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Plague and intoxicants in the Baltic and North seas during the long seventeenth century
Full text linkThe article argues that medical responses to plague contributed to the ‘psychoactive revolution’ during the long seventeenth century. Focusing on four metropoles in the Baltic and North Sea region, it shows that the commodification of sugar, opiates, and tobacco during the last century of the Second Great Pandemic correlates both with outbreaks of plague in Amsterdam, Hamburg, London, and Stockholm and with the intraregional prescription of these intoxicants in popular and authorised plague physic. In so doing, it argues for the importance of household consumption practices in driving the psychoactive revolution and points to the importance of women and well as men in the popularisation of intoxicants. By tracing the popularisation of sugar, tobacco and opium from c. 1600 and using plague physic as an example of medical prescription more generally it delineates an under-appreciated set of consumer motives informing household consumption practices: not least the need to allay fear, pain, and bodily and mental disorder. The article concludes by introducing the concept of ‘accustomisation’ as the way in which contemporary observers explained how reactive consumption in the face of epidemics could become habitual, recreational, and possibly involuntary consumption over time
What do the public think about artificial intelligence note-taking tools in social care?
No full textDozens of Local Authorities across England are piloting automated note-taking tools – often called ‘digital scribes’ – in social care assessments and other interactions. These AI-enabled technologies automatically record, transcribe, and summarise assessment meetings into standardised templates, promising a reduction in administrative burden and more time to focus on interpersonal interactions. While research has begun to explore staff attitudes toward these tools, public perspectives remain heavily underexplored. This paper details findings from a survey experiment with 1,127 carers in England, examining attitudes toward these automated note-taking technologies. The study compares perceptions between: automated versus manual note-taking; fully automated systems versus those with human review (‘human in the loop’); and investigates demographic differences in attitudes. We draw on this data to set out a four-fold typology of attitudes: ‘enthusiasts’, ‘cautious adopters’, ‘pragmatists’ and the ‘resistant’
Alignment between intended and enacted pedagogies: a study of ELT curriculum innovation implementation in Pakistan.
No full textThis study investigates the alignment between English language education (ELE) pedagogy in policy (the pedagogical practices outlined in the ELE national curriculum) and pedagogy in practice (the pedagogical methods implemented by teachers in the classroom) at the secondary level (grades 9–10) in public schools in Punjab, Pakistan. The study is contextualised within the framework of ELE reforms, which were vital components of the broader Education Sector Reforms programme, initiated in Pakistan between 2001 and 2005. As part of these ELE reforms, a revised curriculum for English language instruction was introduced, promoting a comprehensive set of pedagogical principles that prioritise communicative, learner-centred, and inductive teaching approaches. Thirty-six English language lessons by twelve teachers were observed to assess their adherence to the pedagogical practices stipulated by the national curriculum. Additionally, post-observation interviews were conducted with the teachers to explore their reasoning behind the pedagogical strategies they employed or avoided in their instruction. The findings reveal a low level of compliance (29 %) with the recommended pedagogical policy. Key factors contributing to this compliance gap include exam-related pressures, institutional challenges, infrastructure limitations, and students’ low proficiency in English. The study has important implications for education policymakers, curriculum developers, administrators, and teachers
How is same day emergency care (SDEC) being implemented across England?
Full text linkBackground: In 2019, the National Health Service (NHS) England announced the implementation of same day emergency care (SDEC) in every hospital with a type 1 emergency department (ED). SDEC aims to provide timely and appropriate specialist care to patients on the same day, expediting their investigations and avoiding unnecessary hospitalisation. There is limited evidence for SDEC adoption and its effectiveness. This mixed-method study identifies and analyses SDEC implementation methods and describes subjective workforce views through both surveys and interviews.
Methods: An electronic survey was developed and distributed via email to 60 randomly selected hospitals in England with type 1 EDs. Follow-up interviews were conducted to contextualise survey responses and explore perceptions of SDEC and subjective barriers to efficiency.
Results: In total, 39 responses (including dual responses from SDEC and ED staff) were received from 34 hospitals (57%). All hospitals had an acute medical SDEC, with more limited implementation of surgical (53%) and frailty SDECs (29%). The SDECs opened on average 12 hours on weekdays and 10 hours on weekends. Referral and patient selection models varied. 79% of hospitals used their SDECs as emergency bed spaces. 85% of units assessed between 31 and 50 patients/day, with no unit admitting >10 patients/day. Although interviews were generally positive regarding SDEC efficiency, issues included differing perceptions of SDEC purpose, variability in models of patient selection, unclear referral pathways and inconsistent staffing levels.
Conclusions: Since its introduction, SDEC has been implemented and developed with great variability across England. While the introduction of the NHS SAMEDAY guidelines in 2024 may assist in mitigating these discrepancies nationally, more research is vital to identify optimal methods of service delivery and evaluation of this new healthcare system
On the promises and challenges of AI-powered XR glasses as embodied software
No full textAI-powered Extended Reality (XR) glasses represent the next frontier in software interface, integrating spatial computing with foundation models (FMs) to interact with physical environments in real-time. This technology promises a rich, immersive, and interactive user experience with seamless integration in real-world scenarios, while simultaneously introducing unprecedented challenges at the intersection of AI and Software Engineering (SE). This vision paper aims to catalyse the development of robust spatial software by characterising XR glasses as a distinct software paradigm through a conceptual framework and defining its advanced capabilities. We identify critical research problems, including security and privacy, validation of spatial capabilities, and explainability, while highlighting broader societal implications spanning ethics, accessibility, inclusivity, and open development ecosystems. Finally, we outline pathways for developing reliable and trustworthy XR systems in the FM era
XRintTest: An automated framework for user interaction testing in extended reality applications
No full textExtended Reality (XR) technologies offer immersive user experiences across diverse application domains, presenting unique testing challenges due to their spatial interaction paradigms. While existing works test XR applications through scene navigation and interaction triggering, they fail to synthesise realistic spatial input via specialised XR devices, such as 6 degrees of freedom controller gestures, that are essential for modern XR user experiences. To address this gap, we present XRintTest, an automated testing framework for Unity-based XR applications. XRintTest starts by constructing an XR User Interaction Graph that models interaction targets and required events. Leveraging this graph, it then automatically explores the XR scene under test and generates user interactions. We evaluated XRintTest on XRBench3D, a novel benchmark comprising seven XR scenes containing 367 distinct 3D user interactions. XRintTest shows great effectiveness, achieving 97% coverage of trigger and grab interactions across all scenes, 9x more effective and 5x more efficient than random exploration, while detecting runtime exceptions and functional defects. We open-sourced our tool and dataset at https://github.com/ruizhengu/XRintTest and https://github.com/ruizhengu/XRBench3D, respectively. A video demo is available on YouTube at https://youtu.be/K0Q6waE47Us
‘Mammothfluidics’:Amino acid dating of fossil mammal tooth enamel using a modular microfluidic system
Full text linkDating fossil samples helps reconstruct evolutionary history, aiding conservation efforts and mitigating climate change impacts. Amino acid geochronology of tooth enamel using the intra-crystalline protein decomposition (IcPD) approach allows direct dating of mammal teeth over Quaternary timescales (∼2.5 million years), beyond the limits of radiocarbon dating (∼50,000 years). However current methods require specialist equipment and relatively lengthy processing times. We developed a modular microfluidic system for chiral amino acid analysis of tooth enamel samples, consisting of three sequential glass microfluidic devices for sample bleaching, release of hydrolysable amino acids, and biphasic separation. Relative concentrations and D/L values of key amino acids were measured using reverse-phase high performance liquid chromatography (RP-HPLC). The microfluidic method reduced sample amounts from ∼15 mg to ∼1 mg and bleaching time from 72 h to 2 h. Amino acid compositions of modern and fossil samples were similar between the microfluidic approach and standard IcPD method, with good agreement up to D/L values ∼0.5 for phenylalanine (Phe) and glutamic acid (Glx). The method worked successfully across various genera and operators, with reduced sample mass and analysis time. This approach results in less destructive sampling of precious fossil samples and enables preparation steps in non-specialist labs, potentially allowing IcPD dating within the fossils’ country
Real-world effectiveness of autologous haematopoietic stem cell transplantation for multiple sclerosis in the UK
Full text linkBackground: Autologous haematopoietic stem cell transplantation (AHSCT) is increasingly used as a one-off disease-modifying therapy for aggressive forms of multiple sclerosis (MS). We report real-world effectiveness of AHSCT for MS in the UK.
Methods: This retrospective open-label study included patients with (pw)MS treated with AHSCT between 2002 and 2023 in 14 UK centres. Outcomes included relapse-free survival (RFS), MRI activity-free survival (MFS), progression-free survival (PFS) and no evidence of disease activity (NEDA-3). We assessed 6-month confirmed Expanded Disability Status Scale (EDSS) score progression or improvement compared with pre-treatment. Treatment-related mortality (TRM) was defined as death from any cause within 100 days post-autologous graft reinfusion.
Results: 364 pwMS were included (median age 40 years; 58% female). Of these, 271 pwMS had adequate neurological follow-up data: 168 (62%) had relapsing-remitting MS (pwRRMS) and 103 (38%) had progressive MS (pwPMS). Median disease duration from symptom onset was 10 years (IQR 6–14), EDSS 6 (IQR 4.0–6.5) and follow-up from AHSCT 46 months. At 2 and 5 years from AHSCT, RFS was 94.6% and 88.6%; MFS 93.1% and 80.1%; PFS 83.5% and 62.4%; NEDA-3 72.3% and 46.2%. pwRRMS had significantly higher rates of PFS (p=0.007) and NEDA-3 (p=0.001) than pwPMS. RRMS was a predictor of EDSS improvement, whose prevalence was 24.2% at 2 years and 20.4% at 5 years. TRM was 1.4% (n=5/364).
Conclusions: In this cohort with high EDSS at baseline and including pwPMS, AHSCT led to durable remission of inflammatory activity and stabilisation or improvement of neurological disability, particularly in pwRRMS
Combining sequential test cases into an equivalent set of adaptive test cases
Full text linkWhen testing a state-based system one might use a set of (negative) test cases in which each test case is a sequence of events that should not occur. Testing then involves executing the system under test (SUT) in order to check whether any of these disallowed sequences can occur. While testing using such sequences can be effective, they introduce a source of inefficiency: if a test case expects the SUT to produce output a after observing a sequence σ and the SUT instead produces a different output a' after σ then testing with that test case did not show an error, because the SUT can autonomously produce outputs, and terminates because the test case only makes sense if the exact sequence is observed. This is a source of inefficiency if there is another test case that starts with σ followed by a': we could have continued evaluating whether the application of this second test case leads to an error. This paper considers scenarios in which events represent inputs, outputs, or the passing of discrete time. We show how a set of sequential test cases can be converted into an equivalent set of adaptive test cases, with adaptivity addressing the above source of inefficiency. The proposed approach has the potential to improve efficiency when using any test generation technique that returns negative sequential test cases
Decoding acceptance of driver monitoring systems: Evaluating alternative measurement models, cross-country variations, and behavioural intention
Full text linkDriver monitoring systems (DMS) demonstrate significant potential for enhancing road safety. It is imperative to comprehend potential users’ attitudes towards DMS to optimise their benefits and increase public acceptance. This study investigates potential users’ acceptance of DMS in conditionally automated driving systems (SAE level 3) by evaluating alternative measurement models and assessing cross-country variations across nine countries (i.e., Germany, Spain, France, Japan, Poland, Sweden, the United Kingdom, the United States, and China). Utilising survey data from 9025 drivers, we compared the principal component analysis and the four models (a single-factor model, a six factors model, a two higher-order factors model, and a two lower-order factors model) via structural equation modelling. A model with two correlated factors, General Acceptance and Concerns, emerged as the optimal solution with high reliability across constructs. Significant cross-country differences in all constructs were found, although only 0.3% of the variance in behavioural intention was attributable to country-level differences. A linear mixed model demonstrated that the general acceptance factor positively related to behavioural intention, whereas concerns had a small but significant negative effect. The implications for research and practice suggest that while individual-level perceptions are paramount, country context also plays a role, albeit a modest one, in shaping users’ willingness to adopt DMS technologies
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