BMT Group (United Kingdom)

Abstract Introduction GLOBALSTAR is a registry of 1587 FEVAR cases from 15 UK centres (2003–2022), established by BSET. Aims were to report long-term outcomes for FEVAR. Methods Study design: retrospective cohort study of GLOBALSTAR. Inclusion criteria: aneurysmal pathology and custom-made FEVAR alone. Data were collected according to a standardised protocol. Time-to-event analyses were conducted for all-cause survival, aneurysm-related mortality and re-intervention. Log-rank sub-analyses were conducted for octogenarians and sexes. Results 1587 patients across 15 centres were included. Median age = 75 years [69–79,IQR] and male = 87.9%. Patients were co-morbid with 45.0% IHD and 73.3% hypertension. All-cause survival at 3, 5 and 10 years was 79.5% [95% c.i., 77.6–81.6%], 64.2% [61.8–66.7%] and 30.3% [27.4–33.4%] with median survival = 6.9 years [6.6–7.2]. Aneurysm-related mortality cumulative incidence = 6.7% at 10 years [5.4–8.1%]. Secondary sac rupture was rare with 4.0 events/1000 patient-years. Cumulative incidence of re-intervention at 3, 5 and 8 years was 20.2% [18.2–22.3%], 24.4% [22.2–26.7%] and 27.7% [25.3–30.2%]. Graft-related complications accounted for 73.8% of re-interventions. Women had significantly worse 2-year survival (80.4%, [75.0- 86.3%]) than men (86.4%, [84.6–88.3%]) (P < 0.05), driven by peri-operative mortality. Beyond 2 years, differences in survival were not significant. Octogenarians had equivalent survival (89.6% [86.5–92.7%]) to non-octogenarians (92.2% [90.7–93.7%]) up to 1 year (P = 0.098). Beyond 1 year, survival differences were significant. Octogenarians' median survival = 5.4 years [5.0–6.1]. Conclusions Long-term outcomes for FEVAR appear acceptable, with low rates of secondary sac rupture. FEVAR carries risk, especially of re-intervention- driven by graft-related complications, highlighting the importance of surveillance. Peri-operative mortality was significantly higher in women, warranting further investigation.

Abstract The paper presents the development and deployment of a wave energy converter demonstrator in Albany, on the southern coast of Western Australia. The project, funded by the Blue Economy Cooperative Research Centre (BE-CRC), the Western Australian Government, and The University of Western Australia (UWA), aims at demonstrating the potential of wave energy to decarbonise local industry, including the aquaculture industry, at demonstrating the capability of the local supply chain in undertaking complex ocean energy projects, and at advancing the development of the technology. The demonstrator is a wave attenuator called M4 for ‘Moored MultiMode Multibody’. M4 is an open access technology that has undergone extensive optimisation, with published results demonstrating high energy capture and excellent survivability. Design has been undertaken by BE-CRC partners BMT in collaboration with UWA. Data associated with mooring line loads, hydrodynamic response, power generation and biofouling have been monitored during the six-month deployment period, and preliminary results will be communicated extensively upon analysis.

Digital and AI-driven technologies hold significant potential to enhance health system efficiency, equity and quality. One emerging area of interest is the use of AI-enabled virtual humans—interactive, avatar-based agents capable of providing health-related guidance through human-like conversations. On 22 October 2024, the WHO Health Promotion team, in collaboration with BMJ, convened a virtual roundtable to explore the role of AI-enabled virtual humans, exemplified by the WHO prototype tool, Smart AI Resource Assistant for Health (S.A.R.A.H.), in advancing public health goals. This meeting report summarises key discussions, challenges and strategies proposed by experts from diverse sectors and geographies to expand the impact of these tools in global health promotion.

Abstract In newly diagnosed acute myeloid leukemia, immediate initiation of treatment is standard of care. However, deferral of antileukemic therapy may be indicated to assess comorbidities or pre-therapeutic risk factors. We explored the impact of time from diagnosis to treatment on outcomes in newly diagnosed acute myeloid leukemia undergoing venetoclax-based therapy in two distinct cohorts. By querying the Study Alliance Leukemia database and the health network TriNetX, we identified 138 and 717 patients respectively with an average age of 76 and 72 years who received venetoclax-based first-line therapy. When comparing patients who started treatment earlier or later than 10 days after initial diagnosis, no significant difference in median overall survival was observed - neither in the SAL cohort (7.7 vs. 9.6 months, p=.42) nor in the TriNetX cohort (7.5 vs. 7.2 months, p=.41). Similarly, severe infections, bleeding, and thromboembolic events were equally observed between early and later treatments, both in the overall patient groups and specific subgroups (age ≥75 years or leukocytes ≥20/nl). This retrospective analysis indicates that delaying the start of venetoclax-based therapy in newly diagnosed acute myeloid leukemia might be a safe option for selected patients, provided that close clinical monitoring is performed.

This paper presents the development of an objective, transparent and adaptive process for evaluating water models that identifies key challenges, opportunities and risks for future model development and application. While many frameworks dealing with best practice model development and application exist, there are relatively few attempts to provide more holistic guidance on investment in model development from the perspective of a broader set of stakeholders comprising model developers, model users and decision makers. In response, a model assessment framework (MAF) was developed based on the principles used in the technology readiness levels (TRL) successfully applied in other branches of science and engineering.

Abstract There have been a number of unexpected girth weld failures in pipelines, both in-service and during pre-service hydrostatic testing. Investigation of these incidents indicated that the line pipe met industry standard requirements, such as API 5L and the welding procedures had been qualified to API 1104 and construction welding/inspection had been completed according to industry standards. The investigation of these failures indicated that they were not related to hydrogen cracking or misalignment, however, line pipe chemical composition and tensile properties were identified as having contributed to these failures. Low carbon and low carbon equivalent (CE) higher strength line pipe materials produced with thermo-mechanical controlled processing (TMCP) practice is believed to have contributed to the failures. Higher heat input welding in these lean chemistry steels can result in heat affected zone (HAZ) softening that produces a lower strength zone adjacent to the girth weld, making it susceptible to tensile failure from axial loading. In the presence of thermal or geohazard loading, these softened or lower strength HAZ’s become a concern where there has been pipe settlement or in strain-based assessment. To understand the factors that influence the susceptibility to HAZ softening and identify those materials that can be considered at risk, a material testing procedure has been developed. This new testing procedure is a weld bead-in-plate test that was designed to maximize the potential for HAZ softening in an effort to identify those line pipe materials that may be susceptible to HAZ softening in construction or during in-service welding. This paper presents the results of experimental trials comparing the susceptibility of leaner chemistry materials to HAZ softening. The testing procedure is described along with opportunities to enhance the procedure to develop a standardized test for HAZ softening assessment. This test has the potential to be used to identify materials at risk to HAZ softening and may also be used to qualify line pipe to demonstrate its resistance to HAZ softening.

The focus in this project was a workshop with the objective of promoting the standardization of fracture toughness testing procedures applicable to pipeline girths welds using SENT specimens. The participants included those currently active in the test procedures used in North America and Europe. The aim of this workshop was to develop guidelines for a round robin testing program with the focus on testing of SENT specimens with a surface notch in the girth weld zone

High-quality research into education costs can inform better decision making. Improvements to cost research can be guided by information about the research questions, methods and reporting of studies evaluating costs in health professions education (HPE). Our objective was to appraise the overall state of the field and evaluate temporal trends in the methods and reporting quality of cost evaluations in HPE research. We searched the MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE, Business Source Complete and ERIC (Education Resources Information Centre) databases on 31 July 2017. To evaluate trends over time, we sampled research reports at 5-year intervals (2001, 2006, 2011 and 2016). All original research studies in HPE that reported a cost outcome were included. The Medical Education Research Study Quality Instrument (MERSQI) and the BMJ economic checklist were used to appraise methodological and reporting quality, respectively. Trends in quality over time were analysed. A total of 78 studies were included, of which 16 were published in 2001, 15 in 2006, 20 in 2011 and 27 in 2016. The region most commonly represented was the USA (n=43). The profession most commonly referred to was that of the physician (n=46). The mean±standard deviation (SD) MERSQI score was 10.9±2.6 out of 18, with no significant change over time (p=0.55). The mean±SD BMJ score was 13.5±7.1 out of 35, with no significant change over time (p=0.39). A total of 49 (63%) studies stated a cost-related research question, 23 (29%) stated the type of cost evaluation used, and 31 (40%) described the method of estimating resource quantities and unit costs. A total of 16 studies compared two or more interventions and reported both cost and learning outcomes. The absolute number of cost evaluations in HPE is increasing. However, there are shortcomings in the quality of methodology and reporting, and these are not improving over time.