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A dissimilar metal weldment consisting of SA508-309L-308L-304L is widely used in light-water nuclear reactors. These weldments demonstrate dissimilar susceptibility to stress corrosion cracking that are related to the microstructure, properties, and residual stress. In this work, microstructures, hardness, and the residual stress distribution of the dissimilar metal weldments were investigated, with the correlation of increased hardness in the heat-affected zone (HAZ) to the microstructure. 304L HAZ demonstrated similar grain morphology as the base material, and the increase in hardness was primarily attributed to the increased dislocation density. SA508 HAZ demonstrated a change of grain morphology resulting from the different peak temperatures and cooling rates. The increased hardness in the SA508 HAZ was attributed to the refined grain morphology, higher dislocation density, and higher number density of precipitates. A ~ 20–30-μm-wide martensitic zone formed at the fusion boundary of SA508-309L, where Cr-rich carbide precipitates were observed, with the average size and the number density of 44.1 ± 16.9 nm and 1.5 × 1021 m−3, respectively. Residual stress results demonstrated the largest tensile stress at 309L butter, indicating its high cracking susceptibility.

Background Most medical responders are not adequately trained to recognize and treat maternal medical emergencies, including maternal cardiac arrest, and national credentialing standards do not exist. Obstetric Life Support (OBLS) is a validated simulation-based curriculum designed to equip prehospital and hospital-based healthcare workers (HCWs) with the knowledge and skills necessary to prevent, recognize, and manage maternal medical emergencies. Widespread implementation of OBLS could enhance patient safety and reduce disparities in maternal morbidity and mortality. However, research is needed to develop strategies that ensure sustained and equitable access for HCWs across diverse healthcare settings. This paper presents a protocol for evaluating a train-the-trainer approach to implement OBLS in hospitals, freestanding birthing centers, and prehospital contexts across Arizona. Methods This multisite, mixed-methods study is being conducted in collaboration with the Arizona Perinatal Trust, a regional perinatal health system that encompasses 38 in-hospital birthing centers and Level I-IV hospitals across Arizona, and the Arizona Emergency Medical Systems LLC, which coordinates 85 emergency medical services agencies statewide. A Steering Committee comprising local, regional, and national stakeholders provides guidance and oversight for all study activities. To promote rapid learning, two consecutive OBLS implementation and evaluation cycles will be conducted, with the second cycle incorporating feedback and lessons learned from the first. HCWs from 16 implementation sites (8 per cycle) serving areas with high maternal vulnerability indexes will be trained as OBLS instructors. These instructors will train at least 160 HCWs (80 per cycle) within their respective or nearby institutions. Outcomes to be assessed include reach (proportion and representation of institutions offering OBLS, instructors trained, and HCWs participating), effectiveness (impact of OBLS on knowledge and clinical competencies, presence of code carts containing OBLS cognitive aids and resuscitative cesarean delivery kits in hospitals, and the use of an OB Arrest Alert in prehospital settings), adoption (allocation of resources for OBLS), implementation (number of courses completed, fidelity of the training delivery), and maintenance (extent to which training becomes integrated into routine practice and policy). Discussion Findings from this statewide study will be used to promote the scale-up and sustainability of OBLS, ultimately enhancing maternal healthcare quality and equity.

Physiological evidence of small airways dysfunction (SAD) is present in some patients with asthma and is associated with poor disease control. It is unclear if this represents a distinct phenotype of asthma or if it is an early manifestation of the disease. The study aimed to evaluate SAD in asthma and its clinical associations. A retrospective analysis of routinely collected health data obtained from adults referred for routine spirometric assessment as part of their clinical management. The Maximal Mid-Expiratory Flow (MMEF) z-scores were used to assess the prevalence and association factors for SAD. Pre- and post-bronchodilator data of MMEF and FEV in patients with and without SAD or airflow obstruction (AO) were analysed. A total of 1094 patients were included. 366 (33.5%) had evidence of SAD of whom 261 (71.3%) also had AO. Current smokers were at an increased risk of having SAD (OR: 2.05; 95% CI: 1.43-2.93). 214 patients had Bronchodilator response (BDR) data with 157 (73.4%) demonstrating BDR for MMEF and 121 (56.5%) for FEV . SAD at baseline was associated with a significant BDR for FEV (OR of 3.59 (95% CI: 1.77-7.57)) and MMEF (OR of 2.89 (95% CI: 1.41-5.95)). Males were less likely to have a positive BDR for MMEF than females (OR of 0.46; 95% CI: 0.24-0.89). SAD is common in asthma and is related to the presence of AO, cigarette smoking and is associated with increased BDR for both FEV and MMEF. The assessment of SAD in routine clinical practice may help identify airway impairment early for the initiation of targeted therapies.

This paper focuses on the development and demonstration of a novel blade morphing system within a whirl tower facility. The scope is to investigate the behavior of the proposed architecture under representative loads, demonstrating its capability to alter the blade original shape in operation under centrifugal, aerodynamic, and internal forces. The morphing concept was developed inside the European project “Shape Adaptive Blades for Rotorcraft Efficiency”, SABRE, and consists of a shape memory alloy system able to change the original twist law and, in this way, enhance rotor performance at certain specific regimes, such as hover and vertical flight. These phases, indeed, are generally penalized with respect to other more extended flight regimes (cruise). The work starts with an overview of the research in the field of morphing, with specific reference to the researches envisaging rotary wing demonstrations. Then, an overview of the morphing twist concept is provided, with particular attention paid to those features particularly suited for the whirl tower representative test environment. The laboratory characterization and commissioning operations are illustrated. Then, the task of the installation of the prototype on the whirl tower facility is described together with the testing modality adopted. Finally, the results of the test campaign are illustrated and critically discussed, providing the reader with insights and possible future steps to be taken in further research. The impact on the morphing capability of the following different parameters was investigated: the number of the prototype segments switched on, the speed and thus the centrifugal actions, and the angles of attack. The stiffening effect due to centrifugal actions was quantified through the measurement of the actual twist and the internal deformation. The link between speed, angle of attack at root, and twist and flap angles was also tracked, building a database useful for the comprehension of the phenomenon, and for the assessment of numerical predictive models. The achieved results highlighted the capability of the system to produce a twist angle matching the target of 8° per blade radius; this figure is related to a potential power saving of 10% in hover and vertical flight and an improvement of about 1% on the over-all efficiency of the rotorcraft.

In this work, aligned discontinuous fibre composite (ADFRC) tapes were developed and investigated as precursors for a novel 3D printing filament. ADFRCs have the potential to achieve mechanical performance comparable to continuous fibre reinforced composites, given sufficient fibre length and high level of alignment, and avoid many of the manufacturing difficulties associated with continuous fibres, e.g., wrinkling, bridging and corner radii constraints. Their potential use for fused filament fabrication (FFF) techniques was investigated here. An extensive down-selection process of thermoplastic matrices was performed, as matrix properties significantly impact both the processing and performance of the filament. This resulted in four candidate polymers (ABS, PLA, Nylon, PETG) which were used to manufacture ADFRC tapes with a Vf of 12.5% using the high performance discontinuous fibre (HiPerDiF) technology and an in-house developed continuous consolidation module. Tensile stiffness and strength up to 30 GPa and 400 MPa respectively were recorded, showing that a discontinuous fibre filament has the potential to compete with continuous fibre filaments.

BackgroundEthnic minorities account for 34% of critically ill patients with COVID-19 despite constituting 14% of the UK population. Internationally, researchers have called for studies to understand deterioration risk factors to inform clinical risk tool development.MethodsMulticentre cohort study of hospitalised patients with COVID-19 (n=3671) exploring determinants of health, including Index of Multiple Deprivation (IMD) subdomains, as risk factors for presentation, deterioration and mortality by ethnicity. Receiver operator characteristics were plotted for CURB65 and ISARIC4C by ethnicity and area under the curve (AUC) calculated.ResultsEthnic minorities were hospitalised with higher Charlson Comorbidity Scores than age, sex and deprivation matched controls and from the most deprived quintile of at least one IMD subdomain: indoor living environment (LE), outdoor LE, adult skills, wider barriers to housing and services. Admission from the most deprived quintile of these deprivation forms was associated with multilobar pneumonia on presentation and ICU admission. AUC did not exceed 0.7 for CURB65 or ISARIC4C among any ethnicity except ISARIC4C among Indian patients (0.83, 95% CI 0.73 to 0.93). Ethnic minorities presenting with pneumonia and low CURB65 (0–1) had higher mortality than White patients (22.6% vs 9.4%; p<0.001); Africans were at highest risk (38.5%; p=0.006), followed by Caribbean (26.7%; p=0.008), Indian (23.1%; p=0.007) and Pakistani (21.2%; p=0.004).ConclusionsEthnic minorities exhibit higher multimorbidity despite younger age structures and disproportionate exposure to unscored risk factors including obesity and deprivation. Household overcrowding, air pollution, housing quality and adult skills deprivation are associated with multilobar pneumonia on presentation and ICU admission which are mortality risk factors. Risk tools need to reflect risks predominantly affecting ethnic minorities.

Predicting the occurrence of solidification cracking during the solidification of metallic alloys by numerical simulation is a crucial move for avoiding such defects. Several models are widely available, however, the application of such are impacted due to the specific and not accessible parameters required. A simple, composition-based approach to rank solidification cracking susceptibility is presented. The procedure links computational thermodynamic and computational fluid dynamics (CFD) to provide an evaluation tool for solidification cracking. The method is related to the liquid filling phenomena in dendritic arms during solidification, which plays a critical role in solidification cracking phenomena. The dendritic profiles were constructed using the fraction of solid calculated by commercial thermodynamic software packages. The calculated results were compared with experimental solidification cracking data and showed satisfactory accuracy. The method capability to rank the solidification cracking propensity of similar alloys based on composition provides an important new operative tool to aid alloy development in welding and additive manufacturing related areas.

Soon after Joseph Smith Jr. founded the Church of Jesus Christ of Latter-day Saints (LDS Church/LDS), evangelicals sought to defend evangelicalism from Latter-day Saint teachings. Likewise, evangelicals have provided many responses to LDS teachings in hopes of guiding Latter-day Saints out of the LDS Church.I examine two popular evangelical methodologies that engage the LDS Church: the counter-cult and relational methodologies. Specifically, I showcase various prominent counter-cult and relational methodologists’ practices of how each one engages the LDS Church. While each methodologist employs specific nuances, the counter-cult methodology typically attempts to undermine Latter-day Saints’ confidence in their religion, and the relational methodology typically desires to explore similarities between evangelicalism and Mormonism. At times, relational methodology can result in evangelicals and Latter-day Saints praying together, attending one another’s worship services, and working towards shared social goals. Often, relational methodology forfeits proselytization for the sake of finding common ground, striving to grow in mutual understanding and appreciation of one another. In Acts 17:16–34, Paul interacted with a pluralistic audience. Throughout his discourse, Paul contextualized his message about how someone can be saved. The audience had varied responses: some mocked him, some wanted to hear from him again, and others began believing in his salvific message. Thus, I survey a few evangelical works that incorporate Acts 17:16–34 to guide their methodology toward various religions. I then survey several evangelical and critical commentaries on Acts 17:16–34, specifically looking for Paul’s approach to his pluralistic audience. From my survey of Acts 17:16–34, I show how many people (both LDS and non-LDS) have attempted to demarcate official LDS doctrine. However, the LDS Church believes in continuing revelation, making it almost impossible to determine what is (and is not) official LDS belief. Therefore, I limit my focus to what the LDS Church’s missionary handbook, Preach My Gospel, instructs LDS missionaries to teach potential converts regarding salvation. Once I show what Preach My Gospel teaches on how someone can be saved, I then examine what the Bible instructs. Specifically, I analyze 1 Corinthians 15:1–6, 2 Corinthians 5:21, and Galatians 2:15–21, in order to determine how someone can be saved. Next, I show what evangelicals Greg Gilbert and Wayne Grudem teach about how someone can be saved; evangelical teaching is consistent with biblical teaching regarding how one can be saved. I conclude by stating both the benefits and detriments of the counter-cult and relational methodologies, proposing a new evangelical methodology that stems from an Acts 17:16–34 framework called the gospel-centric methodology. This new evangelical methodology contextualizes what 1 Corinthians 15:1–6, 2 Corinthians 5:21, and Galatians 2:15–21 teach about how someone can be saved in order to target the LDS Church’s beliefs on how to be saved.

Oxide-dispersion-strengthened (ODS) steels have long been viewed as a prime solution for harsh environments. However, conventional manufacturing of ODS steels limits the final product geometry, is difficult to scale up to large components, and is expensive due to multiple highly involved, solid-state processing steps required. Additive manufacturing (AM) can directly incorporate dispersion elements (e.g., Y, Ti and O) during component fabrication, thus bypassing the need for an ODS steel supply chain, the scale-up challenges of powder processing routes, the buoyancy challenges associated with casting ODS steels, and the joining issues for net-shape component fabrication. In the AM process, the diffusion of the dispersion elements in the molten steel plays a key role in the precipitation of the oxide particles, thereby influencing the microstructure, thermal stability and high-temperature mechanical properties of the resulting ODS steels. In this work, the atomic diffusivities of Y, Ti, and O in molten 316L stainless steel (SS) as functions of temperature are determined by ab initio molecular dynamics simulations. The latest Vienna Ab initio Simulation Package (VASP) package that incorporates an on-the-fly machine learning force field for accelerated computation is used. At a constant temperature, the time-dependent coordinates of the target atoms in the molten 316L SS were analyzed in the form of mean square displacement in order to obtain diffusivity. The values of the diffusivity at multiple temperatures are then fitted to the Arrhenius form to determine the activation energy and the pre-exponential factor. Given the challenges in experimental measurement of atomic diffusivity at such high temperatures and correspondingly the lack of experimental data, this study provides important physical parameters for future modeling of the oxide precipitation kinetics during AM process.

We present the case of a middle-aged man who was admitted with acute chest pain and markedly elevated troponin levels, initially raising concerns for acute coronary syndrome. Diagnostic evaluations revealed an apical pneumothorax, and pneumomediastinum, without evidence of dynamic ischaemic ECG changes. Despite the concerning elevation in troponin levels, minimal variation in serial measurements (<10%) indicated a non-ischaemic aetiology. The troponin elevation was attributed to stress from pneumomediastinum, localised inflammation and myocardial strain. This case highlights the importance of differentiating ischaemic and non-ischaemic causes of troponin elevation to avoid unnecessary interventions. Conservative management focused on diagnostic stewardship resulted in a favourable outcome. Given the rarity of such presentations, we aim to publish this case to enhance understanding and emphasise the importance of considering pneumomediastinum in patients presenting with chest pain and elevated cardiac biomarkers.