11237 research outputs found
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Time for consensus: establishing core outcomes meaningful to survivors of out-of-hospital cardiac arrest
No full textMore people are surviving out-of-hospital cardiac arrest (OHCA) than ever before, yet meaningful functional recovery and reintegration into daily life remain uncertain for many survivors.1, 2 Current clinical guidelines, consensus statements, and quality standards all emphasize the importance of systematically measuring quality of life, functional impairments, cognitive deficits and psychopathology. Survivors’ outcome measures are primarily used in three key areas: firstly, in clinical practice, where outcome measures enable identification and monitoring of survivors’ individual problems; secondly, in clinical registries and observational research studies, to better understand the epidemiology of cardiac arrest survivorship; and thirdly, in interventional research studies to determine and compare the effect of survivor aftercare intervention.</p
A risk and conformity assessment framework to ensure security and resilience of healthcare systems and medical supply chain
No full textIn recent years, the healthcare sector has undergone a significant digital transformation, driven by the rise of the Internet of Medical Things and the exponential use of connected medical devices in healthcare service delivery. This transformation offers numerous benefits, including enhanced patient data collection, processing, and informed treatment decisions. Despite these advantages, digital adoption brings several security challenges that pose considerable risks to overall healthcare service delivery. Additionally, connected medical devices must comply with sector-specific regulatory requirements to ensure trustworthiness and facilitate their broader adoption in the healthcare sector. There is, therefore, a pressing need to understand and manage these risks and compliance issues to secure and strengthen the resilience of healthcare systems. This work addresses these needs by introducing a novel Risk and Conformity Assessment Framework and Certification Scheme, implemented within an agile Information Security Management System context to enhance the security and resilience of healthcare systems. The framework leverages Artificial Intelligence (AI) in risk management practices, improving security assessments, risk prediction, security control implementation, and continuous monitoring. AI algorithms analyze large data volumes from various sources, enabling efficient processing and the identification of potential risk patterns. Additionally, AI-driven automation tools ensure consistent deployment of security controls, while continuous AI monitoring detects abnormal activities and enables rapid response to security incidents. The proposed Cybersecurity Certification Scheme incorporates AI-based security assessments into the certification process, facilitating efficient conformity assurance. This scheme also promotes a collaborative approach with relevant regulatory bodies to achieve compliance. While this work introduces a conceptual framework, its implementation and potential refinements remain subjects for future research. Further studies are necessary to validate its effectiveness, enhance its components, and evaluate its practical application in real-world healthcare environments.</p
Rapamycin induced autophagy enhances lipid breakdown and ameliorates lipotoxicity in Atlantic salmon cells
No full textAutophagy is a highly conserved cellular recycling process essential for homeostasis in all eukaryotic cells. Lipid accumulation and its regulation by autophagy are key areas of research for understanding metabolic disorders in human and model mammals. However, the role of autophagy in lipid regulation remains poorly characterized in non-model fish species of importance to food production, which could be important for managing health and welfare in aquaculture. Addressing this knowledge gap, we investigate the role of autophagy in lipid regulation using a macrophage-like cell line (SHK-1) from Atlantic salmon (Salmo salar L.), the world's most commercially valuable farmed finfish. Multiple lines of experimental evidence reveal that the autophagic pathway responsible for lipid droplet breakdown is conserved in Atlantic salmon cells. We employed global lipidomics and proteomics analyses on SHK-1 cells subjected to lipid overload, followed by treatment with rapamycin to induce autophagy. This revealed that activating autophagy via rapamycin enhances storage of unsaturated triacylglycerols and suppresses key lipogenic proteins, including fatty acid elongase 6, fatty acid binding protein 2 and acid sphingomyelinase. Moreover, fatty acid elongase 6 and fatty acid binding protein 2 were identified as possible cargo for autophagosomes, suggesting a critical role for autophagy in lipid metabolism in fish. Together, this study establishes a novel model of lipotoxicity and advances understanding of lipid autophagy in fish cells, with significant implications for addressing fish health issues in aquaculture.</p
Social prescribing of cultural opportunities to support health and wellbeing: the importance of language, community engagement, and inclusion in developing local approaches
No full textBackground: There is growing evidence for the role of culture in supporting health and wellbeing, including as part of social prescribing provision. This study set out to explore the existing cultural provision and mechanisms for connecting people to cultural opportunities as part of a local social prescribing offer in the UK and how it could it be strengthened to better support health and wellbeing. A broad view of culture was adopted encompassing the creative and digital industries, heritage, food, hospitality, nature, greenspaces, and sport. It covers activity associated with the artforms and organisations such as collections, combined arts, dance, libraries, literature, museums, music, theatre and the visual arts.Methods: A qualitative exploratory descriptive approach using focus groups was employed to explore the perspectives and experiences of social prescribing and the cultural provision in an area of the East of England. Six focus groups were conducted with social prescribers, community connectors, healthcare professionals, cultural providers, adults with lived experience of adverse health, and young people. Data was analysed using a reflexive thematic approach.Results: Findings from the research highlight the need for a clear and shared understanding of culture and health and the link to social prescribing. Barriers for connecting people with culture and health opportunities in the area were identified including gaps in provision and processes, challenges due to language and terminology, accessibility issues for marginalised groups, and issues around funding for transport and sustainable and equitable provision of cultural opportunities.Conclusions: This study indicated that to engage local communities in social prescribing and the development of cultural provision for social prescribing, proactive outreach community strategies are required. This could be achieved by involving community leaders, organisers, connectors, and representatives. In addition to promote the concept of culture for health and social prescribing and engage the wider community it was suggested that community members should be involved in and contribute to culture and health social prescribing locally through volunteering, roles for students, training opportunities, and befriending or buddy schemes.</p
The role of cyclic adenosine monophosphate (cAMP) in pathophysiology of fibrosis
No full textFibrosis, the excessive production and disorganised deposition of extracellular matrix proteins, can occur in any organ system, disrupting functionality and causing fatality. The number, efficacy and safety of antifibrotic drugs are incredibly limited. Therapeutics which elevate intracellular cyclic adenosine monophosphate (cAMP) offer a potential solution. In this review, we present the signalling mechanisms involved in fibrosis pathophysiology, how cAMP and its effectors might interact with these pathways, and the current preclinical and clinical efforts in this field. cAMP elevating agents have the potential to be future antifibrotic drug candidates, but further studies are required, particularly to develop tissue specific therapeutics.</p
El presupuesto público chileno con enfoque de derechos humanos: estándares, brechas y el caso SUSESO
No full textThis chapter examines the Chilean public budget from a human rights perspective, in light of international and regional standards. Drawing on a normative and institutional analysis, it identifies structural gaps in the Chilean budgetary cycle, particularly with regard to participation, progressivity, transparency, and enforceability. As an empirical illustration, the chapter analyses the predictive model for medical leave claims implemented by the Superintendence of Social Security (SUSESO), highlighting the risks associated with incorporating algorithmic technologies into public functions without adequate safeguards. The study shows how budgetary decisions linked to digitalisation can deepen inequalities if they are not subordinated to human rights principles. The chapter concludes with a set of recommendations to strengthen a rights-based approach to fiscal policy in Chile and proposes, as an annex, an eight-step methodological tool for assessing budgetary programmes through a human rights lens.</p
Quantum-inspired dynamic spatiotemporal matching transformer for traffic flow forecasting
No full textAccurate spatiotemporal traffic modeling and prediction are essential for intelligent transportation systems (ITS). Conventional models struggle with complex spatiotemporal variation and dynamic traffic patterns. The spatiotemporal heterogeneity of different road networks is challenging, which limits the models to accurately capture traffic flow patterns. In this paper, we propose a quantum-inspired dynamic spatiotemporal matching transformer (DSTMT) to achieve more robust and accurate traffic flow forecasting. We first design a temporal pattern embedding to capture temporal heterogeneity to improve the accuracy of traffic flow forecasting. Then, we design a memory-augmented pattern matching to extract the representative traffic pattern for each traffic node. We also develop a quantum-inspired adaptive transfer mechanism to mitigate the error caused by the discrepancy between historical traffic flow and forecasting. After that, we introduce an iTransformer to capture the spatial heterogeneity for each traffic node to improve prediction performance. Extensive experiments are conducted on five real-world datasets compared with 21 state-of-the-art methods and 7 baselines. The experimental results demonstrate the superior performance of DSTMT for traffic flow forecasting.</p
Therapeutic Interventions for Music Performance Anxiety: A Systematic Review and Narrative Synthesis
No full textThe aim of this systematic review was to summarise and evaluate the published literature on interventions for treating music performance anxiety (MPA). Adhering to the PRISMA guidelines, a comprehensive literature search of three electronic databases was conducted: PubMed, Web of Science, and PsychInfo (Ovid). Records were included in this review if they were quantitative pre–post interventional studies that utilised a recognised outcome measure or a clinical diagnosis for evaluating MPA. A narrative synthesis was orchestrated on 40 extracted studies assessing 1365 total participants. The principal intervention types observed included cognitive behavioural therapy, acceptance and commitment therapy, music therapy, yoga and/or mindfulness, virtual reality, hypnotherapy, biofeedback, and multimodal therapy. Although most of the reviewed studies demonstrated encouraging improvements in musicians’ MPA following delivered interventions, the current evidence base remains in its infancy, and numerous methodological weaknesses exist across studies. Small sample sizes, heterogeneity amongst treatment programmes, lack of follow-up data, a scarcity of standardised MPA assessments, and few randomised controlled designs render it imprudent to draw definitive recommendations concerning the interventions’ efficacy.</p
How might theological action research enable the local church to engage with and respond to the Anthropocene and climate change?
No full textThe Anthropocene reveals a planet in profound crisis on multiple fronts. One of its manifestations, anthropogenic climate change, continues to adversely impact humans and nature, and vulnerable communities who have contributed the least to the climate crisis are being disproportionately affected. As a Church of England vicar, I know that the local church has a positive role to play in tackling climate change. However, many parishes are not responding for various reasons. This research proposes that an intervention is required in the church community to change the conversation and allow new voices to be heard in dialogue with each other on these issues, including theological ones. Consequently, I located this study in the discipline of practical theology and explored the approach of Theological Action Research (TAR) in the local context. The Anthropocene lens was used primarily as a stimulus for theological reflection on human domination over nature in light of the biblical imperative for creation care (Gen.1:26-28).The research took place in my parish over a period of seven months. It consisted of a partnership between parishioners in a focus group and diocesan ministry leaders in an external support group. Both worked collaboratively to progress the focus group’s action plan. My research produced four main findings: the practitioner-researcher role was pivotal to participant engagement; diverse voices engaged positively in a co-creative theological and environmental project; the Dream Initiative culminated in a plan to reduce the church’s carbon footprint; using the Four Voices of Theology and Lectio Divina was challenging for some but led to significant theological insights and participants realizing humankind’s role in the climate crisis.The above findings indicate that using Theological Action Research as an intervention was very effective. Participants engaged deeply in theological reflection on the Anthropocene and climate change, and the result was meaningful climate action.</p
The Politics of the Pig from Burke to Beckett
No full textThis essay on Irish Literature examines the politics of the image of the pig in the works of Edmund Burke, Percy Shelley, Richard Porson and Samuel Beckett.</p
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