Control of a Dual-Stage Piezoelectric Scanner
Authors: Chang Yuhe , Andersson Sean B.
Published: November 2019

Despite its proven success in a wide variety of applications, the atomic force microscope (AFM) remains limited by its slow imaging rate. One approach to overcome this challenge is to rely on algorithmic approaches that reduce the imaging time not by scanning faster but by scanning less. Such schemes are particularly useful on older instruments as they can provide significant gains despite the existing (slow) hardware. At the same time, algorithms for sub-sampling can yield even greater improvements in imaging rate when combined with advanced scanners that can be retrofitted into the system. In this work, we focus on the use of a dual-stage piezoelectric scanner coupled with a particular scanning algorithm known as Local Circular Scan (LCS). LCS drives the tip of the AFM along a circular trajectory while using feedback to center that circle on a sample edge and to move the circle along the feature, thus reducing imaging time by concentrating the samples to the region of interest. Dual-stage systems are well-suited to LCS as the algorithm is naturally described in terms of a high-frequency, short range path (the scanning circle) and a slower, long range path (the track along the sample). However, control of the scanner is not straightforward as the system is multi-input, single-output. Here we establish controllability and observability of the scanning stage, allowing us to develop individual controllers for the long-range and short-range actuators through the principle of separation. We then use an internal model controller for the short range actuator to track a sinusoidal input (to generate the circular motion) and a state-space set-point tracking controller for the long range actuator. The results are demonstrated through simulation.
A Supervisory Lateral Slip Prevention Controller for Autonomous Vehicles
Authors: Kumbhani Nikunj , Bashash Saeid
Published: November 2019

This paper analyzes the behavior of autonomous vehicles in simulated environment and develops an integrated control system for maneuvering and slip prevention in curvy roads. First, a longitudinal and lateral control system is designed for the vehicle using the feedback linearization method. The longitudinal controller enforces tracking the desired velocity, while the lateral controller steers the vehicle toward, and maintains it on a desired lane. A two-level supervisory controller is then developed to prevent lateral slip while driving on curvy roads. On the lower level, the steering wheel angle is actively limited based on the vehicle speed to avoid oversteering. On the supervisory level, a predictive controller is integrated into the system to optimally slow down the vehicle ahead of a detected road curvature. Simulation results indicate the effectiveness of the proposed schemes in maintaining desirable maneuvering conditions and preventing lateral slips.
Amplitude-Frequency Response of Superharmonic Resonance of Third Order of Electrostatically Actuated MEMS Cantilever Resonators
Authors: Caruntu Dumitru I. , Reyes Christopher
Published: November 2019

This work deals with amplitude frequency response of MEMS cantilever resonators undergoing superharmonic resonance of third order. The cantilever resonator is parallel to a ground plate and under alternating current (AC) voltage that excites the cantilever into vibrations. The driving frequency of the AC voltage is near one sixth of the first natural frequency of the cantilever beam resulting into superharmonic resonance of third order. The cantilever beam is modeled using Euler-Bernoulli beam theory. The electrostatic force is modeled using Palmer’s formula to include the fringe effect. In order to investigate the amplitude frequency behavior of the system reduced order models (ROMs) are developed. Three methods are used to solve these ROMs they are 1) the method of multiple scales (MMS) for ROM with one mode of vibration, 2) homotopy analysis method (HAM) for ROM with one mode of vibration, and 3) direct numerical integration for 2 modes of vibration Reduced Order Model (2T ROM) producing time responses of the tip of the cantilever resonator. In this work the limitations of MMS and HAM are highlighted when considering large voltage values i.e hard excitations. For large voltage values MMS and HAM cannot accurately predict the amplitude frequency response; the results from 2T ROM time responses disagree significantly with the MMS and HAM solutions. The effect of voltage on the frequency response is investigated. As the voltage values in the system increase the responses shift to lower frequencies and larger amplitudes.
Autonomous Real-Time Monitoring of Crops in Controlled Environment Agriculture
Authors: Faryadi Saba , Davoodi Mohammadreza , Mohammadpour Velni Javad
Published: November 2019

In this work, we develop a system that can be used for real-time monitoring of multiple important areas in controlled environment agriculture (and in particular greenhouses) using an autonomous ground vehicle (AGV). To model the greenhouse layout, as well as the tasks that should be accomplished by the AGV, we generate two weighted directed graphs. Based on those graphs, an algorithm is then proposed for finding the optimal (in the sense of traveled distance) trajectory of the vehicle with the goal of precisely monitoring important areas in the greenhouse. Furthermore, a data collection system and image processing algorithm is proposed and implemented so that the vehicle: (i) can capture images and detect changes that have occurred on the crops in real time, and (ii) construct (if needed) a map of the plant rows, when arriving at each one of the important areas. Based on this work, the images can either be stitched onboard the vehicle and then sent to a server or be sent directly to the server and then processed (stitched) there. Both simulation and experimental results are provided to demonstrate the effectiveness and performance of the proposed system.
Comparing Collective Foraging With Interactions Inspired by Pheromones and Sonar
Authors: Bradley Aidan J. , Shirazi Masoud Jahromi , Abaid Nicole
Published: November 2019

Communication inspired by animals is a timely topic of research in the modeling and control of multi-agent systems. Examples of such bio-inspired communication methods include pheromone trails used by ants to forage for food and echolocation used by bats to orient themselves and hunt. Source searching is one of many challenges in the field of swarm robotics that tackles an analogous problem to animals foraging for food. This paper seeks to compare two communication methods, inspired by sonar and pheromones, in the context of a multi-agent foraging problem. We explore which model is more effective at recruiting agents to forage from a found target. The results of this work begin to uncover the complicated relationship between sensing modality, collective tasks, and spontaneous cooperation in groups.
Distributed Control of a Planar Discrete Elastic Rod Model for Caterpillar-Inspired Locomotion
Authors: Nguewou-Hyousse Helene , Scott William L. , Paley Derek A.
Published: November 2019

During crawling, a caterpillar body stretches and bends, and a wave repeatedly travels from the tail to the head. Recently, caterpillar locomotion has been modeled using the theory of planar discrete elastic rods (PDER). This work takes a similar modeling approach and introduces feedback control laws with communication between neighboring segments. Caterpillar locomotion is modeled first as a network of spring-mass-dampers connected through nearest neighbor interactions and then as a network of linked torsional springs. Feedback laws are designed to achieve consensus and traveling wave solutions. Simulation results show the displacement of each segment of a caterpillar during locomotion. These results show promise for the design of feedback control laws in a network model of soft robotic systems.
Drop Volume Control in Drop-on-Demand Inkjet Printing
Authors: Wang Jie , Chen Xia , Chiu George
Published: November 2019

Drop-on-demand (DoD) inkjet printing is used in precise-dosage deposition applications where consistent drop volume is important. Existing drop volume regulation in DoD inkjet printing are mainly open-loop approaches that are not effective in compensating for uncertainties during high volume printing applications. In this paper, a real-time image-based feedback system is proposed for regulating drop volume. A rotational symmetric model estimates drop volume from real-time images. Estimation accuracy is analyzed and validated. A simple feedback controller is developed to regulate drop volume. Experimental results validate the effectiveness of the proposed approach.
Control-Oriented Physics-Based NOx Emission Model for a Diesel Engine With Exhaust Gas Recirculation
Authors: Duraiarasan Saravanan , Salehi Rasoul , Stefanopoulou Anna , Mahesh Siddharth , Allain Marc
Published: November 2019

Publisher’s Note:

This paper was selected for publication in ASME Letters in Dynamic Systems and Control.

https://www.asmedigitalcollection.asme.org/lettersdynsys/article/doi/10.1115/1.4046450/1074858/Control-Oriented-Physics-Based-NOX-Emission-Model
Ellipsometric studies for thin polymer layers of organic photovoltaic cells
Authors: Nosidlak Natalia , Jaglarz Janusz , Danel Andrzej
Published: November 2019

In this study, ellipsometry was used to study thin films on organic photovoltaic cells. The investigated cells contained a traditional donor-acceptor structure as the active layer in the form of a bulk heterojunction. The tested photovoltaic cells had the following structure: ITO/poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS)/poly (3-hexylthiophene-2-diyl) (P3HT) + 1,3-phenyl-6-fluorine-1H-pyrazolo[3,4-b]quinoline (PQ)/Al. The active layer was a blend of P3HT and a compound from the pyrazoloquinoline group with a low molecular weight marked as PQ. The ITO film acted as the electrode collecting the holes. The PEDOT:PSS layer was used to smoothen the ITO film and facilitate the transport of holes. The layers were tested using spectroscopic ellipsometry (SE), and the spectral dispersion of optical constants was determined in a wavelength range of 300–1700 nm. The appropriate theoretical models were then fitted to the SE measurement results. This information was used to determine the thickness of the layers and the dispersion relation of refractive and extinction indices. The temperature dependence of refractive indices of polythiophene layers during the heating and cooling process is also presented for a temperature range of 25–110 °C. Additionally, the authors calculated thermo-optic and thermal expansion coefficients and characterized the conditions of thermal stability of the layers and reversibility issues in thermal processes.
Exploring Friction with the Ancient Egyptians
Authors: Renner Susan M. , Schwert Daniel D.
Published: November 2019

We devised an activity to explore friction by testing some of the common theories on how ancient Egyptians moved the stones used to build the pyramids. The activity is suitable for a high school physics course or introductory college courses for both science majors and non-science majors. The students investigate dragging a 1-kg mass (representing a stone) on a small wooden sled under three conditions: over dry sand, using wooden rollers over dry sand, and over wet sand. This last condition has been recently proposed as a potential method used by the Egyptians. The force required to pull the sled at a constant velocity is measured and used to calculate the kinetic coefficient of friction for each of the three test conditions. Students then perform a similar activity pulling their professor across a sand volleyball court. Versions of this experiment have been done in four classes of science majors (general physics, two 2-hour lab periods) and in four classes of non-science majors (physical sciences for educators, one 2-hour lab period).
The Influence of Surface Temperature on the Coefficient of Static Friction
Authors: Lukovic Milentije
Published: November 2019

Friction is one of the common forces that affect our everyday life and one of the oldest problems studied in physics. An interpretation of its nature is included in all general physics courses, in both high school and college. The desire and need to better understand it guided a long list of scientists who devoted themselves to the study of friction over the past several centuries. In this regard a number of physical and mathematical models have been created to explain different types of friction. Models related to dry friction and its origins can be classified into two groups. The first group includes those that deal with the explanation of static friction, such as the fundamental understanding of friction provided by Charles Augustin de Coulomb in 1781. The second group includes models that explain kinetic friction derived from the Dahl model. Coulomb’s model of the friction force remained dominant in the following centuries, and his contribution continued to be so striking that the term “Coulomb model of friction” can often be found even in modern books. However, an improved understanding of the essence of friction in the past few decades has been a result of better insight into molecular dynamics, which opened a way for the creation of a modern science of friction and wear—tribology.
Energy storage: The future enabled by nanomaterials
Authors: Pomerantseva Ekaterina , Bonaccorso Francesco , Feng Xinliang , Cui Yi , Gogotsi Yury
Published: November 2019

Thinking small to store more

From mobile devices to the power grid, the needs for high-energy density or high-power density energy storage materials continue to grow. Materials that have at least one dimension on the nanometer scale offer opportunities for enhanced energy storage, although there are also challenges relating to, for example, stability and manufacturing. In this context, Pomerantseva
et al.
review fundamental processes of charge storage that apply specifically to nanostructured materials and briefly explore potential manufacturing processes. The authors also consider some of the skepticism, such as that found in the battery community, to the use of these materials.

Science
, this issue p.
eaan8285
Turning lateral roots into nodules
Authors: Bishopp Anthony , Bennett Malcolm J.
Published: November 2019

The evolutionary origin of legume root nodules that help them grow is revealed
Pneumococcal Vaccines
Authors: Briles D. E. , Paton J. C. , Mukerji R. , Swiatlo E. , Crain M. J.
Published: November 2019

Streptococcus pneumoniaeis a Gram-Positive pathogen that is a major causative agent of pneumonia, otitis media, sepsis and meningitis across the world. The World Health Organization estimates that globally over 500,000 children are killed each year by this pathogen. Vaccines offer the best protection againstS. pneumoniaeinfections. The current polysaccharide conjugate vaccines have been very effective in reducing rates of invasive pneumococcal disease caused by vaccine type strains. However, the effectiveness of these vaccines have been somewhat diminished by the increasing numbers of cases of invasive disease caused by non-vaccine type strains, a phenomenon known as serotype replacement. Since, there are currently at least 98 known serotypes ofS. pneumoniae, it may become cumbersome and expensive to add many additional serotypes to the current 13-valent vaccine, to circumvent the effect of serotype replacement. Hence, alternative serotype independent strategies, such as vaccination with highly cross-reactive pneumococcal protein antigens, should continue to be investigated to address this problem. This chapter provides a comprehensive discussion of pneumococcal vaccines past and present, protein antigens that are currently under investigation as vaccine candidates, and other alternatives, such as the pneumococcal whole cell vaccine, that may be successful in reducing current rates of disease caused byS. pneumoniae.
Staphylococci: Evolving Genomes
Authors: Lindsay Jodi A.
Published: November 2019

Staphylococci, and in particular
Staphylococcus aureus
, cause an extensive variety of infections in a range of hosts. The comprehensive analysis of staphylococcal genomes reveals mechanisms controlling the organism’s biology, pathobiology, and dissemination. Whole-genome sequencing technologies led to a quantum leap in our understanding of bacterial genomes. The recent cost reduction of sequencing has resulted in unprecedented volumes of genomic information about
S. aureus
, one of the most sequenced bacterial species. Collecting, comparing, and interpreting big data is challenging, but fascinating insights have emerged. For example, it is becoming clearer which selective pressures staphylococci face in their habitats and which mechanisms allow this pathogen to adapt, survive, and spread. A key theme is the constant evolution of staphylococci as they alter their genome, exchange DNA, and adapt to new environments, leading to the emergence of increasingly successful, antibiotic-resistant, immune-evading, and host-adapted colonizers and pathogens. This article introduces the structure of staphylococcal genomes, details how genomes vary between strains, outlines the mechanisms of genetic variation, and describes the features of successful clones.
Complete Genome Sequence of Lactobacillus harbinensis Strain NSMJ42, Isolated from Makgeolli, a Traditional Korean Alcoholic Beverage
Authors: Jung Ji Young , Han Sang-Soo , Kim Z-Hun , Ryu Byung-Gon , Jin Hyun Mi , Chung Eu Jin
Published: November 2019

In the present work, we report the complete genome sequence of
Lactobacillus harbinensis
NSMJ42, isolated from makgeolli (a Korean traditional alcoholic beverage) in South Korea. The final genome assembly consists of a 3.29-Mbp chromosome with 3,082 protein-coding sequences and a G+C content of 53.36%.
Draft Genome Sequence of Enterobacter hormaechei Strain MHSD6, a Plant Endophyte Isolated from Medicinal Plant
Pellaea calomelanos
Authors: Tshishonga Khuthadzo , Serepa-Dlamini Mahloro H.
Published: November 2019

We describe here the draft genome sequence of
Enterobacter hormaechei
strain MHSD6, a bacterial endophyte isolated from the medicinal plant
Pellaea calomelanos
. The
Enterobacter hormaechei
strain MHSD6 draft genome is 4,817,102 bp in length, with a G+C content of 55.50%.
Multilaboratory Comparison of Pneumococcal Multiplex Immunoassays Used in Immunosurveillance of Streptococcus pneumoniae across Europe
Authors: Meek Bob , Ekström Nina , Kantsø Bjørn , Almond Rachael , Findlow Jamie , Gritzfeld Jenna F. , Sværke Jørgensen Charlotte , Ljungberg Karl , Atterfelt Fredrik , Batstra Manou R. , Andeweg Kevin , de Jong Ben A. W. , Prince Harry E. , Lapé-Nixon Mary , Gageldonk Pieter G. M. , Tcherniaeva Irina , Aaberge Ingeborg , Herstad Tove Karin , Melin Merit , Rijkers Ger T. , Berbers Guy A.
Published: November 2019

Serology of
Streptococcus pneumoniae
is challenging due to existence of multiple clinically relevant serotypes and the introduction of multivalent vaccines in national immunization programs. Multiplex immunoassays (MIAs) are applied as high-throughput cost-effective methods for serosurveillance, and yet laboratories use their own protocols. The aims of this study were to assess the agreement of results generated by MIAs in different laboratories within the EU Pneumo Multiplex Assay Consortium, to analyze factors contributing to differences in outcome, and to create a harmonized protocol. The study demonstrated good agreement of results of MIAs performed by laboratories using controlled assays for determination of levels of vaccine-induced pneumococcal antibodies. The EU Pneumo Multiplex Assay Consortium is open to everyone working in public health services, and it aims to facilitate efforts by participants to run and maintain a cost-effective, reproducible, high-quality MIA platform.
The epidemiology of pulmonary tuberculosis in children in Mainland China, 2009–2015
Authors: Yang Ruling , Liu Mengyang , Jiang Hui , Zhang Yingjie , Yin Jinfeng , Li Qihuan , Li Qing , Liu Yue , Wang Xiaonan , Xu Hongmei , Yang Yang , Li Weimin , Guo Xiuhua
Published: November 2019

Objective

To describe the incidence and epidemiological characteristics of child pulmonary tuberculosis (PTB) notified to the Chinese Center for Disease Control and Prevention (CDC) Tuberculosis Information Management System (TBIMS) from 2009 to 2015.

Study design

A database of child PTB for 31 provinces in mainland China over 7 years was retrospectively analysed. The spatiotemporal distribution of child PTB was described.

Results

In total, 35,710 child PTB cases were notified to the TBIMS, representing only 0.60% of all 5,991,593 PTB case notifications. The average annual notified incidence of child PTB was 2.44/ per 100,000 children (95% CI: 1.77–3.10) and decreased by 52.53% in all age groups during the study period. Tibet had the highest incidence (15.95/ per 100,000 children), followed by Guizhou and Xinjiang. However, the case numbers were the most in Guizhou. The 0-1 year and 12–14 years of age groups exhibited the most cases. The positive rates of sputum smears, bacteriology and chest X-rays abnormality were 21.5%, 21.7% and 98.1%, respectively, which were lower than those 15 years of age and older (all p-values<0.0001).

Conclusion

The notified incidence of child PTB in mainland China decreased substantially over 7 years. Future prevention and control of PTB in children should focus on the 0–1 and 12–14 years of age groups, and Tibet and Guizhou provinces. However, the notified incidence is still low, relative to adults, suggesting substantial under-reporting. Thus, more effective care seeking, identification and registration of children with TB are crucial.
HOSPITAL Score, LACE Index and LACE+ Index as predictors of 30-day readmission in patients with heart failure
Authors: Ibrahim Abdisamad M , Koester Cameron , Al-Akchar Mohammad , Tandan Nitin , Regmi Manjari , Bhattarai Mukul , Al-Bast Basma , Kulkarni Abhishek , Robinson Robert
Published: November 2019

This study aimed to evaluate the accuracy of the HOSPITAL Score (Haemoglobin level at discharge, Oncology at discharge, Sodium level at discharge, Procedure during hospitalization, Index admission, number of hospital admissions, Length of stay) LACE index (Length of stay, Acute/emergent admission, Charlson comorbidy index score, Emerency department visits in previous 6 months) and LACE+ index in predicting 30-day readmission in patients with diastolic dysfunction. Heart failure remains one of the most common hospital readmissions in adults, leading to significant morbidity and mortality. Different models have been used to predict 30-day hospital readmissions. All adult medical patients discharged from the SIU School of Medicine Hospitalist service from 12 June 2016 to 12 June 2018 with an International Classification of Disease, 10th Revision, Clinical Modification diagnosis of diastolic heart failure were studied retrospectively to evaluate the performance of the HOSPITAL Score, LACE index and LACE+ index readmission risk prediction tools in this patient population. Of the 730 patient discharges with a diagnosis of heart failure with preserved ejection fraction (HFpEF), 692 discharges met the inclusion criteria. Of these discharges, 189 (27%) were readmitted to the same hospital within 30 days. A receiver operating characteristic evaluation showed C-statistic values to be 0.595 (95% CI 0.549 to 0.641) for the HOSPITAL Score, 0.551 (95% CI 0.503 to 0.598) for the LACE index and 0.568 (95% CI 0.522 to 0.615) for the LACE+ index, indicating poor specificity in predicting 30-day readmission. The result of this study demonstrates that the HOSPITAL Score, LACE index and LACE+ index are not effective predictors of 30-day readmission for patients with HFpEF. Further analysis and development of new prediction models are needed to better estimate the 30-day readmission rates in this patient population.
The costs of developing, deploying and maintaining electronic immunisation registries in Tanzania and Zambia
Authors: Mvundura Mercy , Di Giorgio Laura , Lymo Dafrossa , Mwansa Francis Dien , Ngwegwe Bulula , Werner Laurie
Published: November 2019

Objective

To determine the costs to develop, roll out and maintain electronic immunisation registries (EIRs) and a related suite of data use interventions.

Methods

The Better Immunisation Data (BID) Initiative conducted the activities from 2013 to 2018 in three regions in Tanzania and one province in Zambia. The Initiative’s financial records were used to account for the financial costs of designing and developing the EIRs, BID staff time, expenditures for rolling out the EIR systems and the related suite of interventions to health facilities, and recurrent costs. Total financial costs, cost per facility and cost per child were calculated in 2018 US$.

Findings

Total expenditures were ~US$4.2 million in Tanzania and US$3.6 million in Zambia. System design and development costs accounted for ~33% and 26% of the expenditures in each country, respectively, while BID staff costs accounted for 39% and 52%, respectively. Average expenditures per health facility for rolling out the EIR system were between US$709 and US$1320 for the Tanzania regions and US$2591 for Zambia. The annualised average expenditure per child was estimated to be between US$3.30 and US$3.81 for the regions in Tanzania and US$8.46 in Zambia. Expenditures per child were higher in Zambia partly because of a much smaller birth cohort compared with Tanzania.

Conclusion

Other countries may benefit from the investments made and lessons learnt in Tanzania and Zambia by leveraging these now existing EIR platforms and rollout strategies, and hence may be able to implement EIRs at lower costs than reported here.
Intimate partner violence in pregnancy: a cross-sectional study from post-conflict northern Uganda
Authors: Clarke Susan , Richmond Robyn , Black Eleanor , Fry Helen , Obol James Henry , Worth Heather
Published: November 2019

Objectives

To determine the prevalence of intimate partner violence (IPV) in pregnancy and to understand associations and determinants.

Design

Cross-sectional survey.

Setting

Two rural health clinics in post-conflict northern Uganda.

Participants

Women attending two rural health clinics for a new service providing cervical cancer screening, who had experienced pregnancy.

Primary and secondary outcome measures

Data were collected by a questionnaire using validated questions from the demographic health survey women’s questionnaire and the domestic violence module. Data were entered into tablets using Questionnaire Development System software. Bivariate and multivariate logistic regression was performed, using experience of IPV in pregnancy as the dependent variable. SPSS V.25 was used for all analysis.

Results

Of 409 participant women, 26.7% (95% CI 18.6% to 35.9%) reported having been slapped, hit or beaten by a partner while pregnant. For 32.3% (95% CI 20.2% to 37.9%) of the women the violence became worse during pregnancy. Women who had ever experienced IPV in pregnancy were more likely to have experienced violence in the previous 12 months (OR 4.45, 95% CI 2.80 to 7.09). In multivariate logistic regression, the strongest independent associations with IPV in pregnancy were partner’s daily drinking of alcohol (OR 2.02, 95% CI 1.19 to 3.43) and controlling behaviours (OR 1.17, 95% CI 1.03 to 1.33).

Conclusions

The women in this study had more exposure to IPV in pregnancy than previously reported for this region. Women’s previous experience of intimate partner violence, partner’s daily use of alcohol and his controlling behaviours were strong associations with IPV in pregnancy. This study highlights the uneven distribution of risk and the importance of research among the most vulnerable population in rural and disadvantaged settings. More research is needed in local rural and urban settings to illuminate this result and inform intervention and policy.
Do Norwegian providers comply with national recommendations when prescribing combined oral contraceptives to starters? A cohort study
Authors: Ekman Julie , Skjeldestad Finn Egil
Published: November 2019

Objectives

To assess whether changes in patterns of combined oral contraceptive (COC) prescriptions to starters between 2008 and 2016 were in line with changes in national recommendations for use.

Design

Historical prospective cohort study.

Setting

The national Norwegian Prescription Database.

Participants

Women aged 10–49 years who started COCs between 1 January 2008 and 30 June 2016, in total 285 009 women.

Primary outcome

The proportion of levonorgestrel-containing COC prescriptions to starters.

Intervention

The Norwegian Medical Agency recommended levonorgestrel-containing COCs to starters from 2010 onwards.

Results

The proportion of levonorgestrel-containing COCs prescribed to starters increased from 41% in 2008 to 80% in 2016 with the greatest increase from 2011 to 2012. This prescription pattern comprised all age groups but was observed to a lower extent among older women. Public health nurses and midwifes had the highest compliance with recommendations and prescribed levonorgestrel-containing COCs to 96% of starters aged <20 years in 2016, compared with 75% and 86% among general practitioners and doctors with no specialty.

Conclusion

All professions have increased the proportion of levonorgestrel-containing COC prescriptions to starters. Public health nurses and midwives had the highest compliance with the new recommendations. Future studies will examine whether this shift in prescription pattern has prevented venous thromboembolism in women of reproductive age in Norway.
Improved parental understanding by an enhanced informed consent form: a randomized controlled study nested in a paediatric drug trial
Authors: Koonrungsesomboon Nut , Traivaree Chanchai , Tiyapsane Charnunnut , Karbwang Juntra
Published: November 2019

Objective

This study was designed to evaluate the applicability and effectiveness of the enhanced informed consent form (ICF) methodology, proposed by the Strategic Initiative for Developing Capacity in Ethical Review (SIDCER), in paediatric research requiring parental consent. The objective of this study was to compare the parental understanding of information between the parents who read the SIDCER ICF and those who read the conventional ICF.

Design

A prospective, randomized, controlled design.

Setting

Paediatric Outpatients Department, Phramongkutklao Hospital, Thailand.

Participants

210 parents of children with thalassemia (age=35.6 ± 13.1 years).

Interventions

The parents were randomly assigned to read either the SIDCER ICF (n=105) or the conventional ICF (n=105) of a paediatric drug trial.

Primary and secondary outcome measures

Parental understanding of trial information was determined using 24 scenario-based questions. The primary endpoint was the proportion of parents who obtained the understanding score of more than 80%, and the secondary endpoint was the total score.

Results

Forty-five parents (42.9%) in the SIDCER ICF group and 29 parents (27.6%) in the conventional ICF group achieved the primary endpoint (relative risk=1.552, 95% CI 1.061 to 2.270, p=0.021). The total score of the parents in the SIDCER ICF group was significantly higher than the conventional ICF group (18.07±3.71 vs 15.98±4.56, p=0.001).

Conclusions

The SIDCER ICF was found to be superior to the conventional ICF in improving parental understanding of trial information.
Prognostic models for the clinical management of malaria and its complications: a systematic review
Authors: Njim Tsi , Tanyitiku Bayee Swiri
Published: November 2019

Objective

Malaria infection could result in severe disease with high mortality. Prognostic models and scores predicting severity of infection, complications and mortality could help clinicians prioritise patients. We conducted a systematic review to assess the various models that have been produced to predict disease severity and mortality in patients infected with malaria.

Design

A systematic review.

Data sources

Medline, Global health and CINAHL were searched up to 4 September 2019.

Eligibility criteria for selecting studies

Published articles on models which used at least two points (or variables) of patient data to predict disease severity; potential development of complications (including coma or cerebral malaria; shock; acidosis; severe anaemia; acute kidney injury; hypoglycaemia; respiratory failure and sepsis) and mortality in patients with malaria infection.

Data extraction and synthesis

Two independent reviewers extracted the data and assessed risk of bias using the Prediction model Risk Of Bias Assessment Tool.

Results

A total of 564 articles were screened and 24 articles were retained which described 27 models/scores of interests. Two of the articles described models predicting complications of malaria (severe anaemia in children and development of sepsis); 15 articles described original models predicting mortality in severe malaria; 3 articles described models predicting mortality in different contexts but adapted and validated to predict mortality in malaria; and 4 articles described models predicting severity of the disease. For the models predicting mortality, all the models had neurological dysfunction as a predictor; in children, half of the models contained hypoglycaemia and respiratory failure as a predictor meanwhile, six out of the nine models in adults had respiratory failure as a clinical predictor. Acidosis, renal failure and shock were also common predictors of mortality. Eighteen of the articles described models that could be applicable in real-life settings and all the articles had a high risk of bias due to lack of use of consistent and up-to-date methods of internal validation.

Conclusion

Evidence is lacking on the generalisability of most of these models due lack of external validation. Emphasis should be placed on external validation of existing models and publication of the findings of their use in clinical settings to guide clinicians on management options depending on the priorities of their patients.

PROSPERO registration number

CRD42019130673.
Sex differences in the association between ideal cardiovascular health and biomarkers of cardiovascular disease among adults in the United States: a cross-sectional analysis from the multiethnic study of atherosclerosis
Authors: Osibogun Olatokunbo , Ogunmoroti Oluseye , Tibuakuu Martin , Benson Eve-Marie , Michos Erin D
Published: November 2019

Objectives

This study investigated the sex differences in the associations between ideal cardiovascular health (CVH), measured by the American Heart Association’s Life’s Simple 7 metrics, and cardiovascular disease (CVD)-related biomarkers among an ethnically diverse cohort of women and men free of clinical CVD at baseline.

Setting

We analysed data from the Multi-Ethnic Study of Atherosclerosis conducted in six centres across the USA (Baltimore, Maryland; Chicago, Illinois; Forsyth County, North Carolina; Los Angeles, California; New York, New York; and St Paul, Minnesota).

Participants

This is a cross-sectional study of 5379 women and men, aged 45–84 years old. Mean age (SD) was 62 (10), 52% were women, 38% White, 11% Chinese American, 28% Black and 23% Hispanic.

Primary measures

The seven metrics (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure and blood glucose) were each scored as 0 points (poor), 1 point (intermediate) or 2 points (ideal). The total CVH score ranged from 0 to 14. The CVD-related biomarkers studied were high-sensitivity C-reactive protein, D-dimer, fibrinogen, homocysteine, high-sensitivity cardiac troponin T, N-terminal pro B-type natriuretic peptide (NT-proBNP) and interleukin 6. We examined the association between the CVH score and each biomarker using multivariable linear regression, adjusting for age, race/ethnicity, education, income and health insurance status.

Results

Higher CVH scores were associated with lower concentrations of all biomarkers, except for NT-proBNP where we found a direct association. There were statistically significant interactions by sex for all biomarkers (p<0.001), but results were qualitatively similar between women and men.

Conclusion

A more favourable CVH score was associated with lower levels of multiple CVD-related biomarkers for women and men, except for NT-proBNP. These data suggest that promotion of ideal CVH would have similarly favourable impact on the reduction of biomarkers of CVD risk for both women and men.
Completeness and validity of alcohol recording in general practice within the UK: a cross-sectional study
Authors: Mansfield Kathryn , Crellin Elizabeth , Denholm Rachel , Quint Jennifer K , Smeeth Liam , Cook Sarah , Herrett Emily
Published: November 2019

Background

Since 2010 the National Institute for Health and Care Excellence has recommended screening adults for excessive alcohol consumption to try and help prevent alcohol-use disorders. Little is known about the extent to which these recommendations are followed, and the resulting completeness and validity of alcohol-related data recording in primary care.

Objective

To investigate the completeness and accuracy of recording of alcohol use within primary care records in the UK.

Design and setting

Cross-sectional study in the Clinical Practice Research Datalink.

Participants

We included all adult patients registered on 1stJanuary 2018 with ≥1 year of follow-up.

Primary and secondary outcome measures

We calculated prevalence of alcohol consumption recording overall and within patient groups. We then validated alcohol consumption data against recommended screening tools (Alcohol Use Disorders Identification Test (AUDIT)) as the gold standard. We also calculated how prevalence of alcohol recording changed over the preceding decade.

Results

In 2018, among 1.8 million registered adult patients, just over half (51.9%) had a record for a code related to alcohol in the previous 5 years. Recording of alcohol consumption was more common among women, older people, ex-smokers and those from more deprived areas, who were overweight/obese, or with comorbidities. A quarter of patients had units per week recorded in the last 5 years, but <10% had an AUDIT or Fast Alcohol Screening Test (FAST) alcohol screening test score. The recorded alcohol measures corresponded to results from gold standard AUDIT scores. The distribution of consumption among current drinkers was similar to the Health Survey for England.

Conclusions

Half of adults in UK primary care have no recorded alcohol consumption data. When consumption is recorded, we have demonstrated internal and external validity of the data, suggesting greater recording may help identify opportunities for interventions to reduce harms.
From ‘screen time’ to the digital level of analysis: protocol for a scoping review of digital media use in children and adolescents
Authors: Browne Dillon Thomas , May Shealyn , Hurst-Della Pietra Pamela , Christakis Dimitri , Asamoah Tracy , Hale Lauren , Delrahim-Howlett Katia , Emond Jennifer A , Fiks Alexander G , Madigan Sheri , Prime Heather , Perlman Greg , Rumpf Hans-Jürgen , Thompson Darcy , Uzzo Stephen , Stapleton Jackie , Neville Ross
Published: November 2019

Introduction

Research on the relationship between digital media exposure and child development is complex, inconsistent and fraught with debate. A highlighted area of inadequacy surrounds the methodological limitations of measuring digital media use for both researchers and clinicians, alike. This protocol aims to (1) identify core concepts in the area of screen time and digital media use in children and adolescents (2) map existing research paradigms and screening/measurement tools that serve to underpin and operationalise core concepts and (3) provide an initial step in integrating these findings into a consolidated screening toolkit. It is expected this enterprise will help advance research and clinical evaluation in fields concerned with digital media use, namely medicine, child development and the social sciences.

Methods and analysis

The planned scoping review will search relevant electronic databases, including Ovid MEDLINE, PsycINFO and Scopus, in addition to grey literature. All empirical investigations and presentation of original research will be considered, and measurement/screening tools for digital media usage in children and adolescents will be identified and reported on. Two reviewers will pilot test the screening criteria, and data extraction forms prior to independently screening all relevant literature and extracting the data. A three-stage synthesis process will be used to map the existent measurement and screening tools for digital media usage in children and adolescents.

Ethics and dissemination

There are no ethical considerations for this scoping review. Plans for dissemination include publication in a top-tier, open-access journal, public presentations and conference proceedings. Presentation of the full scoping review has been accepted to the American Academy of Child & Adolescent Psychiatry 66th Annual Meeting.
Workplace violence among prehospital care providers in India: a cross-sectional study
Authors: Lindquist Benjamin , Koval Kathryn , Mahadevan Aditya , Gennosa Christine , Leggio William , Niknam Kian , Rao G V Ramana , Newberry Jennifer A , Strehlow Matthew
Published: November 2019

Objectives

The purpose of this study was twofold: (1) establish the prevalence of safety threats and workplace violence (WPV) experienced by emergency medical technicians (EMTs) in a low/middle-income country with a new prehospital care system, India and (2) understand which EMTs are at particularly high risk for these experiences.

Setting

EMTs from four Indian states (Gujarat, Karnataka, Tamil Nadu and Telangana) were eligible to participate during the study period from July through November 2017.

Methods

Cross-sectional survey study.

Participants

386 practicing EMTs from four Indian states.

Results

The overall prevalence of any WPV was 67.9% (95% CI 63.0% to 72.5%). The prevalence of physical assault was 58% (95% CI 52.5% to 63.4%) and verbal assault was 59.8% (95% CI 54.5% to 65%). Of physical assault victims, 21.7% were injured and 30.2% sought medical attention after the incident. Further, 57.3% (n=216) of respondents reported they were ‘somewhat worried’ and 28.4% (n=107) reported they were ‘very worried’ about their safety at work.

Conclusion

WPV and safety fears were found to be common among EMTs in India. Focused initiatives to counter WPV in countries developing prehospital care systems are necessary to build a healthy and sustainable prehospital healthcare workforce.