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SPIRIT-Children and Adolescents (SPIRIT-C) 2026 extension statement: enhancing the reporting and usefulness of paediatric randomised trial protocols
Get PDFRandomised controlled trial (RCT) protocols contain essential details needed to understand and evaluate the trial's planned aims, design, data collection methods, monitoring, data analysis, and participants' safety. However, key information is often omitted from paediatric RCT protocols, including details on dose adjustments of interventions based on age, body surface area, or weight; developmental appropriateness of trial outcome measures and processes; or strategies to minimise participants' anxiety and pain. These deficiencies impair the planning and implementation of potentially impactful trials for children and adolescents. Appropriate guidance is needed to support harmonised, comprehensive reporting of paediatric RCT protocols involving participants aged 0–19 years. The methodological framework for developing reporting guidelines published by the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network was implemented to develop a paediatric extension to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2025 guidelines, called SPIRIT-Children and Adolescents (SPIRIT-C) 2026. A list of candidate reporting items was generated from the literature, and a Youth Advisory Group and a Family Caregiver Advisory Group contributed essential input throughout the project. An international Delphi study with a priori consensus thresholds, a consensus meeting, group writing of the explanation and elaboration paper, and pilot testing of the draft guideline were conducted. SPIRIT-C 2026 consists of a checklist with 17 new reporting items for reporting paediatric RCT protocols; four items are youth generated and six youth endorsed. SPIRIT-C 2026 can be considered a minimum set of reporting items pertinent to paediatric RCT protocols that are relevant to various interest holders, including young people, family caregivers, researchers, paediatric trialists, ethics committees, regulators, funders, and journal editors. The accompanying explanation and elaboration paper explains all items and offers examples of good reporting. Widespread implementation and uptake of SPIRIT-C 2026 should enhance the quality and usefulness of protocols for RCTs that involve participants from birth through adolescence, and ultimately foster high-quality paediatric trials
Prevalencia de alergia a antibióticos, y asociación con asma y enfermedades alérgicas en niños de La Habana
Get PDFIntroducción: La epidemiología de la alergia a los antibióticos en poblaciones ambulatorias es relativamente escasa.Objetivo: Identificar la prevalencia de alergia a antibióticos, y su relación con asma y enfermedades alérgicas en niños preescolares de La Habana.Métodos: Estudio transversal en 1106 niños de cinco a seis años residentes en La Habana, a partir de la base de datos del estudio “Historia natural de las sibilancias en una cohorte de lactantes cubanos”. Se aplicó el cuestionario International Study of Asthma and Allergies. Se recogieron datos sobre factores sociodemográficos, y antecedentes familiares y personales de alergia. La prueba de hipótesis de asociación basada en la distribución X 2 se utilizó para las tablas. Se obtuvieron las razones de prevalencia brutas y sus intervalos de confianza del 95 % para cada variable de exposición. Se consideró significación estadística cuando el valor asociado con la prueba fue p < 0,05.Resultados: El 7 % tuvo diagnóstico médico de alergia a algún antibiótico en los últimos 12 meses, con la penicilina como la más frecuente (89,6 %) con respecto al cotrimoxazol, ciprofloxacino, eritromicina, doxiciclina y tetraciclina. En el 2,6 % de casos la alergia fue por la combinación de dos antibióticos. Hubo una discreta mayor prevalencia de alergia a antibióticos en pacientes con historia personal de eccema y asma. No se encontraron diferencias según sexo, uso frecuente de antibióticos, reacción adversa a los alimentos, alergia a insectos ni rinitis alérgica.Conclusiones: La alergia a los antibióticos en prescolares es reportada por primera vez en La Habana. La alergia a antibióticos se asoció con antecedentes personales de asma y eccema.Introduction: The epidemiology of antibiotic allergy in outpatient populations is relatively scarce.Objective: To identify the prevalence of antibiotic allergy and its relationship with asthma and allergic diseases in preschool children in Havana.Methods: A cross-sectional study was conducted on 1106 children aged five to six years residing in Havana, using data from the “Natural History of Wheezing in a Cohort of Cuban Infants” study database. The International Study of Asthma and Allergies questionnaire was administered. Data were collected on sociodemographic factors and family and personal history of allergies. The hypothesis test of association based on the χ² distribution was used for the tables. Crude prevalence ratios and their 95% confidence intervals were obtained for each exposure variable. Statistical significance was considered when the p-value associated with the test was < 0.05.Results: Seven percent had a medical diagnosis of allergy to an antibiotic in the last 12 months, with penicillin being the most frequent (89.6%) compared to co-trimoxazole, ciprofloxacin, erythromycin, doxycycline, and tetracycline. In 2.6% of cases, the allergy was due to a combination of two antibiotics. There was a slightly higher prevalence of antibiotic allergy in patients with personal history of eczema and asthma. No differences were found according to sex, frequent antibiotic use, adverse food reactions, insect allergy, or allergic rhinitis.Conclusions: Antibiotic allergy in preschool children is reported for the first time in Havana. Antibiotic allergy was associated with a personal history of asthma and eczema
Benchmarking Permeability Predictions for an Engineered Reference Medium: Toward Calibration of Permeability Rigs
Get PDFAccurate permeability prediction in fibrous media is essential for modeling liquid composite manufacturing processes, yet numerical predictions are often inconsistent owing to modeling assumptions and numerical implementation choices. This work introduces a 3D-printable anisotropic reference porous medium designed to reproduce the main flow pathways and anisotropy trends observed in textile reinforcements, while avoiding the inherent variability of real fabrics. The idealized geometry provides a well-controlled, reproducible benchmark for permeability prediction, acknowledging that it does not capture fine-scale features such as intra-tow pores or fiber surface curvature, and may have higher absolute permeability values than real textiles. Fourteen research groups independently simulated fully saturated, incompressible, laminar, and steady-state flow through a given CAD-based medium using their own numerical setups. While simple analytical flows (e.g., laminar flow in a pipe or slit) can validate individual codes, they are insufficient to capture the complexity and anisotropy of textile-like porous media. Benchmarking is therefore necessary to reveal real-world variability in permeability predictions. Results show good consistency for in-plane permeability (Kxx: mean 2.75 × 10−9 m2, CoV = 0.105; Kzz: mean 6.8 × 10−10 m2, CoV = 0.205), while out-of-plane permeability (Kyy) shows much higher variability (unit-cell mean 1.40 × 10−10 m2, CoV = 0.790; periodic-assembly mean 1.27 × 10−10 m2, CoV = 0.470). These findings (i) demonstrate the feasibility of using idealized additive-manufactured porous media as reproducible calibration benchmarks and (ii) highlight the value of cross-validation across multiple numerical platforms to bolster confidence in permeability prediction for composite manufacturing
Evaluation of the Falls Management Exercise (FaME) programme implemented across three United Kingdom regions: a prospective cohort study
Get PDFAimsThe Falls Management Exercise (FaME) programme, delivered over 24 weeks, reduces falls in randomised controlled trials and ‘real world’ delivery, but some services deliver shorter, adapted FaME programmes. We investigated the ‘real-world’ effectiveness of FaME delivered for 12 or 24 weeks across three UK regions.MethodsDesign: prospective cohort study.Participants: 1,601 FaME programme attendees (median age 79.5 years), of whom 873 had follow-up data recorded.Setting: 14 provider organisations in Greater Manchester, Devon and the East Midlands.Procedure: Participant data were collected by FaME providers at baseline and up to 24 weeks later.Outcomes: Timed up-and-go (TUG); Short Falls Efficacy Scale-International (Short FES-I); at least one self-reported fall, and number of self-reported falls, in the past 3 months.Analysis: Univariate before-and-after tests; multivariable multilevel logistic, linear, Poisson, negative binomial regression.ResultsAt final follow-up (≤24 weeks), compared to baseline, the odds of a self-reported fall within 3 months (Odds ratio 0.16 [95% confidence interval [CI] 0.10 to 0.25], p <.001) and TUG time had decreased (difference-between-paired-medians -1.0 (95% CI -1.50 to -1.0), p <.001). Short FES-I scores had not significantly changed. Twenty-four- rather than 12-week programmes were associated with faster TUG times (mean difference -3.31 seconds [95% CI -5.97 to -0.65]) and reduced concerns about falling (mean Short FES-I difference -2.00 [95% CI -3.65 to -0.34], p = 0.018), but no significant difference in the odds of a self-reported fall or number of falls within 3 months.ConclusionsFaME programmes of both 12 and 24-weeks were associated with improved functional mobility and reduced falls. Participants who attended 24-, rather than 12-week, programmes had significantly greater improvements in functional mobility and reduced concerns about falling. Due to follow-up data missingness, the study was not adequately powered to detect differences in falls risk or rate between 12 and 24-week programmes
No evidence that same‐language subtitles improve children's reading fluency
Get PDFHigh-profile campaigns globally have argued that same-language television subtitles may help children improve their reading. In this intervention study, we tested the causal hypothesis that exposure to subtitles improves children's reading fluency. We tested 127 British children in Years 2 and 3 before and after a 6-week home-based intervention, in which children were randomly assigned to an experimental group that watched television with English subtitles or a control group that watched television without subtitles. Children's reading fluency was assessed via two standard tests of reading fluency and their engagement with subtitles while watching videos, measured with eye-tracking. Results showed that both groups improved their reading fluency over 6 weeks. Crucially, there was no evidence that subtitle exposure (of around 66 hr on average) drove an improvement in reading fluency, or that greater subtitle exposure provided any additional benefit. We conclude that same-language subtitles are unlikely to improve children's reading fluency. However, the primary school reading curriculum has a positive impact on reading fluency that can be observed over a relatively short time-scale
Dominant contribution of fossil fuel combustion to carbonaceous aerosol pollution in Delhi: Insights from radiocarbon and organic tracers
Get PDFDelhi experiences some of the highest levels of fine particulate matter (PM 2.5) pollution among megacities worldwide. Here, we integrated radiocarbon (14 C) analysis with organic molecular tracers to quantify the sources of carbonaceous aerosols in Delhi. Through time-resolved seasonal and diurnal PM 2.5 sampling at two representative urban sites and using 14 C as an unambiguous tracer, we provide robust quantitative constraints on source contributions. We found that fossil fuel combustion is the dominant contributor, accounting for 62-65 % of organic carbon and 64-66 % of elemental carbon in PM 2.5. Crucially, primary organic carbon from fossil fuels (POC FF) constituted the largest fraction of PM 2.5 organic carbon (31-44 %). Its contribution peaked in the post-monsoon season, driven mainly by traffic emissions and coal combustion. Secondary organic carbon from fossil sources (SOC FF), biomass burning (OC BB), and cooking emissions (OC CK) contributed 21-29 %, 10-18 % and 3-7 % of PM 2.5 organic carbon, respectively. Furthermore, comparisons with Positive Matrix Factorization (PMF) results suggest that conventional methods may overestimate the biomass burning contribution, underscoring the value of the 14 C-based approach for accurate apportionment in this complex environment. This study underscores the critical need to reduce fossil fuel reliance and accelerate the shift toward clean energy infrastructure to effectively combat carbonaceous aerosol pollution in Delhi
Langer's nucleation rate reproduced on the lattice
No full textWe show that Langer’s rate of bubble nucleation is quantitatively correct up to small higher-loop corrections, in comparison to lattice simulations. These results are a significant advancement on decades of lattice studies showing only qualitative trends, and the first showing agreement for any conservative field theory. We confirm that the failure to fully thermalize the metastable phase explains discrepancies with recent lattice studies that found disagreement with Langer’s rate. The key theoretical development is the translation of Langer’s perturbative definition of a thermal metastable phase into a nonperturbative statement that can be implemented on the lattice. Our statistical and systematic errors are small enough to allow us to measure on the lattice the coefficient of the two-loop contribution, missing from the perturbative prediction. Our conclusions also exclude a possible systematic uncertainty in 3He experiments
Private Sector Engagement in Global health: WHO and WHO-Foundation
Get PDFThe World Health Organisation Foundation (WHO-F) is an independent Swiss charitable Foundation established in May 2020 to pursue funding for WHO from the private sector and high net worth individuals. Created at the height of the pandemic, WHO-F is part of a long awaited attempt at reforming funding of WHO and global health more broadly. With WHO having suffered funding crises almost since its inception, innovative action is needed. This paper examines the role of WHO-F and its relationship with WHO. In situating this within a broader discussion of the problematic identity of international organisations, the paper argues that this financial crisis is inevitable and that diversification of financial sources is necessary. However, the complexity of WHO-F as separate to, but fundamentally entangled with, WHO precipitates difficulties of accountability of action
Virtual Small Signal-Based Online Identification of PMSM Drive System for Model Predictive Control
No full textThis article presents a virtual small signal-based online parameter identification method for permanent magnet synchronous machine (PMSM) drive systems under model predictive control (MPC). By extracting inherent high-frequency features from the MPC-sampled data via convolution operations, the proposed method enables accurate parameter estimation without the need for external signal injection, thus avoiding additional torque ripple and power losses. The method decouples the parameter estimation problem into several single-input single-output (SISO) observers, substantially reducing computational complexity and improving real-time compatibility. Compared with conventional time-domain identification approaches, the proposed method achieves full-order parameter estimation with a magnetic parameter identification error of less than 5% across the entire operating range. It requires only 13.7 floating-point operations (FLOPs) per parameter and introduces a minimal 14% overhead in execution time, making it highly suitable for embedded controller implementation. Experimental validation confirms improved accuracy and fast convergence under dynamic conditions, demonstrating the method’s effectiveness for real-time MPC-based drive control applications
Collected Writings of Charles Brockden Brown, Volume 2: The Monthly Magazine, and Other Writings, 1789-1800
No full textThe second volume in the Collected Writings of Charles Brockden Brown assembles for the first time his major periodical writings from the period when he was also producing his famous novels.All the pieces he contributed to The Columbian Magazine and The Weekly Magazine are joined by an expansive collection of stories and essays from The Monthly Magazine, which he also edited between 1799 and 1800. Texts offering major insights into Brown's ideas about the human imagination, American society, and the art of fiction such as “The Rhapsodist,” “The Man at Home,” and “The Difference Between History and Romance,” are complemented by dozens of other works, many never before attributed to him, covering topics ranging from the theatre and classical literature to racial identity and geographical knowledge. Each edited text provides detailed information concerning publication history and provenance, along with extensive scholarly annotation. The editors of the volume include two additional essays: "A Historical Essay," offering detailed contextualization of the post-Revolutionary cultural milieu from which Brown's magazine writing emerged, and "A Textual Essay," offering new bibliographical information about the texts and explains editorial protocols for the volume
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