Feasibility Study Research Articles

A Hybrid Digital Parenting Program Delivered Within the Malaysian Preschool System: Protocol for a Feasibility Study of a Small-Scale Factorial Cluster Randomized Trial.

The United Nations' Sustainable Development Goal 4, and particularly target 4.2, which seeks to ensure that, by 2030, all children have access to quality early childhood development, care, and preprimary education so that they are ready for primary education, is far from being achieved. The COVID-19 pandemic compromised progress by disrupting education, reducing access to well-being resources, and increasing family violence. Evidence from low- and middle-income countries suggests that in-person parenting interventions are effective at improving child learning and preventing family violence. However, scaling up these programs is challenging because of resource constraints. Integrating digital and human-delivered intervention components is a potential solution to these challenges. There is a need to understand the feasibility and effectiveness of such interventions in low-resource settings. This study aims to determine the feasibility and effectiveness of a digital parenting program (called Naungan Kasih in Bahasa Melayu [Protection through Love]) delivered in Malaysia, with varying combinations of 2 components included to encourage engagement. The study is framed around the following objectives: (1) to determine the recruitment, retention, and engagement rates in each intervention condition; (2) to document implementation fidelity; (3) to explore program acceptability among key stakeholders; (4) to estimate intervention costs; and (5) to provide indications of the effectiveness of the 2 components. This 10-week factorial cluster randomized trial compares ParentText, a chatbot that delivers parenting and family violence prevention content to caregivers of preschool-aged children in combination with 2 engagement components: (1) a WhatsApp support group and (2) either 1 or 2 in-person sessions. The trial aims to recruit 160 primary and 160 secondary caregivers of children aged 4-6 years from 8 schools split equally across 2 locations: Kuala Lumpur and Negeri Sembilan. The primary outcomes concern the feasibility and acceptability of the intervention and its components, including recruitment, retention, and engagement. The effectiveness outcomes include caregiver parenting practices, mental health and relationship quality, and child development. The evaluation involves mixed methods: quantitative caregiver surveys, digitally tracked engagement data of caregivers' use of the digital intervention components, direct assessments of children, and focus group discussions with caregivers and key stakeholders. Overall, 208 parents were recruited at baseline December 2023: 151 (72.6%) primary caregivers and 57 (27.4%) secondary caregivers. In January 2024, of these 208 parents, 168 (80.8%) enrolled in the program, which was completed in February. Postintervention data collection was completed in March 2024. Findings will be reported in the second half of 2024. This is the first factorial cluster randomized trial to assess the feasibility of a hybrid human-digital playful parenting program in Southeast Asia. The results will inform a large-scale optimization trial to establish the most effective, cost-effective, and scalable version of the intervention. OSF Registries; https://osf.io/f32ky. DERR1-10.2196/55491.

Taste-Masked Pellets of Warfarin Sodium: Formulation towards the Dose Personalisation

The bitter drug, warfarin, has a narrow therapeutic index (NTI) and is used in paediatrics and geriatrics. The aim of this feasibility study was to formulate the taste-masked warfarin-containing pellets to be applicable for dose personalisation and to improve patient compliance, as well as to investigate the effect of the core type (PharSQ® Spheres M, CELPHERE™ CP-507, and NaCl) on the warfarin release from the Kollicoat® Smartseal taste-masking-coated pellets. The cores were successfully drug-loaded and coated in a fluid-bed coater with a Wurster insert. An increase in particle size and particle size distribution was observed by optical microscopy. In saliva-simulated pH, at the Kollicoat® Smartseal level of 2 mg/cm2, none of the pellets demonstrated drug release, confirming their efficient taste-masking. However, in a stomach-simulated pH, a faster drug release was observed from PharSQ® Spheres M- and CELPHERE™ CP-507-coated pellets in comparison with NaCl cores. Additional experiments allowed us to explain the slower drug release from NaCl-containing pellets because of the salting-out effect. Despite the successful taste masking, the drug release from pellets was relatively slow (not more than 91% per 60 min), allowing for further formulation improvements.

Mi Sleep Coach Mobile App to Address Insomnia Symptoms Among Cancer Survivors: Single-Arm Feasibility Study.

Rates of sleep disturbance among survivors of cancer are more than 3 times higher than the general population. Causes of sleep disturbance among survivors are many and multifaceted, including anxiety and fear related to cancer diagnosis and treatments. Cognitive behavioral therapy for insomnia (CBT-I) is considered a first-line treatment for insomnia; However, a lack of access to trained professionals and limited insurance coverage for CBT-I services has limited patient access to these effective treatments. Evidence supports digital delivery of CBT-I (dCBT-I), but there is only limited evidence to support its use among survivors of cancer. Broad adoption of smartphone technology provides a new channel to deliver dCBT-I, but no prior studies have evaluated mobile dCBT-I interventions for survivors. To address the need for accessible and efficacious CBT-I for survivors of cancer, the Mi Sleep Coach program was developed to adapt CBT-I for delivery to survivors of cancer as a self-directed mobile health app. This single-arm feasibility study assessed the adherence, attrition, usefulness, and satisfaction of the Mi Sleep Coach app for insomnia. A 7-week, single-arm study was conducted, enrolling adult survivors of breast, prostate, or colon cancer reporting sleep disturbances. In total, 30 participants were enrolled, with 100% completing the study and providing data through week 7. Further, 9 out of 10 app features were found to be useful by 80% (n=24) to 93% (n=28) of the 30 participants. Furthermore, 27 (90%) participants were satisfied with the Mi Sleep Coach app and 28 (93%) would recommend the use of the Mi Sleep Coach app for those with insomnia. The Insomnia Severity Index showed a decrease from baseline (18.5, SD 4.6) to week 7 (10.4, SD 4.2) of 8.1 (P<.001; Cohen d=1.5). At baseline, 25 (83%) participants scored in the moderate (n=19; 15-21) or severe (n=6; 22-28) insomnia range. At week 7, a total of 4 (13%) patients scored in the moderate (n=4) or severe (n=0) range. The number of patients taking prescription sleep medications decreased from 7 (23%) at baseline to 1 (3%; P<.001) at week 7. The number of patients taking over-the-counter sleep medications decreased from 14 (47%) at baseline to 9 (30%; P=.03) at week 7. The Mi Sleep Coach app demonstrated high levels of program adherence and user satisfaction and had large effects on the severity of insomnia among survivors of cancer. The Mi Sleep Coach app is a promising intervention for cancer-related insomnia, and further clinical trials are warranted. If proven to significantly decrease insomnia in survivors of cancer in future randomized controlled clinical trials, this intervention would provide more survivors of cancer with easy access to evidence-based CBT-I treatment. ClinicalTrials.gov NCT04827459; https://clinicaltrials.gov/study/NCT04827459.

Improving diagnostics using extended point-of-care testing during in-home assessments of older adults with signs of emerging acute disease: a prospective observational non-randomised pilot and feasibility study

BackgroundDelayed recognition of acute disease among older adults hinders timely management and increases the risk of hospital admission. Point-of-Care testing, including Focused Lung Ultrasound (FLUS) and in-home analysis of biological material, may support clinical decision-making in suspected acute respiratory disease. The aim of this study was to pilot test the study design for a planned randomised trial, investigate whether in-home extended use of point-of-care testing is feasible, and explore its’ potential clinical impact.MethodsA non-randomised pilot and feasibility study was conducted during September–November 2021 in Kolding Municipality, Denmark. A FLUS-trained physician accompanied an acute community nurse on home-visits to citizens aged 65 + y with signs of acute respiratory disease. The acute community nurses did a clinical assessment (vital signs, capillary C-reactive protein and haemoglobin) and gave a presumptive diagnosis. Subsequently, the physician performed FLUS, venipuncture with bedside analysis (electrolytes, creatinine, white blood cell differential count), nasopharyngeal swab (PCR for upper respiratory pathogens), and urine samples (flow-cytometry). Primary outcomes were feasibility of study design and extended point-of-care testing; secondary outcome was the potential clinical impact of extended point-of-care testing.ResultsOne hundred consecutive individuals were included. Average age was 81.6 (SD ± 8.4). Feasibility of study design was acceptable, FLUS 100%, blood-analyses 81%, PCR for upper respiratory pathogens 79%, and urine flow-cytometry 4%. In addition to the acute community nurse’s presumptive diagnosis, extended point-of-care testing identified 34 individuals with a condition in need of further evaluation by a physician.ConclusionOverall, in-home assessments with extended point-of-care testing are feasible and may aid to identify and handle acute diseases in older adults.

Differential tractography and whole brain connectometry in primary motor area gliomas resection: A feasibility study

ObjectiveEstablish the evolution of the connectome before and after resection of motor area glioma using a comparison of connectome maps and high-definition differential tractography (DifT). MethodsDifT was done using normalized quantitative anisotropy (NQA) with DSI Studio. The quantitative analysis involved obtaining mean NQA and fractional anisotropy (FA) values for the disrupted pathways tracing the corticospinal tract (CST), and white fiber network changes over time. ResultsWe described the baseline tractography, DifT, and white matter network changes from two patients who underwent resection of an oligodendroglioma (Case 1) and an IDH mutant astrocytoma, grade 4 (Case 2). Case 1. There was a slight decrease in the diffusion signal of the compromised CST in the immediate postop. The NQA and FA values increased at the 1-year follow-up (0.18 vs. 0.32 and 0.35 vs. 0.44, respectively). Case 2. There was an important decrease in the immediate postop, followed by an increase in the follow-up. In the 1-year follow-up, the patient presented with radiation necrosis and tumor recurrence, increasing NQA from 0.18 in the preop to 0.29. Fiber network analysis: whole-brain connectome comparison demonstrated no significant changes in the immediate postop. However, in the 1-year follow up there was a notorious reorganization of the fibers in both cases, showing the decreased density of connections. ConclusionsConnectome studies and DifT constitute new potential tools to predict early reorganization changes in a patient’s networks, showing the brain plasticity capacity, and helping to establish timelines for the progression of the tumor and treatment-induced changes.

Transient deoxyhemoglobin formation as a contrast for perfusion MRI studies in patients with brain tumors: a feasibility study.

Background: Transient hypoxia-induced deoxyhemoglobin (dOHb) has recently been shown to represent a comparable contrast to gadolinium-based contrast agents for generating resting perfusion measures in healthy subjects. Here, we investigate the feasibility of translating this non-invasive approach to patients with brain tumors. Methods: A computer-controlled gas blender was used to induce transient precise isocapnic lung hypoxia and thereby transient arterial dOHb during echo-planar-imaging acquisition in a cohort of patients with different types of brain tumors (n = 9). We calculated relative cerebral blood volume (rCBV), cerebral blood flow (rCBF), and mean transit time (MTT) using a standard model-based analysis. The transient hypoxia induced-dOHb MRI perfusion maps were compared to available clinical DSC-MRI. Results: Transient hypoxia induced-dOHb based maps of resting perfusion displayed perfusion patterns consistent with underlying tumor histology and showed high spatial coherence to gadolinium-based DSC MR perfusion maps. Conclusion: Non-invasive transient hypoxia induced-dOHb was well-tolerated in patients with different types of brain tumors, and the generated rCBV, rCBF and MTT maps appear in good agreement with perfusion maps generated with gadolinium-based DSC MR perfusion.

Occupational Therapy Using Zones of Regulation™ Concepts: A Feasibility Study.

There is a lack of peer-reviewed research on occupational therapy using Zones of Regulation™ concepts for autistic youth. The purpose of this article is to describe the feasibility of a newly-developed occupational therapy intervention using Zones of Regulation™ concepts (OT-ZOR) for autistic youth. Specifically, we aimed to evaluate: (a) participant recruitment, retention, and attendance; (b) intervention fidelity, safety, and assessment completion; (c) intervention acceptability; and (d) preliminary participant outcomes. A single-arm feasibility study was completed with outcome measures before and after 10 weeks of OT-ZOR. Fourteen autistic youth ages 6 to 13 completed the study. Youth attended 94% of OT-ZOR sessions. Providers achieved 97% fidelity to the intervention. Occupational therapists and caregivers expressed overall satisfaction with the OT-ZOR intervention. Youth demonstrated significant decreases in irritability, hyperactivity, emotional reactivity, and dysphoria. OT-ZOR is feasible to implement, acceptable to providers and caregivers, and may improve self-regulation in autistic youth.

Supplemental Material for Acceptance and Commitment Therapy-Based Intervention for Parents Living With Chronic Pain: Feasibility and Acceptability Study

Supplemental Material for Acceptance and Commitment Therapy-Based Intervention for Parents Living With Chronic Pain: Feasibility and Acceptability Study

Analysis of critical factors affecting green office retrofits based on the latest green building regulations in Indonesia

The construction industry is responsible for over 40% of global energy consumption and one-third of global greenhouse gas emissions. Generally, 10%–20% of energy is consumed in the manufacturing and transportation stages of materials, construction, maintenance, and demolition. The way the construction industry to deal with these impacts is to intensify sustainable development through green building. The author uses the latest Green Building Certification Standard in Indonesia as the Green Building Guidelines under the Ministry of Public Works and People’s Housing (PUPR) Regulation No. 01/SE/M/2022, as a basis for evaluating existing office buildings or what is often referred to as green retrofit. Structural Equation Modeling-Partial Least Squares (SEM-PLS) is used by the authors to detail the factors influencing the application of green building by analyzing several variables related to the problem studied, which are used to build and test statistical models of causal models. From this study, it is concluded that the most influential factors in the implementation of green retrofitting on office buildings are energy savings, water efficiency, renewable energy use, the presence of green building socialization programs, cost planning, design planning, project feasibility studies, material cost, use of the latest technology applications, and price fluctuations. With the results of this research, there is expected to be shared awareness and concern about implementing green buildings and green offices as an initiative to present a more energy-efficient office environment, save operating costs, and provide comfort to customers.

Experimental and feasibility study of bio-waste valorization through pyrolysis for energy and materials production in the concept of circular economy

The pyrolysis and co-pyrolysis characteristics of large abundant bio-wastes, namely date pits (DP), peanut shells (PS), coffee grounds (CG), and tea waste (TW) were investigated in detail. The TG/DTG and pyrolysis procedures were used to examine the thermal pyrolysis behavior of these agro-wastes and their blends (50%CG/50%DP, 50%CG/50%PS, 50%DP/50%PS, 50%TW/50% DP,50%TW/50%PS and 50%CG/50% TW by weight). The characterization of these feedstock has shown their suitability for energy and material valorization. Experiments were carried out in a batch pyrolysis at a medium heating rate of 10 °C/min. The goal was to identify the best combination aiming to produce either char or hydrogen-rich gas, which can contribute to the development of the circular bio-economy. It was demonstrated that pyrolysis favored the liquid product, fluctuating from 34.31% (TW) to 50.92% (DP), while the co-pyrolysis greatly increased the gaseous product, which ranged between 42.02% (TW-DP) and 55.17% (PS-TW). The blending of CG and PS resulted in heightened reactivity, leading to an enhanced generation of H2 (34.44%). The optimal mixture was found to be CG-TW, showcasing superior performance in terms of gas quality (38.39% H2) and yield (53.74%). This outcome underscores the potential of CG and TW as a synergistic blend for efficient hydrogen-rich gas production. The FTIR findings revealed that the recovered biochars have the potential to serve as solid fuels, biofertilizers, or carbon materials. Additionally, they could be used as eco-friendly precursors for chemical and related industries. By analyzing various waste mixtures and their respective pyrolysis properties, this research aims to contribute to the development of sustainable waste management practices as well as efficient energy and material production methods.

Empowering healthcare professionals in West Africa-A feasibility study and qualitative assessment of a dietary screening tool to identify adults at high risk of hypertension.

Dietary risks significantly contribute to hypertension in West Africa. Food frequency questionnaires (FFQs) can provide valuable dietary assessment but require rigorous validation and careful design to facilitate usability. This study assessed the feasibility and interest of a dietary screening tool for identifying adults at high risk of hypertension in Nigeria. Fifty-eight (58) consenting adult patients with hypertension and their caregivers and 35 healthcare professionals from a single-centre Nigerian hospital were recruited to complete a 27-item FFQ at two-time points and three 24-hour recalls for comparison in a mixed method study employing both quantitative questionnaires and qualitative techniques to elicit free form text. Data analyses were conducted using R software version 4.3.1 and NVivo version 14. The trial was registered with ClinicalTrials.gov: NCT05973760. The mean age of patients was 42.6 ± 11.9 years, with an average SBP of 140.3 ± 29.8 mmHg and a BMI of 29.5 ± 7.1 Kg/m2. The adherence rate was 87.9%, and the mean completion time was 7:37 minutes. 96.6% of patients found the FFQ easy to complete, comprehensive, and valuable. A minority reported difficulty (3.4%), discomfort (10.3%), and proposed additional foods (6.9%). Healthcare professionals considered the dietary screening tool very important (82.9%) and expressed a willingness to adopt the tool, with some suggestions for clarification. Patients and healthcare professionals found the screening tool favourable for dietary counselling in hypertension care. The tailored dietary screening tool (FFQ) demonstrated promising feasibility for integration into clinical care as assessed by patients and healthcare professionals. Successful implementation may benefit from proactive time management and addressing training needs. This user-centred approach provided key insights to refine FFQ and set the foundation for ongoing validity testing and evaluation in clinical practice.

Laser Powder Bed Fusion Processing of Low Cost CoCrFeNiMoxNby High Entropy Alloys with Promising High-Temperature Properties via In Situ Alloying Commercial Powders

A blend of only commercial powders, including Ni625, CoCrF75, and 316L, were used as the raw material for fabricating non-equiatomic CoCrFeNiMoxNby high entropy alloys (HEAs) through laser powder bed fusion (PBF-LB/M) via in situ alloying, instead of using pure elemental powders, thus reducing the raw materials cost. The rapid cooling inherent in the PBF-LB/M process facilitated the dissolution of Mo and Nb, resulting in a single FCC phase characterized by high relative densities. High-temperature tensile tests were conducted at room temperature, 700 °C, 800 °C, and 900 °C, revealing mechanical properties that surpassed those reported in existing HEA literature. The remarkable strength of the HEAs developed in this study primarily stemmed from the incorporation of Mo and Nb, leading to the precipitation of Mo and Nb-rich lave phases at elevated temperatures. While constraining elongation when confined to grain boundaries, these precipitates enhanced strength without compromising elongation when distributed throughout the matrix. This work is a feasibility study to explore the usage of commodity compositions from the market to develop HEAs using PBF-LB/M, which opens the possibility of using scraps to further the development of new materials. Consequently, this study presents a rapid and cost-effective approach for HEA development, improving efficiency and sidestepping the direct utilization of critical raw metals for sustainable manufacturing. Moreover, this work also underscores the outstanding mechanical performance of these HEAs at high temperatures, paving the way for the design of innovative alloys for future high-temperature applications.

Feasibility Study of UHPC Reinforced Masonry Structure

With the increase of service life of masonry structure and the damage of masonry structure caused by external environment, the structure will be difficult to meet the design requirements. It is necessary to repair and reinforce the existing structure or replace the original structure with a new type of composite structure. ultra-high performance concrete (UHPC) is a kind of high strength, high ductility, high durability material, which has the advantages of almost impermeability, almost no carbonization, and almost zero chloride ion penetration and sulfate penetration. UHPC has been widely used in the field of concrete structure reinforcement, whether the masonry structure can be better strengthened has become the research content of this paper. Basic mechanics of UHPC materials at home and abroad By systematically combing and summarizing the research progress of performance and reinforcement design, the feasibility of UHPC reinforced masonry structure is obtained.

Behavior Change Approaches in Digital Technology-Based Physical Rehabilitation Interventions Following Stroke: Scoping Review.

Digital health technologies (DHTs) are increasingly used in physical stroke rehabilitation to support individuals in successfully engaging with the frequent, intensive, and lengthy activities required to optimize recovery. Despite this, little is known about behavior change within these interventions. This scoping review aimed to identify if and how behavior change approaches (ie, theories, models, frameworks, and techniques to influence behavior) are incorporated within physical stroke rehabilitation interventions that include a DHT. Databases (Embase, MEDLINE, PsycINFO, CINAHL, Cochrane Library, and AMED) were searched using keywords relating to behavior change, DHT, physical rehabilitation, and stroke. The results were independently screened by 2 reviewers. Sources were included if they reported a completed primary research study in which a behavior change approach could be identified within a physical stroke rehabilitation intervention that included a DHT. Data, including the study design, DHT used, and behavior change approaches, were charted. Specific behavior change techniques were coded to the behavior change technique taxonomy version 1 (BCTTv1). From a total of 1973 identified sources, 103 (5%) studies were included for data charting. The most common reason for exclusion at full-text screening was the absence of an explicit approach to behavior change (165/245, 67%). Almost half (45/103, 44%) of the included studies were described as pilot or feasibility studies. Virtual reality was the most frequently identified DHT type (58/103, 56%), and almost two-thirds (65/103, 63%) of studies focused on upper limb rehabilitation. Only a limited number of studies (18/103, 17%) included a theory, model, or framework for behavior change. The most frequently used BCTTv1 clusters were feedback and monitoring (88/103, 85%), reward and threat (56/103, 54%), goals and planning (33/103, 32%), and shaping knowledge (33/103, 32%). Relationships between feedback and monitoring and reward and threat were identified using a relationship map, with prominent use of both of these clusters in interventions that included virtual reality. Despite an assumption that DHTs can promote engagement in rehabilitation, this scoping review demonstrates that very few studies of physical stroke rehabilitation that include a DHT overtly used any form of behavior change approach. From those studies that did consider behavior change, most did not report a robust underpinning theory. Future development and research need to explicitly articulate how including DHTs within an intervention may support the behavior change required for optimal engagement in physical rehabilitation following stroke, as well as establish their effectiveness. This understanding is likely to support the realization of the transformative potential of DHTs in stroke rehabilitation.

Lagrangian dynamics and regularity of the spin Euler equation

We derive the spin Euler equation for ideal flows by applying the spherical Clebsch mapping. This equation is based on the spin vector, a unit vector field encoding vortex lines, instead of the velocity. The spin Euler equation enables a feasible Lagrangian study of fluid dynamics, as the isosurface of a spin-vector component is a vortex surface and material surface in ideal flows. We establish a non-blowup criterion for the spin Euler equation, suggesting that the Laplacian of the spin vector must diverge if the solution forms a singularity at some finite time. The direct numerical simulations (DNS) of three ideal flows – the vortex knot, the vortex link and the modified Taylor–Green flow – are conducted by solving the spin Euler equation. The evolution of the Lagrangian vortex surface illustrates that the regions with large vorticity are rapidly stretched into spiral sheets. The DNS result exhibits a pronounced double-exponential growth of the maximum norm of Laplacian of the spin vector, showing no evidence of the finite-time singularity formation if the double-exponential growth holds at later times. Moreover, the present criterion with Lagrangian nature appears to be more sensitive than the Beale–Kato–Majda criterion in detecting the flows that are incapable of producing finite-time singularities.

Techno-economic and environmental feasibility study of MILD combustion in domestic utility boilers under partial load operation

This paper aims to achieve the benefits of MILD combustion, such as enhanced thermal efficiency with simultaneous NOx reduction in existing conventional domestic hot water utility boilers which encounter partial heat loads. For this purpose, a system based on waste heat recovery and flue gas recirculation (FGR) is introduced to perform techno-economic and environmental studies under continuous fluctuations of heat load demand in a typical building at various climate conditions. Technical investigations on several types of utility boilers revealed that MILD combustion could be implemented only in modulation boilers, which can serve combustion stability requirements in turndown conditions due to partial load demands. Up to 6 % fuel saving, which aligns with a commensurate decrease in CO2 emissions and a minimum 75 % reduction in NOx emissions, is foreseeable by manipulating optimal FGR for each specific boiler in various climate conditions. Finally, economic investigation demonstrated that the payback period for the proposed revamped system is less than one year for most climates.

Feasibility Study of Anisotropic Full-Waveform Inversion with DAS Data in a Vertical Seismic Profile Configuration at the Newell County Facility, Alberta, Canada

Feasibility Study of Anisotropic Full-Waveform Inversion with DAS Data in a Vertical Seismic Profile Configuration at the Newell County Facility, Alberta, Canada

Fusion of cellulose microspheres with pulp fibers: Creating an unconventional type of paper

Cellulose microspheres (CMS) are a type of spherical regenerated cellulose particles with versatile properties which have been used as carrier materials in medical and technical applications. The integration of CMS into paper products opens up novel application scenarios for paper products in a wide range of fields. However, the incorporation of CMS carriers into paper products is challenging and hitherto no reports do exist in literature. Here, we present a feasibility study to incorporate up to 50 w.% CMS in paper hand sheets using retention aids. Our primary observations highlight the successful formation of uniform paper hand sheets retaining its tensile strengths at elevated CMS concentrations. Sheets with high CMS contents exhibit an increase in density and display enhanced surface smoothness — an outcome of a CMS layer forming atop the fiber base — which effectively bridges voids and rectifies surface irregularities as supported by Gurley testing, infinite focus microscopy and scanning electron microscopy. While our primary objective centered on the general feasibility to manufacture CMS-containing papers, the resulting composite scaffold carries significant potential as a platform for innovative, functional paper-based materials.

Feasibility Study of a Novel Secondary Zinc‐Flow Battery as Stationary Energy Storage System: From Design to Environmental Assessment

Herein, a zinc‐air flow battery (ZAFB) as an environmentally friendly and inexpensive energy storage system is investigated. For this purpose, an optimized ZAFB for households is designed based on the most recent publications, and an economic and ecological analysis of the system is carried out. The results show that the customer price of the designed ZAFB is estimated at ≈5000 € and is thus about one‐third lower than the quoted price for a comparable vanadium flow battery (VFB). The carbon footprint (CF) analysis shows that especially the alkaline electrolyte and the silver‐containing gas diffusion electrode have a high share of the greenhouse gas emissions of the ZAFB system. However, the CF is 41% lower than that of the VFB, highlighting the great potential of the ZAFB as an alternative home storage system.

P050 Determining the feasibility of a multi-centre randomised clinical trial to test the effectiveness of integrated symptom tracking for managing rheumatoid arthritis

Abstract Background/Aims In a series of studies, we co-developed and piloted the remote monitoring of rheumatoid arthritis (REMORA) system. REMORA enables patients to daily track symptoms via their smartphone and integrates this data into their electronic health record for discussion during routine clinic visits. This offers the opportunity to make better, and shared, treatment decisions and improve disease management. The effectiveness of integrated daily symptom tracking on clinical and patient-reported outcomes will be tested in a multi-centre stepped wedge randomised clinical trial (RCT). Here, we present the results of the REMORA feasibility study to test trial procedures and intervention delivery. Methods Across two NHS sites in the Northwest of England we aimed to recruit 60 patients, aged ≥18 years with rheumatoid arthritis (RA) or inflammatory arthritis (IA), and access to an Android/iOS smartphone with daily internet access. Participants were asked to complete a baseline web-survey and use the REMORA app to collect daily symptom reports for up to six months. Clinical care teams extracted data from participants’ medical records for all baseline and follow-up appointments, including disease activity scores. To assess feasibility, we reported recruitment rates, participants’ uptake of and adherence to daily symptom tracking, and outcome data completeness. We also compared characteristics of a) those who consented vs. trackers (defined as submitting ≥1 symptom report, i.e., successful intervention uptake), and b) high adherers (symptoms reported on &amp;gt; 60% days) vs. low adherers (symptoms reported on &amp;lt; 25% days). Results A total of 130 patients were screened across study sites, and 52 were eligible and provided consent to take part (40.0%). Of those, 32 (61.5%) initiated symptom tracking; their demographic characteristics were broadly similar to those who consented, though more people of white ethnicity appeared higher in the tracker group (93.8% (95% CI 79.2-99.2) vs 86.5% (74.2-94.4), respectively). Participants completed at least one symptom report on 63.2% of study days (2384/3771 days). We observed few differences between low vs high adherers, though low adherers (n = 6) were younger (median (IQR) years: 41.5 (34.5-55.3)) than the high engagers (n = 20; 61.0 (50.5-65.3)) and had a shorter disease duration (years: 1.0 (0-5.8) vs 3.0 (0.8-10.8)). In total, 48 consented participants had at least one follow-up appointment during the study window; 46 (95.8%) had complete primary outcome data. Conclusion Across two clinical sites, we determined that the procedures and intervention delivery designed for use within a future multi-centre stepped wedge RCT of the REMORA system were feasible for recruitment, adherence to the intervention and completion of the primary outcome. However, uptake of the intervention was lower than we hoped. To enhance intervention uptake in the main trial, we clarified inclusion criteria, improved patient information on what is required to initiate symptom tracking and modified our supporting materials. Disclosure K.L. Druce: None. M. Parkes: None. R. Bravo: None. D. Griffiths-Jones: None. S.N. van der Veer: None. W. Dixon: Consultancies; consultancy fees from Google unrelated to this work. J. McBeth: None.