159370 research outputs found
Sort by
Implementing evidence into practice for the management of frozen shoulder:Engaging with key stakeholders and evaluating barriers and facilitators using the Consolidated Framework for Implementation Research
Get PDFBACKGROUND Frozen shoulder (FS) is a painful, stiff, and disabling shoulder condition affecting adults of a working age. A multi-centre randomised controlled trial (UK FROST) comparing three of the most common treatments provided by the NHS in secondary care, found all three treatments improved patient outcomes with none being overall clinically superior. Each treatment had its advantages and disadvantages. This paper describes the use of the Consolidated Framework of Implementation Research (CFIR) as an exemplar of knowledge translation for the latest evidence from UK FROST in the management of FS. It describes using stakeholder feedback in the development of a FS pathway, considering the barriers and facilitators to implementation in relation to the UK FROST findings and current clinical practice. METHODS Healthcare professionals, academics, policymakers, and patient and public representatives were invited as stakeholders to three meetings, held in November 2022 and January 2023. An overview of the UK FROST study, current pathways, referral processes and guidelines for FS in the context of the study results and the development of patient resources were discussed at the first meeting, in November. Outcomes from this meeting informed the January meetings. The CFIR was used to guide analysis of the discussions from the stakeholder meetings. RESULTS Overall, 67 stakeholders attended across three meetings. From the meetings, we categorised the FS pathway into four components (1) presentation and assessment; (2) initial management; (3) treatment options – physiotherapy and steroid injection, secondary care referrals; (4) enhanced recovery and follow-up; with shared decision-making emphasised throughout the pathway. Barriers and facilitators in each of the pathway components were identified using the five domains of the CFIR. A proposed evidence-based FS pathway was developed with stakeholders using an eight-step process. CONCLUSIONS This study has led to the development of an evidence-based FS care pathway, ready to be considered by policymakers for implementation, with considerations of barriers and facilitators. There was consensus that it is feasible to embed a modified physiotherapy intervention form UK FROST within current primary and community care settings to optimise service delivery and referral pathways. TRIAL REGISTRATION The trial registration is ISRCTN48804508. KEYWORDS Frozen shoulder; implementation; stakeholder engagement; evidence-based practice; knowledge translatio
Towards Achieving Energy Efficiency and Service Availability in 6G O-RAN via Formal Verification
Get PDFAs Open Radio Access Networks (O-RAN) continue to expand, AI-driven applications (xApps) are increasingly being deployed to enhance network management. However, developing xApps without formal verification risks introducing logical inconsistencies, particularly in balancing energy efficiency and service availability. In this paper, we argue that prior to their development, the formal analysis of xApp models should be a critical early step in the O-RAN design process. Using the PRISM model checker, we demonstrate how our results provide realistic insights into the thresholds between energy efficiency and service availability. While our models are simplified, the findings highlight how AI-informed decisions can enable more effective cell-switching policies. We position formal verification as an essential practice for future xApp development, avoiding fallacies in real-world applications and ensuring networks operate efficiently
Human-artificial intelligence collaboration in supply chain outcomes: the mediating role of responsible artificial intelligence
Get PDFHuman-artificial intelligence collaboration (CAIT) presents considerable opportunities for optimising supply chain outcomes. Nonetheless, it poses numerous ethical, technological, and organisational obstacles that could impede its efficacy. This study contends that responsible AI (RAI) systems can function as a conduit between CAIT and supply chain outcomes to tackle these challenges. Accordingly, we leveraged the resource-based view (RBV) and socio-technical system (STS) theoretical lenses to analyse the mediating role of RAI in the relationship between CAIT and two supply chain outcomes (supply chain wellbeing (SCWB) and sustainable business performance (SBP)). The suggested model was evaluated using PLS-SEM on survey data from 301 supply chain managers in the UK. Our analysed data revealed a statistically insignificant relationship between CAIT and supply chain outcomes (SCWB and SBP). However, the mediating role of RAI was confirmed. The findings suggest that CAIT is merely a component of a supply chain's capacity to produce intrinsic resources, rather than a universal solution. To harness the dividends of human-AI collaboration involves designing boundaries, aligning CAIT to supply chain goals and integrating ethical and transparent strategies. Our findings contribute to the discourse on AI use in supply chain literature by showing that CAIT can influence supply chain outcomes by bridging ethical, operational and technological gaps while fostering trust and efficiency
Ethnic disparities in rapid tranquillisation use and explanations in adult mental health emergency settings? A systematic review
Get PDFObjective
Ethnicity is a frequently reported risk factor for rapid tranquillisation (RT) use in mental health. We aimed to investigate the association between ethnicity and RT use in adult mental health emergency settings and explore potential explanations for the relationship between ethnicity and RT use in these settings.
Methods
Studies were included if they reported the association between ethnicity and RT use in adult mental health emergency settings. Searches were conducted across six databases and in grey sources and references until 15 April 2024. A narrative synthesis was performed and, in addition, a random-effects model was used for meta-analysis, with odds ratio as the measure. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to evaluate the overall certainty of evidence. Potential explanations for RT use in relation to ethnicity were also synthesised narratively.
Results
Five studies from Norway (n = 1), Spain (n = 1) and the United States (n = 3) were included (14,777 individuals). Multiple classifications of ethnicity were used, with White, non-Hispanic and native-born serving as the ethnic majority group compared to ethnic minority counterparts. Overall, ethnic minorities in adult mental health emergency settings were non-statistically more likely to receive RT than ethnic majority populations. The overall certainty of evidence was deemed as low according to GRADE.
Conclusion
While RT use was not statistically significantly higher among ethnic minorities overall, Black individuals, as a specific ethnic group, had significantly increased odds of experiencing RT compared to ethnic majority populations. Additional research is necessary to confirm these findings and better understand the reasons behind these disparities through valid explanations
Toward a consensus on dyslexia: findings from a Delphi study
Get PDFBackground
Dyslexia is one of the most common neurodevelopmental disorders. There have been many definitions over the past century, and debate continues as to how dyslexia should be defined. This debate contributes to confusion and misinformation. We move beyond the debate by establishing areas of consensus among a wide range of experts.
Methods
We conducted a Delphi study with a panel of dyslexia experts, including academics, specialist teachers, educational psychologists, and individuals with dyslexia, asking them for their views on a set of key statements about dyslexia. We carried out two survey rounds, in each case accepting statements with greater than 80% consensus and reviewing and revising other statements using feedback from the expert panel. This was followed by discussion with a subset of the panel around a few statements with marginal consensus.
Results
Forty-two statements were ultimately accepted. In the current paper we review those statements that pertain to a definition of dyslexia, demonstrate how they align with the research literature, and build on previous definitions of dyslexia.
Conclusions
There was considerable consensus in our expert panel that dyslexia is a difficulty in reading and spelling, associated with multiple factors, and that it frequently co-occurs with other developmental disorders. It was agreed that difficulties in reading fluency and spelling are key markers of dyslexia across different ages and languages. We conclude with a proposed new definition of dyslexia
4 Advancements in cardiac structures segmentation: a comprehensive systematic review of deep learning in CT imaging
No full textIs There a Role of Photoacoustic Imaging in Sports Medicine: Evidence Today
Get PDFDiagnostic imaging in sports medicine includes traditional imaging modalities such as x-ray, computed tomography (CT), and magnetic resonance imaging (MRI). Despite having certain advantages, these imaging techniques often have lower sensitivity and specificity, making it difficult to detect soft tissue injuries and early-stage cartilage damage. They also lack the ability to assess the biomechanical properties and functional states of tissues. Photoacoustic imaging (PAI) offers a powerful, non-ionizing, and cost-effective alternative to traditional imaging techniques in the diagnosis and therapeutic monitoring of sports injuries. PAI combines the benefits of optical imaging and ultrasound to provide high-resolution images of deep tissues, including tendons and ligaments. This technology uses pulsed lasers to irradiate tissues, causing thermal expansion and generating ultrasound waves, which are then captured and converted into images. PAI is particularly adept at depicting blood vessels and soft tissues with high resolution and sensitivity to the optical absorption contrasts of oxy- and deoxyhemoglobin. It can assess tissue oxygenation and metabolic activities, which are crucial for evaluating the healing process in sports injuries. Herein, the role of PAI in sports medicine is assessed and particularly its advantages over traditional imaging methods such as x-rays, CT scans, and MRI scans in diagnosing musculoskeletal injuries
Computerized adaptive testing with the I-HaND scale for monitoring patients with upper limb nerve pathology
No full textThe Impact of Hand Nerve Disorders scale is a patient-reported outcome measure for upper limb nerve pathology. We aimed to assess its structural validity using item response theory and to develop computerized adaptive testing algorithms. We conducted a series of psychometric studies to assess constructs measured, applied an item response theory model to the data, then developed computerized adaptive testing algorithms. The results showed two distinct factors: ‘Motor Function’ and ‘Pain’. We developed two separate computerized adaptive tests which reduced the number of questions from six (‘Pain’) and 16 (‘Motor Function’) to a median of three questions each at a high level of precision (standard error of measurement <0.3). For optimal measurement precision, the Impact of the Hand Nerve Disorders scale should be divided into two subscales and administered through computerized adaptive testing. In some circumstances (such as screening for specific issues) it may be preferable to administer all 32 items
Sub-second optical/near-infrared quasi-periodic oscillations from the black hole X-ray transient Swift J1727.8–1613
Get PDFWe report on the detection of optical/near-infrared (O-IR) quasi-periodic oscillations (QPOs) from the black hole (BH) X- ray transient Swift J1727.8–1613. We obtained three X-ray and O-IR high-time-resolution observations of the source during its intermediate state (2023 September 9, 15, and 17) using NICER, HAWK-I@VLT, HIPERCAM@GTC, and ULTRACAM@NTT. We clearly detected a QPO in the X-ray and O-IR bands during all three epochs. The QPO evolved, drifting from 1.4 Hz in the f irst epoch, up to 2.2 Hz in the second, and finally reaching 4.2 Hz in the third epoch. These are among the highest O-IR QPO frequencies detected for a BH X-ray transient. During the first two epochs, the X-ray and O-IR emission are correlated, with an optical lag (compared to the X-rays) varying from + 70 to 0 ms. Finally, during the third epoch, we measured, for the first time, a lag of the z s band with respect to the g s band at the QPO frequency ( ≈+ 10 ms). By estimating the variable O-IR SED we find that the emission is most likely non-thermal. Current state-of-the-art models can explain some of these properties, but neither the jet nor the hot flow model can easily explain the observed evolution of the QPOs. While this allowed us to put tight constraints on these components, more frequent co v erage of the state transition with fast multiwavelength observations is still needed to fully understand the evolution of the disc/jet properties in BH low-mass X-ray binaries
Data sources:
Access Repository Dashboard
Do you manage Open Research Online? Become a CORE Member to access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard! 👇