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Easy Read Health Information for people with Intellectual Disabilities: a systematic review of the evidence
Full text linkBACKGROUND: Easy Read materials are sometimes provided by healthcare services to help people with intellectual disabilities to understand written information. This study examined literature on the development, review, regulation, delivery, and impact of Easy Read health information (ERHI) with the aim of elucidating best practice. METHODS: A systematic review of five bibliographic databases and three grey literature databases was registered, conducted, and synthesised using meta-aggregation. Studies from 2006 onward regarding ERHI for individuals with intellectual disabilities were included. RESULTS: The twenty-nine included studies revealed variability in ERHI development, review, and quality control processes. Individuals with intellectual disabilities valued ERHI and assistance in appraising it, however empirical evidence of ERHI effectiveness was limited. CONCLUSIONS: ERHI's empirical evidence base is underdeveloped and largely consists of low-quality research. Subjective and inconsistent application of guidance leads to variable ERHI quality. Standardised resources and rigorous research are needed to evaluate ERHI as a health education intervention
Robust data envelopment analysis models for efficiency evaluation with new uncertainty sets
Full text linkThe integration of robust optimisation techniques and data envelopment analysis (DEA) models results in a methodology called robust DEA. This methodology aims to tackle uncertain data and ensure robust and reliable efficiency measures. In applying robust optimisation approaches, the selection of the uncertainty set plays a pivotal role since it determines the trade-off between achieving optimal objective and ensuring a high probability of constraint feasibility, a concept well-known as the price of robustness. This trade-off can be adjusted using a robust parameter based on managers’ risk preferences. Similar to robust optimisation, robust DEA aims to protect the deterministic DEA models against data uncertainty within a user-specified uncertainty set, providing a probability bound on constraint feasibility. Despite recent advancements in robust optimisation approaches, robust DEA models are still in their early stages of development, accentuating the need for further research, especially in the application of new types of uncertainty sets. To address the identified research gap, this study aims to develop two novel robust DEA models considering recently introduced uncertainty sets—namely, variable budgeted and order statistic uncertainty sets—to improve the flexibility and generality of the existing robust DEA models. We discuss in depth how the existing robust DEA models under budgeted uncertainty sets represent a special case of the proposed robust DEA models in this paper when the robust parameter is appropriately selected. Finally, we present a case study on EU banks to illustrate the efficacy and applicability of the proposed models, which show a robust evaluation strategy for management in uncertain environments
A novel, PCP-dependent tissue organising principle coordinating morphogenesis between embryonic skin epidermal layers
Full text linkPlanar cell polarity (PCP) provides cells and tissues with a sense of direction in relation to the principal body axes of the embryo. In the developing mouse skin, PCP coordinates cell behaviours within the plane of the epidermal basal monolayer. In this report, evidence is presented for a novel, three-dimensional PCP protein-dependent tissue organising principle(s) operating within the mouse embryonic epidermis which coordinates cell long axis orientation across multiple epidermal layers. Here, the core-PCP protein, Frizzled-6 (Fz6), is found within different layers of developing trunk epidermis. Analysis of fz6 mouse mutant skin suggests Fz6 signalling contributes to several aspects of the novel tissue organising principle. Firstly, the robust coordination of epidermal cell long axis orientation between epidermal layers. Secondly, the timing of the switch in epidermal cell long axis orientation between orthogonal principal body axes, circumferential and longitudinal. Finally, the establishment of robust mirror symmetry of epidermal cell long axis orientation between each mouse embryo mid-flank, when viewed across the ventral midline. Local cell arrays/cell rosette-type arrangements within adjacent epidermal layers are implicated in the underlying mechanism coordinating epidermal cell long axis orientation. A previously unreported morphogenetic event within the superficial layers of the nascent epidermis may also rely on three-dimensional tissue polarity processes
Creation and clinical utility of a 3D atlas-based model for visualising brain nuclei targeted by MR-guided focused ultrasound thalamotomy for tremor
Full text linkMagnetic resonance guided focused ultrasound (MRgFUS) thalamotomy is an established treatment for tremor. MRgFUS utilises ultrasound to non-invasively thermally ablate or "lesion" tremorgenic tissue. The success of treatment is contingent on accurate lesioning as assessed by tremor improvement and minimisation of adverse effects. However, coordinate planning and post-procedure lesion visualisation are difficult as the key targets, cannot be seen on standard clinical imaging. Thus, a computational tool is needed to aid target visualisation. A 3D atlas-based model was created using the Schaltenbrand-Wahren atlas. Key nuclei were manually delineated, interpolated and smoothed in 3D Slicer to create the model. Evaluation of targeting approaches across a seven-year period and patient-specific analyses of tremor treatments were performed. The anatomical position of MRgFUS lesions in the model were compared against varying clinical outcomes. The model provides an anatomical visualisation of how the change in targeting approach led to improved tremor suppression and a reduction in adverse effects for patients. This study demonstrates the successful development of a 3D atlas-based computational model of the brain target nuclei in MRgFUS thalamotomy and its clinical utility for tremor treatment analysis
Microbial competitiveness and risk of ochratoxin A in salami: in situ evaluation along maturation
Full text linkThis study investigated interactions and competition between the starter culture Penicillium nalgiovense and the toxigenic fungus Aspergillus westerdijkiae, focusing on their effects on processing parameters and on ochratoxin A (OTA) production on the dryfermented salami surface during ripening. The influence of Lactococcus lactis, incorporated into the meat matrix, was also assessed. Salami was produced in accordance with official technical standards in a controlled environment. Half of the meat batter was inoculated with L. lactis. Following stuffing, salami was treated with one of three inoculum solutions: (A) P. nalgiovense, (B) P. nalgiovense plus A. westerdijkiae, or (C) A. westerdijkiae alone. Samples ripened for 20 days under industry-standard conditions. At days 0, 4, 8, 12, 16, and 20, pH, water activity, total bacterial counts in the meat, total fungal counts on the casing, and OTA concentrations in both matrices were measured. A. westerdijkiae rapidly colonised and dominated the casing surface by day 4, even in the presence of P. nalgiovense, and reached peak growth between days 8 and 12. OTA concentrations increased significantly after day 12, reaching 69 µg/g in the casing and 16 µg/g in the meat by day 20. Indicating that the surface provides more favorable conditions for toxin production, so removing casing could reduce the exposure to the toxin. The addition of L. lactis accelerated early acidification and temporarily reduced bacterial load but did not significantly affect fungal growth or OTA biosynthesis. These findings demonstrate that, under favorable environmental conditions, toxigenic fungi represent a significant food safety risk during salami ripening. Starter cultures alone are insufficient to prevent mycotoxin contamination in dry-cured meat products
Experiences of self-identification, diagnosis and support for adults seeking a recognition of tic disorders in the United Kingdom
Full text linkAims: This study aimed to examine the experiences of self-identification, diagnosis, and support for adults with tic disorders (including Tourette Syndrome) in the United Kingdom (UK). Background: Traditionally viewed as a neurological disorder of childhood-onset, tic disorders have been observed to remit or persist, often in a milder form, into adulthood. However, the reappearance of problematic symptoms after periods of asymptomatic latency might be more common than previously recognized. The medical exposure and standardization of clinical practice for primary adult-onset or non-typical adult-presenting cases of tic disorders is currently limited and poses barriers to diagnosis. Methods: An online survey of 42 adults with self-identified tic symptomology explored their tic recognition and journey of attaining a confirmed diagnosis and/or self-identifying after the age of 18 in the UK. Findings: No significant differences were found between adult and childhood-onset cases. Elevated scores on the Acceptance and Action Tic Specific Questionnaire (AAQ-T) correlated with higher overall frequency, intensity, and severity of motor tics from the Adult Tic Questionnaire (ATQ). The AAQ-T was also shown to negatively correlate with increasing age. Nearly all adults expressed dissatisfaction with the diagnostic process, especially regarding information provided and lack of post-diagnostic support. Those who self-identified quoted fear of dismissal, long waiting lists and lack of understanding from clinicians as reasons for not seeking a formal diagnosis. Overall, the results emphasize the importance for a standardized improved comprehension of tic conditions in healthcare including how to best support adults seeking recognition later in life
Stereo-Based Single-Shot Hand-to-Eye Calibration for Robot Arms
Full text linkRobot hand-to-eye calibration is a necessary process for a robot arm to perceive and interact with its environment. Past approaches required collecting multiple images using a calibration board placed at different locations relative to the robot. When the robot or camera is displaced from its calibrated position, hand-eye calibration must be redone using the same tedious process. In this research, we developed a novel method that performs hand-to-eye calibration using a stereo camera to automatically generate a transformation matrix from the world to the camera coordinate frame from a single stereo image. We use a robot-pointer tool attached to the robot’s end-effector to establish a relationship between the world and the robot coordinate frame. Then, we establish the relationship between the camera and the robot using a transformation matrix that maps points observed in the stereo image frame from two-dimensional space to the robot’s three-dimensional coordinate frame. Our analysis of the stereo calibration showed a reprojection error of 0.26 pixels. An evaluation metric was developed to test the camera-to-robot transformation matrix, and the experimental results showed root mean square errors of less than 1 mm in the x and y directions, and less than 2 mm in the z directions in the robot coordinate frame. The results show that with this work, we contribute a hand-to-eye calibration method that uses three non-collinear points in a single stereo image to map camera-to-robot coordinate-frame transformations
Updated Analysis: Blue-Light Transurethral Resection and Biopsy of Bladder Cancer with Hexaminolevulinate in a Single UK Centre
Full text linkObjective: To evaluate the diagnostic yield of blue-light cystoscopy (BLC) compared with white-light cystoscopy (WLC) in detecting carcinoma in situ (CIS) and muscle-invasive bladder cancer (MIBC), and to assess recurrence-free survival (RFS) following BLC-HAL resection. Patients and Methods: We retrospectively analysed 238 patients undergoing BLC-HAL between July 2017 and July 2024. Seventy-two underwent primary BLC at initial resection, and 166 underwent BLC re-resection following WLC. Endpoints were CIS detection, tumour upstaging, and recurrence-free survival at 12 and 24 months using Kaplan–Meier analysis. Results: Overall, malignancy was confirmed in 113/238 patients (47%). Detection was higher in the secondary arm (55%) compared with the primary arm (29%). In the primary arm, CIS was detected in 19% and MIBC in 24%. In the secondary arm, CIS increased from 18% on WLC to 38% with BLC (p = 0.001), with 26% detected only under blue light; 10% were upstaged to MIBC (p = 0.022). Over one-third of patients were reclassified into a higher EAU NMIBC risk group. Kaplan–Meier analysis showed 12- and 24-month RFS of 71% (95% CI: 36–92%) and 67% (95% CI: 35–88%) in the primary arm, and 62% (95% CI: 49–74%) and 63% (95% CI: 43–79%) in the secondary arm. Median RFS was not reached within 24 months. Conclusions: BLC significantly enhances CIS detection and identifies MIBC and higher-risk disease not seen on WLC, directly influencing patient management. Despite improved detection, recurrence-free survival remains modest, consistent with high-risk NMIBC, supporting guideline recommendations for routine use of BLC at TURBT, particularly in suspected CIS and high-grade disease
The impact of the Great War of 1914-18 on tourism in the UK: Implications for tourism research
Full text linkThis paper examines an overlooked feature of tourism management – the relationship between the state, the population and their holidaytaking habits and behaviour during World War One in the UK. The paper provides a series of important insights into a period of traumatic social and economic change to illustrate how a state anti-tourism policy evolved, utilising various policy sanctions and tools to try and limit the demand for holidays and leisure travel. The research is paradigm shifting in terms of addressing a major research gap and misconceptions that the war led to a cessation of tourism, or constitutes a period of limited research interest. As a study of tourism management and policy, it demonstrates the protracted problem of seeking to change tourist behaviour, even in periods of major crises and global upheaval that offers important lessons for governments and other policymakers in addressing issues such as overtourism and sustainable tourism
A Spatially Resolved Evolutionary Sequence of Multi-wavelength AGN Host Galaxies
Full text linkWe study the spatially resolved star formation, gas ionisation, and outflow properties of 1813 active galactic nuclei (AGNs) from the MaNGA survey, which we classify into infrared (IR), broad-line (BL), narrow-line (NL), and radio (RD) AGNs based on their mid-infrared colours, optical spectra, and/or radio photometry. We also provide estimations of AGN power at different wavelengths. AGN incidence is found to increase with stellar mass following a power-law, with the high-mass end dominated by RDAGNs and the low-mass end dominated by NLAGNs. Compared to their mass-matched non-AGN counterparts, we find that IRAGNs, BLAGNs, and NLAGNs on average show enhanced specific star formation rates, younger stellar populations, and harder ionisation towards the centre. RDAGNs, in contrast, show radial profiles similar to quiescent galaxies. [OIII] outflows are more common and stronger in BL/IRAGNs, while RDAGNs on average show no outflow features. The outflow incidence increases with [OIII] luminosity, and the features in BL/IRAGNs on average extend to ~2 kpc from the nuclei. We further discuss a possible evolutionary sequence of AGNs and their host galaxies, where AGNs with strong emission lines or dust tori are present in star-forming galaxies. Later, young compact radio jets emerge, the host galaxies gradually quench, and the AGN hosts eventually evolve into globally quiescent systems with larger radio jets that prevent further gas cooling