47011 research outputs found
Sort by
Impact of the United Kingdom's smokefree generation policy on tobacco-related equity in England: a simulation study
Get PDFBackground Modelling studies find the smokefree generation (SFG) policy could help achieve the tobacco endgame. The UK is on course to introduce an SFG in 2027 that prohibits tobacco sales to individuals born in or after 2009.Methods We adapted an individual-level microsimulation model with a synthetic representative English population, and used previously validated smoking initiation, quit and relapse probabilities by age and deprivation quintile. We simulated four scenarios from 2023 to 2075: no intervention, pessimistic SFG, central SFG and optimistic SFG. Proportionate universalism sensitivity analyses assumed effective targeting led to greater effects in more deprived areas and smaller effects in less deprived areas. Equity was assessed using slope and relative indices of inequality.Results The central SFG scenario forecast smoking prevalence to be reduced to <5% in 12–30 year-olds by 2049, but not until 2055 for males and not until 2059 for those living in the most deprived quintile. Absolute socioeconomic inequalities were reduced but not relative inequalities. Under proportionate universalism, <5% prevalence is achieved a year earlier (2048) and both absolute and relative inequalities by index of multiple deprivation quintile are substantially reduced by 2050. By 2075, 87 899 (85 293–90 791) discounted quality-adjusted life years were gained in the central scenario compared with baseline.Conclusions The SFG policy has potential to reduce absolute inequalities among its target population and achieve significant gains in quality and length of life. Achieving reductions in relative inequalities will likely require targeted interventions that lead to greater effectiveness in lower socioeconomic areas and for males
Joint control of icing and flow separation using co-flow jet
Get PDFDuring climbing and descending, an aircraft operates at high angles of attack, where the boundary layer is prone to separation, resulting in increased drag and reduced lift. Additionally, these scenarios involve a high risk of ice accretion. These challenges highlight the need for an integrated control strategy capable of simultaneously addressing aerodynamic performance degradation and anti-icing requirements, both of which depend on modulating surface flow conditions. In this work, a Co-Flow Jet (CFJ) technique is proposed as a novel strategy for concurrently suppressing flow separation and mitigating ice accretion. Simulations demonstrate that the CFJ effectively introduces suction forces near the upper trailing edge, eliminating separation in this region. Meanwhile, the two-slot leading-edge blowing produces turbulent jets, generating a bubble and virtual surfaces for anti-icing around the lower leading edge and three-dimensional vortical structures around the upper leading edge. These structures reduce the pressure on the upper leading edge, enhancing lift and reducing drag, while also altering water droplet trajectories and impingement dynamics, thereby limiting ice accumulation on the upper surface. Overall, the findings indicate that the CFJ concept offers a promising pathway toward integrating aerodynamic performance enhancement with robust anti-icing capability under high-angle-of-attack conditions
Peri‐operative management of diabetes mellitus: a multidisciplinary consensus statement from the Association of Anaesthetists and the Joint British Diabetes Societies for Inpatient Care group
Get PDFIntroduction: Surgery in patients with diabetes mellitus is associated with increased morbidity and mortality compared with those who do not have diabetes mellitus. This is likely multifactorial and could be attributed to organisational issues; dysglycaemia; hospital-acquired diabetic ketoacidosis; errors with insulin prescribing and administration; issues with fluids and electrolytes; and systemic and surgical site infections. There was a need to update guidance for the peri-operative management of diabetes mellitus given improvements in our understanding, introduction of novel drugs and development of wearable technologies.Methods: This was a multidisciplinary consensus statement with a diverse authorship group, including diabetologists; anaesthetists; surgeons; pharmacists; surgical diabetes inpatient specialist nurses; and patients with lived experience. We undertook a directed literature search and a three-round Delphi process to develop, refine and agree recommendations.Results: Following three rounds, 38 recommendations were included, spanning all phases of the peri-operative pathway. Recommendations were made for organisations and general principles for the management of patients with diabetes, aiming to improve pathways, implement protocols and support training. We prioritise individualised care plans, encourage clinical judgement regarding proceeding with surgery with out-of-range HbA1c concentrations and recommend ensuring appropriate insulin regimens are prescribed and administered. We also provide guidance for capillary blood glucose and ketone monitoring and management; safe handovers of care; and multidisciplinary care plans for the peri-operative use of wearables.Discussion: This consensus statement provides principles to be applied throughout the entire peri-operative pathway by healthcare professionals, institutions and patients. It is hoped that the implementation of these key recommendations will improve experience and outcomes for patients with diabetes mellitus having surgery
Pore structure evolution in organic-rich shale during thermal maturation: Insights from hydrous pyrolysis of two lacustrine kerogens
Get PDFAccurately predicting the evolution of pore networks under realistic thermo-hydro-mechanical conditions remains a critical challenge, limiting the reliable identification of hydrocarbon “sweet spots” in mature shale basins. This study aims to decouple the synergistic controls of thermal maturity, shale composition, water, and pressure on pore development. We conducted systematic, sequential high-pressure hydrous pyrolysis experiments on two compositionally distinct lacustrine shales, immature Huadian (Type II kerogen, high TOC, illite–smectite mixed-layer clay-rich) and Fushun (Type I kerogen, low TOC, siderite-rich) shales. Integrated geochemical analyses (vitrinite reflectance, Rock-Eval pyrolysis, TOC) and pore structure characterization (low-pressure N2/CO2 adsorption, SEM) revealed that thermal maturity is the primary driver for pore development, but its expression is fundamentally mediated by composition. Kerogen type dictates the evolutionary pathway, and TOC dominates the porosity magnitude. Minerals further modulate pore evolution, with carbonate dissolution regenerating porosity and clay stability determining pore integrity. Water is the most critical environmental factor, enhancing porosity by facilitating hydrocarbon expulsion, inhibiting pore-filling, and promoting mineral dissolution. Pressure exerts a dual role, with internal pore pressure promoting porosity, outweighing external compaction in our closed system. Notably, water pressure results in an additional 1.9–4.5-fold increase in pore volume during the wet gas cracking stage compared to non-hydrous conditions. These results establish a novel, integrated shale-water-pressure framework that advances beyond traditional maturity-centric models by quantitatively distinguishing the roles of and interactions between key controlling factors, providing a mechanistic basis for predicting reservoir quality, although its field application requires calibration to account for basin-specific geological complexity
Cultural adaptation of RECOLLECT fidelity measure and checklists in a recovery-oriented NGO in Brazil
Get PDFPurposeThe global spread of recovery colleges (RCs) demands culturally adapted fidelity measures to support international implementation and research. This study aims to translate, culturally adapt and pilot test the RECOLLECT Fidelity Measure and Checklists for Brazil, addressing the critical need for assessing RC fidelity in diverse contexts.Design/methodology/approachA rigorous five-step methodology was used for translation and cultural adaptation. This included initial and back-translation, consultation with original developers, multidisciplinary review and pilot testing of student and peer educator checklists within a Brazilian artistic-cultural recovery project.FindingsThis study produced a culturally adapted Brazilian Portuguese version of the instruments. Pilot data from the Checklists (descriptive, non-psychometric tools) showed that the adaptation mainly involved linguistic modifications for Brazilian relevance. The pilot demonstrated overall high fidelity to RC principles. However, the Co-production and Community Focus domains exhibited less alignment, suggesting areas for future Brazilian RC development.Originality/valueTo the best of the authors’ knowledge, this research is the first adaptation and pilot testing of RC fidelity instruments for a Latin American context, providing culturally appropriate measures to inform future recovery research and practice in the region. This study provides the necessary foundational step of cultural adaptation, which is a prerequisite for future psychometric validation of the Fidelity Measure. These findings highlight the feasibility and importance of adapting fidelity measures to local contexts, especially in resource-scarce regions such as Brazil and Latin America
Empowering community-based learning in nutrition through student co-production of an ethnographic assessment resource
Get PDFCommunity-based learning facilitates localised application of theoretical concepts. Use of this approach in assessment is challenged by student perceptions of barriers to civic engagement. To support students on a nutrition course to undertake a community-based assessment on social food movements, we developed a student partnership, recruiting a student to undertake 13 ethnographic visits to scrutinise the task. This provided practical insights for the teaching team and the co-production of the Social Food Guide, a resource supporting students to navigate unfamiliar community spaces through paths paved by the student partner. The co-produced resource supported critical conscientisation of three cohorts taking the assessment. The student partnership was valuable in giving future cohorts the agency to navigate, access, and learn from community spaces, generating novel opportunities to explore careers in evolving practice arenas. Embracing student partnership to co-produce the assessment initiated a practice turn in our teaching team, in which we envisioned student co-production as a useful tool of inquiry for democratising the design of assessments
Psychobiological Reactivity to Acute Psychological Stress as a Predictor of Cardiovascular Disease and Mortality: The Multi-Ethnic Study of Atherosclerosis
Get PDFBackgroundDysregulated psychobiological reactivity to acute psychological stress is associated with subclinical cardiovascular disease (CVD) risk, but its association with clinical CVD and mortality remains unclear—especially when considering both exaggerated and blunted responses, non-cardiovascular biomarkers, and potential racial/ethnic differences. This study aimed to test (1) relationships between multi-system stress reactivity and CVD/mortality, and (2) effect modification by race/ethnicity.MethodsParticipants were CVD-free adults (N = 957, age=69 ± 9 years, 56 % female, 27 % non-Hispanic White, 32 % non-Hispanic Black, 41 % Hispanic) enrolled in the Multi-Ethnic Study of Atherosclerosis. The following responses to a standardized psychological stress protocol were recorded: blood pressure (BP), heart rate, heart rate variability (HRV), salivary alpha-amylase (sAA), and cortisol. Participants were followed for a median of 8 years. Covariate-adjusted Cox proportional hazard models investigated associations of stress reactivity (baseline-to-stress changes: low/blunted: ≤25th percentile; intermediate/moderate [reference]: 26–74th; high/exaggerated: ≥75th) with incident CVD (N = 111) and all-cause mortality (N = 114). Race/ethnicity was tested as an effect modifier.ResultsStress reactivity was not linked with CVD incidence. Blunted diastolic BP reactivity was associated with premature all-cause mortality (HR=1.92, 95 % CI: 1.03—3.56). Exaggerated (HR=0.58, 95 % CI: 0.35—0.98) and blunted (HR=0.52, 95 % CI: 0.30—0.89) sAA reactivity were associated with reduced mortality risk. Race/ethnicity was not an effect modifier (all p for interaction > 0.05).ConclusionsBlunted DBP reactivity may serve as an early marker of increased mortality risk; randomized trials should test whether interventions that normalize DBP reactivity improve long-term survival. Further research should explore why dysregulated sAA reactivity was associated with lower mortality risk
AHP4 attenuates cytokinin signalling in the phloem companion cells to control root growth under osmotic stress
Get PDFCytokinins regulate diverse aspects of plant development. They are perceived by membrane-localised receptors that transmit a signal to nuclear-localised response regulators via the Histidine Phosphotransfer proteins (HPts). These HPts can be divided into two classes: authentic HPts (AHPs), which positively regulate cytokinin signalling, and pseudo HPts (PHPs), which inhibit it. Whilst four of the five Arabidopsis AHPs form a well-conserved monophyletic clade, AHP4 evolved separately and is more closely related to the monocot PHPs than to the dicot AHPs. AHP4's role in cytokinin signalling has been ambiguous; in some cases, it has been shown to act as a positive regulator, whilst in others, it acts negatively. Here, we propose that AHP4 act like a dimmer switch to dampen cytokinin output. Under optimal growth conditions, AHP4 is expressed at a low level in the phloem companion cells and has little effect on either cytokinin signalling or plant development. However, AHP4 expression is induced under osmotic stress, and under this condition, we show a novel role for AHP4 in reducing cytokinin signalling in the phloem and maintaining primary root growth. We propose that AHP4 fine-tunes responses to the osmotic environment by attenuating cytokinin signalling
Production of poly(3-hydroxybutyrate-co-3-hydroxypropionate) with regulated monomeric ratios from crude glycerol by recombinant Cupriavidus necator H16
Get PDFPoly(3-hydroxybutyrate-co-3-hydroxypropionate), also known as P(3HB-co-3HP), is a microbially produced biopolymer proposed as a sustainable alternative to petroleum-based plastics. However, most biosynthetic pathways for its production rely on costly precursor or cofactor supplementation, limiting their industrial applicability. In this study, Cupriavidus necator H16 was engineered to produce P(3HB-co-3HP) directly from central metabolism by introducing a heterologous β-alanine pathway for 3HP biosynthesis. Two strategies were employed to modulate copolymer composition: (i) a constitutive pathway modulated by nitrogen availability, and (ii) an arabinose-inducible system regulating the synthesis of the pathway intermediate β-alanine. Both approaches enabled the production of copolymers with adjustable 3HP content without the need for external precursors or cofactors. The N-based strategy achieved a maximum 3HP content of 66.5 mol% with a PHA titer of 1.1 g/L, while the inducible system allowed finer monomer control and reached up to 51.7 mol% 3HP with a PHA titer of 2.5 g/L. Additionally, copolymer production was demonstrated using crude glycerol as the sole carbon source, where the 3HP incorporation was tunable from 6.9 to 37.7 mol%, depending on the arabinose concentration, and the PHA titer ranged from 1.6 to 2.0 g/L. This study highlights the potential of the β-alanine pathway for sustainable 3HP-containing copolymers biosynthesis and demonstrates the feasibility of using crude glycerol, to support cost-effective bioplastic production
A protocol for a systematic review of the psychosocial effects of experiencing compassion from others and its interpretation through secular and religious frameworks
Get PDFBackgroundCompassion is widely studied as a prosocial motivator with recognized mental health benefits, yet the psychosocial effects of receiving compassion remain underexplored. Interpretive frameworks—whether religious or secular—may influence how individuals perceive and emotionally respond to compassionate acts.ObjectivesTo systematically review (1) the psychosocial effects of receiving compassion from others, and (2) how recipients interpret these experiences through secular or religious frameworks.MethodsThis protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and is registered with the International Prospective Register of Systematic Reviews (PROSPERO). Eligible studies will be empirical, involving adult participants in any setting, and using qualitative, quantitative, or mixed-method designs. Studies will be excluded if they focus solely on self-compassion, compassion fatigue, or lack psychological outcome data related to receiving compassion. Information sources include PubMed, Psychological Information Database (PsycINFO), Web of Science, Scopus, and Google Scholar. Risk of bias will be assessed using the Risk Of Bias In Non-randomized Studies of Exposures (ROBINS-E) tool for nonrandomized studies, the Joanna Briggs Institute (JBI) checklist for quasi-experimental and qualitative designs, and the Mixed Methods Appraisal Tool (MMAT) for mixed-methods designs. Data synthesis will follow a convergent integrated approach combining thematic and narrative techniques. Where feasible, pooled effect sizes and forest plots will be presented.DiscussionThis review will explore how receiving compassion—interpreted through secular or religious lenses—affects psychological well-being and social interactions, including potential reductions in distress, increases in resilience, and prosocial behaviors. It aims to develop culturally sensitive and spiritually aware models of compassionate interaction, with relevance for clinical practice, public health ethics, and interdisciplinary education
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! 👇