The Influence of Iron in Minimizing the Microstructural Anisotropy of Ti-6Al-4V Produced by Laser Powder-Bed Fusion

There remains a significant challenge in adapting alloys for metal based Additive Manufacturing (AM). Adjusting alloy composition to suit the process, particularly under regimes close to industrial practice, is therefore a potential solution. With the aim of designing new Ti-based alloys of superior mechanical properties for use in laser powder-bed fusion, this research investigates the influence of Fe on the microstructural development of Ti-6Al-4V. The operating mechanisms that govern the relationship between the alloy composition (and Fe in particular) and the grain size are explored using EBSD, TEM and in-situ high-energy synchrotron X-ray diffraction. It was found that Fe additions up to 3 wt% lead to a progressive refinement of the microstructure. By exploiting the cooling rates of AM and suitable amount of Fe additions, it was possible to obtain microstructures that can be optimized by heat treatment without obvious precipitation of detrimental brittle phases. The resulting microstructure consists of a desirable and well studied fully laminar α+ β structure in refined prior-β grains

The influence of iron in minimizing the microstructural anisotropy of Ti-6Al-4V produced by laser powder-bed fusion

There remains a significant challenge in adapting alloys for metal-based additive manufacturing (AM). Adjusting alloy composition to suit the process, particularly under regimes close to industrial practice, is therefore a potential solution. With the aim of designing new Ti-based alloys of superior mechanical properties for use in laser powder-bed fusion, this research investigates the influence of Fe on the microstructural development of Ti-6Al-4V. The operating mechanisms that govern the relationship between the alloy composition (and Fe in particular) and the grain size are explored using EBSD, TEM, and in situ high-energy synchrotron X-ray diffraction. It was found that Fe additions up to 3 wt pct lead to a progressive refinement of the microstructure. By exploiting the cooling rates of AM and suitable amount of Fe additions, it was possible to obtain microstructures that can be optimized by heat treatment without obvious precipitation of detrimental brittle phases. The resulting microstructure consists of a desirable and well-studied fully laminar α + β structure in refined prior-β grains

Microstructural characterisation of subsurface deformation and the degradation of Stellite 6 induced by self-mated sliding contact in a simulated PWR environment

© 2021 Elsevier Ltd Stellite 6 (Co-29.5%Cr-5%W-1.2%C in wt%) is traditionally used as a hardfacing material in the primary circuit of pressurised water reactors (PWRs) due to its good corrosion and wear resistance in water at up to 300 °C. In this study, pin-on-disc type sliding contact tribocorrosion testing was conducted on HIPed Stellite 6 at 20 °C and 250 °C using a bespoke tribometer to simulate a primary circuit environment. Transmission electron microscopy (TEM), scanning electron microscopy (SEM), and X-ray diffraction (XRD) were used to characterize, for the first time, the material affected by tribocorrosion. Whilst the material loss increases by 16–39 times when the test temperature is increased from 20 °C to 250 °C, the mechanisms of degradation and deformation remain largely unchanged. Furthest from the sliding contact, strain is principally accommodated by the deformation-induced transformation of the γ Co-based matrix to ε-martensite. Closer to the sliding contact, the ε-martensite phase accommodates further strain via twinning and dislocation slip. At the sliding contact the intense deformation generates a nanocrystalline structure. The tribologically affected material is resistant to plastic strain localisation; this confines wear to the nanoscale where the synergistic effects of chemical degradation and mechanical deformation permit the removal of nanoscale particulates (corrosion enhanced nanowear (tribocorrosion)). The increased wear rate at 250 °C is attributed to a temperature dependent increase in corrosion enhanced nanowear. The degradation mechanisms revealed are important for the design of future hardfacings

Informing investment to reduce inequalities: a modelling approach

Background: Reducing health inequalities is an important policy objective but there is limited quantitative information about the impact of specific interventions. Objectives: To provide estimates of the impact of a range of interventions on health and health inequalities. Materials and methods: Literature reviews were conducted to identify the best evidence linking interventions to mortality and hospital admissions. We examined interventions across the determinants of health: a ‘living wage’; changes to benefits, taxation and employment; active travel; tobacco taxation; smoking cessation, alcohol brief interventions, and weight management services. A model was developed to estimate mortality and years of life lost (YLL) in intervention and comparison populations over a 20-year time period following interventions delivered only in the first year. We estimated changes in inequalities using the relative index of inequality (RII). Results: Introduction of a ‘living wage’ generated the largest beneficial health impact, with modest reductions in health inequalities. Benefits increases had modest positive impacts on health and health inequalities. Income tax increases had negative impacts on population health but reduced inequalities, while council tax increases worsened both health and health inequalities. Active travel increases had minimally positive effects on population health but widened health inequalities. Increases in employment reduced inequalities only when targeted to the most deprived groups. Tobacco taxation had modestly positive impacts on health but little impact on health inequalities. Alcohol brief interventions had modestly positive impacts on health and health inequalities only when strongly socially targeted, while smoking cessation and weight-reduction programmes had minimal impacts on health and health inequalities even when socially targeted. Conclusions: Interventions have markedly different effects on mortality, hospitalisations and inequalities. The most effective (and likely cost-effective) interventions for reducing inequalities were regulatory and tax options. Interventions focused on individual agency were much less likely to impact on inequalities, even when targeted at the most deprived communities

Pulmonary Function and Blood DNA Methylation: A Multiancestry Epigenome-Wide Association Meta-Analysis

Rationale: Methylation integrates factors present at birth and modifiable across the lifespan that can influence pulmonary function. Studies are limited in scope and replication. Objectives: To conduct large-scale epigenome-wide meta-analyses of blood DNA methylation and pulmonary function. Methods: Twelve cohorts analyzed associations of methylation at cytosine-phosphate-guanine probes (CpGs), using Illumina 450K or EPIC/850K arrays, with FEV1, FVC, and FEV1/FVC. We performed multiancestry epigenome-wide meta-analyses (total of 17,503 individuals; 14,761 European, 2,549 African, and 193 Hispanic/Latino ancestries) and interpreted results using integrative epigenomics. Measurements and Main Results: We identified 1,267 CpGs (1,042 genes) differentially methylated (false discovery rate, \u3c0.025) in relation to FEV1, FVC, or FEV1/FVC, including 1,240 novel and 73 also related to chronic obstructive pulmonary disease (1,787 cases). We found 294 CpGs unique to European or African ancestry and 395 CpGs unique to never or ever smokers. The majority of significant CpGs correlated with nearby gene expression in blood. Findings were enriched in key regulatory elements for gene function, including accessible chromatin elements, in both blood and lung. Sixty-nine implicated genes are targets of investigational or approved drugs. One example novel gene highlighted by integrative epigenomic and druggable target analysis is TNFRSF4. Mendelian randomization and colocalization analyses suggest that epigenome-wide association study signals capture causal regulatory genomic loci. Conclusions: We identified numerous novel loci differentially methylated in relation to pulmonary function; few were detected in large genome-wide association studies. Integrative analyses highlight functional relevance and potential therapeutic targets. This comprehensive discovery of potentially modifiable, novel lung function loci expands knowledge gained from genetic studies, providing insights into lung pathogenesis

Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]