Legibility of machine readable codes used for gas turbine part tracking

Gas turbines are comprised of many parts, which are often expensive and required to survive a harsh environment for significant periods (with or without reconditioning). To differentiate between parts, and facilitate keeping accurate historical records, they are often given a unique identification number. However, manually recording and tracking these is difficult. This has led to increased adoption of machine readable codes to help reduce or eliminate many of the issues currently faced (mostly human error). The harsh environment of a gas turbine means that typical methods of applying machine readable codes, such as printed adhesive labels, are simply not durable enough. Direct part marking (DPM) is necessary to ensure the desired longevity of the code over the part's useful life. The research presented in this thesis was approached in two main phases. Firstly, the author sought to investigate the technical solutions available for the elements required of a part tracking system (encoding, marking and scanning). This included identifying the characteristics of each and their compatibility with one other (across elements). In conjunction with Alstom, criteria were identified that were used as a basis for comparison so that the preferred technical solutions could be determined. The outcome of this process was enhanced by the author developing a number of industrial contacts experienced in implementing part tracking systems. The second phase related to the legibility of the codes. The harsh environment of a gas turbine results in surface degradation that may in turn reduce the legibility of any machine readable codes present. To better understand why read failures occur, the author _rst looked to the scanning process. Data Matrix symbols (marked via dot peen) require the scanner to capture an image for processing. Image capture is typically achieved using a charge-coupled device (CCD), each pixel of which induces a charge proportional to the incident illumination. This illumination is received via reflection from the surface of the part and hence the Data Matrix marked on it. Several surface features were identified that govern the way in which the part surface will reflect light back to the scanner: surface roughness, dot geometry and surface colour. These parameters are important because they link the degradation mechanisms occurring { broadly categorised as deposition, erosion or corrosion { with the scanning process. Whilst the degradation mechanisms are distinctly different in their behaviour, their effect on surface reflectivity is common in that they can all be characterised via the surface parameters identified. This was deduced theoretically and so the author completed tests (utilising shot blasting to change the surface roughness and oxidation to change its colour, independently) to show that these surface parameters do indeed change with the introduction of surface degradation and that there is a commensurate change in symbol legibility. Based on the learning derived with respect to Data Matrix legibility, the author has proposed a framework for developing a tool referred to as a Risk Matrix System. This tool is intended to enhance the application of part tracking to gas turbine engines by enabling symbol durability to be assessed based on the expected operating conditions. The research presented is the first step in fully understanding the issues that affect the legibility of symbols applied to gas turbine parts. The author's main contribution to learning has been the identification of knowledge from various other sources applicable to this situation and to present it in a coherent and complete manner. From this foundation, others will be able to pursue relevant issues further; the author has made a number of recommendations to this effect

The JAK2V617F mutation and the role of therapeutic agents in alleviating myeloproliferative neoplasm symptom burden

Funding information: MPNVoice,Grant/AwardNumber:0001 Acknowledgements: The authors would like to express gratitude to the participants who gave their time to take part in the MOSAICC pilot study. We would also like to acknowledge the work of the charity MPN Voice (grant number 0001), formerly MPD Voice, who kindly funded the work of the MOSAICC pilot study. Finally, we would like to thank Dr Barry Crouch from the University of Aberdeen Digital Research Service, whose knowledge and assistance in coding and statistical software were fundamental to the completion of this research.Peer reviewe

Electronic Cigarette Use Among Emerging and Young West Indian Adults

Currently, evidence concerning electronic cigarette (e-cigarette) use in the West Indies is unavailable. This study examines the prevalence and associated factors of e-cigarette use in young Trinidadian adults, 6 years after e-cigarettes were introduced in Trinidad. Young adults between the ages of 18 and 40 years were surveyed from May–June 2016. Based on the survey results, descriptive statistics and logistic regression models were used to identify correlations in e-cigarette use. The prevalence of those who had used e-cigarettes was 24.6%, and 41.9% of these people had used both e-cigarettes and tobacco cigarettes. A high proportion (16.95%) of those who had never used tobacco cigarettes had used e-cigarettes. Males were twice as likely as females to have used e-cigarettes (odds ratio [OR]: 2.60; 95% confidence interval [CI]: 1.85–3.68), and participants aged 18–25 years were more likely than those aged 36–40 years to use e-cigarettes (OR: 0.37; 95% CI: 0.14–0.81). The predictors of e-cigarette use as assessed by univariate analysis were current tobacco cigarette smoking (OR: 9.34; 95% CI: 6.14–14.39; p<0.001) and the belief that e-cigarettes are dangerous to health (OR: 0.61; 95% CI: 0.44–0.85; p=0.004). The predictors as assessed by multivariate logistic regression (adjusted OR) were ethnicity (p=0.043), education (p=0.012), and age group (p=0.007). Those who quit using tobacco cigarettes were 7.98 times more likely to use e-cigarettes (95% CI: 4.21–15.45), and those who knew that e-cigarettes contain nicotine were 2.70 times more likely to use them (95% CI: 1.53–4.86; p<0.001). Two summative scales were constructed that measured knowledge and perception. The perception scale, but not the knowledge scale (Cronbach’s alpha=0.736), was a significant predictor of e-cigarette use. The number of e-cigarette users is high (24.6%) in young adults in Trinidad and in those who have never smoked tobacco (16.95%). Current smokers, as well as those who have quit smoking, are at an increased risk of e-cigarette use. This study established that young adults have a low level of knowledge regarding e-cigarettes and shows that they should be educated on e-cigarette use. Further research to examine the reasons for, and susceptibility to, e-cigarette use is necessary

Results of a national UK physician reported survey of COVID-19 infection in patients with a myeloproliferative neoplasm

Funder: Cancer Research UK (CRUK); doi: https://doi.org/10.13039/501100000289Funder: DH | National Institute for Health Research (NIHR); doi: https://doi.org/10.13039/50110000027

Cost effectiveness of potential ART adherence monitoring interventions in sub-saharan Africa

Background Interventions based around objective measurement of adherence to antiretroviral drugs for HIV have potential to improve adherence and to enable differentiation of care such that clinical visits are reduced in those with high adherence. It would be useful to understand the approximate upper limit of cost that could be considered for such interventions of a given effectiveness in order to be cost effective. Such information can guide whether to implement an intervention in the light of a trial showing a certain effectiveness and cost. Methods An individual-based model, calibrated to Zimbabwe, which incorporates effects of adherence and resistance to antiretroviral therapy, was used to model the potential impact of adherence monitoring-based interventions on viral suppression, death rates, disability adjusted life years and costs. Potential component effects of the intervention were: enhanced average adherence when on ART, reduced risk of ART discontinuation, and reduced risk of resistance acquisition. We considered a situation in which viral load monitoring is not available and one in which it is. In the former case, it was assumed that care would be differentiated based on the adherence level, with fewer clinic visits in those demonstrated to have high adherence. In the latter case, care was assumed to be primarily differentiated according to viral load level. The maximum intervention cost required to be cost effective was calculated based on a cost effectiveness threshold of $500 per DALY averted. Findings In the absence of viral load monitoring, an adherence monitoring-based intervention which results in a durable 6$50 per person-year on ART, mainly driven by the cost savings of differentiation of care. In the presence of viral load monitoring availability, an intervention with a similar effect on viral load suppression was cost-effective when costing $23-$32 per year, depending on whether the adherence intervention is used to reduce the level of need for viral load measurement. Conclusion The cost thresholds identified suggest that there is clear scope for adherence monitoringbased interventions to provide net population health gain, with potential cost-effective use in situations where viral load monitoring is or is not available. Our results guide the implementation of future adherence monitoring interventions found in randomized trials to have health benefit

Ibrutinib as initial therapy for patients with chronic lymphocytic leukemia

Background: chronic lymphocytic leukemia (CLL) primarily affects older persons who often have coexisting conditions in addition to disease-related immunosuppression and myelosuppression. We conducted an international, open-label, randomized phase 3 trial to compare two oral agents, ibrutinib and chlorambucil, in previously untreated older patients with CLL or small lymphocytic lymphoma. Methods: we randomly assigned 269 previously untreated patients who were 65 years of age or older and had CLL or small lymphocytic lymphoma to receive ibrutinib or chlorambucil. The primary end point was progression-free survival as assessed by an independent review committee. Results: the median age of the patients was 73 years. During a median follow-up period of 18.4 months, ibrutinib resulted in significantly longer progression-free survival than did chlorambucil (median, not reached vs. 18.9 months), with a risk of progression or death that was 84% lower with ibrutinib than that with chlorambucil (hazard ratio, 0.16; P<0.001). Ibrutinib significantly prolonged overall survival; the estimated survival rate at 24 months was 98% with ibrutinib versus 85% with chlorambucil, with a relative risk of death that was 84% lower in the ibrutinib group than in the chlorambucil group (hazard ratio, 0.16; P=0.001). The overall response rate was higher with ibrutinib than with chlorambucil (86% vs. 35%, P<0.001). The rates of sustained increases from baseline values in the hemoglobin and platelet levels were higher with ibrutinib. Adverse events of any grade that occurred in at least 20% of the patients receiving ibrutinib included diarrhea, fatigue, cough, and nausea; adverse events occurring in at least 20% of those receiving chlorambucil included nausea, fatigue, neutropenia, anemia, and vomiting. In the ibrutinib group, four patients had a grade 3 hemorrhage and one had a grade 4 hemorrhage. A total of 87% of the patients in the ibrutinib group are continuing to take ibrutinib. Conclusions: ibrutinib was superior to chlorambucil in previously untreated patients with CLL or small lymphocytic lymphoma, as assessed by progression-free survival, overall survival, response rate, and improvement in hematologic variables. (Funded by Pharmacyclics and others; RESONATE-2 ClinicalTrials.gov number, NCT01722487.)