St. Luke's General Hospital

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    Evolving the control-chaos continuum: part 2—shifting “Attention” to progress on-pitch rehabilitation

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    BACKGROUND: On-pitch rehabilitation is key to supporting return to sport in elite soccer (football). The control-chaos continuum (CCC) guides practitioners through the sport-specific components of return to sport. There is a need to update the framework with recent research in injury neurophysiology, soccer performance, and coaching science. CLINICAL QUESTION: How do practitioners integrate the insights from injury neurophysiology, soccer performance, and coaching science discussed in part 1 of this 2-part series into an updated version of the CCC, to enhance the planning and execution of on-pitch rehabilitation for elite soccer players KEY RESULTS: The revised CCC framework emphasizes the design and delivery of progressive training in increasingly chaotic conditions. The updated framework supports practitioners to incorporate elements of visual-cognitive challenges, attentional challenges, decision making, and progression representation of the game model when players are preparing to return to sport. CLINICAL APPLICATION: The updated CCC outlines training progression from High Control, which involves returning to on-pitch linear running, to High Chaos, which simulates the team environment at game speed. The High Chaos phase can be tailored to support players during their reintegration into team training. The model is adaptable for both short- and long-term injuries, integrating physical-cognitive load monitoring and strength and power diagnostics to enhance decision making throughout return to sport.</p

    International student mobility, Covid-19, and the labour market: a scoping review

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    The Covid-19 pandemic resulted in significant disruptions to both international student mobility and labour markets. Against this background, this scoping review documents findings from 35 studies, published between January 2020 and February 2024, that focused on international student mobility, Covid-19, labour market outcomes, and related regulations. The review shows that the Covid-19 pandemic negatively impacted (1) the labour market outcomes of international students before studying abroad, through changes in visa regulations, (2) skill acquisition during their mobility, (3) the duration of their studies, and (4) the availability of jobs during and after their mobility period. These negative impacts occurred at a time when international students’ needs for work were heightened. This ‘double whammy’ was more pronounced among international students from lower socio-economic backgrounds, increasing pre-existing inequalities. It was also affected by students’ residency status and policy changes. These findings underline the critical role that temporality plays in shaping the returns to international student mobility. However, the existing literature on the topic is relatively sparse and has primarily relied upon qualitative approaches and rapid research. Future studies are needed to better understand the impact of Covid-19 on the labour market outcomes of international students</p

    Ecological momentary assessment of physical and eating behaviours: The WEALTH feasibility and optimisation study with recommendations for large-scale data collection

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    Ecological Momentary Assessment (EMA) enables the real-time capture of health-related behaviours, their situational contexts, and associated subjective experiences. This study aimed to evaluate the feasibility of an EMA targeting physical and eating behaviours, optimise its protocol, and provide recommendations for future large-scale EMA data collections. The study involved 52 participants (age 31±9 years, 56% females) from Czechia, France, Germany, and Ireland completing a 9-day free-living EMA protocol using the HealthReact platform connected to a Fitbit tracker. The EMA protocol included time-based (7/day), event-based (up to 10/day), and self-initiated surveys, each containing 8 to 17 items assessing physical and eating behaviours and related contextual factors such as affective states, location, and company. Qualitative insights were gathered from post-EMA feedback interviews. Compliance was low (median 49%), particularly for event-based surveys (median 34%), and declined over time. Many participants were unable or unwilling to complete surveys in certain contexts (e.g., when with family), faced interference with their daily schedules, and encountered occasional technical issues, suggesting the need for thorough initial training, an individualised protocol, and systematic compliance monitoring. The number of event-based surveys was less than desired for the study, with a median of 2.4/day for sedentary events, when 4 were targeted, and 0.9/day for walking events, when 3 were targeted Conducting simulations using participants’ Fitbit data allowed for optimising the triggering rules, achieving the desired median number of sedentary and walking surveys (3.9/day for both) in similar populations. Self-initiated reports of meals and drinks yielded more reports than those prompted in time-based and event-based EMA surveys, suggesting that self-initiated surveys might better reflect actual eating behaviours. This study highlights the importance of assessing feasibility and optimising EMA protocols to enhance subsequent compliance and data quality. Conducting pre-tests to refine protocols and procedures, including simulations using participants’ activity data for optimal event-based triggering rules, is crucial for successful large-scale data collection in EMA studies of physical and eating behaviours.</p

    Chemical compatibility of various working fluids with additively manufactured materials for two-phase thermal control systems

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    The chemical compatibility between container materials and their working fluid is a critical aspect for the long-term heat transfer performance of two-phase thermal management systems. With the recent emergence of additive manufacturing (AM), which has shown significant potential for the design of next generation thermal control devices, chemical compatibility between AM alloys and different working fluids must first be determined, however, before they can be successfully deployed. In this study, 30 different fluid–metal combinations were selected for experimental characterisation. Working fluids with high heat transport capacity such as water, acetone, methanol, toluene and ethylene glycol were included, as well as ammonia and propylene, which are particularly relevant for spacecraft applications. Selected AM materials comprised of a range of widely available metal alloys, including AlSi7Mg, AlSi10Mg, Invar, 316L stainless steel and Ti6Al4V. Thermosyphon devices were manufactured for experimental life-testing using the Gas Plug Test. Any corrosion or chemical reactions result in the generation of non-condensable gas (NCG) and a corresponding reduction in condenser temperature. At the end of 9000 h of testing, the majority of fluid–metal combinations demonstrated excellent chemical compatibility, with a number of notable exceptions. For the case of Invar–methanol, fluid decomposition took place with the metal acting as a catalyst for the reaction. Galvanic corrosion occurred at the interface between the bimetallic combination of aluminium and stainless steel with toluene as the electrolyte. Regardless of the metal used, ethylene glycol was found to undergo rapid decomposition at temperatures greater than 150 ◦C, leading to device failure. Results for water showed slow continuous NCG generation for the duration of testing. These findings provide important information to designers and engineers who wish to make use of the benefits of AM in the next generation of two-phase thermal control systems.</p

    Climate change assemblies as spaces for the potential mitigation of climate policy misperceptions: A survey experiment

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    Climate action stands as one of the paramount challenges in contemporary society. A significant impediment lies in the prevalence of misperceptions, notably the dissemination of narratives that either endorse climate policy delay or outright climate denial, often perpetuated by vested interests. The World Economic Forum, recognising the gravity of this issue, has underscored” misinformation and disinformation” as the preeminent global risk in the coming biennium, while the UN IPCC has stated that rampant disinformation is delaying climate action. Significantly, misinformation has been linked to climate misperceptions, for example, the belief in technological utopianism, for example, that climate change policies are ineffective and technological solutions will fix the problem in the future, which normalises acceptance of the status quo despite the urgent need for transformative actions. Recent scholarly literature posits that deliberative forums, commonly referred to as mini-publics, can contribute to mitigating such misperceptions while ensuring democratic legitimacy (Muradova et al. 2023) by informing the public. This paper contributes to the special issue on how Climate Change Assemblies (CAs) can contribute to reflexive environmental governance and help societies address the climate emergency, by exploring how CAs perform for the mitigation of climate policy misperceptions. In particular, we focus on whether communication about the procedural, aspects of citizen assemblies to the broader public emerges as a critical component. We understand these mechanisms to be contingent upon complex institutional dynamics, including mechanisms integral to their functioning such as the roles of representation, competence, and voice within assemblies. This empirical inquiry is situated within the framework of a survey experiment conducted across five European countries with varying climate policy salience and emissions levels. We find for most people reading about a climate citizens’ assembly makes little difference. We do find some minimal effects for the wider citizenry in general related to voice, although there are larger effects for some more sceptical cohorts, particularly for representation.</p

    Dynamic shortening of psychometric questionnaires: A focus on PHQ-9

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    The Patient Health Questionnaire-9 (PHQ-9) is a widely utilized assessment tool designed to screen for and measure the severity of depression Recent research has explored the viability of shorter versions of the questionnaire, such as the PHQ-DEP-4 and of depression. Recent research has explored the viability of shorter versions of the questionnaire, such as the PHQ-DEP-4 and PHQ-2, particularly for screening depressed individuals before clinical trials. However, these short tests use a fixed number of questions. This study investigated whether there is merit in posing a dynamic number of questions in screening individuals for depressive symptomatology. To address this, our study focuses on creating a short and dynamic version of the PHQ-9. Our approach utilizes dynamic thresholds tailored to individual responses to predict depression. Optimal thresholds are determined by minimizing the number of questions while simultaneously maximizing the Youden index. Results indicate the Dynamic PHQ-9 model demonstrated superior discrimination ability achieving highest Youden index, sensitivity, and specificity</p

    Definitions of determinants of physical activity behaviour: process and outcome of consensus from the DE-PASS expert group

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    BackgroundDespite extensive research on physical activity behaviour (PAB), consensus is lacking on related terms and definitions, thereby hindering the ability to compare findings between studies and to develop reliable assessment tools. This study therefore aimed to establish consensus on the definitions of key PAB determinants.MethodsFirst, an international expert steering committee was established, comprising members of the European Cooperation in Science and Technology (COST) action “DEterminants of Physical ActivitieS in Settings” (DE-PASS). Recently published review-level studies were used to identify key determinants of PAB. Two independent reviewers systematically reviewed the literature to catalogue the range of definitions used for key determinants of PAB (steps 1–2). A two-round modified Delphi survey was conducted online from February to September 2023, to determine the optimal definition for each determinant. In round 1, experts selected the most suitable definition for each of the 41 initially identified determinants. In round 2, experts ranked the appropriateness of the definition selected from round 1 on a 5-point Likert scale. Consensus was defined a priori as ≥ 75% agreement on the definition (i.e., ratings of ≥ 4 points). A professional English language expert ensured concise, coherent wording and high-quality editing of the definitions (steps 3–6).ResultsEighty-five experts in PAB research participated in round 1, and sixty-nine experts in round 2. Consensus of definitions was achieved for 39 of the 41 determinants (88.4%–98.6% agreement). The consensus threshold was not achieved for two determinants: genetic profile and regulation (69.6%) and backyard access/size (73.9%).ConclusionsThe findings of this study offer a consensus-based set of definitions for 39 key determinants of PAB. These definitions can be used homogenously in academic research on physical activity.</p

    Preparation of new doxycycline monohydrate polymorphs by ultrasonication enhanced supercritical antisolvent recrystallization process

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    Polymorphism is a crucial factor in the pharmaceutical industry, as different polymorphs can display different physicochemical properties, including stability, solubility, and/or bioavailability. The ultrasonication-enhanced supercritical antisolvent recrystallization (UE-SAR) process is a novel investigated approach for producing novel polymorphs.This work aimed to generate and characterize doxycycline monohydrate (DOXY⋅H2O forms II, III, and IV) polymorphs produced from suspensions of its as received form (DOXY⋅H2O form I) using the UE-SAR process. A two-stage Design of Experiments (DoE) analysis was performed to assess the impact of various processing parameters such as ultrasonication, pressure, temperature, and residence time on the polymorphic outcome in each experimental run. The solid state characterization revealed that the produced polymorphs (DOXY⋅H2O form II, DOXY⋅H2O form III) have distinct powder X-ray diffraction (PXRD), Raman, Fourier Transform Infrared (FTIR) patterns and higher thermal stability. Moreover, the structures of DOXY⋅H2O forms I and II were further elucidated by solid state nuclear magnetic resonance (SS NMR) from 13 C and 15 N cross polarization (CP) and magic angle spinning (MAS) spectra. Overall, the results from this work highlight that use US-SAR method can induce the formation of different supramolecular structures in tetracyclines when they are suspended in a supercritical phase, and polymorphic purity can be enhanced by prolonged ultrasonication.</p

    Effect of automated tape placement pass frequency on matrix-dominated mechanical properties and microstructure of wound CF/PEEK

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    Matrix-dominated properties, including Interlaminar Shear Strength, of carbon fibre/PEEK laminates manufactured by laser-assisted automated tape placement are highly influenced by processing parameters selected during manufacturing. In this study, both experimental analysis and a simulation of the thermal characteristics during manufacturing were utilised to determine the influence of processing parameters and laser pass frequency on the quality of the manufactured component. Two cylindrical mandrels with different diameters were used to vary the pass frequency along with various placement rates. While it was determined through mechanical simulations that the geometry of the mandrel did not cause subsequent variations in matrix-dominated mechanical properties, mechanical testing contradicted this finding. Increasing the pass frequency was determined to reduce the void content and increase the Interlaminar Shear Strength. Increasing pass frequency resulted in the substrate temperature remaining near the glass transition temperature for the matrix, with similar effects achieved to that of a heated tool, facilitating further void compaction and increasing the Interlaminar Shear Strength.</p

    Learning to learn differently: Studio-based education for responsible management

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    The pressing need to address the Sustainable Development Goals (SDGs) in business education demands a shift from traditional teaching methods toward design-inspired pedagogical models. This paper introduces a specific pedagogical innovation, that is, a Design for Iteration (DFI) strategy embedded within a studio-based learning environment, developed through a cross-institutional partnership to educate future business leaders. The studio model emphasizes experiential, visual, and iterative learning processes such as the ‘crit’, prototyping, and peer-led feedback. Anchored in a heutagogical (self-determined) approach, this innovation moves beyond isolated creative exercises toward sustained engagement with complex, real-world sustainability challenges. Drawing on qualitative data from the implementation of the EULab Nantes studio, the paper explores how iterative, practice-based learning develops critical skills in adaptive thinking, problem-framing, collaboration, and system-level inquiry. The findings underscore the role of socio-materiality and peer-led sense-making in shaping meaningful learning and identifies the studio as a space for cultivating the mindsets and capabilities central to responsible management and sustainability education. By foregrounding the studio as a site for prototyping sustainable market futures, the paper contributes to reimagining business schools as platforms for transformative sustainability learning</p

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