Composite Tool Research Articles

Wooden hafting technology in the early Neanderthal site of Poggetti Vecchi (Italy)

The invention of hafted tools, between about 500 Ka and 250 Ka years ago, was a fundamental technological innovation that has shaped human social, cognitive, and biological capabilities. Despite the recurrent evidence of hafting observed on lithic tools, handles from this period are rare since they were probably made of perishable materials. Three exceptional wooden sticks interpreted as handles have been found in the Poggetti Vecchi site, allowing a deeper investigation of the technical capabilities of the early Neanderthals who frequented the site around 170,000 years ago. The handles and the lithic tools with hafting traces were analysed using a techno-functional approach, suggesting that they could have been attached to each other to create a specific composite hafted tool. The efficiency of the composite hafted tool was tested through a detailed experimental programme. The results highlighted, for the first time, the complex production processes used to create a composite hafted tool that could have been used to butcher the carcases of the large fauna that are well attested at the site.

Assessing Ecological Environment in Dar es Salaam City: A Settlement Surface Ecological Index (SSEI) Analysis

Urbanization dramatically alters landscapes and ecological conditions. This study examines the environmental conditions within Dar es Salaam, Tanzania, using the Settlement Surface Ecological Index (SSEI). The SSEI combines biophysical parameters from satellite imagery to assess ecological health, revealing disparities across diverse urban typologies. This study’s methodology demonstrates advancements in using the Calculate Composite Index tool for streamlined index creation and greater flexibility in urban analysis. Statistical analysis reveals crucial relationships between ecological conditions and variables like tree cover, impervious surfaces, vegetation moisture, and Land Surface Temperature (LST). Multivariate clustering highlights distinct areas of high and Low SSEI, emphasizing disparities in urban ecological health. This study demonstrates how composite indices like the SSEI can inform targeted urban planning, promote green infrastructure, and mitigate the negative impacts of urbanization, ensuring both equitable and sustainable development in the face of climate change.

Enhancing Surface Quality and Tool Longevity in EDM of D2 Steel Using Copper Composite Tools

Hard material machining and die manufacture are the main applications for electrical discharge machining (EDM). For EDM, conventional electrode materials include graphite, steel, brass, pure copper, and alloys based on copper. Unfortunately, excessive tool wear is a common problem with these materials, which raises the cost of machining. In this investigation, hardened D2 steel was machined using a composite tool made of 90% copper and 10% silicon carbide. The powder metallurgy method was used to create the composite tool. Surface roughness (SR) and electrode wear rate (EWR) were compared to a number of process variables. For experimentation, a response surface methodology based on CCD design in design of experts software was used. SR and electrode wear rate models were created using the CCD approach. Utilizing analysis of variance, the most important factors and their effects on EWR and SR were determined. The lowest tool wear rate of 0.39 gm/min is achieved with a current of 5 Amps, a pulse duration of 100 µs, and a pulse interval of 10 µs with an R2 of 0.9957, which accounts for 99.57% of the variability, the tool wear rate model fits the data very well and obtained lowest surface roughness of 2.8 µm.

Higher oxidative balance score is linearly associated with reduced prevalence of chronic kidney disease in individuals with metabolic syndrome: evidence from NHANES 1999-2018.

Oxidative stress is a key contributor to the development of chronic kidney disease (CKD) in individuals with metabolic syndrome (MetS). The oxidative balance score (OBS) is an emerging composite assessment tool for dietary and lifestyle oxidative balance. We aimed to explore the association of OBS with CKD prevalence in MetS in this national cross-sectional analysis. This was a national cross-sectional analysis. Eligible MetS participants ≥20 years of age from NHANES 1999-2018 were included. OBS was assessed according to previous well-validated methods and consisted of 16 dietary components and 4 lifestyle components. MetS was diagnosed by NCEP-ATP III criteria, while CKD was diagnosed by KDIGO 2021 Clinical Practice Guideline. Multivariate logistic regression models were used to explore the association of OBS with CKD in MetS in this national cross-sectional analysis. A total of 8,095 MetS participants were included, with a CKD prevalence of 24.8%. In fully adjusted models, each score increases in OBS, dietary OBS, and lifestyle OBS was associated with a 2, 1.7, and 7.3% reduction in the prevalence of CKD, respectively. Higher OBS, dietary OBS, and lifestyle OBS were all associated with significantly lower odds of CKD (p for trend all <0.05). Restricted cubic spline analysis showed that these associations all exhibited inverse dose-response. Interaction analyses indicated that cardiovascular disease (CVD) status significantly influenced the impact of OBS and dietary OBS, and these associations were only present in CVD-free subjects. Defining MetS using the IDF criteria did not significantly change the results. OBS was inversely associated with the prevalence of CKD in MetS, especially in CVD-free settings. These findings emphasize that adherence to an antioxidant diet and lifestyle contributes to the early prevention of CKD in the MetS population and necessitates attention to CVD interactions. Future prospective cohort studies are needed to confirm these results.

Rapid manufacturing of copper-graphene composite EDM electrode for improved machining performance

ABSTRACT Recently, graphene has emerged as reinforcing material for copper-based electric discharge machine (EDM) tools because of its superior electrical, thermal and high melting properties. 3D printing methods to fabricate electrodes are convenient and faster compared to conventional methods. Therefore, this study investigated the fabrication of copper-graphene composite electrodes for EDM using rapid tooling and pressureless microwave sintering. The influence of graphene content on the machining performance was examined, revealing enhanced electrical conductivity and machining efficiency. Electrical conductivity of the composite electrodes having 0.25 and 0.5 wt% of graphene was higher than pure copper. Additionally, upto 89% improvement in material removal rate and upto 14% reduction in electrode wear rate was obtained. Optical study showed an improvement of upto 28% in surface finish of the workpiece machined using composite electrode having 0.25 wt% graphene. A complex shaped composite tool was successfully fabricated and machined cavity was obtained.

Experimental and numerical analysis of new thermoplastic composite mandrels

In the field of aerospace, the application of carbon fiber composite parts is increasing year by year. As an important factor in the manufacturing of composite parts, tools play a crucial role in the manufacturing accuracy of composite parts, and composite tools have higher accuracy to better meet the manufacturing requirements. In this study, the properties of the novel thermoplastic composite mandrel of the new polymethyl methacrylate matrix are further investigated and a model is proposed to simulate the curing and spring back process of the composite part with the proposed composite mandrel. In detail, the glass transition temperature test and dynamic frequency test were carried out for the thermoplastic composite mandrel. The material constitutive equation of the thermoplastic composite mandrel was constructed based on the experimental data, and the accuracy of the constitutive equation of thermoplastic matrix material was verified by tensile experiments of matrix materials under constant strain conditions. Finally, the simulation result is compared with the fabricated part, and the effectiveness of the proposed method has been verified. This proved that the developed constitutive model of thermoplastic composite mandrel can effectively predict the curing deformation of composite parts with complex structures.

The Methodology of Saudi Critical Authorship

Methodology is among the most crucial tools for both general linguistic composition and critical analysis. Every classification system requires a methodology to determine how its categories are selected and its contents are organized. Methodology refers to the specific approach appropriate for each science or topic within that science. It consists of a set of general rules designed to uncover the truth in a field of study. Essentially, it is the approach that a researcher uses to explore a problem, discover the truth, or achieve the desired objective.

Investigation of machining performance of waspaloy using copper-graphite composite electrodes in electric discharge machining

Abstract This study endeavoured to investigate the machining of Waspaloy using Electric Discharge Machining (EDM), utilizing copper-graphite composites as the tool material. Given the limited existing research on machining Waspaloy with composite tools, this study aims to address this gap by employing a copper-graphite composite tool. In this work, pure copper electrode and three composite electrodes with varying graphite percentages in copper, viz. copper containing 5%, 10%, and 15% graphite (CuGr-5, CuGr-10, and CuGr-15), are utilized for experimentation. Composite electrodes are fabricated by the stir-casting process. The scanning electron microscope reveals that the graphite specks are homogeneously disseminated over the matrix material. The Taguchi mixed orthogonal array was used for developing experimental runs. By varying the current, polarity, pulse on and off times, tool materials, and gap, machining performance was measured in terms of Material Removal Rate (MRR), Tool Wear Rate (TWR), and Surface Roughness (Ra). It was observed that CuGr-5 provides an enhancement in MRR due to the improved electric conductivity, bridging effect, and increased energy concentration at the spark gap. Diverse characteristics witnessed on the surface morphology include black dots, globules, remelted layers, micro-cracks, and scratches. When machined with a CuGr5 electrode, the surface quality improved owing to the completed flushing and uniform distribution of generated heat as confirmed through worn surface morphology. The parameters were optimized utilizing the PROMETHEE optimization technique; it was found that the CuGr-5 electrode with the assessment value 0.02458 was optimal for machining of Waspaloy.

Analysis of Wear Resistance of Metallic-Reinforced Polyurethane Resin Composites for Sheet Metal Forming

Abstract The paper presents the results of testing the wear resistance and coefficient of friction (COF) tools made of SikaBeresin® F50 polyurethane resin intended for dies and punches for the cold sheet metal forming process. Seven sets of composite tools (rotating rings) additionally reinforced with waste metallic powders from Al and Cu alloys (5-20% by volume) from the dry cutting process of pipes and rods were tested. Wear resistance tests and determination coefficient of friction were carried out using the T-05 block-on-ring tribotester. The tests were performed for heat and corrosion resistant sheets made of nickel alloy AMS5599 (Inconel 625), iron alloy AMS5510 (321) and aluminum alloy sheets AMS4026 (6061-T4). Composite tools with the addition of 20% aluminum powder (A+B+C+20%Al) tested with a specimen of steel alloy AMS5510 and nickel alloy AMS5599 were characterized by the lowest wear resistance. In each case, the composite rotating ring without reinforcements was characterized by the lowest coefficient of friction. The use of Cu powder reinforcements in each case had a positive effect on increasing wear resistance. The best wear resistance of 0.011% was obtained for composite rotating ring with the addition of 10% copper powder paired with specimen of nickel alloy AMS5599 sheet.

Disease severity and activity in bronchiectasis: A paradigm shift in bronchiectasis management.

Bronchiectasis has an increasing prevalence and substantial clinical and economic burden. Therefore, physicians should identify patients with bronchiectasis at high risk of disease progression to ensure optimal management in advance. The heterogeneity of bronchiectasis means it is unlikely that any single parameter could identify high-risk patients, therefore disease severity is usually assessed using validated composite tools, such as the Bronchiectasis Severity Index, FACED, and Bronchiectasis Aetiology Comorbidity Index, to predict long-term outcomes in bronchiectasis. Disease severity, however, implies an advanced process with lung destruction. Earlier intervention may prevent disease progression and improve outcomes. To identify patients at risk, rather than patients with established advanced disease, we need to shift our focus from disease severity to disease activity. Disease activity denotes the activation level of underlying pathophysiological processes and can be measured using clinical presentations and biomarkers. This review discusses a paradigm shift in bronchiectasis management, focusing on disease activity rather than severity, to prevent disease progression.

Research on the key techniques of composite processing of EDM and vibration ultrasonic drilling

PurposeUtilizing electrical discharge machining (EDM) to process micro-holes in superalloys may lead to the formation of remelting layers and micro-cracks on the machined surface. This work proposes a method of composite processing of EDM and ultrasonic vibration drilling for machining precision micro-holes in complex positions of superalloys.Design/methodology/approachA six-axis computer numerical control (CNC) machine tool was developed, whose software control system adopted a real-time control architecture that integrates electrical discharge and ultrasonic vibration drilling. Among them, the CNC system software was developed based on Windows + RTX architecture, which could process the real-time processing state received by the hardware terminal and adjust the processing state. Based on the SoC (System on Chip) technology, an architecture for a pulse generator was developed. The circuit of the pulse generator was designed and implemented. Additionally, a composite mechanical system was engineered for both drilling and EDM. Two sets of control boards were designed for the hardware terminal. One set was the EDM discharge control board, which detected the discharge state and provided the pulse waveform for turning on the transistor. The other was a relay control card based on STM32, which could meet the switch between EDM and ultrasonic vibration, and used the Modbus protocol to communicate with the machining control software. FindingsThe mechanical structure of the designed composite machine tool can effectively avoid interference between the EDM spindle and the drilling spindle. The removal rate of the remelting layer on 1.5 mm single crystal superalloys after composite processing can reach over 90%. The average processing time per millimeter was 55 s, and the measured inner surface roughness of the hole was less than 1.6 µm, which realized the micro-hole machining without remelting layer, heat affected zone and micro-cracks in the single crystal superalloy.Originality/valueThe test results proved that the key techniques developed in this paper were suite for micro-hole machining of special materials.

First identification of a Neanderthal bone spear point through an interdisciplinary analysis at Abric Romaní (NE Iberian Peninsula)

Osseous industry has been observed at an increasing number of Neanderthal sites. Bone fragments were used for practical purposes, and a range of bone shaping techniques were employed. The variability of bone tools observed in different assemblages reflects considerable functional diversity. However, no bone spear points have been reported from these contexts. A comprehensive analysis of a bone spear point from the Middle Palaeolithic site of Abric Romaní (Barcelona, Spain) is presented. Through an interdisciplinary, multi-technique, and multi-scale approach combining technology, taphonomy, and functional analysis, compelling evidence for manufacture, use, and hafting was uncovered. The specimen exhibits clear signs of intentional knapping. The presence of microscopic linear impact marks, an impact fracture at the tip and potential internal stress fractures indicate its use as a spear. Furthermore, the observed wear pattern and a morphological adjustment of the trabecular tissue support the hafting hypothesis. Abric Romaní contributes to our understanding of Neanderthal hunting behaviour and the significance of composite bone tools in their technological repertoire 50,000 years ago. This discovery highlights the flexibility and adaptability of Neanderthal technology, providing evidence of bone technology that is sometimes obscured in the archaeological record and offering valuable insights into their hunting strategies during the Middle Palaeolithic.

A critical analysis of surgical outcomes indicators in hepato-pancreato-biliary surgery: From crude mortality to composite outcomes.

Indicators of surgical outcomes are designed to objectively evaluate surgical performance, enabling comparisons among surgeons and institutions. In recent years, there has been a surge in complex indicators of perioperative short-term and long-term outcomes. The aim of this narrative review is to provide an overview and a critical analysis of surgical outcomes indicators, with a special emphasis on hepato-pancreato-biliary (HPB) surgery. A narrative review of outcome measures was conducted using a combined text and MeSH search strategy to identify relevant articles focused on perioperative outcomes, specifically within HPB surgery. The literature search yielded 624 records, and 94 studies were included in the analysis. Included papers were classified depending on whether they assessed intraoperative or postoperative specific or composite outcomes, and whether they assessed purely clinical or combined clinical and socio-economic indicators. Specific indicators included in composite outcomes were categorized into three main domains: intraoperative metrics, postoperative outcomes, and oncological outcomes. While postoperative mortality, complications, hospital stay and readmission were the indicators most frequently included in composite outcomes, oncological outcomes were rarely considered. The evolution of surgical outcomes has shifted from the simplistic assessment of crude mortality rates to complex composite outcomes. Whether the recent explosion of publications on these topics has a clinical impact in real life is questionable. Outcomes from the patient perspective, integrating social and financial indicators, are not yet integrated into most of these composite analytical tools but should not be underestimated.

Textbook Outcome in Colorectal Surgery for Cancer: An Italian Version.

Background/Objectives: The textbook outcome (TO) is a composite tool introduced to uniform surgical units and regulate surgical quality and outcomes. A patient is considered TO only if all predetermined items are met. In colorectal surgery, TO represents a new tool that can achieve important results given the prevalence of colorectal cancers. However, at present, there is a lack of uniformity in the TO's definition. This study utilized the Delphi process to define an Italian version of the TO in colorectal cancer. Methods: The survey consisted of two rounds of online questionnaires submitted to an expert panel in colorectal oncological surgery, renowned academic surgeons, who had attended multiple scientific conferences and who were authors of papers on this specific topic. Five main topics with 26 questions were investigated through an online modified Delphi method. Items with almost 75% agreement achieved consensus. Results: Twenty-eight Italian experts were selected and participated in the two rounds. The Italian version of the textbook outcome in colorectal surgery was defined as the presence of 90-day postoperative survival, negative margins and at least 12 lymph nodes, a minimally invasive approach, ostomy fashioning if preoperatively planned, postoperative complication < Clavien-Dindo 3b, at least 10 ERAS items, no readmission, proper CHT and RT regimens, complete colonoscopy after or before surgery and Tumor Board Evaluation. Conclusions: The textbook outcome in colorectal cancer patients is a quality instrument providing a complete overview of the care of such patients, from diagnosis to treatment. We hereby propose an Italian version of the TO with outcomes chosen by an expert panel.

Sound and Space as Compositional Tools: Using the Reverberation of a Basilica as part of a Musical Composition

Classical composers such as Wagner, Mahler, Handel, and Debussy, among others, noticed that a space’s acoustic qualities affected their compositions, so they made intuitive arrangements to their performances to suit the space. Some contemporary musicians, on the other hand, incorporate those sonic characteristics as part of their composition. Pauline Oliveros, John Butcher, and Paul Bavister are some composers who produce site-specific works, compositions that include the site’s sound as part of their sound works. This project proposes site stimulation as a methodology to extract Basilica del Voto Nacional’s reverberation, a neo-gothic church in Quito, Ecuador, to produce a site-specific sound work: Composition for a Jazz Quartet and for a Basilica. This research aims not only to use spatial sonic qualities for music composition but also to propose a friendly, day-to-day activity, such as listening to music, as a learning method to acknowledge spatial sound phenomena.

Photoacoustic Image Analysis of Dental Tissue Using Two Wavelengths: A Comparative Study

This work compares photoacoustic images of a tooth by analyzing the signals generated with wavelengths 532 and 355 nm. This comparison addresses the differences in the optical properties of dental tissue for these wavelengths that affect the resulting photoacoustic images. A pulsed Nd:YAG laser was used to illuminate a complete extracted tooth sample, and 2D photoacoustic images (PAIs) were reconstructed using the single-sensor scanning synthetic aperture focusing technique (SSC-SAFT), which is a suitable method for our experimental system with forward detection mode. Signal comparison was conducted using sinogram, signal-to-noise ratio (SNR), root mean square (RMS), arrival time, maximum amplitude, and fast Fourier transform (FFT). PAI comparison utilized intensity profile, edge correlation, and image composition tools. The signal analysis revealed that at 532 nm, the signals exhibited longer decay time and a wider distribution of vibration frequencies due to higher laser pulse energy and greater optical penetration depth. Conversely, at 355 nm, the signals had shorter decay times and a lower frequency distribution, which was attributed to lower energy but improved optical absorption, resulting in reconstructed images with better sharpness and contour definition. This study contributes to the advancement of photoacoustic imaging technology in dentistry by providing insights that could optimize signal generation and image reconstruction for dental tissue.

Using carbon fiber tape to tailor the coefficient of thermal expansion in 3D-Printed composite tooling

In this work, we investigated the effect of plain woven carbon fiber tape embedded in each layer of an additively manufactured part on the coefficient of thermal expansion (CTE) and compared it to conventionally printed parts. Current advancements in Additive Manufacturing enable cost-efficient 3D printing of composite tools. However, these tools do not yet offer a low CTE comparable to Invar, necessary for producing aerospace-quality composite parts. Using the novel Advanced Tape Layer Additive Manufacturing process, the tape is placed on top of the bead immediately after extruding the short fiber-reinforced material. The samples are compared to Material Extrusion specimens from a Large Format Additive Manufacturing System. A lower CTE was achieved within the printing plane. Micro-computed tomography images correlate the preferential orientation of short fibers with measured CTE values. The CTE modification can match the part CTE to the tool CTE and therefore optimize the quality of manufactured parts.

AI-based abdominal CT measurements of orthotopic and ectopic fat predict mortality and cardiometabolic disease risk in adults.

To evaluate the utility of CT-based abdominal fat measures for predicting the risk of death and cardiometabolic disease in an asymptomatic adult screening population. Fully automated AI tools quantifying abdominal adipose tissue (L3 level visceral [VAT] and subcutaneous [SAT] fat area, visceral-to-subcutaneous fat ratio [VSR], VAT attenuation), muscle attenuation (L3 level), andliver attenuation were applied to non-contrast CT scans in asymptomatic adults undergoing CT colonography (CTC). Longitudinal follow-up documented subsequent deaths, cardiovascular events, and diabetes. ROC andtime-to-event analyses were performed to generate AUCs andhazard ratios (HR) binned by octile. A total of 9223 adults (mean age, 57 years; 4071:5152 M:F) underwent screening CTC from April 2004 to December 2016. 549 patients died on follow-up (median, nine years). Fat measures outperformed BMI for predicting mortality risk-5-year AUCs for muscle attenuation, VSR, and BMI were 0.721, 0.661, and 0.499, respectively. Higher visceral, muscle, and liver fat were associated with increased mortality risk-VSR > 1.53, HR = 3.1; muscle attenuation < 15 HU, HR = 5.4; liver attenuation < 45 HU, HR = 2.3. Higher VAT area and VSR were associated with increased cardiovascular event and diabetes risk-VSR > 1.59, HR = 2.6 for cardiovascular event; VAT area > 291 cm2, HR = 6.3 for diabetes (p < 0.001). A U-shaped association was observed for SAT with a higher risk of death for very low and very high SAT. Fully automated CT-based measures of abdominal fat are predictive of mortality and cardiometabolic disease risk in asymptomatic adults and uncover trends that are not reflected in anthropomorphic measures. Fully automated CT-based measures of abdominal fat soundly outperform anthropometric measures for mortality and cardiometabolic risk prediction in asymptomatic patients. Abdominal fat depots associated with metabolic dysregulation and cardiovascular disease can be derived from abdominal CT. Fully automated AI body composition tools can measure factors associated with increased mortality and cardiometabolic risk. CT-based abdominal fat measuresuncover trends in mortality and cardiometabolic risk not captured by BMI in asymptomatic outpatients.

Miniaturized confocal Raman and Laser-induced breakdown spectroscopy imaging system based on micro-electro-mechanical mirror

Detection of the elemental and molecular structural distribution with high resolution and miniaturization of unknown minerals is a main bottleneck in deep space exploration and geology analysis. The aim is to enhance the accuracy of the chemical analysis of micro-samples by combining the distribution information from Raman spectroscopy and laser-induced breakdown spectroscopy (LIBS). The existing Raman-LIBS imaging methods are difficult to balance the imaging performance and system volume. There is an urgent need to develop a Raman-LIBS imaging method with miniaturization, and high imaging performance. A miniaturized Raman-LIBS imaging instrument based on the micro-electro-mechanical (MEMS) mirror has been developed to overcome these challenges. The instrument utilizes dual 2D MEMS mirror scanning technology to shorten the optical length of the system and improve the detection efficiency of hybrid spectral signals. The optical probe measures 94 mm × 66 mm, and has an axial focusing ability of approximately 40 nm, with a lateral resolution of approximately 700 nm for Raman maps and 9.5 μm for LIBS maps. As a proof experiment, 3D high-resolution Raman-LIBS hybrid spectral distribution maps of meteorite Tisserlitine 001 were obtained. The attainment of high imaging performance and miniaturization in hybrid spectral imaging is crucial for on-site chemical analysis. The proposed instrument enables in-situ spectrum and multispectral imaging with miniaturization, high spatial resolution, and high stability. The instrument is a powerful tool for composition and structural information characterization in the fields of space exploration and geological exploration.

Identifying Predictor Variables for a Composite Risk Prediction Tool for Gestational Diabetes and Hypertensive Disorders of Pregnancy: A Modified Delphi Study.

A composite cardiometabolic risk prediction tool will support the systematic identification of women at increased cardiometabolic risk during pregnancy to enable early screening and intervention. This study aims to identify and select predictor variables for a composite risk prediction tool for cardiometabolic risk (gestational diabetes mellitus and/or hypertensive disorders of pregnancy) for use in the first trimester. A two-round modified online Delphi study was undertaken. A prior systematic literature review generated fifteen potential predictor variables for inclusion in the tool. Multidisciplinary experts (n = 31) rated the clinical importance of variables in an online survey and nominated additional variables for consideration (Round One). An online meeting (n = 14) was held to deliberate the importance, feasibility and acceptability of collecting variables in early pregnancy. Consensus was reached in a second online survey (Round Two). Overall, 24 variables were considered; 9 were eliminated, and 15 were selected for inclusion in the tool. The final 15 predictor variables related to maternal demographics (age, ethnicity/race), pre-pregnancy history (body mass index, height, history of chronic kidney disease/polycystic ovarian syndrome, family history of diabetes, pre-existing diabetes/hypertension), obstetric history (parity, history of macrosomia/pre-eclampsia/gestational diabetes mellitus), biochemical measures (blood glucose levels), hemodynamic measures (systolic blood pressure). Variables will inform the development of a cardiometabolic risk prediction tool in subsequent research. Evidence-based, clinically relevant and routinely collected variables were selected for a composite cardiometabolic risk prediction tool for early pregnancy.