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Ethnicity and heart failure outcomes in England: the role of specialist care in a universal health system
No full textBackground:
Poorer cardiovascular outcomes among ethnic minorities have been reported, particularly during the COVID-19 pandemic. However, the relationship between ethnicity and quality of care after hospitalization for heart failure (HF) and long-term outcomes is largely unknown.
Objectives:
The aim of this analysis is to investigate quality of care and longer-term outcomes of patients hospitalized with acute HF according to ethnicity.
Methods:
Routinely collected data for England from the National Heart Failure Audit, National Health Service Hospital Episode Statistics, and Office for National Statistics death register from 2018 to 2023 were used to investigate the quality of care and outcomes after hospitalization with HF according to ethnicity.
Results:
National Heart Failure Audit data for 239,890 patients admitted with HF were grouped by ethnicity as White (215,800), Black (6,610), Asian (12,940), and mixed/other (4,540), with median ages of 81 years (IQR: 73-88 years),75 years (IQR: 60-84 years), 77 years (IQR: 67-84 years), and 75 years (IQR: 61-84 years), respectively. Overall, patients had a median of 3 comorbidities (IQR: 2-4 comorbidities), with Asians having the greatest number. About 50% of patients had HF with reduced ejection fraction in all ethnic groups. For HF with reduced ejection fraction, White patients were least likely to be discharged on guideline-recommended therapies. Over a median follow-up of 68 weeks (IQR: 20-142 weeks), 122,980 (57%) White patients died, as did 2,860 (43%) Black patients, 6,270 (48%) Asian patients, and 1,900 (42%) patients of other/mixed ethnicity. About 90% of deaths were due to cardiovascular or respiratory causes. After adjusting for age, sex, socioeconomic factors, and variables associated with HF severity, all ethnic groups had lower mortality compared with White patients, including those who were Black (HR: 0.81; 95% CI: 0.78-0.84), Asian (HR: 0.77; 95% CI: 0.75-0.79), or from mixed/other ethnic groups (HR: 0.72; 95% CI: 0.69-0.75).
Conclusions:
In a universal health care system, treating an ethnically diverse population hospitalized for HF, non-White patients received better pharmacological management, which was associated with better long-term outcomes
A critical review of policy and research on the transition from early childhood education and care to compulsory primary education in England from 2000-2024
No full textNo abstract available
Simulated in-vivo implantable antenna measurements in gel phantoms and human subjects: channel gain, directivity, and RSSI
Full text linkConventional radio-frequency phantoms for implantable antenna testing fail to replicate the dynamic electromagnetic and biomechanical complexities of in vivo environments. These static phantoms, while reproducible, overlook critical factors, such as tissue heterogeneity, implantation depth variability, and motion-induced transmission fluctuations, leading to unreliable performance estimates for deeply implanted medical devices. To address this, we propose a hybrid experimental method combining a customizable tissue-mimicking gel phantom (fabricated using water, sugar, salt, and agar shaped in 3D-printed molds) with a living human subject. By employing a mobile setup with rotational freedom, we capture real-world channel gain and untethered received signal strength indicator (RSSI) variations, revealing a 20-dB disparity between line-of-sight (LOS) and non-LOS (NLOS) conditions, a critical metric undetectable with conventional bench-top phantoms. This approach bridges the gap between controlled lab testing and clinical realism for implantable antenna design, allowing surgery and animal-free implantation estimates
WIP: A Pedagogical Prompt Engineering Framework for LLM-Based Feedback in Higher Education (PPE-LLM)
No full textThis Work-in-Progress (WIP) paper introduces PPE-LLM, a structured framework for prompt engineering that enables LLM -generated feedback to be pedagogically meaningful and tailored to novice programming students in introductory pro-gramming education. Although large language models (LLMs) show promise for feedback generation, existing research lacks a structured methodology that integrates pedagogical principles, student needs, best-practice prompting, and technical consid-erations. PPE- LLM addresses this gap by providing a theory-driven framework that supports the systematic design of prompts to generate formative feedback, enhancing learning tailored to students' learning levels and needs. This paper presents the key components of the framework, along with a practical example prompt. It also analyses the alignment of recent CER studies with the PPE- LLM components. The results indicate that studies with limited alignment often produced inconsistent or lower-quality feedback, whereas more substantial alignment was found to be pedagogically effective in AI-generated feedback. Future work includes expert validation and student evaluation in real-world settings
Cyber resilience quantification: a probabilistic estimation model for IT infrastructure
Full text linkIn today’s digital landscape, ensuring IT infrastructure resilience against increasingly frequent and sophisticated cyber-attacks is a critical priority. Cyber resilience is the ability of a system or organisation to anticipate and recover from cyber-attacks. Effective cyber resilience quantification enables systematic analysis and comparison of IT infrastructures. Cyber resilience involves resisting and recovering from cyber-attacks. Cyber resilience refers to the ability of a system to absorb, recover from, and adapt to cyber-attacks. However, existing approaches often fail to integrate dynamic probabilistic assessment methods that capture resilience fluctuations over time. This study introduces the Probabilistic Estimation-based Quantification Model for Cyber Resilience (PEQCRM), a novel framework that enhances cyber resilience measurement and strategic decision-making. The proposed model incorporates Resilience Curves (RC) and the Area Under the Curve (AUC) methodology to quantify resilience over attack and recovery phases. Additionally, it expands traditional resilience assessment by integrating cyber resilience strategies as key influencing factors. The PEQCRM model is evaluated through extensive simulations to assess its effectiveness in real-world cybersecurity scenarios. Findings reveal that different resilience strategies exhibit varying adoption, absorption, and recovery effectiveness levels. This study evaluates the extent to which a strategy can mitigate initial attack impact and adoption for the extent to which organisations implement and sustain strategy levels of four different cyber resilience strategies. Specifically, the pre-configuration strategy demonstrates the highest level of preparedness and adoption, while the buffering-supported strategy has the lowest absorption level. The managing complexity strategy achieves the highest absorption level, whereas the mesh topology strategy exhibits strong recovery capabilities and adoption rates
Nanoscale surface morphology modifications for next-generation supercritical CO2 heat exchangers: review and perspective
Full text linkCarbon nanotube (CNT) pin fin arrays, CNT, or nanoparticle coating have emerged in recent decades as novel techniques for enhancing heat transfer and reducing drag. In this paper, the suitability of these techniques is reviewed specifically for heat transfer enhancement and drag reduction in the gas side of supercritical carbon dioxide (SCO2) counterflow tube-in-tube or plate type heat exchangers for applications in CO2 refrigeration systems. The methodology and the applicability of various approaches for predicting the heat transfer rates and the frictional pressure drop associated with flow over a nanocoated surface have been reviewed. Findings from both experimental and numerical studies highlight critical limitations, including a lack of fundamental knowledge about flow over superhydrophobic surfaces and the absence of experimental data for crucial parameters such as temperature jump at the wall, velocity and temperature shifts, and the Reynolds analogy factor for nanotube or nanoparticle coatings in turbulent flow regimes. These limitations significantly hamper the predictive capabilities of both single-scale and multi-scale models for frictional pressure drops and heat transfer coefficients. To enhance the accuracy of these models, it is essential to consider surface parameters such as arithmetic mean roughness (Ra), root-mean-square roughness (Rq), effective slope (Es), skewness (Sk), and kurtosis (ku)
Measuring the causal effect of urban environments on crime with street view images and points of interest
No full textMeasuring the complex influence of urban built environment on crime is a focal point in environmental criminology. Current studies have mainly focused on the correlations between urban built environment and crime. Using two new forms of urban big data, the street view images and points of interest, this research examines the causal relationship between urban built environment and crime with structural causal models. A case study is implemented for Manhattan, New York City. The empirical results suggest that street perception characteristics do not directly affect crime but rather impose an indirect influence through urban facilities. Furthermore, the impact of street perception characteristics on crime varies depending on the type of urban facilities involved. The findings of this research provide valuable insights into the role of urban built environment in shaping crime patterns, thus contributing to evidence-based strategies for crime prevention
Reflecting on China’s electroacoustic music: rethinking the Chinese-Western dualism and exploring ecological perspectives
No full textThe development of electroacoustic music in China over the past four decades has been shaped not only by the nation’s modernisation strategies but also by the interplay of historical contexts, temporal frameworks and cultural connotations. While certain achievements have been made in the current phase, the entrenched dualistic framework of ‘China versus the West’ and a lack of critical inquiry fundamentally constrain the potential for further advancement in China’s electroacoustic music. Positioning ‘Chineseness’ as a central strategy in electroacoustic music composition has proven effective in specific historical contexts. However, with the evolution of the times, this strategy requires re-examination and reassessment within contemporary contexts. This paper seeks to trace the developmental trajectory of electroacoustic music in China and analyse existing academic research to identify and unpack its deeper, underlying issues. By introducing a broader ecological perspective, the paper aims to transcend the rigid, dichotomous framework dominated by Chinese-Western dualism, deconstruct cultural essentialism and critically reassess the positioning of Chinese electroacoustic music within these constructs. Finally, it will explore the potential possibilities and responses of an ecological perspective in practice, based on a selection of compositional practices, including my own work Mixobloodify
Keep positive and defend democracy: framing democratic messages under authoritarianism
No full textBuilding popular support for democracy is especially necessary in countries ruled by authoritarian regimes. Can educational interventions promote democratic support in these countries and influence how citizens evaluate their country’s political regime? To answer these questions, we conducted two online experiments in Turkey comparing the effects of two pro-democratic educational interventions, a positive frame emphasizing gains from democratic institutions and a negative frame highlighting the losses under authoritarian regimes. Both treatment frames were successful at building democratic demand. However, only participants exposed to the pro-democracy messages with a positive frame took important additional cognitive steps, decreasing their evaluations of Turkey’s democratic supply and, therefore, becoming less likely to vote for the parties aligned with the autocratic regime. We offer a reference points theory to explain this divergence. Overall, our research makes significant contributions to the literature on democracy promotion and democratic support among ordinary citizens
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