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First permanent molar root canal configurations in a South African sample: a descriptive micro-computed tomographic report
Get PDFThe aim of this paper was to describe root canal configurations using micro-CT in South African first molars. A segmentation process was followed on micro-focus X-ray computed tomography (micro-CT) scans of 101 maxillary and 86 mandibular first molars. Main and accessory root canal anatomy were considered to describe root canal configurations of South African first molars. Intra- and inter-observer reliability was determined using the unweighted Cohen’s Kappa test. Intra- and inter-rater agreement was 93% for maxillary configurations; 92.9% and 86.2% respectively for mandibular configurations. The most common main canal configurations were: 3MXFM MB1DB1P1 (n = 33/93, 35.5%) and 2MDFM M1-2D1 (n = 8/84, 9.5%) (separate three-rooted maxillary and two-rooted mandibular respectively). The addition of accessory canals resulted in configurations that were mostly individualised with only a few notable similarities. A total of 97 unique configurations were found in maxillary teeth and 85 in mandibular teeth. In the separate three-rooted maxillary molars, the only similarities were 3MXFM MB1(A2) DB1(A1) P1 (n = 4/93, 4.3%) and 3MXFM MB1(A1) DB1(A1) P1 (n = 2/93, 2.2%). In two-rooted mandibular molars, only 2MDFM M1D1 (n = 2/84, 2.4%) was noted. Root canal configurations were found to be diverse and complex
Beyond the Ceiling (Long Gallery, Lanhydrock)
No full text3 min film about the ceiling and roof cavity of the Long Gallery and the at Lanhydrock
Exploring the international terminology associated with nurses caring for neonates, infants, children, young people and their families.
Get PDFThe terminology used for Registered Nurses specializing in caring for neonates, infants, children, young people (CYP), and their families varies globally. While many countries’ nursing students qualify as “Registered Nurses” upon completion of undergraduate education, specialist titles like “Children’s Nurses” in the United Kingdom or “Pediatric Nurses” in Italy denote expertise in CYP care. In countries like the United States and Canada, neonatal and pediatric nursing specialization typically requires postgraduate study. However, there is limited evidence on the range of international terms for nurses in this field. This expert opinion paper presents the results from a scoping survey designed to identify and catalog these terms across different countries. This exercise and the data collected were used to inform a larger cross-section study: “A Survey To map the glObal provision of children’s nUrsiNg eDucation” (the ASTOUND study). Conducted between May and August 2024, the survey collected responses from 76 participants across 34 countries representing all continents. Content analysis and descriptive statistics revealed 20 distinct terms, with “Paediatric/Pediatric Nurse” (n = 28) as the most common, followed by “Children’s Nurse” (n = 7), “Child Health Nurse” (n = 5), and others. Additional findings highlighted regional variation in terminology based on the clinical setting and population age range, underscoring historical and cultural influences on these terms. This initial survey provides a snapshot of global terminology. It underscores the need for further research, setting the stage for exploration in the ASTOUND study to map the provision of children’s nursing education worldwide
High performance synthetic fiber-reinforced concrete mixed with nanoparticles: A proof-of-concept green railway sleeper product
Get PDFThis paper investigates the effects of nanoparticles and fibers on the durability and microstructural properties of mortar and concrete, aiming to create a high-performance railway sleeper product as an alternative sustainable material in the market. In the Phase 1, the main objective is to evaluate the effectiveness of nanoparticles, such as nano alumina (NA) and nano silica (NS), at 1%, 3%, and 5% additions, along with rice husk ash (RHA) and ground granulated blast furnace slag (GGBFS) in terms of strength and durability performance. To further enhance structural integrity, the study incorporates fibers such as polypropylene fiber (PPF) and polyvinyl alcohol fiber (PVA) at a constant volume fraction of 0.5%. The hybridization of NA and NS with PPF and PVA fibers was developed and analyzed through scanning electron microscopy (SEM) and energy dispersion X-ray (EDX) analysis. The mechanical property tests revealed that hybrid nanoparticles enhanced compressive strength by 15% compared to control and mono nanoparticle composites. Durability tests, including water absorption, rapid chloride penetration, and water penetration, showed that adding 5% hybrid nanoparticles and 0.5% fibers resulted in high strength (17.81%) and significant pre refinement. In Phase 2, a proof-of-concept green railway sleeper was developed using 100% recycled aggregate concrete (RAC), reinforced with glass fiber-reinforced polymer (GFRP) and the hybrid fibers from Phase 1, demonstrating enhanced mechanical properties and durability. Additionally, finite element crack analysis using Abaqus® software provided an in-depth understanding of sleeper performance, revealing improved crack resistance under operational fatigue loading and reduced maintenance costs. This innovative approach showcases a sustainable product with superior performance, addressing both environmental and structural challenges in railway infrastructure
Employability of international postgraduate taught students in the UK: a systematic literature review using PRISMA
Get PDFOne-year postgraduate taught programmes in the UK attract global talent through high-quality education, yet the employability and career pathways of these students remain understudied despite their recognised vital economic and cultural contributions. Amid the UK\u27s higher education financial crisis, marked by funding cuts, staff layoffs, rising costs, and reliance on international student recruitment, this study employs the PRISMA 2020 framework to systematically review literature (2014–2024) on international postgraduate taught student employability. Analysing 13 studies from Web of Science, Scopus, and Google Scholar, the findings reveal gaps in tailored sector-specific career and employability support, access to employment development opportunities and work-integrated learning practices, and culturally sensitive language support. The limited number of available studies highlights the need for further research, particularly in STEM-related subjects of study and among African and Indian Subcontinent students, to address systemic barriers and enhance employability support in a shifting academic and geopolitical landscape
Unreliable landmarks disrupt egocentric navigation in desktop virtual environments
No full textNavigation relies on the integration of both allocentric (world-centred) and egocentric (navigator-centred) spatial cues. An influential real-world navigational task dissociated allocentric place learning from egocentric path integration, highlighting the decline in allocentric cue use associated with cognitive ageing. This report describes a novel computer-based replication of this task, designed as a remote test of navigational ability, that also addresses potential confounds in the original task, including tighter control of spatial cue competition. In Experiment 1a, participants learned a location signalled either by landmark cues in the absence of a stable starting position (Allocentric), distance and direction from the starting position in the absence of landmarks (Egocentric), or a combination of the two (Control). In the Allocentric condition, participants exhibited lower accuracy, greater reorientation, and more complex paths compared to the Control and Egocentric conditions. Experiment 1b employed the same design but featured an Egocentric condition with unstable landmarks that did not predict the target location. In Experiment 1b, Egocentric condition accuracy was equivalent to the Allocentric condition, and lower compared to Experiment 1a’s Egocentric condition. Additionally, in Experiment 1b’s Egocentric condition, participants took more complex paths and reorientated more to the unstable landmarks. Experiments 2a and 2b replicated findings from Experiment 1a and 1b, indicating their reliability. These data suggest that path complexity is associated with navigational error, and underscore the benefits of integrating different sources of information during navigation. Cross-experiment comparisons also show how the presence of unstable visual cues can lead to the adoption of unsuitable strategic approaches
Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackground Timely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality estimates measured in counts, rates, and years of life lost (YLLs). GBD 2023 aimed to enhance our understanding of the relationship between age and cause of death by quantifying the probability of dying before age 70 years (70q0) and the mean age at death by cause and sex. This study enables comparisons of the impact of causes of death over time, offering a deeper understanding of how these causes affect global populations. Methods GBD 2023 produced estimates for 292 causes of death disaggregated by age-sex-location-year in 204 countries and territories and 660 subnational locations for each year from 1990 until 2023. We used a modelling tool developed for GBD, the Cause of Death Ensemble model (CODEm), to estimate cause-specific death rates for most causes. We computed YLLs as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. Probability of death was calculated as the chance of dying from a given cause in a specific age period, for a specific population. Mean age at death was calculated by first assigning the midpoint age of each age group for every death, followed by computing the mean of all midpoint ages across all deaths attributed to a given cause. We used GBD death estimates to calculate the observed mean age at death and to model the expected mean age across causes, sexes, years, and locations. The expected mean age reflects the expected mean age at death for individuals within a population, based on global mortality rates and the population\u27s age structure. Comparatively, the observed mean age represents the actual mean age at death, influenced by all factors unique to a location-specific population, including its age structure. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 250-draw distribution for each metric. Findings are reported as counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2023 include a correction for the misclassification of deaths due to COVID-19, updates to the method used to estimate COVID-19, and updates to the CODEm modelling framework. This analysis used 55 761 data sources, including vital registration and verbal autopsy data as well as data from surveys, censuses, surveillance systems, and cancer registries, among others. For GBD 2023, there were 312 new country-years of vital registration cause-of-death data, 3 country-years of surveillance data, 51 country-years of verbal autopsy data, and 144 country-years of other data types that were added to those used in previous GBD rounds. Findings The initial years of the COVID-19 pandemic caused shifts in long-standing rankings of the leading causes of global deaths: it ranked as the number one age-standardised cause of death at Level 3 of the GBD cause classification hierarchy in 2021. By 2023, COVID-19 dropped to the 20th place among the leading global causes, returning the rankings of the leading two causes to those typical across the time series (ie, ischaemic heart disease and stroke). While ischaemic heart disease and stroke persist as leading causes of death, there has been progress in reducing their age-standardised mortality rates globally. Four other leading causes have also shown large declines in global age-standardised mortality rates across the study period: diarrhoeal diseases, tuberculosis, stomach cancer, and measles. Other causes of death showed disparate patterns between sexes, notably for deaths from conflict and terrorism in some locations. A large reduction in age-standardised rates of YLLs occurred for neonatal disorders. Despite this, neonatal disorders remained the leading cause of global YLLs over the period studied, except in 2021, when COVID-19 was temporarily the leading cause. Compared to 1990, there has been a considerable reduction in total YLLs in many vaccine-preventable diseases, most notably diphtheria, pertussis, tetanus, and measles. In addition, this study quantified the mean age at death for all-cause mortality and cause-specific mortality and found noticeable variation by sex and location. The global all-cause mean age at death increased from 46·8 years (95% UI 46·6–47·0) in 1990 to 63·4 years (63·1–63·7) in 2023. For males, mean age increased from 45·4 years (45·1–45·7) to 61·2 years (60·7–61·6), and for females it increased from 48·5 years (48·1–48·8) to 65·9 years (65·5–66·3), from 1990 to 2023. The highest all-cause mean age at death in 2023 was found in the high-income super-region, where the mean age for females reached 80·9 years (80·9–81·0) and for males 74·8 years (74·8–74·9). By comparison, the lowest all-cause mean age at death occurred in sub-Saharan Africa, where it was 38·0 years (37·5–38·4) for females and 35·6 years (35·2–35·9) for males in 2023. Lastly, our study found that all-cause 70q0 decreased across each GBD super-region and region from 2000 to 2023, although with large variability between them. For females, we found that 70q0 notably increased from drug use disorders and conflict and terrorism. Leading causes that increased 70q0 for males also included drug use disorders, as well as diabetes. In sub-Saharan Africa, there was an increase in 70q0 for many non-communicable diseases (NCDs). Additionally, the mean age at death from NCDs was lower than the expected mean age at death for this super-region. By comparison, there was an increase in 70q0 for drug use disorders in the high-income super-region, which also had an observed mean age at death lower than the expected value. Interpretation We examined global mortality patterns over the past three decades, highlighting—with enhanced estimation methods—the impacts of major events such as the COVID-19 pandemic, in addition to broader trends such as increasing NCDs in low-income regions that reflect ongoing shifts in the global epidemiological transition. This study also delves into premature mortality patterns, exploring the interplay between age and causes of death and deepening our understanding of where targeted resources could be applied to further reduce preventable sources of mortality. We provide essential insights into global and regional health disparities, identifying locations in need of targeted interventions to address both communicable and non-communicable diseases. There is an ever-present need for strengthened health-care systems that are resilient to future pandemics and the shifting burden of disease, particularly among ageing populations in regions with high mortality rates. Robust estimates of causes of death are increasingly essential to inform health priorities and guide efforts toward achieving global health equity. The need for global collaboration to reduce preventable mortality is more important than ever, as shifting burdens of disease are affecting all nations, albeit at different paces and scales. Funding Gates Foundation
Application and suitability of using paraffin wax in a thermal store for residential buildings in the UK
No full textHeating costs and pressure to reduce carbon emissions are rapidly increasing. A possible solution is the implementation of efficient energy storage systems for UK residential buildings. Paraffin wax-based thermal energy storage offers a promising solution due to its low-cost, high-energy density, and long-term stability. However, its low thermal conductivity significantly reduces its practicality. Multiple upgrades, such as implementing highly conductive particles and nanotubes, have been previously studied but lack the inclusion of cost-effectiveness and real-world feasibility. This paper reviews current research and develops a numerical model using the Enthalpy method and a 2D finite difference approach, utilised in Python. It was calculated that 293 kg of paraffin wax is required to store a full day’s heating demand for an average residential building. A validation study was conducted by comparing simulation results to real-world experimental data. However, natural convection was not fully captured in the model, causing a possible slower melting process. The results showed that it would take 1,106 hours for the energy to fully disperse through the paraffin wax, causing it to melt completely. For the enhancements, finned-tubed heat exchanger (£3.65/% melting time improvement) and expanded graphite (£6.85/% melting time improvement) were the most cost-effective. While aluminium foam saw the greatest improvement (reducing the melting time to 63 hours), it came with an unrealistic additional cost of £175,000. From these results it was deemed unreasonable to use paraffin wax to store enough heat for a day. Instead, a smaller system to eliminate boiler short cycling and to assist in smoothing out the heating demand is a more reasonable design. This could save the UK £1 billion and 3 million tons of carbon emissions a year
The evolution and continued monitoring of seagrass meadows in Higher Town Bay, Isles of Scilly, United Kingdom
No full textThe pressures of modern society have been proven to have widespread negative effects on worldwide seagrass meadows, thus necessitating an increased need for the accurate and long-term monitoring of sites of special interest. These monitoring programs have typically relied on the in-situ measurement of individual seagrass plants. However, technological advancements have increased the prevalence of new surveying techniques, including satellite imagery, aerial photography and bathymetric measurement. With the advent of machine learning, the processing of these methods has increased in efficiency and become more objective in nature, transforming the way surveys are being undertaken. This study focuses on the unique habitat of Higher Town Bay (St Martins) in the Isles of Scilly and provides a comprehensive evaluation of how the seagrass meadows have changed over a 16-year period. A combined dataset of bathymetric and remote sensing data is analysed to map these changes, and two machine learning (ML) methods are suggested to automate this process. A sensitivity analysis of both the ML algorithms and processing methods is undertaken. The resulting trend shows the damage inflicted on the meadow by the 2013/14 winter storms, demonstrating the impact of extreme wave events on the archipelago and the subsequent recovery of the meadow in the following years. This study provides guidance into how to combine bathymetric and remote sensing data types for more comprehensive seagrass surveys and gives suggestions for ML techniques to be used in the broader scope of seagrass detection and management
The effect of the Patient Health Engagement model–based care strategy on improving patient–ventilator synchrony in patients with respiratory failure: a quasi-experimental study
No full textBackground: Non-invasive positive pressure ventilation (NPPV) is a crucial method for treating acute and chronic respiratory failure. The effectiveness of NPPV treatment heavily depends on the active participation of patients. However, research on strategies to enhance patient engagement during NPPV therapy is still lacking. Aim: To evaluate the effect of nursing interventions based on the Patient Health Engagement (PHE) model in enhancing patient–ventilator synchrony and improving outcomes of NPPV in patients with respiratory failure. Study Design: This quasi-experimental study employed a pre-post design with non-equivalent control group. Convenience sampling was used to select patients with respiratory failure receiving NPPV at Zhongshan Hospital, Fudan University. A total of 104 participants entered the data analysis phase. The control group (n = 52) received routine NPPV care, while the intervention group (n = 52) received care based on the PHE model. Results: The intervention group showed decreased patient–ventilator asynchrony index {Δ [95% confidence interval (95% CI)] = −2.82 (−4.02, −1.62), p \u3c 0.001} and NPPV non-adherence score [Δ (95% CI) = −1.08 (−1.42, −0.74), p \u3c 0.001] within 48 h compared to the control group. The dyspnoea score in the intervention group decreased more rapidly after NPPV and was lower than that in the control group at 4 h [Δ (95% CI) = −1.27 (−2.03, −0.51), p = 0.001]. Additionally, the intervention group had higher comfort scores [Δ (95% CI) = 2.26 (1.56, 2.96), p \u3c 0.001] and shorter ICU stays [Δ (95% CI) = −0.95 (−1.89, −0.01), p = 0.049]. Conclusion: Interventions based on the PHE model enhance comfort, synchrony, and adherence during NPPV in patients with respiratory failure, leading to improved respiratory and oxygenation outcomes, and reduced ICU stays. Relevance to Clinical Practice: Patient engagement is essential for optimizing NPPV outcomes in critical care. This study provides recommendations on cognitive, behavioural, and emotional aspects of NPPV care, offering a reference for intensive care managers to enhance nursing processes, standards, and the integration of humanistic care in the critical care setting