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Correction to:One-year outcomes in sepsis: a prospective multicenter cohort study in Japan (Journal of Intensive Care, (2025), 13, 1, (23), 10.1186/s40560-025-00792-0)
No full textFollowing publication of the original article [1], a sentence in Abstract Result section has been corrected from: “The rate of death for those who met PICS Criteria at hospital discharge was 89%, with a death or PICS incidence of 73%, 64%, and 65% at 3, 6, and 12 months, respectively.” to: “The rate of death or those who met PICS Criteria at hospital discharge was 89%, with a death or PICS incidence of 73%, 64%, and 65% at 3, 6, and 12 months, respectively.” The original article [1] has been updated.</p
Artificial Intelligence (AI) and the future of information privacy-Experts viewpoints
Get PDFAI's expanding role in daily life offers data-driven decision-making but risks privacy breaches. This study, using the Communication Privacy Management theory, explores AI adoption's future privacy implications. Through thematic analysis of 42 AI expert interviews, we identify six key themes: human agency, data use/abuse, AI transparency/opacity, information weaponization, cyberbullying, and privacy enforcement. These themes contextualize the evolving AI-privacy relationship. We argue that AI's advancement will challenge traditional privacy ownership concepts. This research provides insights into navigating the complex interplay between AI's growth and safeguarding information privac
Empathic and Agentic Approaches to Community-Engaged Research Scholarship: A Playful, Frugal, and Co-creative Framework through the ACES Project in Southeast Asia
Get PDFEducational disparities, particularly in remote and rural areas of Southeast Asia remain a critical challenge, especially regarding access to equitable and inclusive quality education. In response, four universities from the UK, Malaysia, Vietnam, and Indonesia came together in the ACES project - A Community-centred Educational Model for Developing Social Resilience, funded by the UKRI-ESRC under the Global Challenges Research Fund. By leveraging playful and frugal educational design methods within a community-engaged framework, ACES sought to address how university partnership with community stakeholders across local, regional, national and international contexts could target and collaboratively address educational challenges in a culturally relevant and sustainable manner. This paper discusses the methodological insights of how Community-Engaged Scholarship (CES) and Community-Engaged Research (CER) were combined and integrated through the lens of the ACES project. CES and CER have each been discussed as approaches useful for leveraging and strengthening community research relations with higher education. Collectively referred to as Community-Engaged Research Scholarship (CERS) in this paper, we critique how a collaborative CERS study design was applied to bridge the gap between academic research and community needs by fostering equitable and mutually beneficial partnerships. ACES strategies have focused on how CERS values have been consciously integrated to create impactful educational interventions. Adopting a Case Study approach, the paper analyses initiatives from Indonesia, Malaysia, and Vietnam, mapping the ACES 's core principles—community engagement, playfulness, frugality, and co-creation—to the participatory and community-engaged values of CERS. The findings reveal how ACES served to bridge the urban-rural educational divide, empowering educators and communities to co-create culturally relevant and sustainable learning experiences integrating playful and frugal methods. The CERS design underscores the importance of agile and co-creative pedagogical approaches, especially in the context of crises like the COVID-19 pandemic to enhance the resilience and effectiveness of community-engaged educational projects
Edible Plant-Derived Xanthones as Functional Food Components for Metabolic Syndrome Mitigation: Bioactivities and Mechanisms
Get PDFMetabolic syndrome has emerged as a significant global public health concern worldwide, characterized by a cluster of interrelated risk factors such as hypertension, hyperlipidemia, hyperglycemia, and abdominal obesity. In recent years, functional foods containing bioactive phytochemicals have attracted considerable scientific interest as potential therapeutic approaches for metabolic syndrome management. Xanthones, a class of naturally occurring tricyclic phenolic compounds abundant in various fruits and medicinal plants, demonstrate diverse biological activities relevant to metabolic health. This comprehensive review examines the dietary sources of xanthones, their bioactivity, and their promising role as functional food components for mitigating metabolic syndrome. The underlying mechanisms of action include modulation of lipid metabolism, improvement of insulin signaling pathways, potent anti-inflammatory and antioxidant effects, and modulation of glucose metabolism. Additionally, we discuss the stability and processing considerations of xanthones in food products. These findings highlight the development of xanthone-enriched functional foods and nutraceuticals as dietary interventions for metabolic syndrome prevention and management. This review comprehensively covers all relevant studies published up to the present without time restrictions
No access for you: modelling the impact of inaccessible streetscapes on disabled people’s mobility
Get PDFThis novel study models the lived experiences of disabled people navigating streetscape barriers through the lens of the impact on their life. 408 disabled people across the UK completed an online questionnaire, analysed through a robust methodology employing Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and Structural Equation Modelling (SEM). The research provides the first empirical prioritisation of the most critical barriers in street design and governance. The study identifies the top issues affecting disabled people, ranked by their impact on their life as: Pavement Needs, Pavement Blockers, Previous Negative Experiences, Local Authorities and Roadworks. The study makes three contributions. It provides the first empirically prioritised model of streetscape barriers, establishing an evidence base for targeted interventions. It demonstrates that inaccessibility has long-term effects, as repeated negative encounters alter travel habits, diminish trust in public space, and reinforce exclusion. Finally, it shows that governance matters as much as physical design, with perceptions of neglect and poor communication from local authorities significantly impacting disabled people. Actionable recommendations are drawn out for policymakers and researchers. Future work must now prioritise collaboration with disabled people to build a fairer, more equitable society. This study establishes a critical foundation for addressing systemic inequities in street design, pushing for a paradigm shift toward inclusivity and accountability in urban planning and transport
Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990–2023:a systematic analysis for the Global Burden of Disease Study 2023
Get PDFBackgroundFor more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions.MethodsThe GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010–23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution.FindingsTotal numbers of global DALYs grew 6·1% (95% UI 4·0–8·1), from 2·64 billion (2·46–2·86) in 2010 to 2·80 billion (2·57–3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0–14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31–1·61) global DALYs in 2010, increasing to 1·80 billion (1·63–2·03) in 2023, alongside a concurrent 4·1% (1·9–6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176–209] DALYs), stroke (157 million [141–172]), and diabetes (90·2 million [75·2–107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0–107·5]), depressive disorders (26·3% [11·6–42·9]), and diabetes (14·9% [7·5–25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837–917) in 2010 to 681 million (642–736) in 2023, and a 25·8% (22·6–28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7–61·0) for diarrhoeal diseases, 42·9% (38·0–48·0) for HIV/AIDS, and 42·2% (23·6–56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6–22·0) and 24·8% (7·4–36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7–19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18–1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation—with high SBP accounting for 8·4% (6·9–10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories—behavioural, metabolic, and environmental and occupational—risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8–37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0–11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023—eg, declining by 54·4% (38·7–65·3) for unsafe sanitation, 50·5% (33·3–63·1) for unsafe water source, and 45·2% (25·6–72·0) for no access to handwashing facility, and by 44·9% (37·3–53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [–2·7 to 15·6]; non-significant).InterpretationOur findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors—eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG—including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic—the complex interaction of multiple health risks, social determinants, and systemic challenges—will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity
Enhancing biochar quality for the steel industry via Hydrothermal Pretreatment-Steam Explosion and pyrolysis
Get PDFBiochar has potential applications in steelmaking processes, but faces technical challenges such as low material density, high alkali content, and high reactivity compared to coal. This study explores converting the solid residue, following hydrothermal pretreatment-steam explosion (HTP-SE) of Miscanthus and other biomass feedstocks, into biochar to facilitate the replacement of coal in blast furnace and electric arc furnace operations. It is the first to demonstrate the enhanced combustion characteristics of pretreated fibre and the compatibility of the biochar for use in steelmaking. Biomass from birch, miscanthus, wheat straw, both untreated and pretreated, was evaluated. HTP-SE was conducted at 192 °C and 1.3 MPa, conditions aligned with hemicellulose extraction for application in biobased products. Biochars were produced at temperatures ranging from 300 °C to 550 °C. HTP-SE increased the carbon, hydrogen, and energy content by approximately 10%, 8%, and up to 5 MJ/kg, respectively, while reducing ash quantity by up to 45%. In addition, it reduced the alkali and phosphorus content from the solid fraction into aqueous phase. Gas analysis indicated that HTP-SE enhanced the energy content of pyrolysis syngas. Thermogravimetric studies revealed that pretreated biochars exhibited significantly lower reactivity with carbon dioxide compared to untreated counterparts, approaching the reactivity of coal. This was attributed to increased aromaticity, C=C bonding, cross-linkages enriching lignin and by the removal of hemicellulose through HTP-SE. Overall, the upgraded biochar addresses key limitations of conventional biochar and shows strong potential as a substitute to replace injection coal entirely in both blast and electric arc furnaces. [Abstract copyright: Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.
A sustainable route to manufacture refractory high entropy alloy of AlMoNbTaTiZr from metal powder produced in solid state
Get PDFTo enhance efficiency and reduce CO2 emissions in applications such as jet-engines, gas turbines, and nuclear powerplants, alloys that withstand high temperatures are essential. High entropy alloys (HEA) containing refractory elements offer superior high-temperature properties. One of these refractory high entropy alloys (RHEAs) is AlMo0.5NbTa0.5TiZr. There are challenges when manufacturing these compositionally complex alloys using conventional techniques since they have elements with very high (Nb, Ta, Mo), high (Zr, Ti) and lower (Al) melting temperatures, creating mixing and homogeneity issues in alloy preparation. The Fray-Farthing-Chen (FFC) Cambridge process directly creates RHEA’s powders without melting, but these feedstocks require a suitable consolidation technique. In this work field-assisted sintering technique (FAST), a novel rapid sintering technique, was used to make parts from powder of this alloy produced in solid-state.Among the process parameters the consolidation temperature had a more profound effect on density. From studied temperatures 1400 °C with a dwell time of 15 minutes produced the highest density level. Such a manufacturing route, occurring at temperatures lower than traditional casting, increases sustainability, and produces a homogeneous microstructure leading to parts with uniform properties and enhanced in-service performance
Gamifying Museum Exploration:A Virtual Reality Approach to Enhancing Visitor Engagement
Get PDFEntertainment plays a pivotal role in capturing attention and encouraging self-involvement, enhancing the appeal of experiences through engaging practices like storytelling and game-based activities. This paper investigates the impact of gamification elements on user experience, with a focus on how users perceive interaction, immersion, and learning when these elements are integrated into virtual reality (VR) environments in museum settings. Two versions of a gamified VR experience were developed using the Unreal Engine (UE) 3D computer graphic game engine to ensure high fidelity and presence for end users through real-time simulation. The first version was tested at the Transport Museum in Coventry, UK, providing insights into the improvements to be made to better address the interaction, immersion, and learning aspects. The second refined version was deployed in Geelong and Melbourne, Australia. A quantitative approach was used to compare the two experiences using the mean and significance between items. The findings show a significant improvement in user experience in the second gamified experience in Australia. The enhanced gamified elements promoted motivation and intuitive navigation with minimal game inputs, improving user interaction and concentration while reducing external distractions. The results indicate a notable difference between the two experiences in terms of interaction and immersion, with the simplified inputs in the second experience significantly enhancing usability during VR navigation. Overall, the second experience was more effective than the first regarding mechanics, inputs, and guidance. These results underscore the importance of avoiding complexity and facilitating intuitive interaction when designing gamified experiences
Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050:a forecasting study for the Global Burden of Disease Study 2021
Get PDFBackground: Despite the well documented consequences of obesity during childhood and adolescence and future risks of excess body mass on non-communicable diseases in adulthood, coordinated global action on excess body mass in early life is still insufficient. Inconsistent measurement and reporting are a barrier to specific targets, resource allocation, and interventions. In this Article we report current estimates of overweight and obesity across childhood and adolescence, progress over time, and forecasts to inform specific actions. Methods: Using established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we modelled overweight and obesity across childhood and adolescence from 1990 to 2021, and then forecasted to 2050. Primary data for our models included 1321 unique measured and self-reported anthropometric data sources from 180 countries and territories from survey microdata, reports, and published literature. These data were used to estimate age-standardised global, regional, and national overweight prevalence and obesity prevalence (separately) for children and young adolescents (aged 5–14 years, typically in school and cared for by child health services) and older adolescents (aged 15–24 years, increasingly out of school and cared for by adult services) by sex for 204 countries and territories from 1990 to 2021. Prevalence estimates from 1990 to 2021 were generated using spatiotemporal Gaussian process regression models, which leveraged temporal and spatial correlation in epidemiological trends to ensure comparability of results across time and geography. Prevalence forecasts from 2022 to 2050 were generated using a generalised ensemble modelling approach assuming continuation of current trends. For every age-sex-location population across time (1990–2050), we estimated obesity (vs overweight) predominance using the log ratio of obesity percentage to overweight percentage. Findings: Between 1990 and 2021, the combined prevalence of overweight and obesity in children and adolescents doubled, and that of obesity alone tripled. By 2021, 93·1 million (95% uncertainty interval 89·6–96·6) individuals aged 5–14 years and 80·6 million (78·2–83·3) aged 15–24 years had obesity. At the super-region level in 2021, the prevalence of overweight and of obesity was highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and the greatest increase from 1990 to 2021 was seen in southeast Asia, east Asia, and Oceania (eg, Taiwan [province of China], Maldives, and China). By 2021, for females in both age groups, many countries in Australasia (eg, Australia) and in high-income North America (eg, Canada) had already transitioned to obesity predominance, as had males and females in a number of countries in north Africa and the Middle East (eg, United Arab Emirates and Qatar) and Oceania (eg, Cook Islands and American Samoa). From 2022 to 2050, global increases in overweight (not obesity) prevalence are forecasted to stabilise, yet the increase in the absolute proportion of the global population with obesity is forecasted to be greater than between 1990 and 2021, with substantial increases forecast between 2022 and 2030, which continue between 2031 and 2050. By 2050, super-region obesity prevalence is forecasted to remain highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and forecasted increases in obesity are still expected to be largest across southeast Asia, east Asia, and Oceania (eg, Timor-Leste and North Korea), but also in south Asia (eg, Nepal and Bangladesh). Compared with those aged 15–24 years, in most super-regions (except Latin America and the Caribbean and the high-income super-region) a greater proportion of those aged 5–14 years are forecasted to have obesity than overweight by 2050. Globally, 15·6% (12·7–17·2) of those aged 5–14 years are forecasted to have obesity by 2050 (186 million [141–221]), compared with 14·2% (11·4–15·7) of those aged 15–24 years (175 million [136–203]). We forecasted that by 2050, there will be more young males (aged 5–14 years) living with obesity (16·5% [13·3–18·3]) than overweight (12·9% [12·2–13·6]); while for females (aged 5–24 years) and older males (aged 15–24 years), overweight will remain more prevalent than obesity. At a regional level, the following populations are forecast to have transitioned to obesity (vs overweight) predominance before 2041–50: children and adolescents (males and females aged 5–24 years) in north Africa and the Middle East and Tropical Latin America; males aged 5–14 years in east Asia, central and southern sub-Saharan Africa, and central Latin America; females aged 5–14 years in Australasia; females aged 15–24 years in Australasia, high-income North America, and southern sub-Saharan Africa; and males aged 15–24 years in high-income North America. Interpretation: Both overweight and obesity increased substantially in every world region between 1990 and 2021, suggesting that current approaches to curbing increases in overweight and obesity have failed a generation of children and adolescents. Beyond 2021, overweight during childhood and adolescence is forecast to stabilise due to further increases in the population who have obesity. Increases in obesity are expected to continue for all populations in all world regions. Because substantial change is forecasted to occur between 2022 and 2030, immediate actions are needed to address this public health crisis. Funding: Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.</p