26199 research outputs found
Sort by
A predictive model for classifying low back pain status based on lumbopelvic kinematics measured using inertial measurement units: A cross-sectional study
No full textBackground: Low back pain (LBP) is a leading cause of disability worldwide. Impaired lumbopelvic control contributes to chronic and recurrent LBP, often presenting as aberrant movement patterns. This study aimed to investigate whether inertial measurement units (IMUs) can classify individuals with no LBP (NoLBP), chronic LBP (CLBP), and a history of LBP (HxLBP) based on lumbopelvic kinematics.
Methods: A total of 141 participants (47 per group) performed ten standardized lumbopelvic movement control tests while wearing IMU sensors. Kinematic parameters, including mean velocity (MV), peak-to-peak amplitude (P2P), and area under the curve (AUC) of acceleration, were extracted. One-way ANOVA was used to compare kinematic differences across groups, and binary logistic regression models were developed to identify predictors for classification. Robustness analyses using 10-fold cross-validation with the least absolute shrinkage and selection operator (LASSO) were also performed.
Results: Significant group differences were found in MV, P2P, and AUC across multiple movement tests (P<0.05). The most pronounced differences were observed between NoLBP and CLBP: individuals with CLBP were characterized by slower trunk flexion (odds ratio [OR] = 0.94, 95% CI: 0.90–0.98), greater AUC during prone hip rotation (OR = 2.78, 95% CI: 1.45–5.34), and greater P2P during trunk rotation (OR = 1.32, 95% CI: 1.12–1.55). Robustness analyses confirmed the robustness and stability of the classification models.
Conclusion: IMU-derived kinematic parameters provide objective measures of impaired movement control and may support clinical identification of individuals at risk for chronic or recurrent LBP
Discovery of a Luminosity-dependent Continuum Lag in NGC 4151 from Photometric and Spectroscopic Continuum Reverberation Mapping
No full textAccretion onto supermassive black holes (SMBHs) powers active galactic nuclei (AGNs) and drives feedback that shapes galaxy evolution. Constraining AGN accretion disk structure is therefore essential for understanding black hole growth and feedback processes. However, direct constraints on disk size remain rare -- particularly from long-term, multi-season spectroscopic reverberation mapping (RM), which is critical for isolating the intrinsic disk response from the broad-line region (BLR). We present results from an intensive multi-wavelength RM campaign of NGC 4151 during its brightest state in nearly two decades. This represents the third high-cadence monitoring over the past decade, capturing accretion states spanning the transitional regime between thin and thick disks, making NGC 4151 the only AGN with continuum RM observations across such a wide range in accretion states. Combining spectroscopy from the Lijiang 2.4 m telescope with coordinated Swift UV/X-ray monitoring, we measure inter-band continuum lags from UV to optical. The wavelength-dependent lags follow a tight relation, consistent with reprocessing in a thin disk, but exceed theoretical predictions by a factor of 6.6. Our lag spectrum reveals clear excesses near the Balmer and possibly Paschen jumps, confirming diffuse continuum (DC) contamination from the BLR. By comparing the three campaigns, we discover a non-monotonic lag-luminosity trend (), which cannot be explained by DC emission alone. We propose the lags reflect combined disk and BLR contributions, and present the first evidence that the DC component follows an intrinsic Baldwin effect. These results offer new insights into SMBH mass measurements and theoretical models of AGN inner structure
Efficacy and Safety of Non-Pharmacological Treatments for Paediatric Functional Constipation: A systematic review and meta-analysis
No full textBackground Recent studies have expanded the evidence on novel and existing non-pharmacological treatments for paediatric functional constipation (FC). This study aimed to systematically review the efficacy and safety of non-pharmacological therapies for FC in children.
Methods PubMed, MEDLINE, Embase, PsycINFO, Cochrane Library and trial registries were searched from inception to March 2025. Randomised controlled trials (RCTs), including children (0–18 years) with FC treated with non-pharmacological interventions compared with placebo, no treatment or other interventions, were included. Primary outcomes were treatment success, defecation frequency and withdrawals due to adverse events. Dual data extraction and appraisal was conducted. Certainty was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE).
Results 93 RCTs comprising 7787 children (50.4% female) were included investigating dietary, psycho-educational, physiotherapeutic interventions, various complementary and complementary medicine interventions, and electrical stimulation. A substantial part of the therapies provided evidence that was of very low certainty, meaning no conclusions could be drawn. Abdominal transcutaneous electrical stimulation plus pelvic floor muscle exercises (PFME) may improve treatment success and defecation frequency compared with PFME alone (risk ratio (RR): 1.75 (95%CI 1.25 to 2.44) and mean differences (MD): 1.85 (95%CI 1.28 to 2.43), moderate certainty). Percutaneous tibial nerve stimulation plus PFME leads to more treatment success (RR: 1.73 (95%CI 1.08 to 2.77), low certainty) and greater defecation frequency (MD: 1.82 (95%CI 0.82 to 2.82), moderate certainty). Behavioural therapy plus polyethylene glycol may not improve treatment success (RR: 0.83 (95%CI 0.62 to 1.12), low certainty) and probably reduces defecation frequency (MD: −1.80 (95%CI −2.88 to −0.72), moderate certainty).
Conclusions Imprecise data, poor reporting and substantial heterogeneity led to downgrading in GRADE assessments. Some non-pharmacological treatment options for children with FC show beneficial effects, and these may be considered in the management of children. Future trials should aim to improve methodological rigour.
PROSPERO registration number CRD42023416891
Discrete Gronwall inequalities for demimartingales
Get PDFThe aim of this work is to obtain discrete versions of stochastic Gronwall inequalities involving demimartingale sequences. The results generalize the respective theorems for martingales provided by Kruse and Scheutzow (2018) and Hendy et al. (2022). Moreover, we present an application which provides an upper bound for the a priori estimate of the backward Euler-Maruyama numerical scheme
Spiral Structure Properties, Dynamics, and Evolution in MW-mass Galaxy Simulations
No full textThe structure of spiral galaxies is essential to understanding the dynamics and evolution of disc galaxies; however, the precise nature of spiral arms remains uncertain. Two challenges in understanding the mechanisms driving spirals are how galactic environment impacts spiral morphology and how they evolve over time. We present a catalog characterizing the properties, dynamics, and evolution of m=2 spiral structure in 10 Milky Way-mass galaxies from the FIRE-2 cosmological zoom-in simulations. Consistent with previous literature, we find that FIRE-2 spirals are transient, recurring features simultaneously present in the disc at varying pattern speeds () that broadly decrease with radius. These spirals persist on Gyr timescales (mean duration 1.90 Gyr), but fluctuate in amplitude on timescales of hundreds of Myr. Tidal interactions and bar episodes impact the resulting m=2 spiral structure; strong satellite interactions generally produce shorter-lived, stronger spirals with larger radial extent, and bars can increase . Galactic environment influences spiral structure; kinematically colder discs can support longer-lived, stronger spirals. The properties of identified spirals in FIRE-2 vary widely in radial extent (0.3-10.8 kpc), duration (1.00-6.00 Gyr), and amplitudes (=0.018-0.192). We find the presence of spirals in all age populations, suggesting these are density wave-driven features. This work represents the first time that spiral structure has been cataloged in this manner in cosmological simulations; the catalog can be leveraged with current and forthcoming observational surveys, enabling systematic comparisons to further our understanding of galaxy evolution
Childbirth Experiences in the United Kingdom Compared to the Netherlands: A Cross‐Sectional Survey Study
Get PDFIntroduction: This study was performed to compare childbirth experiences in the United Kingdom (UK) and the Netherlands (NL) and identify determinants of positive childbirth experiences in both countries.
Methods: Women who gave birth in the UK (n = 1303) or the NL (n = 900) between January 2017 and December 2020 who filled in the cross‐sectional Babies Born Better survey were included in this study. Fully adjusted logistic regression models were used to assess differences in the odds of a positive childbirth experience between the two countries. Hierarchical logistic regression analyses were performed to identify determinants of a positive childbirth experience, including socio‐demographic factors, pregnancy and childbirth outcomes, and care‐related determinants.
Results: Respondents giving birth in the UK had decreased odds of a positive childbirth experience compared to NL respondents (66% vs. 85%, AOR 0.45, CI 0.35–0.57). Significant determinants for a positive childbirth experience were multiparity, absence of pregnancy complications, a spontaneous vaginal birth, and giving birth at home. UK respondents who had a planned caesarean section had a higher likelihood of reporting a positive childbirth experience when adjusted for confounders. Having a doctor as the primary birth care provider was less likely to be associated with a positive childbirth experience in the UK.
Conclusions: Most women in both the NL and the UK reported positive childbirth experiences, but NL respondents were more likely to do so. Determinants of a positive birth experience were mostly factors associated with uncomplicated labor and birth, or linked with fulfilled choices and with being multiparous
A systematic review of neurodivergence, vulnerability, and risk in the context of violent extremism
No full textThis systematic review examines the functional role of neurodivergence, specifically autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), in the context of violent extremism, radicalisation, and mass violence. While there is no evidence of a direct causal link in the general population, certain neurodivergent traits and experiences may contextualise vulnerability, resilience, and disengagement in unique ways within extremist populations. By synthesising fragmented knowledge across disciplines, this review contributes to a more nuanced understanding of neurodivergence in violent extremism contexts. This review identified 93 publications. Nine key themes emerged, including social and relationship difficulties, hyperfixation and restricted interests, cognitive styles, sensory issues, vivid ideation, emotional difficulties, and the presence of complex needs. These traits and experiences, especially when combined, may shape individual pathways to risk or resilience. These findings highlight considerations for practice and research with neurodivergent individuals within the extremism context. This review identifies significant gaps in the literature, particularly the scarcity of empirical studies and overreliance on open-source case reports. Key priorities for future research include conducting high-quality empirical studies, analysis of functional links based on detailed closed-source records, and the development of a more nuanced understanding of risk and protective factors in neurodivergent individuals involved in extremism
Co-designing accessible trial information: lessons from designing an inclusive patient information leaflet in the RaCeR2 study
No full textBackground
Informed consent is fundamental to ethical research, yet participant information leaflets (PILs) are often technical and difficult to understand. Although the importance of accessible study materials is widely recognised, practical guidance on how to develop them remains limited. For RaCeR 2, a randomised controlled trial evaluating different approaches to rehabilitation after shoulder rotator cuff repair, the baseline PIL was developed using Health Research Authority guidance. Early PPI consultation identified major concerns including dense formatting, overly complex language, and an unwelcoming tone, indicating the need for substantial redesign to support informed participation.
Description of Patient and Public Involvement Activity
A diverse PPI group (n = 5) supported the development of an accessible PIL. Contributors varied in age, gender identity, ethnicity, preferred language, employment status, disability, and experience of shoulder surgery. Engagement methods were tailored to participant needs and included online discussions, written feedback, and in-person “think-aloud” sessions. Given the depth of insight provided during initial PPI consultation, we adopted an iterative, user-centred approach drawing on co-design principles to enable contributors to directly influence the content, structure, and presentation of the PIL.
Outcome of the Patient and Public Involvement Activity
Contributors identified challenges with the original materials, including confusing layout, inaccessible formatting, technical terminology, and a tone that did not feel supportive. Through iterative cycles of review and refinement guided by co-design principles, the leaflet was substantially redesigned to include clearer headings, formatting aligned with British Dyslexia Association guidance, bullet-pointed and tiered information, simplified explanations of data protection, and a more conversational tone. Accessibility testing confirmed compatibility with freely available online screen-reading software. During the subsequent regulatory review, inconsistencies between legal requirements and participant preferences highlighted tensions that may limit the accessibility of study materials.
Conclusions
This commentary provides a pragmatic example of integrating co-design principles within PPI to create a more accessible PIL. Early engagement, flexible methods, iterative feedback, and testing with screen reading software were central to the process. Our experience also highlights the need for continued dialogue between researchers and regulators to ensure that participant-facing materials meet ethical and legal requirements while remaining understandable to all potential participants.
Plain English summary
When people take part in health research, it is important they understand what the study involves so they can make an informed choice. Researchers usually provide a written information leaflet, but many are difficult to read, particularly for people with lower literacy, disabilities, neurodivergent conditions, or for whom English is not their first language.RaCeR2 is a study comparing two approaches to helping people recover after shoulder surgery. When preparing to start the study, we drafted an initial leaflet using official guidance, but patients reported that it was hard to read, the images were confusing, it was long, and the tone felt “cold.” In response, we collaborated with a group of patients and public contributors to make the leaflet more accessible. Some joined online meetings, others provided written feedback, and one participated in in-person sessions, sharing thoughts aloud while reading the leaflet. This led to major changes: simplified language, clearer layout, bullet points, improved fonts and colours, and testing with screen readers. However, when submitting the leaflet for Health Research Authority approval, several changes were requested, including additional legal information, making the document longer, more complex, and less aligned with patient preferences. Our experience shows that involving patients and the public makes information leaflets clearer and easier to use. But we also learned that current rules can make it difficult to keep the leaflet simple and accessible. We need better ways for researchers and regulators to work together so that study information meets legal requirements and is easy for everyone to understand when deciding whether to take part
Exploring Sleep Disturbances Among Trauma-Exposed Psychiatric Populations
No full textIntroduction: Sleep disturbances are complex, encompassing a range of disruptions to quality, quantity, and timing (Altman, Knauert & Pisani, 2017; Cormier, 1990). A well-established bidirectional relationship exists between poor sleep and mental health issues, with psychological distress increasingly recognised as impacting sleep health (Brindle et al., 2019). Hence, sleep issues are common among those with psychosis, where trauma exposure is prevalent (Kamphuis et al., 2013). However, little research has explored the relationship between life experiences and sleep among this population (Greenwood, 2020). The current study, therefore, explored the nature of sleep disturbances in psychiatric patients at a high-secure forensic mental health hospital in the UK.
Materials and methods: Semi-structured interviews, informed by measures such as the Pittsburgh Sleep Quality Index (Buysse et al., 1989) and the Morning Eveningness Questionnaire (Horne & Östberg, 1976), were conducted with 30 psychiatric inpatients with both active and residual psychosis symptoms. Participants discussed sleep patterns, preferences, and behaviours, as well as past experiences and night-time cognitions. Interviews were recorded and transcribed using Winscribe and thematically analysed using NVivo software.
Results: Five major themes emerged from the data, emphasising sleep behaviours characteristic of this population. Firstly, participants consistently reported evening chronotypes, alongside delayed sleep patterns, highlighting the impact of misaligned circadian rhythms on unhealthy behaviours, such as poor diet and disrupted routines. Secondly, negative night-time cognitions, such as ruminations of past violence and regrets, were common, often causing physical distress and pre-sleep arousal, further driving sleep disturbances. Thirdly, there was a persistent overlap between nightmares and trauma flashbacks, with participants discussing the two interchangeably, emphasising the impact of intrusion symptoms on sleep. Another prevalent theme was a long history of sleep issues, with participants identifying a ‘tipping point’ where both sleep and psychosis symptoms had significantly worsened. This appeared to be used as a reference point from which current sleep perceptions were measured. Finally, trauma therapies, such as eye-movement desensitisation and reprocessing (EMDR), were praised for improving sleep outcomes by reducing post-trauma nightmares and psychological distress.
Conclusions: Overall, findings highlight the relationship between trauma and sleep in those with psychosis, suggesting that circadian misalignment, negative cognitions, such as rumination, and intrusion symptoms, drive sleep disturbances. These findings emphasise the importance of exploring patient perspectives, recognising trauma as a target for improving sleep outcomes across secure settings.
Acknowledgments: I would like to thank Professor Jane Louise Ireland and Dr. Simon Chu for their continued guidance and support throughout my PhD project. I would also like to acknowledge the support from my colleagues at The University of Central Lancashire and Ashworth Research Centre, as well as the patients themselves at Ashworth Hospital