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CONSORT-C 2026 explanation and elaboration: recommendations for enhancing the reporting and impact of paediatric randomised trials
Get PDF•Paediatric randomised controlled trials (RCTs) provide critical evidence that informs healthcare interventions and improves outcomes for newborns, infants, children, and adolescents•An extension to the Consolidated Standards of Reporting Trials (CONSORT) 2025 statement, CONSORT-Children and Adolescents (CONSORT-C) 2026, contains 13 essential reporting items for paediatric RCTs, developed in tandem with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) extension for paediatric RCT protocols (SPIRIT-C 2026)•This explanation and elaboration paper provides examples, explanations, and key elements for each reporting item to facilitate comprehensive and transparent reporting•This pedagogical paper serves as a resource to assist trial authors and evidence users in knowing what details to include in a paediatric RCT protocol, and it should foster comprehensive and transparent reporting to enhance understanding of the applicability and limitations of evidence and ultimately should improve the overall impact of paediatric RCT
Message framing in communications on the consumption and production of sustainable seafood: The significance of negative emotions
No full textThis study investigates how different message frames impacts willingness to pay for sustainable alternatives and support for policies designed to bring about sustainable fishing practices. An online experiment was conducted with a sample from the Norwegian public (N = 707) who were randomly assigned to reading different messages about the consequences of (un)sustainable fishing practices. A specific focus was placed on differences in message valence (positive vs. negative) and message perspective (general vs. personal). The analyses revealed significant total effects for three out of four message framing combinations on willingness to pay. Further examination of indirect effects indicated that both positively and negatively framed messages influenced willingness to pay and policy support primarily through negative emotions such as anger, worry, or sadness. In addition, there was an indirect effect of a negatively framed message through positive emotions for policy support. These findings suggest that emotional responses, particularly when negative, play a role in shaping sustainable seafood choices and public support for related policies, with message effectiveness depending less on framing features per se than on the emotions elicited
Hybridised Stator Characterisation Technique to Accurately Estimate the Peak Performance of Automotive Electric Machines
Get PDFThe rapid expansion of the production of electric vehicles (EV) has increased the demand for high-performance electric motors. The B-H and iron loss of the stator core significantly influence the resulting torque and efficiency of the electric machine. Manufacturing is a major factor that affect the B-H and iron losses of the stator core. Therefore, precise magnetic core characterisation is essential for ensuring reliability and efficiency. End-of-line (EoL) testing a critical validation step, assessing product integrity, defect identification, and regulatory compliance. However, accurate characterisation of the magnetic properties of complex geometries, such as stator cores, is not feasible using standardised measurement methods, which are typically designed for simpler shapes such as toroidal samples. In this paper a hybrid magnetic characterisation method has been developed in which standard experimental data is combined with finite element analysis to improve the estimation of the magnetic characteristics of a stator core material. By compensating for the limitations of conventional stator testing, the proposed method achieves a substantial improvement in material characterisation accuracy by around 69% for the hybrid electric vehicle (HEV) machine and 75% for the electric vehicle (EV) machine. When these refined material properties are employed in finite element motor models, the resulting torque prediction error is reduced by 94.43% in the HEV motor and by 98.39% in the EV motor, relative to predictions based on conventional stator sample testing. The improved agreement between predicted and expected performance demonstrates the relevance of the proposed approach for reliable motor design, particularly in the context of high-volume automotive manufacturing where consistency and repeatability are critical
Extended Comparative Analysis of Aircraft Energy Management Strategies for Improvements in Energy Expenditure, Hydrogen Savings, and Battery Lifecycle Assessment
Get PDFSustainable aviation requires electrical power systems that can deliver both high energy and high power. Hybrid fuel cell–battery architectures offer a promising solution to meet these demands, and their overall performance can be significantly enhanced through the application of energy management strategies (EMSs). This paper develops several EMSs approaches, including rule-based state machine, equivalent consumption minimisation strategy (ECMS), and dynamic programming (DP) for a hybrid fuel cell–battery aircraft targeting specific objectives, such as improving system efficiency, reducing hydrogen consumption and extending battery lifetime. The EMS approaches are then evaluated across both nominal missions and a fuel cell-failure scenario to assess their effectiveness in meeting their defined objectives. Results show that while ECMS achieves the lowest cost per mission, it does not maximise system efficiency. DP provides the highest overall energy efficiency and longest battery lifetime but is limited to offline implementation. To bridge this gap, a hybrid DP–ECMS strategy is introduced and evaluated. The results show that the approach delivers globally optimal performance under nominal conditions, accounting for the trade-offs between cost, efficiency, and battery ageing, while also preserving real-time responsiveness during unforeseen events. This demonstrates the benefits of combining offline optimisation with real-time control for hybrid electric aircraft. Software-in-the-loop (SIL) further validates the real-time applicability and robustness of the proposed strategy
Social Structure of Sheep Flocks at Points of the Production Cycle and Relationship to Disease Spread, Using a Simulated Epidemic of Footrot
Get PDFFootrot is one of the top five globally important diseases of sheep and causes lameness, leading to poor welfare and productivity. Transmission of Dichelobacter nodosus, the causative agent, occurs via surfaces such as pasture or bedding and persistence occurs from diseased sheep shedding bacteria into the environment; D. nodosus cannot replicate off host. High resolution proximity sensors were deployed on a flock of Poll Dorset sheep for 10–17 days at several points of the production cycle (teasing, tupping, pregnancy, and lactation (<6-week-old lambs)) between July 2018 and May 2021. Association indices between pairs of sheep were calculated, and outbreaks of footrot were simulated using a network-based susceptible-exposed-infected-recovered model. Two management approaches were modelled (1) where sheep were treated either not promptly, or effectively, resulting in long recovery times (28–100 days) and (2) where sheep were treated and recovered within 15 days, assuming ‘active management’ of footrot by the farmer using ‘best practice’ of prompt recognition of lame sheep and parenteral and topical antibiotics. Under ‘active management’ conditions (scenario 2), outbreak sizes were smaller at all points of the production cycle. This adds to existing evidence that prompt, effective treatment of sheep at all stages of the production cycle is key to reducing the prevalence of footrot in the flock, including at breeding when sheep are more likely to be in close contact
Developing research resources and minimum data set for care homes' adoption and use (DACHA)
Get PDFBackground: In England, care homes are the primary providers of long-term care for older adults. The increasing recognition of the importance of social care underscores the importance of collaboration between the National Health Service and care homes. The lack of data sharing among stakeholders limits opportunities for co-ordinated care, service development and research. Objectives: Identify how to support research, service development and innovation in care homes. Combine existing evidence with care home-generated resident data to create a minimum data set that is relevant and usable for stakeholders, including residents, relatives, practitioners, researchers, regulators and commissioners. Design and methods: The study used a mixed-methods approach, structured into five work packages, supported by patient and public involvement and engagement with residents, carers and staff: Work package 1: Conducted two evidence reviews on outcome measures and factors enhancing research productivity in care homes. Work package 2: Created a trial archive for secondary data analysis. Work package 3: Conducted a scoping review, a realist review and a national survey to define minimum data set content and assess implementation challenges in English care homes. Work package 4: Linked residents' data from National Health Service and social care data sets with data from study care homes, deriving useful minimum data set variables and assessing data quality. Work package 5: Piloted the minimum data set at two points in care homes within three integrated care systems, conducted focus groups and interviews with care home and integrated care system staff. Three national consultations explored how stakeholders use resident information, measure quality of life and minimum data set usefulness. Additionally, subprojects examined data availability in domiciliary settings, staff reasoning when assessing resident well-being and completing research during rapid policy changes. Findings: The reviews revealed significant heterogeneity in outcome measurement and questioned the appropriateness of some methods and measures used for care home research. The Virtual International Care Home Trials Archive merged data from 6 United Kingdom randomised controlled trials with 5674 residents across 308 care homes. International minimum data set studies are a valuable resource for international comparative research. The wide range of measures used are mostly clinical with under-representation of measures important to care homes (e.g. quality of life). A national survey of care homes demonstrated the range of information, including clinical measures being routinely collected. The realist review identified motivation, front-line staff monitoring and embedded recording systems as important for minimum data set implementation. The pilot study recruited 996 residents from 45 care homes, with 727 residents' data included in the minimum data set. Residents' digital care records were linked to statutory health and social care data sets, creating a viable minimum data set prototype with metadata as resource. Conclusions: The study provided an evidence-based critique of care home research and a resource for secondary data analysis for future research. It developed a prototype minimum data set linking National Health Service, social care and care home data, demonstrating its importance as a basis for discussions between health and care staff. Limitations: The COVID-19 pandemic disrupted relationships and recruitment. Governance challenges prevented linking residents' data to general practitioner records. Future work: Future research should assess whether the care home minimum data set improves resident outcomes, service delivery, staff experience, cross-sector collaboration, resource use and digital technology implementation. Funding: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR127234
Emerging Role of Taste Receptors, Entero-Endocrine Cells in Type 2 Diabetes and Metabolic Disorders
Get PDFType 2 diabetes (T2D) is a major global healthcare challenge and burden on the quality of life in affected individuals. While lifestyle management is the mainstay treatment for T2D, the advent of gut-incretin-based therapies with powerful effects on metabolic health, appetite and weight regulation has focussed attention on the role of the gut in the risk, progression and management of T2D. Beyond the tongue, intestinal sweet taste receptors (STRs) are increasingly being identified and functionally characterised. Growing evidence now supports a role for nutrient-activated (e.g., sugars) intestinal STRs in the release of gut hormones from enteroendocrine cells (EECs) and the control of blood glucose and body weight. However, the specific STR pathway and mechanisms linking STRs to these homeostatic controls are poorly understood, with a notable gap existing between evidence from preclinical studies and clinical validation. This review explores intestinal STR-EEC functions and the evidence on how these functions regulate glucose metabolism and energy homeostasis. We further discuss the impact of environmental and dietary factors on these signalling pathways. Full knowledge of the signalling and regulation of intestinal STR-EEC and integrated neural pathways will bridge the current knowledge gap, with a high potential to develop new novel strategies targeting STRs or EECs that preserve hedonic taste rewards and reduce cravings, as well as improve the management of individuals with metabolic diseases
The long-term impact of early HbA1c control on nephropathy, neuropathy, and retinopathy in type 2 diabetes: Findings from a large UK observational study
Get PDFIntroductionThe evidence remains contradictory regarding the optimal glycaemic targets needed to address the long-term effects of hyperglycaemia in people with diabetes mellitus (T2DM). We examined the association between HbA1c levels and the risk of individual microvascular complications among people with T2DM.MethodsWe used the Clinical Practice Research Datalink (CPRD) GOLD database for a prospective cohort study, following patients ≥18 years old from diagnosis of T2DM between January 2007 and December 2017. Neuropathy included foot ulcers, peripheral arterial disease, gangrene, and amputation. Nephropathy was classified by chronic kidney disease stages, and retinopathy included blindness and macular oedema. The risk of each complication in five HbA1c intervals [1.0%] intervals compared to 48.0–57.9 mmol/mol (6.5–7.5%) was assessed using a multivariate time-varying Cox regression adjusted by various patients' characteristics. Subgroup analyses were performed according to age, hypertension, and the use of antihypertensive medications.ResultsOur study included 172,869 patients (mean age 62.6 years and, 54.6% women). The risks were the highest in HbA1c levels >81.0 mmol/mol (>9.6%) (HR 1.27, 95%CI 1.17–1.39 for nephropathy; 1.55, 1.27–1.47 for neuropathy; 1.66, 1.41–1.96 for retinopathy). The lowest risks observed in levels 48.0–57.9 mmol/mol (6.5–7.5%) for nephropathy and in levels <48.0 mmol/mol (<6.5%) for neuropathy (0.98, 0.88–1.09) and for retinopathy (0.89, 0.79–0.99). In the subgroup analysis, higher HbA1c levels were associated with an increased risk of nephropathy, particularly in individuals over 60, those with hypertension, and those using antihypertensive medications. For neuropathy, being over 60 was associated with an increased risk across all HbA1c levels. In retinopathy, hypertension and the use of antihypertensive medications were associated with lower risk across all HbA1c levels, while individuals under 60 were associated with higher risks at elevated HbA1c levels compared to those over 60.ConclusionThe risk of retinopathy and neuropathy was lowest in individuals with HbA1c levels within the non-diabetic range <48.0 mmol/mol (<6.5%) and increased progressively with higher HbA1c levels. In contrast, the lowest risk of nephropathy was observed in individuals with HbA1c levels between 48.0 and 57.9 mmol/mol (6.5–7.5%). These findings underscore the importance of a personalized approach to diabetes management that considers multiple risk factors and incorporates novel therapeutic strategies beyond glucose control
Assistive Robotics for Healthy Aging: A Foundational Phenomenological Co-Design Exercise
No full textBackground:Assistive robotics for helping older people live well and stay independent has, to date, failed to fulfill its promise: there are few assistive robots in everyday use. In part, this failing can be attributed to inadequate or missing co-design activities that would ensure that these technologies and any services that incorporate them are developed with prospective end users, addressing their actual needs and wants, and not merely for them, and based on lazy assumptions about heterogeneous user groups.Objective:This exercise aimed to address some of these limitations by taking a “phenomenological snapshot” of what it means to be an older person in the current sociotechnological context, and making this snapshot, along with the co-design materials developed, available to the wider assistive robotics community to provide solid foundational evidence for steering the development of assistive robotics in more productive directions.Methods:Two rounds of co-design workshops have been conducted with older people and their caregivers, based on an innovative methodology that used personas and speculative designs to explore sensitive everyday difficulties faced by participants and highlight some of their general wishes for and concerns about assistive robotics. The data collected during the workshops were analyzed, and key themes were extracted.Results:Analysis of the workshop data gives access to the lived experience of older people and their caregivers, and their opinions about domestic robotics and assistive technologies more generally. The findings are organized thematically as everyday difficulties, the daily problems faced by older people; ideas for aging better, older people’s own suggestions for how their lives could be improved; and living with technology, their preferences and requirements for assistive robots, along with their concerns about what the introduction of robots might mean, both for themselves and for society more widely.Conclusions:We believe that our findings provide solid foundational evidence for the development of assistive robotics for older people. We are in the process of disseminating these results through various channels to the wider assistive robotics community; ultimately, the success of our activities will be demonstrated only through the development of acceptable, useful, and viable assistive robotics for older people
How Chinese Higher Vocational Education and Training (HVET) Students Determine Their Post-College Pathway in the Post-Covid 19 Era
Get PDFContext: Vocational training has been a critical issue in China, where large percentages are regularly cited for unemployment statistics. In addition, Chinese higher vocational education and training (HVET) students are from relatively disadvantaged socio-economic backgrounds and they are experiencing a more complex and high-risk post-college transition than previous generations in the context of the economic shock from COVID-19. The policy of extending university enrolment since 2012 to recruit HVET students across China has led to an increase in the number of HVET students opting to enter university. This article reports on the perceptions of 27 HVET final-year students from five colleges about their decisions on their post-college pathway prior to finishing their studies and training. Methodology: This study adopted a qualitative research design and the semi-structured interview data were analysed using thematic analysis. Using the conceptual framework of possible selves, this paper examines the key factors shaping the formation of HVET students’ possible selves in determining their future pathways. Findings: The findings reveal several key insights. First, both individual and contextual factors play a significant role in influencing HVET students’ decisions about their future trajectories. Second, there is a noticeable shift in the focus of HVET graduates’ possible selves, with most participants envisioning pathways that diverge from immediate entry into the labour market. This study reports a major transition, with 23 out of 27 respondents intending to pursue higher education, reflecting a departure from the trends observed in previous research. Third, the COVID-19 pandemic has had a profound impact, disrupting the development of occupational skills and shaping post-college pathways for recent HVET students. Finally, the findings underscore the strong desire among Chinese HVET students to escape the HVET identity, which emerges as a significant driver in their pursuit of higher education trajectories. Key message: This study highlights the critical factors influencing HVET students' post-college transitions, including COVID-19, social stigma, socio-economic constraints, and competitive societal pressures, which drive their pursuit of higher education. It shows the complex challenges faced by HVET students in post-COVID-19 China within a broader systemic contex
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