12508 research outputs found
Sort by
The influence of imaging protocols on complex ankle fracture manipulation in the ED: A before and after study
No full textYesIntroduction: Ankle injuries that present to the ED with instability of the joint due to multiple fractures/disruption of the mortise need to be re-aligned promptly to minimise complications. A protocol change was introduced whereby mobile radiographs would be performed in the ED resuscitation room during manipulation of a complex ankle injury. The aim of this study was to determine if the overall time to definitive reduction had reduced for these patients, improving patient flow.
Method: Data was collected from patients attending the ED with a complex or unstable ankle injury in a UK single-centre over 6-months periods, pre pathway introduction (2019), immediately post change (2021) and 2 years post implementation (2023).
Results: In excess of 3000 patients had ankle radiographs performed in each cohort of data collection with an average of 2.9 % of injuries categorised as complex or unstable and requiring manipulation, consistent across the cohorts (p = 0.246). Increasing compliance with the new pathway was evident over time with a significant time reduction demonstrated from initial ED presentation to final post manipulation imaging if mobile radiographs were obtained with the mean time 113 min quicker than those performed in the radiology department in 2023 (p = 0.00).
Conclusion: Although it takes time to embed new pathways and changes in practice, this study demonstrated that a simple change in imaging provision had a positive impact for patients with a complex ankle injury.
Implications for practice: Providing post manipulation radiographs in the ED resuscitation room allowed earlier confirmation of restored anatomical alignment for patients with a complex ankle injury and enabled clinicians to perform multiple manipulation attempts, if necessary, under the same sedation episode
Residual structural performance of fire-exposed concrete slabs reinforced with hybrid GFRP-steel bars: Experimental and numerical studies
No full textYesThe use of glass fiber–reinforced polymer (GFRP) bars in concrete structures, such as bridge decks, has increased significantly due to their superior corrosion resistance in severe environments. To enhance ductility, hybrid steel- GFRP reinforcement solutions have been proposed for GFRP-reinforced concrete structures. This study presents the experimental results of twelve full-scale one-way reinforced concrete slabs, including both control and fire- exposed specimens. The slabs were reinforced with GFRP bars, steel bars, or hybrid reinforcement, with test variables including bar arrangement, mechanical reinforcing ratio, and the ratio of steel bar area to GFRP bar area. Six specimens were subjected to a reduced-scale standard fire with a maximum temperature of 650 C testing in a tunnel-type gas furnace, cooled to ambient temperature, and then tested under four-point loading until failure. Furthermore, a finite element model was developed, validated, and used to conduct a parametric study examining the impact of key reinforcement parameters on the structural behavior of fire-exposed slabs. Results indicate that fire exposure reduces the ultimate load-bearing capacity of all specimens. However, the reduction in GFRP-reinforced specimens is comparable to that of steel-reinforced specimens. Additionally, hybrid reinforcement with a higher steel-to-GFRP area ratio improves the residual performance of fire-exposed specimens. Notably, the ductility of hybrid-reinforced specimens remains largely unaffected by fire exposure
Novel methods applied to security and privacy problems in future networking technologies
No full textYesThe rapid development of future networking technologies, such as 5G, 6G, blockchain, the Internet of Things (IoT), cloud computing, and Software-Defined Networking (SDN) is set to revolutionize our methods of connection, communication, and data sharing. While these technologies facilitate more efficient communication and enable the creation of previously unimaginable applications and services, they also pose significant security and privacy challenges. These include expanded attack surfaces, new attack vectors, evolving threats, and concerns over data privacy and user trust. Addressing these challenges is crucial to ensuring that future networking technologies can be utilized safely and securely while realizing their full potential.
This Special Issue is particularly timely, as it highlights cutting-edge research and solutions aimed at overcoming these security and privacy challenges. Recent advancements in networking technologies and security frameworks have laid a strong foundation for tackling long-standing issues in secure communication and data privacy. By showcasing both theoretical innovations and practical applications, the Special Issue aims to inspire further advancements in the field. The objective is to bridge the gap between theory and practice, promoting collaboration across various disciplines to develop more resilient and secure networking infrastructures that can address the emerging security and privacy concerns of our digital future.
In this Special Issue on cybersecurity, we received 19 submissions, each carefully evaluated by at least one of the Guest Editors to ensure relevance to the theme of securing emerging technologies. Submissions considered relevant underwent a comprehensive review process involving at least two external reviewers, while those that did not meet the necessary criteria were rejected. After a rigorous peer-review process, 11 articles were selected for publication. These contributions explore critical topics such as the development of robust cybersecurity strategies for emerging technologies, including 5G, blockchain, IoT, cloud computing, and SDN, as well as Zero Trust frameworks. The articles provide innovative insights into how these technologies can be safeguarded against evolving security threats, addressing issues such as expanded attack surfaces, data privacy concerns, label-flipping attacks, and user trust issues. Key technologies such as Convolutional Neural Networks (CNNs), Generative Adversarial Networks (GANs), Deep Reinforcement Learning (DRL), and blockchain for identity management, along with Zero Trust principles for enhancing security, are applied to tackle cybersecurity challenges. A summary of the findings and conclusions from each article is presented below, offering a diverse range of solutions for securing these rapidly advancing technologies in the face of complex cyber threat
How psychostimulant treatment changes the brain morphometry in adults with ADHD: sMRI Comparison study to medication-naïve adults with ADHD
No full textYesADHD is increasingly recognised as a cause of functional impairment in adults. Treatment guidelines recommend stimulants as the first-line treatment for adult ADHD, but concerns exist about long-term efficacy and potential tolerance. We investigated the long-term effect of stimulant therapy on brain morphometry in individuals with ADHD.
We obtained structural MRI data from the UCLA Consortium for Neuropsychiatric Phenomics for 26 adults with ADHD. We compared grey matter volume, cortical thickness, sulcal depth, gyrification index, and fractal dimension between individuals with ADHD who had received psychostimulant treatment and medication naïve. For clinical assessment, we also compared Barratt's impulsivity score, Dickman impulsivity inventory II, and Eysenck's impulsivity inventory and investigated how brain morphometry were associated with these scores
The treated group exhibited significantly higher values in surface-based metrics (FWE-corrected p-value < 0.05), including gyrification index, sulcal depth, and fractal dimension. There was an increased gyrification observed in the right Rolandic operculum, left supplementary motor area, left superior temporal gyrus, right fusiform gyrus, and left cuneus. Increased sulcal depth was detected in the inferior and superior orbitofrontal regions, while increased fractal dimension was also evident in the left superior orbitofrontal gyrus. Treated group venturesomeness scores positively correlated with the grey matter volume of the right anterior cingulate gyrus and negatively with the right superior occipital gyrus.
Our results suggest a limited treatment effect on ADHD scores and grey matter volume in adults. Despite significant surface-based metrics, these changes were not accompanied by improvements in the clinical scores
Decarbonization in Supply Chain Management with Blockchain Technology: Using Multi-Criteria Decision Making in Industry 4.0
No full textYesThis study explores the role of blockchain technology (BT) in enabling decarbonisation within healthcare supply chain management (SCM) in the context of Industry 4.0. A novel hybrid methodological framework combining the fuzzy spherical analytical hierarchy process (FS-AHP) and the Z-number logarithm methodology of additive weights (ZLMAW) is developed to address the complexities and uncertainties inherent in this domain. The research identifies critical factors influencing the adoption of BT in decarbonised SCM and ranks healthcare companies based on their suitability for implementation. The results highlight the lack of a robust scope framework as a priority concern and demonstrate the efficacy of the proposed model in advancing sustainable practices. This work contributes to theoretical advancements, by integrating multi-criteria decision-making (MCDM) techniques with blockchain in SCM, and practical insights, by offering a scalable approach to supply chain decarbonisation. The findings bridge gaps in the literature by addressing the intersection of blockchain, Industry 4.0, and sustainability in healthcare, presenting actionable strategies for supply chain optimisation.The full-text of this article will be released for public view at the end of the publisher embargo 12 months after first publication.The full-text of this article will be released for public view at the end of the publisher embargo on 27 May 2026
Unraveling the Binding Mode of TSC2–Rheb through Protein Docking and Simulations
No full textYesProteasome inhibitors (PIs) constitute the first line of therapy for multiple myeloma (MM). Despite the impressive clinical efficacy, MM remains fatal due to the development of drug resistance over time. During MM progression, stress responses to hypoxia and PIs suppress mammalian target of rapamycin complex 1 (mTORC1) activity by releasing tuberous sclerosis complex 2 (TSC2), which deactivates Ras homologue enriched in brain (Rheb), a crucial regulator of mTORC1. The efficacy of PIs targeting MM is enhanced when mTORC1 is hyperactivated. We thus propose that the inhibition of TSC2 will improve the efficacy of PIs targeting MM. To the best of our knowledge, no cocrystallized structure of the TSC2–Rheb complex has been reported. We therefore developed a representative model using the individual structures of TSC2 (PDB: 7DL2) and Rheb (PDB: 1XTS). Computational modeling involving an extensive protein–protein docking consensus approach was performed to determine the putative binding mode of TSC2–Rheb. The proposed docking poses were refined, clustered, and evaluated by MD simulations to explore the conformational dynamics and protein mobility, particularly at the drug-binding interface of TSC2–Rheb. Our results agree with the suggested binding mode of TSC2–Rheb previously reported in the literature. The results reported herein establish a basis for the development of new inhibitors blocking the binding of TSC2 and Rheb, aiming to reinstate mTORC1 activation and facilitate improved efficacy of PIs against multiple myeloma
Fostering eco-friendly behaviors in hospitality: engaging customers through green practices, social influence, and personal dynamics
No full textYesAbstract
Purpose
This study aims to delve into the intricate dynamics of customers’ pro-environmental behavior, examining the impact of external stimuli like hotel green practices (as contextual factors); internal stimuli, i.e. perceived consumer effectiveness, perceived environmental responsibility and pro-environmental self-identity (as individual factors); and social norms as social factors, on customers’ engagement in sustainable consumption (CEISC) and subsequent pro-environmental behaviors (PEBs).
Design/methodology/approach
An age-based quota sampling technique was used to gather data from customers visiting hotels in Pakistan. SmartPLS v.4 software was used to analyze the data, applying structural equation modeling and testing for the predictive powers of the model.
Findings
The results revealed the significant impact of both external and internal stimuli on customers’ PEBs, with higher impacts of hotel green practices and pro-environmental self-identity, underlining the complex nature of these influences. Results also revealed that social norms augment the influence of extrinsic and intrinsic factors on CEISC.
Practical implications
Hotels can enhance customer engagement by implementing green practices. In addition, leveraging social norms and tailoring communication strategies to highlight collective benefits can further amplify PEBs among guests.
Originality/value
This research provides a pioneering theoretical contribution by integrating the stimulus-organism-response model, the theory of planned behavior and the value-belief-norm theory in the realm of green consumerism in the hotel industry. It also addresses the potential gap linked to hotel green practices in leveraging customers’ PEBs in addition to their positive perceptions
Chemical Analysis of Polyphenolic Content and Antioxidant Screening of 17 African Propolis Samples Using RP-HPLC and Spectroscopy
No full textYesBackground and objectives: Propolis is a resinous material produced by honeybees. Its chemical composition is highly complex and varies significantly depending on geographic region and season. This intrinsic variability presents challenges to the standardization and quality control of propolis. This study aimed to evaluate the chemical composition, total phenolic content, and antioxidant potential of propolis collected from seventeen geographical regions across Africa.
Methods: A reverse-phase high-performance liquid chromatography (RP-HPLC) method coupled with a photodiode array detector was used for analysis of propolis samples. The flavonoid and phenolic contents of the samples were determined using colorimetric and Folin-Ciocalteu methods. Antioxidant capacity was assessed using the 2,2-diphenyl-1-picrylhydrazyl assay.
Results: Five flavonoids (naringenin, pinocembrin, galangin, chrysin, and quercetin), one flavonoid glycoside (rutin), six phenolic acids (caffeic acid, p-coumaric acid, cinnamic acid, chlorogenic acid, ferulic acid, and gallic acid), and an aromatic ester - caffeic acid phenethyl ester were simultaneously detected and quantified using RP-HPLC with an ACE-5 C18 column (250 mm × 4.6 mm i.d., 5 µm) and photodiode array detector detector. The reference standards showed good linearity with regression coefficients (R2) ranging from 0.96 to 0.99. For precision, repeatability, and stability studies, the relative standard deviation for all reference standards was below 2.5%. The 2,2-diphenyl-1-picrylhydrazyl assay yielded EC50 values ranging from 17.6 ± 0.39
to 0.16 ± 0.001 mg/mL.
Conclusions: RP-HPLC method for the simultaneous quantification of thirteen reference standards will serve as a reliable tool for the standardization and quality evaluation of propolis. The flavonoid and phenolic contents are key contributors to the antioxidant activity of propolis and reflect local plant biodiversity and bee–plant interactions within the ecosystem
“They take the mum off you when you come in": An ethnographic study of parent experiences of medicines safety systems in English hospitals
Get PDFYesMedication safety in healthcare settings is a persistent problem, and children may be at greater risk of harm than adults. Most existing research examining medication safety for hospitalised children is from the perspective of healthcare professionals and organisations. This study aimed to ethnographically explore parent and staff perspectives on the role of parents in medication safety in the paediatric hospital setting.
Methods
230 hours of ethnographic observation and 19 semi-structured interviews with clinical staff and parents were conducted over paediatric wards in three acute hospitals in Northern England between October 2020 and May 2022. Data was organised and coded using NVivo and analysed thematically.
Results
Three main themes were identified; 1) Capacity and Capability: Parents were often assumed to be incompetent by organisational policies and managers but at the same time were co-opted to undertake medication processes to meet operational needs. Parental experience was often ignored or judged negatively. When things went wrong parents were sometimes blamed. 2) Communication: parents were seldom meaningfully involved in decisions about their children’s medication or provided with appropriate information unless requested. Parental medication histories were treated with suspicion and validated against inaccurate records; 3) Agency and Autonomy: parents often wanted to participate in their child’s care but were expected to be passive observers.
Conclusions
Medication safety for children is a social phenomenon involving healthcare professionals and parents. However, parents are often relegated to a passive role by healthcare staff. We posit that this represents an example of epistemic injustice in the way parents are assumed to be incompetent outsiders with no understanding of the medical care of their children, despite them offering resilience for medicines safety. We recommend further exploration of how parents contribute to resilience and safety for children in hospital and the barriers to this, and how health services can safely support increased engagement and involvement of parents in the care of their children while in hospital.
Patient or public contribution
Parents contributed to the analysis and interpretation of the data collection and have contributed to the preparation of the manuscript.NIHR (Health Education England Integrated Clinical Academic Programme - CDRF-17-024), NIHR through the Greater Manchester Patient Safety Research Collaboratio
Professionals' views on social care planning and provision for people with young-onset dementia and their families in England: Findings from the DYNAMIC study
No full textYesObjectives: Access to appropriate social care post‐diagnosis is crucial for people with young onset dementia (YOD) and their families. Yet care is hugely variable, frequently lacking, and poorly coordinated. We aimed to establish levels of awareness, knowledge, and practice among professionals regarding social care provision for people with YOD.
Methods: A short survey (24 items) was developed based on previous research and through consultation with experts by experience and the project steering group. The aim was to establish awareness, knowledge, and practice among professionals regarding social care needs, care planning, and provision for people YOD. The survey was available online.
Results: There were 139 responses from health and social care professionals. A wide range of situations triggered referrals to social care, illustrating the holistic impact of YOD. However, most referrals were triggered by crises rather than a proactive approach and were in response to carers' needs rather than those of the person with YOD. Referrals for advice and guidance around financial impacts were common. Most respondents reported there was no agreed care pathway and no YOD‐specific guidelines in their service. Areas of good practice in social care provision included: person‐centred and reablement based approaches; multi‐disciplinary and multi‐agency working; support from peers and the third sector; seamless care pathways and dedicated YOD services; support for carers; and personal budgets.
Conclusions: Staff need accurate knowledge and awareness of specific YOD‐related issues to provide effective social care for those with YOD and their families. The current system tends to be reactive at point of crisis, whereas proactive planning and provision could pre‐empt crises and provide more effective support. YOD‐specific care pathways and guidance are needed to improve social care for this population.National Institute for Health and Care Research. Grant Number: NIHR20426