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The effectiveness of clinical frailty assessment in older patients with Traumatic brain injury in predicting outcome and quality of life: a systematic review
No full textGround-level falls are the most common cause of Traumatic brain injury (TBI) leading to emergency hospital admissions, in adults aged 65 years and older. The world’s population is ageing and frailty is becoming more relevant in healthcare provision, therefore assessment of frailty on admission is integral to care planning. Identifying whether frailty is a risk factor for poor outcomes may facilitate clinical decision making and direct care appropriately. This review aimed to evaluate the effectiveness of a clinical frailty assessment or scale in predicting outcomes in older patients following a TBI, including mortality, functional recovery, hospital length of stay, and discharge disposition. A systematic review of OVID, EBSCO, Elsevier and Wiley from 2005 to 2025. Included a majority of patients aged 65 years and over, diagnosed with a TBI with a validated frailty assessment tool and at least one outcome measure reported. A total of 12 observational studies (464,606 patients) were included, with a mean age ranging between 70 and 83 years. These studies utilised seven distinct frailty assessment tools. Falls from standing were the most common mechanism of injury identified. Frailty was associated with 30-day and 1-year mortality and unfavourable outcome in combination with a reduced Glasgow Coma Score (GCS) on admission. Frailty was an independent predictor of length of hospital stay, discharge disposition and functional recovery but no study used a validated quality of life tool. Various frailty assessment tools demonstrate effectiveness in predicting clinical outcomes when used in combination with patients age, co-morbidity and neurological evaluation. The predictive value of these tools supports their clinical utility in clinical decision making. Further prospective research is needed to understand how frailty relates to longer term outcomes, particularly quality of life, which was not measured in the included studies. Clinical trial number Not applicable
Non-invasive ultrasonic neuromodulation of the human nucleus accumbens impacts reward sensitivity
No full textPrecisely neuromodulating deep brain regions could bring transformative advancements in both neuroscience and treatment. We demonstrate that non-invasive transcranial ultrasound stimulation (TUS) can selectively modulate deep brain activity and affect learning and decision making, comparable to deep brain stimulation (DBS). We tested whether TUS could causally influence neural and behavioural responses by targeting the nucleus accumbens (NAcc) using a reinforcement learning task. Twenty-six healthy adults completed a within-subject TUS-fMRI experiment with three conditions: TUS to the NAcc, dorsal anterior cingulate cortex (dACC), or Sham. After TUS, participants performed a probabilistic learning task during fMRI. TUS-NAcc altered BOLD responses to reward expectation in the NAcc and surrounding areas. It also affected reward-related behaviours, including win-stay strategy use, learning rate following rewards, learning curves, and repetition rates of rewarded choices. DBS-NAcc perturbed the same features, confirming target engagement. These findings establish TUS as a viable approach for non-invasive deep-brain neuromodulation
Exploring the role of use in sustainable innovation and technology transitions
Get PDFUse plays a crucial role in technology innovation, diffusion and transitions. This is especially so with the increasing innovation in IoTs, AI, robotics and platform-based technologies among other technologies that enable seamless interaction between innovators and users. Yet relatively little is known about the role of use in technology innovation and transitions. This developmental paper seeks to explore the role of use in sustainable innovation and technology transitions. It is expected that this will have significant theoretical and managerial implications for addressing the dark-side of innovation in contexts where the noxious consequences of innovation for society and the environment involve end-user behaviours and waste disposal of innovations
Developing Human-Autonomy Teaming Strategies for Maritime Cyber Security Resilience in Uncrewed Autonomous and Remote Surface Vessel Operations
Get PDFThe development of new technologies and digital capabilities for Uncrewed Autonomous and Remote Surface Vessel Operations (UARSVO) is driven by various industry stakeholders. This evolution impacts the maritime industry\u27s human role, transforming from Human-Autonomy Hybrid (HAH) to Human-Autonomy Teaming (HAT). Human-Autonomy Collaboration (HAC) is vital for maritime safety, security, and sustainability, particularly in light of increasing cyber incidents in remote operations, which necessitates greater cyber resilience due to technology at sea and ashore. This paper aims to provide a holistic socio-technical approach to investigate and present an overview of the current state-of-the-art research, focusing on the human perspective in maritime cyber resilience for UARSVO. The view is developed using 76 semi-structured interviews with participants from various stakeholder groups across the Maritime Autonomous Surface Vessel (MASS) industry worldwide. Findings provide unique, holistic, and human-centred operational strategies for maritime cyber resilience, as well as the perceived training required to enhance these operations
Zen and the Art of Praxis: New Adventures in Live Coding, Quantum Computing, and The Web.
Get PDFIn recent years, quantum computing has emerged from the realm of science fiction, becoming a real-world discipline with practical applications. Although NISQ-era hardware imposes significant limitations, and the case for quantum advantage over classical algorithms remains largely theoretical, its potential is being increasingly embraced by the arts; a domain where the merit of exploring new terrain may outweigh the need for technical precision. In particular, quantum computer music has evolved from its origins as a branch of unconventional computing, to an established practice with a growing global community of composers, performers, and researchers. However, the available tools remain largely experimental: often designed for exploring single problem domains, challenging to install, and lacking the flexibility and momentum to drive the field forward.In this time, live coding has also expanded and diversified, operating outside of algorithmic music\u27s often academic confines, and establishing itself as a vibrant and dynamic cultural force. By contrast, it offers a plethora of mature tools, catering for a wide range of approaches and aesthetic concerns, which have done much for the advancement of the field. This research investigates how these can inform the development of a quantum computer music programming language, one that combines the expressive power of live coding with the computational model of quantum computing. By addressing this challenge, the project aims to open up quantum computer music to non-specialist composers and performers.The thesis begins with some philosophical reflections on the historical separation of mind and body, thinking and doing, and theory and practice, arguing that, as dichotomies, these fail to capture the lived experience of creative activity. These misconceptions are clearly exposed by live coding, where algorithms are a workable material, and the boundary between thought and action is blurred in the feedback loop between performer and machine. The term praxis is adopted to describe such processes, ones that integrate thought and action. The thesis explores what lessons can be learned from live coding, in order that the experience of performing and composing quantum computer music might similarly embody praxis. Zen, a live coding environment built with modern web technologies, is presented as the primary research solution.Using an iterative software development methodology, the project documents Zen\u27s evolution, from a live coding environment for exploring pattern interference, to a richly-featured, stand-alone application for the design, execution, and sonification of quantum algorithms. To prioritise learnability, Zen\u27s syntax is deliberately simple, yet, in adhering to pure JavaScript, it maintains the power and flexibility required for advanced algorithmic composition. A selection of music and code examples showcase the software\u27s capabilities, demonstrating the ability to approach quantum computer music in a variety of ways.The study concludes by evaluating Zen\u27s contribution to both live coding and quantum computer music, positioning it as a necessary step in the broader adoption of quantum technologies in the arts, as well as a novel addition to the live coding canon. Opportunities for future research are outlined to emphasise the potential for live coding and quantum computing to further explore new musical territories
Introduction to the Special Section on Earthquakes in Slowly Deforming Mountain Belts and the High Atlas Earthquake of 8 September 2023
No full textEarthquakes in slowly deforming mountain belts result from low‐tectonic loading and occur on individual fault segments. Although most of the significant seismic strain rate concentrates along the plate boundaries, large earthquakes with may still be generated along faults in regions at a distance (≫100 km) from plate boundaries. Intraplate regions, or continental interiors, exhibit active deformation characterized by relatively low tectonic and seismic strain rates (\u3c5 mm/yr; Johnston, 1996), consistent with geodetic strain rates and models of plate motions that predict comparable velocities (Kreemer et al., 2014). Active faults in continental interiors..
Collecting and Sharing Person-Centered AI Clinical Summaries Across Frailty Services Provided by the National Health Service and Voluntary, Community, and Social Enterprise: Protocol for a Co-Design and Feasibility Study
Get PDFBackground:Due to its association with multimorbidity, frailty gives rise to multidimensional needs for different services. Too often, patient preferences and service encounter information are not adequately shared.Objective:This developmental study aims to co-design, collect, and analyze encounter data from multiple community and primary-based multidisciplinary teams (MDTs) providing services for people with frailty to develop prototype large language models that can generate clinical and person-centered care summaries.Methods:Engaging stakeholders in 2 primary care networks, we will co-design the large language model to ensure it meets local needs and preferences as well as infrastructure, information governance, and regulation requirements. General practitioners will identify 50 patients with frailty requiring MDT engagement. Three consecutive encounters between the patients and different members of MDTs will then be audio-recorded. Recordings will be transcribed into text for concept design and model pretraining. These data combine stakeholder engagement insights to develop sensitive artificial intelligence (AI) models responding to stakeholders’ needs, workflows, and preferences. To generate the person-centered summaries, we will test 2 approaches to modeling the encounter data: graph-based modeling and hierarchical transformers. The AI-generated summaries will be compared to human-written summaries of the same encounter data and assessed for accuracy, quality, fluency, and person-centeredness. They will also be shared with the original MDT members for validation. We will capture inputs, processes, and outcomes across all key phases of the implementation journey to identify capability requirements, determinants of implementation (including key challenges and best practices to overcome them), and the value added by the technology.Results:This protocol aims to review implementation evidence and engage stakeholders in co-design. This work package will aid the development of contextually sensitive, longitudinal, and AI-generated person-centered summarization tools. Model development will aim to achieve longitudinal person-centered summaries tested against MDT standards. If deemed suitable for deployment, optimum ways of integrating these summaries into shared care records will be explored with local key system leaders. Model evaluations will provide conclusive insights into such technologies’ benefits and risks. As of August 2025, this study has not yet been funded, nor has ethical approval for the project been obtained. Consequently, dates of data collection and numbers of recruited participants are not applicable at this time.Conclusions:Our protocol provides a robust method of co-designing, evaluating, and implementing a longitudinal AI medical summary tool. Including key stakeholders at multiple stages facilitates an iterative development strategy that is designed to solve implementation challenges as they emerge. This project fits within our long-term vision to deliver a multimodal AI tool that saves clinicians time and deepens the health care professional–patient relationship. Future studies should include a larger patient sample, video-recorded health care professional–patient encounters, and a more extensive longitudinal evaluatio
Evaluation of graphite and activated carbon as suitable water purification media for in-situ resource utilisation (ISRU) on Mars
No full textEventual human missions to the red planet will require large-scale in-situ resource utilisation to meet their objectives. Perhaps the most critical element for developing a sustainable architecture is propellant production from the products of water electrolysis and atmospheric carbon dioxide. The purpose of this study was to assess how graphitic materials may be used as porous filters to remove solvated ions from Martian water prior to electrolysis, reducing the overall complexity of ISRU systems. The two materials under study were PG25 graphite and activated carbon powder.
A comprehensive three-technique characterisation of both materials was performed, using helium pycnometry, N2 gas adsorption, and mercury intrusion porosimetry. Helium pycnometry revealed a skeletal density of 2.201 g/cm3 and 1.925 g/cm3 for graphite and activated carbon respectively. Gas adsorption experiments and application of BET theory revealed a surface area of 0.51m2/g for graphite and 1800 m2/g for activated carbon, with the isotherm shape and C value for activated carbon being consistent with microporosity and/or adsorption onto high energy surface sites. Mercury porosimetry confirmed significant macroporosity in the graphite and extensive mesoporosity in the activated carbon, although the microporous regime was unresolved due to instrumental limitations. ICP-OES analysis showed effective sodium and calcium ion removal in the case of the pure graphite (80 – 90%), whereas particulate contamination from the activated carbon doped samples precluded an analysis of its performance. Therefore, graphite was determined to be the most suitable material for water purification in the context of ISRU. Future studies may focus on optimisation of the surface chemistry of the graphite via oxidation, as well as refining performance through variable flow rate and filter dimensions
Quantification of trace metal(loids) in the River Seaton, Cornwall, UK and the influence of the South Caradon Mine on ecological risk
No full textFreshwater quality is critical to the health of aquatic ecosystems and human water security, yet anthropogenic activities, such as historic mining, continue to degrade aquatic systems. While extensive research has examined metal contamination in major rivers like the River Tamar, smaller tributaries affected by legacy mining remain understudied. This study investigates trace metal contamination and its controlling factors in the River Seaton, Cornwall, a small river influenced by historic mining from the South Caradon Mine. Water samples collected from four study sites along the river gradient and a reference site at Siblyback Lake were subjected to ICP-MS analysis and physico-chemical characterisation to identify potential correlations between trace metal(loids) concentrations (Metals: Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Cd, Tl, Pb and Zn; Metalloids: Ge, As, Se, Sb) and environmental factors such as pH, redox potential, temperature, and Dissolved Oxygen (DO). These samples were quantified and analysed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Physico-chemical factors were taken in situ in the River Seaton, Cornwall, and ecological risk was calculated using the Potential Ecological Risk Index (PERI). Pearson\u27s Correlation Coefficient analysis identified pH and redox potential as the dominant geochemical controls on trace metal speciation and mobility.
Results revealed severely elevated metal concentrations, particularly at site two directly below the South Caradon Mine, which alone accounted for 87% of the cumulative PERI score across all four study sites. Copper (Cu) had the highest average concentration across all sites, at 177 µg/L in site 2, with metal concentrations decreasing substantially toward the river mouth (site 5) due to spatial and temporal distribution patterns driven by river flow. Zinc (Zn) was exceedingly significant in all sites, with a concentration of 400 µg/L at site 3. Both Cu and Zn exceed the Environmental Quality Standard (EQS) and the Dutch Maximum Permissible Concentration (MPC), with an average PERI score of 491, indicating high ecological risk across the study sites. Although not surpassing the EQS, high concentrations of Arsenic (As) (12.3 µg/L) under the formation of arsenite (As(III)) and arsenate (As(V)) were sampled in site 2. The presence of As confirms the release of AMD into the river, resulting from the oxidative dissolution of arsenic-bearing sulphide minerals in the catchment\u27s historic mining areas. These findings indicate a significant anthropogenic imprint on the River Seaton, confirming that legacy mining activities continue to influence water chemistry, degrade ecological status, and pose risks to downstream aquatic systems. This was confirmed by comparing the River Seaton water samples with those from the reference site in Siblyback Lake. These findings provide crucial baseline data for the River Seaton; however, further investigation incorporating temporal variability and biological assessments will be necessary to comprehensively classify the river health index
Adaptive and robust smartphone-based step detection in multiple sclerosis
Get PDFBackground: Many attempts to validate gait pipelines that process sensor data to detect gait events have focused on the detection of initial contacts only in supervised settings using a single sensor. Objective: To evaluate the performance of a gait pipeline in detecting initial/final contacts using a step detection algorithm adaptive to different test settings, smartphone wear locations, and gait impairment levels. Methods: In GaitLab (ISRCTN15993728), healthy controls (HC) and people with multiple sclerosis (PwMS; Expanded Disability Status Scale 0.0-6.5) performed supervised Two-Minute Walk Test [2MWT] (structured in-lab overground and treadmill 2MWT) during two on-site visits carrying six smartphones and unsupervised walking activities (structured and unstructured real-world walking) daily for 10-14 days using a single smartphone. Reference gait data were collected with a motion capture system or Gait Up sensors. The pipeline\u27s performance in detecting initial/final contacts was evaluated through F1 scores and absolute temporal error with respect to reference measurement systems. Results: We studied 35 HC and 93 PwMS. Initial/final contacts were accurately detected across all smartphone wear locations. Median F1 scores for initial/final contacts on in-lab 2MWT were \u3e=98.2%/96.5% in HC and \u3e=98.5%/97.7% in PwMS. F1 scores remained high on structured (HC: 100% [0.3%]/100% [0.2%]; PwMS: 99.5% [1.9%]/99.4% [2.5%]) and unstructured real-world walking (HC: 97.8% [2.6%]/97.8% [2.8%]; PwMS: 94.4% [6.2%]/94.0% [6.5%]). Median temporal errors were \u3c=0.08 s. Neither age, sex, disease severity, walking aid use, nor setting (outdoor/indoor) impacted pipeline performance (all p\u3e0.05). Conclusion: This gait pipeline accurately and consistently detects initial and final contacts in PwMS across different smartphone locations and environments, highlighting its potential for real-world gait assessment