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Venous blood point-of-care testing (POCT) for paramedics in urgent and emergency care: a single-site feasibility study (POCTPara)
No full textYesIntroduction: Paramedics play an important role in addressing the growing demands in urgent and emergency care. Point-of-care testing (POCT) devices are increasingly portable and may assist with appropriate non-conveyance, but limited research exists to support this. This feasibility study aimed to inform the design of a larger study to determine whether it is practical for paramedics to use blood analysis POCT.
Methods: An eight-month single-site feasibility sequential explanatory mixed-method study was conducted between April and December 2023, with a team of specialist paramedics who were provided with Abbott® i-STAT Alinity™ POCT devices with CHEM8+ and CG4+ cartridges. Using a qualitative evaluation of paramedic participants’ experience with a POCT device and a descriptive analysis of case report forms and routine ambulance service data collection.
Results: Seven specialist paramedics were recruited; 287 patients were screened, of which 252 (88%) were excluded and 35 (12%) were recruited. Lack of mental capacity excluded 76% of cases. The mean age was 82 years; 40% of participants were female and 60% were male. Hospital conveyance rates were four (11%) of the recruited patients. In those recruited and not conveyed, the median time on scene was 120 minutes. The success rate to obtain a test result at the first attempt was 81% (CHEM8+) and 84% (CG4+). Test result failure rates were 13% (CHEM8+) and 3% (CG4+). Focus group data revealed that paramedic participants considered POCT useful for decision making and the device procedures to be acceptable. Paramedics reported that extended time on scene was related to trial procedures and waiting times to discuss test results with healthcare professionals.
Conclusion: The POCT devices were acceptable and practical for use by our specialist paramedic participants. The results of this feasibility study should inform the design of a larger study to test the impact of using POCT, to understand challenges in recruitment and retention where POCT is utilised and to determine the clinical presentations where POCT can be applied.NIHR Yorkshire and Humber Patient Safety Translational Research Centre
Resilience of energy market under geopolitical risks: What’s the policy implications?
No full textYesThis paper studies the global energy market under geopolitical risk shocks from a novel perspective of resilience. Using the time-varying parameter factor-augmented vector autoregressive model, we quantify resilience by measuring the absorption duration and the intensity from temporal and magnitude aspects. We describe the resilience of the energy market over time. Sub-market analysis shows that the oil market has a longer recovery period but higher absorption intensity than the natural gas and coal markets. We also observe that the energy market exhibits different resilience to geopolitical threats versus actual geopolitical events. Furthermore, we show that market resilience is significantly correlated with hedge ratios and market returns, underscoring the critical role of resilience in risk management. Our study highlights the importance of understanding and measuring market resilience, which provides valuable insights for policymakers and investors to enhance the security and robustness of energy markets.The full text will be available at the end of the publisher's embargo: 2026-11-1
Hindutva and anti-Christian violence in contemporary India
No full textYesIn this special issue introduction, we analyse the trajectory and forms of anti-Christian violence in India and its role in the wider Hindu nationalist project today. Inspired by Galtung’s work on direct, structural, and cultural violence, we show how different forms of anti-Christian violence have waxed, waned, and combined in shifting constellations at different moments of India’s postcolonial political history and in different state contexts. At the current conjuncture, however, the imagined threat of ‘the Christian Other’ has acquired an unprecedented centrality to Hindu nationalist politics, producing a systemic escalation in anti-Christian violence across many states. This violence is, we argue, characterised by a strong convergence of direct, structural, and cultural forms of violence, involving vigilante attacks and police complicity, but also an increasingly coercive use of state law, coupled with the production of a wider cultural common sense about the anti-national essence of non-Hindu religious minorities
Nanotechnology Assisted Drug Delivery Strategies for Chemotherapy: Recent Advances and Future Prospects
No full textNoIn pursuit of the treatment of cancer, nanotechnology engineering has emerged as the simplest and most effective means, with the potential to deliver antitumor chemotherapeutics at the targeted site. Employing nanotechnology for drug delivery provides diverse nanosize particles ranging from one to a thousand nanometers. Reduced size improves drug bioavailability by increasing drug diffusion and decreasing the efflux rate. These nanocarriers offer an enormous scope for modification following the chemical and biological properties of both the drug and its disease. Moreover, these nanoformulations assist in targeting pharmaceutically active drug molecules to the desired site and have gained importance in recent years. Their modern use has revolutionized the antitumor action of many therapeutic agents. Higher drug loading efficiency, thermal stability, easy fabrication, low production cost, and large-scale industrial production draw attention to the application of nanotechnology as a better platform for the delivery of drug molecules. Furthermore, the interaction of nanocarrier technology-assisted agents lowers a drug’s toxicity and therapeutic dosage, reduces drug tolerance, and enhances active drug concentration in neoplasm tissue, thus decreasing the concentration in healthy tissue. Nanotechnology-based medications are being widely explored and have depicted effective cancer management in vivo and in vitro systems, leading to many clinical trials with promising results. This review summarizes the innovative impact and application of different nanocarriers developed in recent years in cancer therapy. Subsequently, it also describes the essential findings and methodologies and their effects on cancer treatment. Compared with conventional therapy, nanomedicines can significantly improve the therapeutic effectiveness of antitumor drugs. Thus, the adverse effects associated with healthy tissues are decreased, and adverse effects are scaled back through enhanced permeability and retention effects. Lastly, future insights assisting nanotechnology in active therapeutics delivery and their scope in cancer chemotherapeutics have also been discussed
Measures and tools assessing medication self-management capability in older people across the hospital-to-home transition: a systematic scoping review
No full textYesBackground: Adverse drug events from medication-related harm (MRH) can lead to hospital readmissions, compromised quality of life, and even death. Post-hospital discharge is a vulnerable period for older adults, who are often unprepared to resume self-care and medication self-management. Assessing medication self-management capability in older people can guide supportive interventions and improve medication-related outcomes. This review aimed to identify measures and tools used to assess medication self-management capability for older patients during the hospital-to-home transition.
Methods: Medline, EMBASE, PsycINFO, CINAHL and Cochrane Library of Systematic Reviews were comprehensively searched for articles from database inception to December 2023. Eligible studies included participants aged 65 or older across the hospital-to-home transition and measures containing at least one medication self-management component. Data extraction was performed using a standardised form, characteristics of measures tabulated, and a narrative approach used to describe measures. Reporting conforms to the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews checklist (PRISMA-ScR).
Results: Fourteen studies were included, and 12 unique measures identified. Measures predominantly focused on adherence rather than broader medication self-management components. Timing of measure administration and the individual administering the measure varied greatly. Medication self-management capability was determined through assessment of physical and cognitive skills. Number and type of skills assessed varied between measures. No measures considered all medication self-management components.
Conclusions: Current measures for medication self-management capability assessment primarily focus on cognitive and physical skills, with significant emphasis on adherence. Findings emphasise the importance of comprehensive definitions of medication self-management across the hospital-to-home transition. Recommendations are provided for developing future measures
A Review for the Performance of Polymers in Pumice Aggregate Concrete
No full textYesLightweight aggregates have been utilized in concrete production for many years, and the incorporation of polymer materials into such composites has recently received growing attention due to the potential improvements in mechanical and durability performance. Polymer concrete or PC is concrete that has been coated reinforced or made without cement. It uses polymer materials to make the concrete stronger and last longer. The properties of polymer concrete made with pumice aggregate (PAPC) are described for this reason. This review looks at the mechanical and physical properties of PAPC concretes. The results demonstrate that PAPC exhibits superior compressive and flexural strength compared to conventional concrete, along with reduced density and lower water absorption capacity. These enhancements make PAPC a promising material for lightweight and durable construction applications. This study is the first to look at polymer concretes with pumice aggregate and gather information that can be used to guide future research.The full-text of this article will be released for public view on first publication on the publisher website
Hydro-climatic variability and peak discharge response in Zarrinehrud River Basin, Iran, between 1986 and 2018
No full textYesIn recent years, both anthropogenic and climate changes have caused the depletion of surface water resources, shifts in rainfall and accelerations in temperature, which indicates the importance of their examination to flood forecasting analyses. This paper studies the importance of synchronised water management strategies, considering upstream and downstream dynamics using field data from 1986 to 2018. Seasonal and decadal variations show the need for adaptive management strategies to address potential climate change impacts on discharge, precipitation and temperature patterns in the Zarrinehrud River, Iran. The regression analysis was considered via R2 values, and the statistical analysis was regarded by p-values. The regression analysis of monthly river peak discharge indicates strong correlations between the discharge of specific months (September–October upstream, December–January downstream). By the 2000s and 2020s, both stations showed a shift in peak precipitation to the spring months (April–May for upstream and May–June for downstream). This confirms a synchronisation of rainfall trends, which are influenced by climate changes or regional hydrological patterns. This temporal offset between stations
confirms the spatial and seasonal variation in rainfall distribution across the basin. Higher temperatures during the dominant months, particularly late summer to early autumn, accelerate snowmelt from upstream catchments. This aligns with the river discharge peaks observed in the hydrograph. The statistical analysis of river peak discharge indicated that the Weibull (p-value = 0.0901) and the Lognormal (p-value = 0.1736) distributions are the best fitted distributions for the upstream and downstream stations, respectively
The role of interprofessional collaboration for social prescribing: a systematic review
No full textYesAim: The current management of interprofessional collaborations in social prescribing schemes remains unclear. This systematic review aims to explore published reports of social prescribing schemes to examine the ways in which interprofessional collaborations are managed and their influence on social prescribing schemes.
Subjects and methods: We searched CINAHL, Ovid MEDLINE, Embase, PsycINFO PubMed, Social Care Online, and Web of Science and grey literature The searches were conducted between August 2022 and April 2023. Two reviewers independently screened titles and abstracts and assessed the quality of included records and extracted the data.
Results: We included 20 records. All included studies used qualitative methods and seven of the studies utilised mixed methods. Three themes were identified (1) requirements for collaboration, (2) challenges to establishing collaboration, and (3) forms and values of collaboration.
Conclusion: Different models of social prescribing are in operation and mostly reported in the UK. There is a lack of uniformity in the definition of social prescribing and interprofessional collaboration in relation to social prescribing schemes. More inclusive models of social prescribing and co-production with all stakeholders are warranted to sustain social prescribing schemes after initial funding initiatives. The involvement and onboarding of multiple professions is essential to deliver person-centred care in community settings
Performance Comparison of Machine Learning Algorithms for Keratoconus Detection
No full textNoThis paper provides an in-depth examination of eight Machine Learning (ML) algorithms commonly employed in diagnosing keratoconus (KC) over the past decade. The analysis is conducted using a clinical dataset accumulated by the authors from two prominent eye-care centers in Jordan over the same period. By scrutinizing the data collected from these centers, the proposed study aims to shed light on the efficacy and comparative performance of various ML algorithms in KC diagnosis. Through rigorous evaluation and comparison, we seek to identify the algorithms that exhibit superior predictive accuracy and reliability in differentiating between normal, subclinical (or suspect) KC, and clinical KC corneas. The obtained results demonstrated that the tree-based models achieved superior performance compared to other models. Specifically, the Random Forest attained the highest classification accuracy at 99.6%, closely followed by Gradient Boosting at 99.2%, and Decision Tree at 98.4%. These promising findings underscore the effectiveness of these classifying algorithms in KC detection and their promise for practical implementation in clinical settings
Saying enough vs saying too much: Lessons on optimizing project risk description for crowdfunding success in developing countries
No full textYesOnline crowdfunded technology projects offer opportunities for driving sustainable growth in developed and developing countries. However, entrepreneurs propose these projects within a context of information asymmetry and risk uncertainty which prospective backers must grapple with. Although Kickstarter has been requiring technology entrepreneurs to disclose project risk information since 2012, the value of this disclosure remains underexplored amidst controversies in the literature about whether project risk description enhances crowdfunding success. In addressing these issues, this research employs signaling theory and curvilinear analysis to examine what project risk description length and sentiment levels maximize crowdfunding success for technology projects, particularly those in developing countries. Statistical analyses of 1059 campaigns on Kickstarter partly support and challenge this study's theorizations. Risk description sentiment and length have U-shaped and inverted U-shaped effects on crowdfunding success respectively. Although these effects do not differ across projects in developed and developing countries, detailed risk descriptions generally yield better results for projects in developing countries. These insights advance and clarify the underdeveloped literature on the link between project risk description and crowdfunding outcomes and offer guidance on how developing country entrepreneurs can couch project risk statements to optimize crowdfunding success