The Dynamic Effect of Pile Installation in Sand on Nearby Piles

Driven piles have often been used in many civil structures to provide structural loading support. However, the unavoidable vibrations induced by pile driving processes may cause varying degrees of damage to adjacent structures. This research presents experimental studies to investigate the transmitted vibrations induced by impact of pile driving on vicinity piles. In the experimental work, a small scale model was tested in a sand box (steel container 1 × 1.5 × 0.8 m)  with pile driving hammer device to install the impact pile in sand soil by dropping weights (1, 2, 3, 4 and 5 kg) for different heights of falling (4, 8, 12, 16 and 20 cm). The peak particle velocity was measured at a head of the vicinity piles by vibration meter device. In this study, several piles on different distances away from the vibration source were studied. The experimental results indicate that the peak particle velocity for vibrations emitted with impact pile driving is increased with increasing the energy and the penetration depth of pile driving for all vicinity piles and it can be decreased without change in the driving energy by decreasing the weight of hammer and increasing the height of falling hammer. Vibration intensities are attenuated with increasing surface distance from the pile driving and the peak particle velocity decreased uniformly with surface distance from the pile driving for piles. Also, through laboratory model representation and evaluation of the results obtained in the laboratory, the empirical relations which were determined based on the scaled-distance concept, are appropriate and give results very close and can be relied upon to represent the transmission of vibration resulting from the impact of pile driving to nearby piles

Normal-tension glaucoma is associated with cognitive impairment

Published Online First 29 March 2021Background/aims: Recent research suggests an association between normal-tension glaucoma (NTG) and dementia. This study investigated whether cognitive impairment is more strongly associated with NTG than high tension glaucoma (HTG) using cognitive screening within an Australiasian Glaucoma Disease Registry. Methods: The authors completed a case–control cross sectional cognitive screening involving 290 age-matched and sex-matched NTG participants and HTG controls aged ≥65 randomly sampled from the Australian and New Zealand Registry of Advanced Glaucoma. Cognitive screening was performed using the Telephone Version of the Montreal Cognitive Assessment (T-MoCA). The T-MoCA omits points requiring visual interpretation, accounting for confounding factors related to vision loss in visually impaired participants. Cognitive impairment was defined by a T-MoCA score of <11/22. Cognition was compared between NTG and HTG participants using predetermined thresholds and absolute screening scores. Results: A total of 290 participants completed cognitive assessment. There were no differences in NTG (n=144) and HTG (n=146) cohort demographics or ocular parameters at baseline. Cognitive impairment was more prevalent in the NTG cohort than the HTG cohort (OR=2.2; 95% CI 1.1 to 6.7, p=0.030). Though a linear trend was also observed between lower absolute T-MoCA scores in the NTG cohort when compared with the HTG cohort, this association was not statistically significant (p=0.108). Conclusion: This study demonstrated an association between NTG status and poor cognition, supporting the hypothesis that there exists a disease association and shared pathoaetiological features between NTG and dementia.Sean Mullany, Lewis Xiao, Ayub Qassim, Henry Marshall, Puya Gharahkhani, Stuart MacGregor, Mark M Hassall, Owen M Siggs, Emmanuelle Souzeau, Jamie E Crai

A polygenic risk score predicts functional progression in early primary open-angle glaucoma

Abstract #A0353Owen Siggs, Ayub Qassim, Xikun Han, Henry Marshall, Sean Mullany, Emmanuelle Souzeau, Anna Galanopoulos, Ashish Agar, John Landers, Robert Casson, Alex W Hewitt, Paul Healey, Stuart L Graham, Stuart MacGregor, Jamie Crai

A glaucoma polygenic risk score strongly associated with disease prediction and treatment intensity

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.Jamie E Craig; Ayub Qassim; Xikun Han; Mark Hassall; Robert James Casson; Stuart L Graham; David A Mackey; Colin Willoughby; Kathryn P Burdon; John Landers; Emmanuelle Souzeau; Janey L Wiggs; Alex W Hewitt; Stuart MacGrego

The APOE E4 allele is associated with faster rates of neuroretinal thinning in a prospective cohort study of suspect and early glaucoma

Purpose: To investigate the association between the apolipoprotein E (APOE) E4 dementia-risk allele and prospective longitudinal retinal thinning in a cohort study of suspect and early manifest glaucoma. Design: Retrospective analysis of prospective cohort data. Participants: This study included all available eyes from participants recruited to the Progression Risk of Glaucoma: Relevant SNPs [single nucleotide polymorphisms] with Significant Association (PROGRESSA) study with genotyping data from which APOE genotypes could be determined. Methods: Apolipoprotein E alleles and genotypes were determined in PROGRESSA, and their distributions were compared with an age-matched and ancestrally matched normative cohort, the Blue Mountains Eye Study. Structural parameters of neuroretinal atrophy measured using spectral-domain OCT were compared within the PROGRESSA cohort on the basis of APOE E4 allele status. Main Outcome Measures: Longitudinal rates of thinning in the macular ganglion celleinner plexiform layer (mGCIPL) complex and the peripapillary retinal nerve fiber layer (pRNFL). Results: Rates of mGCIPL complex thinning were faster in participants harboring ≥1 copies of the APOE E4 allele (b ¼ e0.13 mm/year; P ≤0.001). This finding was strongest in eyes affected by normal-tension glaucoma (NTG; b ¼ e0.20 mm/year; P ¼ 0.003). Apolipoprotein E E4 allele carriers were also more likely to be lost to followup (P ¼ 0.01) and to demonstrate a thinner average mGCIPL complex (70.9 mm vs. 71.9 mm; P ¼ 0.011) and pRNFL (77.6 mm vs. 79.2 mm; P ¼ 0.045) after a minimum of 3 years of monitoring. Conclusions: The APOE E4 allele was associated with faster rates of mCGIPL complex thinning, particularly in eyes with NTG. These results suggest that the APOE E4 allele may be a risk factor for retinal ganglion cell degeneration in glaucoma.Sean Mullany, Henry Marshall, Santiago Diaz-Torres, Ella C. Berry, Joshua M. Schmidt, Daniel Thomson, Ayub Qassim, Minh-Son To, David Dimasi, Abraham Kuot, Lachlan S.W. Knight, Georgina Hollitt, Antonia Kolovos, Angela Schulz, Stewart Lake, Richard A. Mills, Ashish Agar, Anna Galanopoulos, John Landers, Paul Mitchell, Paul R. Healey, Stuart L. Graham, Alex W. Hewitt, Emmanuelle Souzeau, Mark M. Hassall, Sonja Klebe, Stuart MacGregor, Puya Gharahkhani, Robert J. Casson, Owen M. Siggs, Jamie E. Crai

RNA Sequencing of Lens Capsular Epithelium Implicates Novel Pathways in Pseudoexfoliation Syndrome

Published: March 29, 2022PURPOSE. Pseudoexfoliation syndrome (PEX) is a common systemic disease that results in severe and often irreversible vision loss. Despite considerable research effort, PEX remains incompletely understood. This study sought to perform the first RNAseq study in elucidate the pathophysiology of PEX, and contribute a publicly available transcriptomic data resource for future research. METHODS. Human ocular lens capsular epithelium samples were collected from 25 patients with PEX and 39 non-PEX controls undergoing cataract surgery. RNA extracted from these specimens was subjected to polyadenylated (mRNA) selection and deep bulk RNA sequencing. Differential expression analysis investigated protein-coding gene transcripts. Exploratory analyses used pathway analysis tools, and curated class- and disease-specific gene sets. RESULTS. Differential expression analysis demonstrated that 2882 genes were differentially expressed according to PEX status. Genes associated with viral gene expression pathways were among the most upregulated, alongside genes encoding ribosomal and mitochondrial respiratory transport chain proteins. Cell adhesion protein transcripts including type 4 collagen subunits were downregulated. CONCLUSIONS. This comparative transcriptomic dataset highlights novel and previously recognized pathogenic pathways in PEX and provides the first comprehensive transcriptomic resource, adding an additional layer to build further understanding of PEX pathophysiology.Sean Mullany, Henry Marshall, Tiger Zhou, Daniel Thomson, Joshua M. Schmidt, Ayub Qassim, Lachlan S. W. Knight, Georgina Hollitt, Ella C. Berry, Thi Nguyen, Minh-Son To, David Dimasi, Abraham Kuot, Joshua Dubowsky, Rhys Fogarty, Michelle Sun, Luke Chehade, Shilpa Kuruvilla, Devaraj Supramaniam, James Breen, Shiwani Sharma, John Landers, Stewart Lake, Richard A. Mills, Mark M. Hassall, Weng O. Chan, Sonja Klebe, Emmanuelle Souzeau, Owen M. Siggs, and Jamie E. Crai

Effect of digital psychoeducation and peer support on the mental health of family carers supporting individuals with psychosis in England (COPe-support): a randomised clinical trial

Background Psychoeducation delivered face-to-face is effective in alleviating mental health morbidities in family carers of individuals with psychosis. However, research in such interventions delivered online is scarce. We evaluated the effectiveness of a digital multicomponent intervention—COPe-support—in improving carers' mental wellbeing and caregiving-related outcomes. Methods In this two-arm, individually randomised, superiority trial, people aged 18 years or older who provided at least weekly support in any format for a relative or close friend affected by psychosis across England were randomly assigned (1:1) to either COPe-support or a passive online information resource using an independent online system. Participants were recruited through 30 mental health UK National Health Service trusts. The study team were masked to allocation and assessment of outcomes as all data collection took place online. Participants had access to either condition for 40 weeks and were advised to spend at least half an hour per week over the initial 20 weeks to go through materials at their own pace and to allow time to integrate knowledge and skills learned into practice. It was not feasible to mask participants or the online facilitator to intervention allocation. COPe-support provided psychoeducation on psychosis-related caregiving strategies and forums with professionals and other carers, and the control intervention comprised a passive online information resource. The primary outcome at 20 weeks was mental wellbeing measured by the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS; minimally clinically important difference [MCID] 3). This trial is registered with ISRCTN, 89563420. Findings Between March 1, 2018, and Feb 14, 2020, 407 participants were randomly assigned, with 204 allocated to COPe-support and 203 allocated to control. The participants (mean age 53·1 years, SD 13·2) were mostly female (330 [81%] of 407 participants) and White (359 [88%] of 407 participants). 346 (85%) of 407 participants provided primary endpoint data, 174 (85%) of 204 participants in the COPe-support group and 172 (85%) of 203 participants in the control group. The mean WEMWBS score at 20 weeks was 44·5 (SD 8·31) for the COPe-support group and 43·3 (9·19) for the control group. We found no evidence of a difference in wellbeing between the two groups (adjusted mean difference 0·37, 95% CI –1·14 to 1·88; p=0·63). In the COPe-support group, 106 (52%) of 204 participants met the complier definition of a minimum of two logins in separate weeks. The complier average causal effect analysis increased the difference in WEMWBS scores (adjusted difference 0·83, 95% CI –1·45 to 3·11; p=0·47), but this was lower than the MCID. There were no adverse events. Interpretation Our findings did not support the use of COPe-support over a passive online information resource. However, further research to optimise digital interventions adjunctive to face-to-face support for carers remains important

Multitrait analysis of glaucoma, intraocular pressure and vertical cup to disc ratio identifies many new loci and enables a polygenic genetic risk score strongly predictive of disease susceptibility in the population, and disease progression and treatment intensity in the clinic

Plenary: Best Paper Presentations #P0404Jamie Craig, Xikun Han, Ayub Qassim, Mark Hassall, Robert Casson, Stuart Graham, John Landers, Colin Willoughby, Andrew Lotery, Janey Wiggs, Owen Siggs, Anna Galanopoulos, Paul Mitchell, Richard Mills, Ashish Agar, Paul Healey, Andrea Vincent, David Mackey, Emmanuelle Souzeau, Alex Hewitt, Stuart MacGrego

Factors associated with spontaneous stone passage in a contemporary cohort of patients presenting with acute ureteric colic. Results from the MIMIC Study (A Multi-centre cohort study evaluating the role of Inflammatory Markers in patients presenting with acute ureteric Colic)

Objectives There is conflicting data on the role of white blood cell count (WBC) and other inflammatory markers in spontaneous stone passage in patients with acute ureteric colic. The aim of the study was to assess the relationship of WBC and other routinely collected inflammatory and clinical markers including stone size, stone position and Medically Expulsive Therapy use (MET) with spontaneous stone passage (SSP) in a large contemporary cohort of patients with acute ureteric colic. Subjects and Methods Multi‐centre retrospective cohort study coordinated by the British Urology Researchers in Surgical Training (BURST) Research Collaborative at 71 secondary care hospitals across 4 countries (United Kingdom, Republic of Ireland, Australia and New Zealand). 4170 patients presented with acute ureteric colic and a computer tomography confirmed single ureteric stone. Our primary outcome measure was SSP as defined by the absence of need for intervention to assist stone passage. Multivariable mixed effects logistic regression was used to explore the relationship between key patient factors and SSP. Results 2518 patients were discharged with conservative management and had further follow up with a SSP rate of 74% (n = 1874/2518). Sepsis after discharge with conservative management was reported in 0.6% (n = 16/2518). On multivariable analysis neither WBC, Neutrophils or CRP were seen to predict SSP, with an adjusted OR of 0.97 [95% CI 0.91 to 1.04, p = 0.38], 1.06 [95% CI 0.99 to 1.13, p = 0.1] and 1.00 [95% CI 0.99 to 1.00, p = 0.17], respectively. Medical expulsive therapy (MET) also did not predict SSP [adjusted OR 1.11 [95% CI 0.76 to 1.61]). However, stone size and stone position were significant predictors. SSP for stones 7mm. For stones in the upper ureter the SSP rate was 52% [95% CI 48 to 56], middle ureter was 70% [95% CI 64 to 76], and lower ureter was 83% [95% CI 81 to 85]. Conclusion In contrast to the previously published literature, we found that in patients with acute ureteric colic who are discharged with initial conservative management, neither WBC, Neutrophil count or CRP help determine the likelihood of spontaneous stone passage. We also found no overall benefit from the use of MET. Stone size and position are important predictors and our findings represent the most comprehensive stone passage rates for each mm increase in stone size from a large contemporary cohort adjusting for key potential confounders. We anticipate that these data will aid clinicians managing patients with acute ureteric colic and help guide management decisions and the need for intervention

A mixed-methods feasibility study of a novel AI-enabled, web-based, clinical decision support system for the treatment of major depression in adults

Background:- The objective of this paper is to discuss perceived clinical utility and impact on physician-patient relationship of a novel, artificial-intelligence (AI) enabled clinical decision support system (CDSS) for use in treating adults with major depression. Methods:- A single arm, naturalistic follow-up study aimed at assessing the acceptability and useability of the software. Patients had a baseline appointment, followed by a minimum of two appointments with the CDSS. Study exit questionnaires and interviews were conducted to assess perceived clinical utility, impact on patient-physician relationship, and understanding and trust. 7 physicians and 17 patients, of which 14 completed, consented to participate. Results:- 86 % of physicians (6/7) felt the information provided by the CDSS provided more comprehensive understanding of patient situations. 71 % (5/7) felt the information was helpful. 86 % of physicians (6/7) reported the AI/predictive model was useful when deciding treatment. 62 % of patients (8/13) reported improved care due to the tool, and 46 %(6/13) reported a significantly or somewhat improved physician-patient relationship 54 % reported no change. 71 % of physicians (5/7) and 62 % of patients (8/13) rated trusting the tool. Limitations:- Small sample size and treatment changes prior to CDSS introduction limits ability to verify impact on outcomes. Conclusions:- Qualitative results from 12 patient exit interviews are analyzed and presented. Findings suggest physicians perceived the tool as useful in conducting appointments and used it while deciding treatment. Physicians and patients generally found the tool trustworthy, and it may have positive effects on physician-patient relationships. (Study identifier: NCT04061642)