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Intravenous fluid bolus resuscitation increases mortality risk in Malawian children with cerebral Malaria
No full textThe Fluid Expansion as Supportive Therapy (FEAST) clinical trial determined that African children with impaired perfusion receiving bolus intravenous (IV) fluids had increased mortality compared to children with impaired perfusion not receiving bolus IV fluids. Malaria was common in FEAST enrollees, but no stratified analysis for children with cerebral malaria (CM), a common cause of febrile coma in Africa, was reported. We investigated whether bolus fluid expansion changed mortality risk in children with CM. To evaluate this association, we performed a propensity score matched retrospective cohort study with data collected from 1,674 children with CM admitted to Queen Elizabeth Central Hospital in Blantyre, Malawi from 2000 to 2018. After matching of participants by covariate balancing propensity score weighting, children who received an IV fluid bolus had increased mortality risk (odds ratio [OR]: 1.92; 95% CI: 1.36-2.71) compared with those who did not. When stratified by admission systolic blood pressure (SBP), children with an SBP greater than 100 mm Hg receiving bolus fluids had increased mortality (OR: 3.15; 95% CI: 1.81-5.48) compared with those not receiving bolus fluids. In children with an SBP ≤100 mm Hg at admission, receiving bolus IV fluids did not change mortality (OR: 1.44; 95% CI: 0.91-2.26). Bolus IV fluids are an ineffective therapeutic intervention in children with CM and are harmful in those with normal or elevated admission SBPs. Our results confirm the lack of efficacy and potential harm of IV bolus fluid administration in Malawian children with CM
Assessing the representativeness of trials of sodium-glucose cotransporter-2 inhibitors in type 2 diabetes: a comparison of individual-level trial data and people newly prescribed treatment in a Welsh routine care database
Get PDFBackground: Randomised controlled trials are often criticised for excluding people with multiple long-term conditions. This study used individual participant data for 25 trials of sodium glucose co-transporter-2 inhibitors (SGLT2i) to compare baseline characteristics, comorbidities, and event rates between trial participants and community SGLT2itreated people in routine care.
Methods: Trials were identified through systematic review with subsequent application for individual-level data. Community SGLT2i-treated people in routine care were identified from the Secure Anonymised Information Linkage (SAIL) databank (Wales, UK). For each trial, we applied the eligibility criteria to the community SGLT2i-treated populations. We then (i) assessed the proportion eligible/ineligible for each trial, (ii) compared age, sex and number of comorbidities between trial participants and those eligible/ineligible in routine care, (iii) compared rates of serious adverse events in the trials to the expected rate in community SGLT2i-treated participants and (iv) compared the rate of major adverse cardiovascular events (MACE), all-cause mortality, non-cardiovascular mortality, and estimated glomerular filtration rate (eGFR) slope between trial and community participants.
Results: The number of comorbidities was consistently lower in trial populations compared to community SGLT2itreated who met trial eligibility criteria. Compared with other trial populations, in the large cardiovascular outcome trials (CANVAS, CANVAS-R, CREDENCE and EMPA-REG) levels of participant comorbidity were higher; comorbidity differences between trial and community were smaller; and serious adverse event rates were broadly similar to the expected rate based on the community. For the remaining trials, the serious adverse event rate was lower in the trials than the expected rate based on community SGLT2i-treated participants. In the cardiovascular outcome trials, rates of MACE, mortality and decline in eGFR slope were similar or higher in trial populations.
Conclusions: While people with comorbidity are under-represented in most trials compared to a Welsh routine care population, the large cardiovascular outcome trials are more representative of SGLT2i-treated patients and have similar rates of serious adverse events. Therefore, while our findings support calls for caution regarding trial representativeness, the criticism that trials are not representative does not apply equally to all trials. Our results broadly support the applicability of cardiovascular outcome trials to people currently treated with SGLT2i within routine clinical practice
Development and modelling study of an evidence-based manualised intervention: PErsonalised Treatment packages for Adults with Learning disabilities who display aggressive challenging behaviour in community settings (PETAL)
Get PDFBackground
Aggressive challenging behaviour is prevalent in adults with an intellectual disability and is associated with over-medication, physical ill-health and psychiatric hospitalisation. We urgently need interventions that can moderate this behaviour and improve quality of life in this population. We report on the development and modelling of a 7-module tailored manualised psychological intervention to support adults who display aggressive challenging behaviour in community settings (hence referred to as the PETAL therapy).
Method
The PETAL therapy was designed following an extensive review of existing management provisions and was co-produced with carers with lived experience and self-advocates with an intellectual disability. A logic model was developed to illustrate the theoretical approach behind the development of the PETAL intervention. A single arm multi-site modelling study was conducted in England to test the delivery and acceptability of the PETAL intervention. Seventeen NHS healthcare professionals were trained during a two-day training programme and were regularly supervised to deliver the therapy in up to 14 weeks. Following completion, we conducted qualitative interviews with stakeholders and explored the intervention’s fidelity and acceptability.
Results
We held seven co-production meetings and developed the PETAL therapy, consisting of the following modules: Getting to know the person, understanding aggressive challenging behaviour, communication, emotions, a calm environment, carer wellbeing and healthy habits. We then recruited ten dyads or triads (person with a learning disability and 1–2 carers) to participate in a modelling study to test delivery aspects and measure fidelity. Nineteen stakeholders were interviewed, and the findings were analysed deductively using Normalisation Process Theory and its four domains: coherence, cognitive participation, collective action and reflexive monitoring.
Conclusion
The PETAL therapy was possible to deliver in community services with high fidelity and was acceptable. The PETAL manual and training programme have been reviewed and refined and a cluster randomised controlled trial is underway
Measurement of ψ (2S) to J/ψ cross-section ratio as function of multiplicity in pPb collisions at √sNN = 8.16 TeV
Get PDFThe production ratio of ψ(2S) to J/ψ charmonium states is presented as a function of multiplicity in proton-lead collisions at a centre-of-mass energy of √sNN = 8.16 TeV, for both prompt and nonprompt sources. The total luminosity recorded by the LHCb experiment corresponds to 13.6 nb−1 for pPb collisions and 20.8 nb−1 for Pbp collisions, where the first particle corresponds to the particle traveling towards the detector. Measurements are performed in the dimuon final state at forward (backward) centre-of-mass rapidity, with respect to the proton direction, 1.5 < y*< 4.0 (−5.0 < y*< −2.5) for pPb (Pbp) collisions. A multiplicity dependence of the prompt production ratio is observed in pPb collisions, whereas no dependence is found in nonprompt production, nor in either prompt or nonprompt production in Pbp collisions. These results suggest that in the Pb-going direction additional suppression mechanisms beyond comover effects may be present, possibly related to the formation of quark-gluon plasma. This highlights a transition from small to large collision systems and provides important insight into the suppression of charmonia in proton-nucleus collisions
Advancing smart disaster response by leveraging social sensing and mobile technology
Get PDFThe integration of citizen science, volunteered geographic information (VGI), and Web/mobile geographic information systems (GIS) has demonstrated significant potential in enhancing disaster response efforts. However, delivering timely, comprehensive and trustworthy information remains a major challenge, particularly when relying on passive data collection from social media. While researchers have developed specialized platforms for natural hazards and advanced models for data analysis, few studies present a holistic lifecycle from stakeholder-oriented design through development, especially with attention to the design phase. To address this gap, this paper introduces an agile and iterative user-centered framework for designing and developing a participatory mobile GIS application for collecting reliable, first-hand observations. A pilot study conducted during real-world hurricane events demonstrated the application’s ability to operate both in real time and offline, enabling the collection of precise geotagged data, categorized labels, and diverse media formats. The results highlight the potential of this active, stakeholder-centered approach to support intelligent disaster response strategies and complement passive and authoritative data sources. This paper advances the integration of citizen science and mobile GIS by providing a framework that follows user-centered design principles to inform future disaster response applications
Ask students to create assessments for industry insight
No full textUsing the same case studies in your class repeatedly can get boring after a while. Students will probably miss out on a lot of the cutting-edge developments in the industry. How can educators refresh their materials to keep students in line with breakthrough knowledge?
Our team decided to trial a student-as-partners initiative in an engineering undergraduate programme, as part of our institution’s partnership with the University of Glasgow.
• Try a ‘not by the book’ teaching approach for student-centred, industry-focused learning
• Authentic assessment for inclusivity and employability
• How industry partnerships and digital credentials can close the skills gap
Three senior students were invited to craft authentic assessments for junior students to work on in class. These seniors had just completed an eight-month integrated work-study programme in separate engineering companies and returned to finish their final year. Using their experience in the workplace and understanding of earlier modules taken, the senior students blended academic and industrial currency to collaborate with faculty to create authentic assessments. The aim was for them to be instructive, realistic and achievable for the junior students, and to open their minds to industry practices
A plurality of (metaphorical) languages: Neue Sachlichkeit under the prism of multilingualism
No full textThis chapter proposes a novel approach to Neue Sachlichkeit by reframing its frequently noted stylistic pluralism through the lens of literal, not just metaphorical, multilingualism. Drawing on theories from multilingualism and creativity studies, the author explores how the multilingual environments of interwar Europe—and especially Weimar Berlin—shaped the practices, identities, and aesthetics of composers linked to the Neue Sachlichkeit. By analysing contexts such as international music networks, composition classes, and works like Krenek’s Jonny spielt auf, the study highlights how multilingualism informed both musical content and broader cultural ideologies. The chapter ultimately argues for multilingualism as a critical and underexplored category for future research on the Neue Sachlichkeit, emphasizing its potential to enhance our understanding of the movement’s engagement with modernity, urbanization, and transnationalism
Navigating teacher agency, empathy, and disability discourses in schools: a reflexive thematic analysis of autistic teachers’ perceptions of work experiences in the United States
No full textBackground:
Research on autistic employment has often focused on quantitative indicators such as employment rates and type of employment. Currently, there is only minimal research on autistic teachers’ experiences, and most of this work was conducted in the United Kingdom. We sought to understand the perspectives of autistic teachers in the United States on their employment experiences.
Methods:
We conducted interviews with eight employed, licensed-diagnosed or self-identified autistic teachers working in U.S. schools. We asked teachers about their work experiences, including whether they were satisfied with their employment, barriers they faced, and strengths they brought as autistic teachers. Interview transcripts were analyzed using reflexive thematic analysis.
Results:
Our analysis generated four themes. First, we found that participants perceived a general disrespect toward the teaching profession; such attitudes may have specific negative impacts on autistic teachers and their ability to enact teacher agency. Second, participants expressed that their unique contributions to supporting neurodivergent and other students were often circumvented by neuro-normative expectations, which manifested in a lack of empathy from non-autistic colleagues and school leaders. Third, our participants reported that non-autistic colleagues participated in disability discourses that reflected ableist assumptions and a lack of knowledge about autism, which led to fears about disclosing their autistic identities. Fourth, some participants reported positive changes in their work experiences, when other school professionals and leaders were willing to be supportive.
Conclusion:
The perspectives of our autistic teacher participants reflect hope for cultural changes that would allow for them to thrive in the teacher workforce. However, there is much work to do to enact these changes; non-autistic teachers and school leaders need to be aware that they have autistic colleagues and make specific efforts to accommodate their needs and resist ableist assumptions about autistic teachers’ potential contributions to the profession
The Role of Lived Experience in the Scottish Parliament
Get PDFThis briefing presents the findings of research undertaken as part of
an Academic Fellowship based with Scottish Parliament Information Centre (SPICe) between January and July 2025. In this research, Dr Clementine Hill O'Connor (University of Glasgow) explored how lived experience has
been integrated into the scrutiny work of the Scottish Parliament. A
separate case study volume has been published to give context to this overarching research briefing
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