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Glyceryl trinitrate versus sham in the treatment of hyperacute stroke: the Efficacy of Nitric Oxide in Stroke-2 (ENOS-2) feasibility randomised controlled trial
Get PDFIntroductionHigh blood pressure is associated with a poor outcome after stroke. Trials of transdermal glyceryl trinitrate (GTN), a nitric oxide donor, have suggested that treatment between 3 and 5 hours might improve functional outcome.MethodsWe randomly assigned hospitalised patients with an acute ischaemic or haemorrhagic stroke to two days of transdermal GTN (5 mg/day) or sham, started between 3 and 5 hours after onset. The primary feasibility outcome was recruitment rate; proof of concept was assessed at 90 days by central observers blinded to treatment assignment using the modified Rankin Scale (mRS). Data are number (%), median [interquartile range] or mean (standard deviation). Comparisons by multiple linear regression.Results39 of an intended 120 participants were recruited. A total of 3314 people were excluded, commonly related to presentation >5 hours of onset or outside of researcher working hours, no eligible symptoms/signs or an unclear onset time. Mean age 72 (13) years, female 41%, blood pressure 161.8 (18.4)/80.8 (14.9) mmHg, time from onset at baseline 216 [186, 251] minutes. The fall in blood pressure over 24 hours did not differ between GTN versus sham. mRS at 3 months did not differ between the groups (difference in means, DIM -0.20, 95% confidence intervals -1.30, 0.90; p=0.72). GTN was associated with improved cognition on the telephone interview of cognition scale (DIM 8.0, 95% CI 1.3, 14.8; p=0.020). Although headache was more common, GTN was associated with fewer serious adverse events (p=0.020).ConclusionRecruitment limitations in this small single centre trial prevented demonstration of feasibility for patients in the time window of 3-5 hours post ictus. GTN demonstrated some evidence of proof-of -concept and was safe. A multicentre trial needs to further test this hypothesis
Functionally graded tungsten–copper coatings produced by axial injection shrouded atmospheric plasma spray
Get PDFThis work investigates the fabrication and microstructural evolution of tungsten–copper (W-Cu) functionally graded material (FGM) coatings produced using a shrouded axial-injection atmospheric plasma spray (APS) process. The central novelty of this study lies in the use of an inert-gas shrouded axial-injection APS system, which markedly suppresses in-flight oxidation and enables deposition of W-rich layers, overcoming a major limitation of conventional APS for refractory metals and allowing the formation of a continuous W-Cu compositional gradient. The resulting architecture exhibits a controlled transition from a Cu-rich region at the substrate interface to a W-rich layer at the coating surface. Microstructural characterisation by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and quantitative XRD revealed phase-pure W and Cu without evidence of intermetallic formation, together with a well-defined spatial gradient in elemental distribution. Through systematic adjustment of stand-off distance, gas composition, and plasma net power, it was observed that elevated net power and reduced stand-off distance improved melting efficiency and splat deformation, leading to significantly enhanced bonding and reduced porosity, particularly in W-rich sections where deposition is most sensitive to thermal input. Porosity analysis demonstrated that coatings produced under higher plasma power exhibited enhanced consolidation, with porosity decreasing from ∼2 % to ∼0.2 % in W-rich regions of the FGM after sub-solidus heat treatment at 650 °C in an argon atmosphere. Heat treatment further promoted diffusion-assisted healing of crack defects. Microhardness values reflected the compositional gradient, ranging from ∼125 HV in Cu-rich zones to ∼310 HV in W-rich regions. These findings establish shrouded APS as a viable, oxidation-controlled method for producing graded W-Cu coatings and provide the processing foundation for future mechanical, thermal, and functional assessment in high-temperature and plasma-facing applications
The characteristics of people with COPD who enrol in home-based pulmonary rehabilitation versus centre-based pulmonary rehabilitation: A nationwide cross-sectional study
Get PDFObjectivesHome-based pulmonary rehabilitation (PR) is increasingly offered as an alternative to centre-based PR. This study explores differences in the characteristics of people with COPD enrolling in home-based versus centre-based PR in England and Wales and assesses whether availability of home-based PR is associated with increased enrolment.MethodsThis study used data from the UK 2023-24 National Respiratory Audit Programme PR audit. Eligible people had a primary condition of COPD, complete mental health and geographic data, and attended an initial assessment at a centre that completed the clinical and organisational audit. For the primary analysis only, people were further restricted to those enrolled on a purely home-based or centre-based programme at a centre that offered both options. Enrolment was defined as having attended an initial assessment and having at least one scheduled PR session with a defined start date. Differences in characteristics were assessed using Chi-square and Kruskal-Wallis tests. The association between availability of home-based PR and enrolment was assessed using a mixed-effects logistic regression model.Results13719/29981 (45.8%) people were eligible for inclusion in the primary analysis and 25039/29981 (83.5%) were eligible for the secondary analysis. Those who enrolled in a home-based programme were more likely to: be female (58.6% vs 48.2%; p<0.001); be more deprived (55.7% versus 46.6% in IMD quintiles 1 or 2, p<0.001); have a greater mental health burden (28.2% versus 22.2% with at least 1 cognitive impairment recorded, p<0.001); and classified their symptom burden as more severe at assessment (CAT score 23 versus 22, p <0.001). Home-based PR was unavailable for 9099/25039 (36.3%) people. Availability of home-based PR was not associated with reduced non-enrolment in PR when compared with centres that did not offer home-based PR (adj-OR for non-enrolment: 0.79; 95%CI:0.51-1.23)).ConclusionHealthcare providers and those developing home-based PR digital applications should consider tailoring their approach to those who are most likely to opt in, who tend to be younger, female, and have a higher burden of respiratory symptoms and mental health comorbidities
A novel one-diode model for enhanced performance modelling of photovoltaic systems
No full textAccurate photovoltaic (PV) performance modelling is essential for reliable power prediction, energy yield assessment, and system-level decision-making. Various models have been developed for this purpose, but most of them face difficulties in obtaining the full set of parameters required for accurate PV prediction. Conventional empirical and one-diode-based models offer a simple approach with reasonable accuracy for PV modelling; however, they often suffer from deviations under high cell temperature and strong irradiance conditions, particularly for thin film PV technologies. This study has enhanced the one-diode PV performance model by incorporating additional empirical coefficients to improve temperature-dependent behavior while maintaining practical model complexity. The proposed model has been comprehensively evaluated across four PV technologies (monocrystalline silicon (c-Si), multi-crystalline silicon (mc-Si), cadmium telluride (CdTe), and amorphous silicon (a-Si)) and compared to the well-established empirical models (PVWatts and Sandia) as well as conventional one-diode-based formulations under a representative subtropical climatic condition. Results demonstrate that the proposed model consistently improves prediction accuracy across all technologies, with particularly pronounced gains for thin-film modules. Annual nRMSE values are reduced to approximately 2.0% for CdTe and 3.1% for a-Si, significantly showing better accuracy than both empirical and conventional one-diode models. Moreover, the proposed model substantially reduces annual cumulative energy prediction errors, with relative improvements of approximately 30–50% compared with conventional one-diode formulations. These improvements translate into substantially enhanced robustness at the system level, especially for large-scale PV installations. Overall, the proposed model provides a robust and practical framework for accurate PV performance and energy prediction across a variety of technologies and operating conditions
ભારતના ગુજરાત રાજ્યના કચ્છ િજલ્લાના બેલા ગામનું આપિ વ્યવસ્થાપન આયોજન
Get PDFબેલા માટે આ આપત્તિ વ્યવસ્થાપન યોજના સંશોધન પ્રોજેક્ટ: ‘ગુજરાત, ભારતના ભૂકંપગ્રસ્ત વારસા વિસ્તારો માટે ટકાઉ પુનઃનિર્માણ માળખાની લાગુ પડવાની અને માપનીયતા’, જેને 3D ફોર હેરિટેજ ઇન્ડિયા - તબક્કો 3 તરીકે પણ ઓળખવામાં આવે છે, તેના સંદર્ભમાં વિકસાવવામાં આવી હતી:. આ માળખામાં ગુજરાતના ભૂકંપગ્રસ્ત વિસ્તારોને આવરી લેવાની ક્ષમતા છે, જે અગાઉના બે તબક્કામાં 3D લેસર સ્કેનિંગ, ડ્રોન કેપ્ચર અને ઇન્ટરવ્યુ જેવી અદ્યતન દસ્તાવેજીકરણ તકનીકો પર આધારિત પદ્ધતિઓનો ઉપયોગ કરીને વિકસાવવામાં આવી હતી. આ માળખું (NTU et. al 2022) NGO (સ્થાનિક સમુદાયો સાથે જોડાણ પૂરું પાડતું અને હુન્નરશાળા ફાઉન્ડેશન દ્વારા રજૂ કરાયેલ); શિક્ષણવિદ (નિષ્ણાત ટેકનિકલ જ્ઞાન પૂરું પાડતું અને NTU અને CEPT યુનિવર્સિટી દ્વારા રજૂ કરાયેલ); અને સરકાર (સંસ્થાકીય સમર્થન પૂરું પાડતું અને GIDM દ્વારા રજૂ કરાયેલ) વચ્ચે વ્યૂહાત્મક ભાગીદારી દ્વારા રચાયેલ છે.આ યોજનાનો ઉદ્દેશ્ય જોખમોને ઓળખીને, નબળાઈઓ ઘટાડીને અને કાર્યક્ષમ પ્રતિભાવ અને પુનઃપ્રાપ્તિ સુનિશ્ચિત કરીને, ટકાઉ પુનઃપ્રાપ્તિના એક મહત્વપૂર્ણ પાસાં તરીકે સાંસ્કૃતિક વારસાના સંરક્ષણને પ્રાથમિકતા આપીને, કુદરતી અને માનવ-સર્જીત જોખમો પ્રત્યે ગ્રામીણ સમુદાયની પ્રતિકારકતાને સુદ્રઢ કરવાનો છે
Pathways to safety: adolescents’ experiences of care and support services for sexual violence in Pernambuco, Brazil
Get PDFObjectiveThis study explores how young people experience care and support services intended for children affected by commercial sexual exploitation (CSE), drawing on their own perspectives to inform service design and delivery.Participants and SettingTwenty young people aged 12–17, based in Pernambuco, Northeast Brazil, took part. All had accessed services aimed at addressing or preventing Commercial Sexual Exploitation of Children (CSEC), often in the context of other adverse childhood experiences.MethodThe study involved semi-structured interviews analysed using techniques from constructivist grounded theory.ResultsThe analysis highlights the complexity of young people’s engagement with support services, which we organise into three overarching thematic frames. First, we identify the intersecting risk factors that contributed to their initial contact with services. Second, we examine their diverse experiences of service relationships, which ranged along a continuum from harmful to protective. Within this, five interrelated factors emerged as shaping perceptions of support: comfort, information, basics, acceptance, and service availability. Third, we explore how young people exercised agency through the companion dynamics of control and trust.ConclusionsFindings indicate the importance of designing services that actively foster young people’s sense of safety. Control and trust emerged as foundational to this sense of safety and are closely linked to the five identified support factors. These insights can guide more responsive and effective care for children and adolescents affected by CSE
Modular Supramolecular Polycations Enable Efficient Delivery of Diverse RNA Therapeutics and Vaccines
Get PDFWe describe a modular, diverse, and customizable supramolecular-materials platform that can deliver nucleic acids in vitro and in vivo. The chemistries deployed enable the generation of multiple supramolecular polycations, which can associate with RNA to form polyelectrolyte complexes, but which have the unique feature of reversible cross-links, via host–guest interactions of monomers that display aromatic amino acid termini with cucurbit[8]uril (CB[8]). Families of supramolecular polymers can be prepared by simple variation in monomer structure, enabling the tuning of properties. We demonstrate that these supramolecular polyelectrolyte complexes with RNA can be prepared easily via automatable procedures to generate nanoparticles that meet Critical Quality Attributes for manufactured RNA vaccines and therapeutics. We show that these materials can deliver RNA to a range of cell types, displaying reporter-protein expression at levels equivalent to, or greater than, commercial transfection reagents, with no acute adverse phenotypic effects. Finally, we demonstrate the success of our materials platform across a range of nucleic acid types, with expression of mRNA within tumors of an orthotopic Triple-Negative Breast Cancer mouse model, knockdown of a kinase implicated in cancer progression via siRNA, and effective protection against H1N1 influenza virus challenge in mice following injections of self-amplifying RNA
On the value of indicators for large-scale water quality assessments
Get PDFGlobal efforts to improve water quality under UN SDG 6.3.2 are undermined by disparate national monitoring standards that prevent coherent assessment. Additionally, water quality modelling can help to provide spatially continuous monitoring data for a set of water quality constituents, but not for all relevant indicators. This inconsistency hinders accountability in supply chains, management of biogeochemical cycles, and mitigation of transboundary pollution. To address this inconsistency, we evaluate and propose a core set of water quality indicators. We compare this proposed set against the against water quality constituents currently included in major international monitoring frameworks (e.g., nutrients, heavy metals, and microbial contaminants) and modeling projects, which simulate outputs like nutrient concentrations and pollutant loads, to identify key areas where modeling efforts could focus. Finally, we propose a tiered roadmap designed to achieve implementation of these core metrics, focusing on harmonizing existing outputs, filling model gaps, and incorporating emerging indicators
Responsible Generative AI for SMEs in UK and Africa (RAISE): An Art AI Case Study
Get PDFThis report presents a series of case studies developed under the Responsible Generative AI for SMEs in the UK and Africa (RAISE) project, examining how small and medium-sized enterprises (SMEs) understand, adopt, and operationalise generative AI in practice. Drawing on in-depth qualitative engagement with participating organisations across diverse sectors, the case studies explore anticipated benefits, technical and organisational challenges, and the ethical, legal, and social considerations shaping AI integration. The RAISE case studies demonstrate how responsible AI principles are interpreted pragmatically by SMEs and illustrate the value of context-sensitive, actionable guidance in supporting responsible adoption. Collectively, the cases provide empirical insight into the realities of generative AI use in resource-constrained environments and inform the development of practical frameworks for responsible AI implementation in SMEs
Transforming stormwater management from Sponge City to Self-Purifying City
Get PDFUrbanisation and climate change exacerbate water pollution, with runoff from impervious surfaces contaminating water bodies during rainfall. China’s Sponge City initiative strategically conserves and/or restores nature to address urban runoff issues. However, Sponge City approaches are limited by single-media pollution control and insufficient pollutant removal capacity. The Self-Purifying City concept advances the Sponge City by integrating air, soil, and water systems to artificially purify cross-media pollutants and enhance overall environmental purification capacity. The transformation from Sponge Cities to Self-Purifying Cities remains underexplored in terms of strategies and laws. In this study, a total of 36 strategies and 141 environmental laws related to stormwater purification were extracted from 693 publications in the Web of Science database and 1539 documents from the Ecolex environmental law database, respectively. Through multidimensional analyses and evidence synthesis, this study explored the characteristics and synergies of these strategies and laws, proposing a transformative stormwater management framework that incorporates community-based, appropriate, and strategic approaches across business activities, financial support, individual behaviours, and institutional controls. Five key measures include mainstreaming Nature-based Solutions, mandating long-term monitoring, establishing dedicated funding mechanisms with incentives and penalties, strengthening stakeholder coordination through legislation, and using data-driven approaches for managing high-risk areas, which are recommended to ensure compliance and governance. To enhance the practical applicability of the proposed framework, we also demonstrate how it can be applied to nitrogen pollution control, thereby better protecting the environment and supporting the development of Self-Purifying Cities
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