47011 research outputs found
Sort by
Hybrid closed-loop systems in UK type 1 diabetes care: National survey of healthcare professional awareness, confidence, and training needs
Get PDFAims: Hybrid closed-loop (HCL) systems significantly improve glycaemia and have become the standard of care for type 1 diabetes (T1D), leading to the recent widescale implementation programme in England and Wales. Limited data exist regarding UK healthcare professionals' (HCPs) confidence and experience with commercially available HCL systems. This survey aimed to evaluate UK HCPs' awareness, confidence, and training needs concerning commercial HCL systems. Materials and Methods: A national survey, developed in collaboration with the Association of British Clinical Diabetologists' Diabetes Technology Network (ABCD-DTN-UK), was distributed to adult and paediatric diabetes care teams. Data were collected between July and November 2024 and analysed descriptively, stratified by professional roles and care settings. Results: Responses from 637 HCPs (42.4% diabetes specialist nurses, 24.5% endocrinologists, 16.6% dieticians, 12.7% endocrinology residents) across 135 healthcare organisations in the UK revealed high overall awareness regarding HCL initiation and safety. Awareness varied significantly by role, with endocrinologists and diabetes nurse specialists reporting greater familiarity than endocrinology residents (p < 0.001). Confidence in system-specific use varied, with notably lower confidence in pregnancy-specific CamAPSFx-based systems. 41% of respondents involved in pregnancy care reported no confidence in advising on these systems, with 7% reporting no access to any CamAPSFx-based system. A majority (73.3%) expressed interest in additional training, favouring remotely accessible modules (52.3%). Conclusions: This survey highlights encouraging overall confidence and awareness of commercial HCL systems among UK HCPs, reflecting successful recent educational initiatives. However, significant gaps, particularly concerning pregnancy-licensed systems and variable exposure to specific HCL systems, identify clear training needs. Addressing these will be crucial in ensuring equitable and effective HCL implementation of systems licensed for use across the lifespan of an individual with T1D and across diverse clinical settings
Integration of sustainability assessment into early-stage carbon capture process design with an Explainable AI framework
Get PDFThis study introduces a novel framework for reducing environmental impacts by optimising operating conditions using a surrogate modelling approach integrated with Explainable AI (XAI). Two surrogate models were developed: a sequential surrogate model (SSM) with a two-step structure, and a direct surrogate model (DSM) with a single-step architecture. Both were trained on data from a validated physics-based simulation of a monoethanolamine (MEA)-based carbon capture process to predict environmental impacts across human health, ecosystem quality, and resource depletion. SHapley Additive exPlanations (SHAP) were used to enhance transparency by identifying key input variables influencing outcomes. Multi-objective optimisation was conducted using Particle Swarm Optimisation (PSO) and NSGA-II to determine optimal operating conditions. DSM achieved high prediction accuracy (R² up to 0.995) and lower errors, while SSM offered better interpretability and broader exploration of Pareto-optimal solutions. This study also shows that our framework identified optimum parameters that reduced environmental impacts by 76–88 % compared with the experiment optimum. This framework supports sustainable process design by combining interpretability, predictive performance, and computational efficiency
Factors Associated With Non-Vasomotor Menopause Symptoms Experienced by 7285 Women: A UK-Wide National Survey
Get PDFObjectiveTo investigate the factors associated with non-vasomotor menopause symptoms among women in the UK, focusing on the perceived importance of specific symptoms and their association with demographic and treatment-related factors.DesignA cross-sectional online survey.SettingUK-wide national survey conducted from February to March 2023.Population or SampleA total of 7285 women completed the survey.MethodsParticipants provided anonymised demographic data and rated the importance of five menopause symptoms (‘low mood’, ‘brain fog’, ‘aches and pains’, ‘feeling tired’, and ‘weight gain’) using a 10-point Likert scale. The full questionnaire is provided in Supporting Information. Univariable and multivariable linear regression analyses were performed to assess the association between symptom importance scores and specific characteristics, including age, HRT and non-HRT treatment, ethnicity, and geographical location.Main Outcome MeasuresImportance scores of menopause symptoms stratified by demographic and treatment factors.ResultsSignificant differences were identified in perceived symptom importance across age groups, geographic locations, ethnic backgrounds, and treatment status. Brain fog was the most frequently prioritised symptom overall. Several moderate-strength associations were observed: for example, HRT use was associated with higher importance ratings for brain fog, tiredness, low mood, and aches and pains. Ethnic minority women (Asian and Black) also gave higher importance ratings to brain fog.ConclusionsThe findings highlight the prominence of cognitive and psychological symptoms during menopause and the influence of demographic and treatment variables on symptom prioritisation. These results support the need for personalised and inclusive menopause care that addresses a wider range of symptom concerns beyond vasomotor issues. These findings have implications for public health policy and financial investment
Enhancing cross-cultural applicability in recovery colleges: A global Delphi study protocol
Get PDFBackgroundRecovery Colleges (RCs) offer an innovative model of mental health support that blends co-production with adult learning to promote personal recovery and social inclusion. While evidence supports their effectiveness, most RC research and practice have been developed in Western contexts, raising concerns about cross-cultural applicability. The RECOLLECT Change Model (RCM) and RECOLLECT Fidelity Measure (RFM) were developed in England to characterise RC mechanisms and assess fidelity. Our previous studies have identified cultural influences on the RC operational model, however how to address these influences remains unknown. Given the increasing global interest in RCs, the aims of this study are to (a) identify the level of cultural influence on the RCM mechanisms and RFM items, and (b) provide recommendations to inform cross-cultural applicability of RCM and RFM.MethodsThis global Delphi study follows Belton’s six-step methodology and uses a decentring approach to cross-cultural research that seeks to extend the relevance of tools developed in a single culture to multiple cultural contexts. Experts will be recruited via the RECOLLECT International Research Consortium, covering 31 countries across six continents. We aim to recruit approximately 100 panellists with at least three years’ RC experience. Data collection will occur via Microsoft Forms across iterative Delphi rounds. Panellists will rate the importance and cultural difficulty of RCM and RFM items, provide feedback on culturally aligned response types, and suggest revisions for improved cultural fit. Quantitative data will be analysed using non-parametric statistics and a collapsed three-point Likert scale to address cross-cultural response bias. Qualitative responses will be analysed using descriptive content analysis informed by Hofstede’s cultural dimension theory. Member checking will be conducted after the final round to enhance trustworthiness.DiscussionThis study will identify which RCM and RFM components are cross-culturally applicable and which require adjustment, contributing to the balance between fidelity and fit in mental health approaches. By developing culturally informed recommendations, this study aims to expand the accessibility and relevance of RC frameworks across diverse settings. Findings will benefit RC practitioners, researchers, and policymakers seeking to improve service delivery and recovery outcomes in culturally meaningful ways.
A Youth-Centered Digital Infographic on Vaping Risks (What’s in a Vape?): Mixed Methods Study
Get PDFBackground: As youth engagement with traditional public health warnings declines, innovative strategies are needed. Visually compelling, youth-driven digital content such as interactive infographics may help bridge knowledge gaps, enhance risk perception, and support more informed decision-making. Despite this potential, limited research has assessed its effectiveness in conveying vaping-related harms to youth. Objective: To address this gap, this study evaluated the impact of a codeveloped, youth-informed digital infographic (What’s in a Vape?) on enhancing vaping education and improving youth understanding of vaping-related harms. Methods: A convergent parallel mixed methods design was used to assess the impact of a youth-informed digital infographic. The infographic was created in collaboration with youth coresearchers and youth advisory councils to ensure relevance. Participants were recruited through community partners, school boards, and youth networks. By May 2024, we had enrolled 63 high school students aged 14 to 19 years (mean age 16.5, SD 1.2 years) primarily from Ontario and British Columbia. The survey evaluated baseline knowledge of vaping, engagement with the infographic, and postexposure perceptions on whether the content contributed to increased awareness or understanding of vaping. Results: Data collection took place between April 2024 and May 2024. Quantitative analysis showed that 87% (55/63) of participants agreed that the infographic effectively communicated key information, and 86% (54/63) gained new knowledge about vaping. In addition, 73% (46/63) found that the infographic was presented in an easy and meaningful way, whereas 52% (33/63) indicated that they would definitely share it with others, reflecting strong engagement. However, over half (33/63, 52%) also found the amount of information excessive, and 17% (11/63) found it difficult to digest, indicating variation in youth information preferences. Thematic analysis of qualitative feedback revealed four key themes: (1) the visual content enabled gaining new insights into and knowledge of vaping, (2) the visual design had a positive impact on engagement with information, (3) sourced information enhanced the credibility of the infographic information, and (4) the digital design of the infographic made complex information more understandable. Qualitative insights contextualized and supported the quantitative findings, highlighting both benefits and areas for improvement. Conclusions: This study demonstrates that youth-driven digital infographics may serve as useful health communication tools. Findings highlight the importance of peer-led design; evidence-based content; and interactive, visually compelling formats in enhancing youth comprehension and receptiveness to health messaging. By integrating youth feedback into development and prioritizing digital engagement, the infographic bridged knowledge gaps while reinforcing the credibility of its content. Variability in feedback about content overload suggests that future versions should consider more layered or modular designs. Results suggest that such approaches may complement broader public health strategies to curb youth vaping and inform future educational interventions. Continued research is warranted to assess long-term impacts on attitudes and behavior
Bounds on Fluctuations of First Passage Times for Counting Observables in Classical and Quantum Markov Processes
Get PDFWe study the statistics of first passage times (FPTs) of trajectory observables in both classical and quantum Markov processes. We consider specifically the FPTs of counting observables, that is, the times to reach a certain threshold of a trajectory quantity which takes values in the positive integers and is non-decreasing in time. For classical continuous-time Markov chains we rigorously prove: (i) a large deviation principle (LDP) for FPTs, whose corollary is a strong law of large numbers; (ii) a concentration inequality for the FPT of the dynamical activity, which provides an upper bound to the probability of its fluctuations to all orders; and (iii) an upper bound to the probability of the tails for the FPT of an arbitrary counting observable. For quantum Markov processes we rigorously prove: (iv) the quantum version of the LDP, and subsequent strong law of large numbers, for the FPTs of generic counts of quantum jumps; (v) a concentration bound for the the FPT of total number of quantum jumps, which provides an upper bound to the probability of its fluctuations to all orders, together with a similar bound for the sub-class of quantum reset processes which requires less strict irreducibility conditions; and (vi) a tail bound for the FPT of arbitrary counts. Our results allow to extend to FPTs the so-called “inverse thermodynamic uncertainty relations” that upper bound the size of fluctuations in time-integrated quantities. We illustrate our results with simple examples
Decent Work in a Changing Climate
Get PDFClimate change is placing increased pressures on workers, including their health, working conditions, and economic outcomes. Whilst efforts by international governance mechanisms and governments espouse the need to achieve decent work, in reality, the threats facing workers are shifting. In this article, we begin to assess how decent work is undermined by climate change. We explore what barriers make decent work increasingly out of reach for some workers in the context of a changing climate. Using examples from the literature, we review different sectors, geographies, and climate impacts, such as extreme heat, flooding, and wildfires, to assess the varied risks to workers. We outline some of the extant approaches in policy and labour rights spaces to identify integrated solutions for decent work in a changing climate. Finally, we conclude that a future shift in discourse is needed to ensure decent work becomes the minimum standard when addressing labour rights and climate change concerns, including centring expertise from worker-led initiatives
Towards the use of satellite remote sensing to validate reservoir storage in global hydrological models: methodology and pilot study in the CONUS
Get PDFAlthough river discharge simulations from global hydrological models (GHMs) have undergone extensive validation, there has been less validation of reservoir operations, primarily because of limited observational data. Recent advancements in satellite remote sensing technology have facilitated the collection of valuable data regarding water surface area and elevation, thereby providing the ability to validate reservoir storage. In this study, we sought to propose a methodology for validation and intercomparison of monthly reservoir storage within GHMs simulations using two satellite-derived reservoir monitoring products, the Database for Hydrological Time Series of Inland Waters (DAHITI) and the Global Reservoir Surface Area Dataset (GRSAD). A pilot study was conducted for seven reservoirs in the contiguous United States (CONUS), with access to long-term ground truth data (the total catchment area accounts for around 9% of CONUS). We assessed two GHMs that participated in the inter sectoral model intercomparison project Phase 3a, H08 and WaterGAP2, with three distinct forcing datasets: GSWP3-W5E5 (GW), CR20v3-W5E5 (CW), and CR20v3-ERA5 (CE). The pilot study results indicate that for the seven reservoirs, WaterGAP2 generally outperforms H08. The CW forcing dataset demonstrated superior results compared with GW and CE, and DAHITI showed better consistency with ground observations than GRSAD if temporal coverage was sufficient. Overall, our study emphasizes the potential uses of satellite remote sensing data in reservoir storage validation and underscores the importance of normalization and decomposition techniques for improved validation efficacy
Impact of inactivated vaccine on transmission and evolution of H9N2 avian influenza virus in chickens
Get PDFH9N2 avian influenza virus (AIV) is endemic in poultry worldwide and increasingly zoonotic. Despite the long-term widespread use of inactivated vaccines, H9N2 AIVs remain dominant in chicken flocks. We demonstrated that inactivated vaccines did not prevent the replication of H9N2 AIVs in the upper airway of vaccinated chickens. Viral transmission was enhanced during sequential passage in vaccinated chickens, which was attributed to the restricted production of defective interfering particles and the introduction of stable mutations (NP-N417D, M1-V219I, and NS1-R140W) which enhanced viral replication. Notably, the genetic diversity of H9N2 AIVs was greater and included more potential mammal/human-adapted mutations after passage through vaccinated chickens than through naïve chickens, which might facilitate the emergence of mammal-adapted strains. By contrast, vaccines inducing cellular/mucosal immunity in the upper respiratory tract effectively limit H9N2 AIV. These findings highlight the limitations of inactivated vaccines and the need for revised vaccination strategies to control H9N2 AIV
Interactive Knowledge-Based Kernel PCA for Solvent Selection
Get PDFSelecting more sustainable solvents is a crucial component to mitigating the environmental impacts of chemical processes. Numerous tools have been developed to address this problem within the pharmaceutical industry, employing data-driven approaches such as multidimensional scaling or principal component analysis (PCA). Interactive knowledge-based kernel PCA is a variant of PCA that allows users to shape 2D solvent maps by defining the positions of data points, imparting expert knowledge that was not included in the original descriptor set. We have applied interactive PCA to the task of solvent selection and present an intuitive interface that is integrated into AI4Green, an electronic laboratory notebook that encourages sustainable chemistry. A set of evidence-based user guidelines were developed and used in combination with the interactive PCA to identify four potential solvent substitutions for an example thioesterification reaction
Access Repository Dashboard
Do you manage Open Research Online? Become a CORE Member to access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard! 👇