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Characteristics and outcomes of patients who discharge against medical advice from Australian and New Zealand burns services
Full text linkBurns patients with recorded discharges against medical advice (DAMA) face potential medical and financial consequences associated with future readmissions. This study aimed to investigate the characteristics and outcomes of patients with recorded DAMA from burns services in Australia and New Zealand. In an observational study using data from individuals aged ≥ 16 years captured by the Burns Registry of Australia and New Zealand with a burn-related admission between July 2009 and June 2022, 325 patients (1.4 %) had recorded DAMA. A greater proportion of patients with recorded DAMA were aged 30–44 years, of Australian Aboriginal and Torres Strait Islander origin, from outer regional Australia, had pre-existing mental health conditions, with substance use, and sustained their injury through suspected assault or abuse. Injuries in patients with recorded DAMA were more severe. Compared to patients without DAMA, a greater proportion of patients with DAMA were readmitted within 28 days of discharge (13.8 % versus 4.9 %), with failed discharge processes (45.5 %) and infection (18.2 %) being the most frequently recorded reasons. They required readmission to the intensive care unit (20 % versus 8.6 %) with longer lengths of stay. Outcome findings remained similar in a matched cohort analysis between those with and without recorded DAMA. These findings highlight the consequences of DAMA, necessitating primary measures to address modifiable, cultural, and social factors preemptively to prevent DAMA among disadvantaged individuals, and secondary measures to minimize the impact of DAMA (e.g., adequate pain and wound discharge management, follow-up care, community-based treatments, etc.)
Anisotropic mesh spacing prediction using neural networks
No full textThis work presents a framework to predict near-optimal anisotropic spacing functions suitable to perform simulations with unseen operating conditions or geometric configurations. The strategy consists of utilising the vast amount of high-fidelity data available in industry to compute a target anisotropic spacing and train an artificial neural network to predict the spacing for unseen scenarios. The trained neural network outputs the metric tensor at the nodes of a coarse background mesh that is then used to generate meshes for unseen cases. Examples are used to demonstrate the effect of the network hyperparameters and the training dataset on the accuracy of the predictions. The potential of the method is demonstrated for examples involving up to 11 geometric parameters on CFD simulations involving a full aircraft configuration
Service Users' Experiences and Perceptions of Carer Support and Involvement in Care and Treatment in Adult Mental Health Inpatient Settings: A Qualitative Evidence Synthesis
Full text linkPerceived Belbin team roles of first year university students studying aerospace engineering: a multi-year study
No full textEffective teamwork is critical in engineering and engineering degree programmes are designed to encourage, develop and allow students to demonstrate this transferable skill. This is particularly true in aerospace engineering where the complexity and inherent multidisciplinary nature of both defined and open-ended projects demands a well-balanced team with diverse team role preferences. This study investigates trends in the perceived team roles of aerospace engineering students over six years (2018–2024), utilising Belbin’s Team Role Self-Perception Inventory (BTRSPI). The study identifies the overall distribution of role perceptions amongst aerospace engineering students, the perceived traits of male or female participants, as well as the trends and fluctuations in role perceptions over time, with consideration given to the influence of the COVID-19 pandemic. Overall, Monitor Evaluator, Plant, and Completer Finisher roles were found to be consistently prominent, while Coordinator, Shaper, and Specialist roles were less favoured. Clear differences are identified between female and male participants, with females showing higher percentile scores in people-orientated roles and males dominating in thinking-orientated roles. Trends and shifts in perceived team roles are considered in the context of aerospace engineering students and their implications for curriculum design and team-based learning strategies in engineering education
Views and understanding of metabolic dysfunction-associated steatotic liver disease in patients with diabetes
Full text linkWords and meanings in cancer communication: Denotational and connotational misalignments
Full text linkShared understanding of words used in cancer care is crucial to the quality of patients’ engagement with their treatment. A cancer diagnosis introduces the patient to many unfamiliar words and meanings. This study identifies words that are prone to impede communication, by i) evaluating lay participants’ (n=292) definitional understanding of terms commonly used in cancer care, and ii) comparing the connotations of terms held by lay participants with those held by healthcare practitioners (n=82). A critical impediment to definitional understanding was found when words are used in a different, sometimes contradictory, way from their meaning in general language use. Participants who misunderstood terms were no less confident in the accuracy of their understanding than those who understood well. Connotational meaning was assessed using semantic differential and word association techniques. A lack of congruence between lay and health practitioner connotations was found for most target terms; a substantial number of ‘fear’- or ‘sad’- related associations from lay participants contrasted with a near absence of such connotations from healthcare practitioners. Findings reveal routes to improved health communication
Phase field fracture in elasto-plastic solids: Numerical implementation and application to transversely isotropic fiber-reinforced composites
Full text linkDue to their superior tensile properties, fiber-reinforced composite (FRC) structures have been widely applied in modern industries. This study employs phase field modeling to simulate the process of elastic-plastic fracture in FRC structures. In this study, we first establish a constitutive model for elastoplastic solids and a phase field model for fracture in solid materials. By employing the Newton-Raphson iterative method, the displacement field and phase field are solved separately based on an alternating iterative scheme.Subsequently, we presented three numerical examples to demonstrate the robustness and accuracy of the proposed model. First, we simulated the elastoplastic fracture response of isotropic materials and validate the accuracy of the elastoplastic fracture phase field model. Next, we examined the tensile and fracture behaviors of unidirectional fiber reinforced composite plate with a central circular hole and varying fiber angles. Finally, the influence of curved fiber on the unilateral tensile fracture of FRC plates was investigated. Considering the pronounced heterogeneity between fibers and matrix materials,this study assumes that the fibers remain in the linear elastic regime and introduces a yield function to describe the matrix behavior. Our computational results demonstrate that the accuracy and robustness of the proposed model for predicting the elastoplastic fracture response of FRC structures. Furthermore, we observed that in comparison to the elastic phase field fracture model, the occurrence of fracture is delayed when an elastoplastic phase model is employed due to the complex interactions between the plastic dissipation energy and the fracture energy
Evidence that the Aso-3 caldera-forming eruption (southwest Japan) marks the termination of Marine Isotope Stage (MIS) 6
No full textThe Aso-3 caldera-forming event of Aso volcano was one of the largest eruptions of the Quaternary period, blanketing vast regions of Japan and surrounding seas in ash. However, uncertainties surrounding the eruption age and geochemical variability have limited its utility as a robust time-stratigraphic marker. Distal occurrences previously attributed to Aso-3 span a broad temporal window (135–110 ka) and glass shards often lack compositional agreement with those of proximal datasets. Here, we re-evaluate the characteristics of Aso-3 using new stratigraphic and geochemical evidence from proximal and distal settings. In the Lake Suigetsu sediments, three Aso tephra layers are newly identified, including a 3 cm thick layer at ∼133 ka with glass shards that compositionally span the proximal Aso-3 range. Additionally, we identify a compositionally identical Aso-3 cryptotephra in the Sea of Japan (core U1427A). Combined stratigraphic, geochemical, and palaeoenvironmental evidence (pollen, diatom and benthic δ18O) from these records confirms that Aso-3 occurred prior to Marine Isotope Stage (MIS) 5e, during the termination of MIS 6. This establishes Aso-3 as a regional isochron, aiding synchronisation of paleoclimate records across the glacial–interglacial transition (Termination II). Our findings caution against correlating to Aso-3 based on partial geochemical matches, given that Aso experienced numerous explosive eruptions responsible for widespread ash dispersals throughout MIS 6 and 5
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