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Working with patients who self-injure: An open label study of an educational intervention to upskill emergency nurses on non-suicidal self-injury
Get PDFNon-suicidal self-injury (NSSI), deliberate damage to body tissue with no intent to die, is not engaged with suicidal intent but is the most reliable predictor of later suicidal behaviour. This makes efforts to reduce self-injury critical. Emergency departments can be the gateways to care for many people who have self-injured and optimal sites for interventions that promote recovery. However, emergency nurses have anecdotally reported that they lack training and feel ill-equipped to provide care for patients who self-injure. In this open label trial (where both participants and researchers were aware who received the intervention), all nurses in a metropolitan emergency department were invited to complete a multi-modal training programme designed to improve their knowledge, attitudes, confidence, and resilience, and reduce burnout related to caring for patients who self-injure. We also invited nurses to provide feedback in one-on-one interviews. Sixty nurses completed self-report measures at pre, post (immediately following training), and 1-month following training. Gains were seen immediately post-training in knowledge, empathy, self-compassion, and resilience, while reductions were seen in negative attitudes and burnout. In all cases these changes were maintained at 1-month follow-up. Eighteen nurses participated in interviews, who reported on the impact of the training on improving understanding of NSSI and confidence in working with patients who self-injure at both a personal and institutional level. They also identified barriers to implementing training, many of which require system-level changes within the health system. Findings suggest that training integrated within emergency settings can have a significant impact, not only on knowledge and confidence but on the wellbeing of emergency staff working with patients who self-injure
The enigmatic pianist Arthur Friedheim: A revised biography and study of his training, performing, writings, teaching and editions
Get PDFArthur Friedheim (1859–1932) was one of the most notable pianists of the late nineteenth century, best remembered as a devoted pupil and disciple of Franz Liszt (1811–1886). Following Friedheim’s Leipzig debut in 1884, Liszt predicted that his young pupil “would yet become the greatest piano virtuoso of the age.” During his lifetime, Friedheim would be compared with such pianistic giants as Carl Tausig (1841–1871), Moriz Rosenthal (1862–1946) and Ferruccio Busoni (1866–1924). Yet his posthumous reception, based on a few surviving recordings and a small number of written sources, has tended to cast doubt on his importance. Some critics disparagingly dismissed Friedheim, and refashioned his reputation into that of a “superficial poseur” who did little more than copy Liszt’s stage mannerisms. This thesis seeks to re-evaluate Friedheim’s place in music history through a deeper exploration of the primary sources. At the centre of the thesis is a scholarly biography, presenting a revised and expanded narrative of Friedheim’s life and career, attempting to fill gaps and correct factual errors found in the existing literature. A large corpus of hitherto unstudied primary sources has informed this research: including over 1,700 clippings relating to Friedheim’s life and career, as well as archival documents at the Peabody Institute of the Johns Hopkins University, Baltimore, and the International Piano Archives at the University of Maryland. In addition, Friedheim’s own writings and music editions—including a collection of some thirty published articles, various unpublished manuscripts, and a forgotten edition called The Student’s Chopin (1925)—form the basis of the latter part of the thesis, which presents a study of Friedheim’s training and his work as performer, writer, teacher and editor
Two-phase covert communication with a wireless-powered jammer by RIS
No full textIn this work, we consider a two-phase covert communication system assisted by a wireless powered jammer via a reconfigurable intelligent surface (RIS) with discrete phase shifts. Specifically, in the first phase, the jammer harvests energy from the same transmitter of covert signals with the aid of RIS and in the second phase the jammer uses all the harvested energy to generate interference for facilitating covert transmissions. We first derive the minimum detection error probability at a warden, based on which we optimize the phase switching ratio between the two phases to maximize the effective transmission rate subject to a covertness constraint. Interestingly, our analysis indicates that the achievable communication covertness does not depend on the transmit power of Alice, which remains the same across the two phases for simplifying system implementation. Our examinations also show that a shorter duration should be allocated to energy harvesting for maximizing the covert communication performance when the capability of the RIS increases, e.g., the element number or discrete phase shift level increases
A comparative study of aluminium properties manufactured using additive friction stir deposition (AFSD) and wire arc additive manufacturing (WAAM)
Get PDFWire arc additive manufacturing (WAAM) has recently gained considerable attention due to its capability to manufacture large-size metal with a length of one meter or above, with good microstructural and mechanical properties. However, the manufacture of critical components exposed to extreme environmental conditions, such as high stresses, remains the focus of most research studies. The applications of WAAM in high-tech industries, such as aerospace and marine modes, remain limited due to metallurgical challenges such as oxidation, porosity, cracking, and deformation, especially for high-strength aluminium alloys, including 6XXX and 7XXX series. The aforementioned metallurgical challenges in WAAM are minimized to some extent by another emerging technology, known as additive friction stir deposition (AFSD). AFSD is capable of manufacturing large-size and high strength (strength equal to or greater than that of the raw material) industrial components with fewer metallurgical defects and refined microstructures. However, this technology is in its developmental stage and possesses some challenges, such as oxidation, which is currently an emerging topic for researchers in metal additive manufacturing (AM). This paper reviews the potential of various additive manufacturing (AM) techniques for the manufacture of high-strength components, using either unweldable virgin or recycled high-strength aluminium alloys. The study also provides a comprehensive overview of the importance of recycling aluminium, as well as the challenges of utilizing aluminium (Al) alloys within metal AM. Considerations related to microstructure, the mechanical properties and metallurgical defects in both these technologies are extensively discussed and compared. The study concludes that both technologies are still being developed and experience various metallurgical issues, which need to be addressed to fully utilize WAAM and AFSD for critical applications. Further, the AFSD process is shown to be a better alternative to the WAAM process in the fabrication of Al components, where it possesses less metallurgical issues, higher strength and more refined microstructures. The literature suggests ultimate tensile stress (UTS) and average elongation percentage during AFSD in the range of 197.3 MPa–306 MPa and 8.6%–39% for Al alloys, respectively. However, slightly better UTS values in the range of 344 MPa–349 MPa and significant reduction in average elongation percentage to 5% is noted during WAAM process. Furthermore, AFSD exhibited significantly higher microhardness values (40.8 HV–151.4 HV) when compared to WAAM (73 HV–111 HV). Accordingly, the study notes that further numerical and experimental studies are needed to fully understand material flow in stirring zones during the AFSD process
A flavonoid-rich diet is associated with a lower risk of chronic kidney disease: A prospective cohort study
Get PDFBackground and aim: Mechanistic data suggests several flavonoids may improve kidney function, but no large-scale prospective cohort study has been conducted. As such, we performed a prospective population-based study on flavonoid intakes, chronic kidney disease (CKD) risk, and all-cause mortality among participants with CKD. Methods: We examined associations between a Flavodiet score (FDS), individual flavonoid-rich foods and subclasses (based on ≥2 24-h dietary assessments) and a) CKD risk among 109,711 adults, and b) all-cause mortality among 3,287 participants with CKD at baseline, aged 40–69 years using multivariable Cox regression analyses. Additionally, we used mediation analysis to examine potential mechanisms of action. Results: Over 10.5 y follow-up, 4,257 cases of incident CKD were identified. A higher FDS, characterized by a median of 6 servings of flavonoid-rich foods per day, was associated with a 16 % lower risk of CKD (HR (95%CI) Q4 vs Q1, P trend = 0.84 (0.77, 0.92), \u3c0.001), in part mediated by levels of triglycerides (2.8 %), high-density lipoprotein (5.9 %), glycated hemoglobin (2.2 %), Cystatin-C (16.6 %), and C-reactive protein (2.1 %). Additionally, we observed significant inverse associations between a range of flavonoid-rich foods (apples, oranges, berries, and red wine) and flavonoid subclasses (anthocyanins, proanthocyanidins, flavonols, flavanones, and flavones) and CKD risk. Among participants with prevalent CKD, a higher FDS (median of 6 servings per day) was associated with a 27 % lower risk of all-cause mortality compared to Q1, although the P for trend did not reach statistical significance (HR (95%CI) Q4 vs Q1, P trend: 0.73 (0.54, 0.97), 0.10). Conclusion: A flavonoid-rich diet consisting of a median of 6 servings per day of commonly consumed flavonoid-rich foods such as apples and berries, was associated with a lower risk of CKD, and a lower risk of all-cause mortality in individuals with CKD in middle-aged adults. Simple dietary change to increase intakes of these commonly consumed food and drink items may lower CKD risk, and improve CKD prognosis
Assessing techno-economic performance of synchronous condensers and static synchronous compensators in renewable energy-integrated weak-grids using hedge feedforward feedback-based online gated recurrent unit
Get PDFTo achieve net-zero targets in many counties, renewable energy generators (REGs) are integrated with grids where less fault current is produced compared to synchronous generators. Accordingly, fault level availability, known as ‘system strength’, is reduced at point of coupling (POC) buses. A minimum system strength level is crucial for REGs to accurately detect and ride-through faults. To maintain adequate system strength in renewable energy-based weak grids, researchers and engineers have recommended supplementary devices, such as synchronous condensers (SynCons) or static synchronous compensators (STATCOMs), to provide the required fault-current. Because SynCons and STATCOMs are costly devices, their optimal sizes and placement were investigated in existing literature. However, no long-term techno-economic analysis was conducted to confirm appropriate selection between SynCons and STATCOMs. To address the research gap, this paper investigates the long-term financial feasibility of SynCons and STATCOMs by considering their optimal allocation and sizes. A hedge feedforward feedback-based online gated recurrent unit (HFF-OLGRU) optimisation learning algorithm is developed and compared with existing learning approaches in order to determine the best solution. The technical and economic findings suggest that SynCons improve voltage recovery time approximately 0.06 s and achieve net profit USD$42.68M over STATCOMs in renewable energy-based weak grids
CNN based deep learning modeling with explainability analysis for detecting fraudulent blockchain transactions
Get PDFIn the era of growing cryptocurrency adoption, Blockchain has emerged as a leading player in the digital payment landscape. However, this widespread popularity also brings forth various security challenges, including the need to safeguard against fraudulent activities. One of the paramount challenges in this regard is the detection of fraudulent transactions within the realm of Bitcoin data. This task significantly influences the trust and security of digital payments. Yet, it\u27s a formidable challenge given the relatively low occurrence of fraudulent Bitcoin transactions. While deep learning techniques have demonstrated their prowess in fraud detection, there remains a scarcity of studies exploring their potential, particularly in Blockchain. This study aims to fill that gap, focusing on our 1D Convolutional Neural Network (CNN) model, which combines the power of eXplainable Artificial Intelligence (XAI) techniques. To understand how our model works and explain its decisions, we use the Shapley Additive exPlanation (SHAP) method, which measures each feature\u27s impact. We also deal with data imbalance by exploring various methods to balance fraudulent and benign Bitcoin transaction data. Our findings are significant, indicating that the proposed 1D CNN model achieves higher accuracy while simultaneously reducing the False Positive Rate (FPR)
Dear Annette…….: Learning through our letters
Get PDFFeminist environmental educational researcher Annette Gough’s recently published book Gender and Environmental Education is a collection of articles that have been foundational to the field of feminist environmental education. This paper shows how two feminist scholars creatively reviewed this book relationally. In doing so, reading, writing, and citational practices were reinvented to create room for generating multiple knowledge relations and connections. Our review demonstrates how letter writing may be used as a form of collective field-building. We invite readers to consider how collective field-building can be made possible through creative and careful reading practices
Finger orthoses for rehabilitation―Part I: Biomedical insights and additive manufacturing innovations
Get PDFBackground: Finger orthoses are essential for treating injuries, deformities, and disorders of the upper limbs by supporting, immobilizing, or correcting deformities. Recent advances in three-dimensional (3D) printing have significantly enhanced precision and customization compared to traditional fabrication methods such as thermoplastic molding, plaster or fiberglass casting, and the use of prefabricated splints. Methods: The present review was conducted using PubMed, Scopus, and other databases with keywords such as “hand therapy”, “additive manufacturing”, “finger and thumb”, and “orthosis”. Only English-language publications were considered, with a primary focus on articles published between 2010 and 2025. Key themes were identified and categorized into conditions necessitating finger orthoses, types and classifications, ergonomic design considerations, and advancements in additive manufacturing. Results: Finger orthoses address musculoskeletal injuries, inflammatory diseases, and neuromuscular disorders. Three-dimensional printing provides enhanced customization, reduced material waste, rapid prototyping, and the ability to create complex geometries, improving patient comfort and functionality. Conclusions: Finger orthoses effectively treat various conditions by supporting and stabilizing fingers. A thorough understanding of anatomy, biomechanics, and fabrication methods is crucial for achieving functional and comfortable designs. Three-dimensional printing offers a transformative approach to producing lightweight, customizable, and cost-effective orthoses, enabling innovative and personalized solutions. By bridging clinical needs and design strategies, this review may guide future innovations in patient-specific orthotic development