11237 research outputs found
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Economic Evaluation of the Digital Application “Support, Monitoring and Reminder Technology for Mild Dementia” for People with Mild Cognitive Impairment and their Informal Caregivers
No full textBackground: A randomized controlled trial was conducted to evaluate the effectiveness of a tablet‐based application, SMART4MD, in improving or maintaining the quality of life for person with mild cognitive impairment (PwMCI) and their informal caregivers. The objective is to conduct an 18‐month economic evaluation of the SMART4MD app, in addition to standard care, compared to standard care alone in Sweden and Spain from a healthcare provider perspective. Method A total of 345 dyads (173 received intervention; 172 received standard care) participated from Sweden, and 347 PwMCI (174 received intervention; 173 received standard care) participated from Spain. The primary outcome measure was quality‐adjusted life years (QALYs). The findings are reported as incremental cost‐effectiveness ratios (ICER). Result The intervention was dominated by standard care at the Swedish site, but at the Spanish site, the ICER was €3,337/QALY for PwMCI. For the informal caregivers at the Swedish site, the ICER was €78,000/QALY. However, neither costs nor QALYs were statistically significantly different for dyads or PwMCI in both sites. Conclusion The difference in site‐specific results warrants further exploration of the use of the SMART4MD application for PwMCI in terms of cost‐effectiveness.</p
Real‐time detection of agitation in people with dementia: The RadioMe system
No full textAbstract
Background
Agitation is a common comorbidity of people with dementia and can be particularly distressing. Technology may be a valid way to detect agitation in people with dementia in real time to allow for intervention. RadioMe combines agitation detection technology (e.g. through wearables) alongside relaxing music response to support people to live independently within the community. The system seamlessly mixes music with a live radio and can incorporate diary reminders too.
Method
The RadioMe system was installed in 20 community‐dwelling people with dementia with agitation symptoms for up to four months, in this proof‐of‐concept study. In the first two months participants had access to the radio and diary reminder elements of the system; in the second two months participants also had access to the relaxing music playlist elements. We measured quality of life, agitation and implementation outcomes across the timepoints. Qualitative interviews were used to better understand participants’ experiences of the system.
Result
Findings indicate that people with dementia were generally satisfied with the system (Mdn = 3.5), and perceived it to be acceptable (AIM, Mdn = 3.7), appropriate (Mdn = 3.5) and feasible (Mdn = 3.5). There was evidence that participants did struggle to integrate it into their day‐to‐day lives, and there were frequent issues with the setup and connectivity of the wearables. There was no evidence that the system had a detrimental effect on people's quality of life or agitation symptoms.
Conclusion
An automated system to detect agitation and respond with relaxing music has potential value, but ensuring the technology is accessible and not disruptive should be a priority before it can be adopted more widely for people with dementia.</p
Assessing healthcare access in rural Algeria: a survey‐based cross‐sectional analysis of healthcare utilization based on socioeconomic and health factors, experiences, and spatial disparities
No full textBackground and Aims: Equitable access to healthcare constitutes a fundamental aspect of the Algerian health policy. Yet, no studies addressed determinants of healthcare access in rural areas. This study quantified healthcare utilization (HCU) in a remote Algerian village, and analyzed the associated socioeconomic and health‐related factors, spatial disparities, and experiences with local healthcare services. Methods: A survey‐based, cross‐sectional study was conducted among 400 adult residents of Boussemghoun village, located in the Saharan Atlas Mountains. A structured questionnaire quantified the utilization of 10 basic healthcare services over the past 12‐months. Socioeconomic and health‐related factors, spatial disparities, and experiences with local healthcare services were analyzed as the independent factors of high HCU using multivariate logistic regression. Results: Among the participants, 39.7% had at least one chronic disease and 36.5% declared having traveled for healthcare during the past year. Levels of HCU were low across all care services, with the median (P75) HCU score was 4 (9) out of 33. Independent factors of high HCU included female (OR = 2.62, p = 0.003), widowed status (OR = 4.65, p = 0.026), high income (OR = 3.64, p = 0.048), taking 2+ chronic medications (OR = 3.61, p = 0.001), acute health issue in the past year (OR = 3.19, p = 0.013), interregional healthcare mobility (OR = 1.87, p = 0.041), longer travel times to local facilities (OR = 3.84, p = 0.004). Conclusion: Healthcare access in Boussemghoun is challenged by a critical lack of comprehensive care, resulting in frequent interregional healthcare mobility and a mismatch between HCU and apparently high healthcare needs. Strategic action is needed to mitigate the resulting inequalities and enhance local access to multidisciplinary quality care.</p
Effects of the 2023 Poole Harbour oil spill on sediment bacterial communities and ecosystem functioning
No full textIn March 2023, approximately 27 t of fluid from an oil and gas reservoir (containing approximately 85 % water and 15 % crude oil spilt from a fractured pipeline beneath Ower Bay creek, entering Poole Harbour (Dorset, UK). This event provided a unique opportunity to investigate the impacts of hydrocarbon contamination on microbial communities in-situ in a temperate coastal, shallow, fine sediment environment. Our aims were to quantify hydrocarbon concentrations (via gas chromatography mass spectrometry (GC–MS)) and effects on microbial community structure and functional potential (via metagenomic sequencing) to understand the capacity for microbial biodegradation across the impacted region. Hydrocarbon contamination was localised to the Spill Site (approximately an area of 1500 m) at the head of the creek, with minimal impact at the Mid Point (164 m from the Spill Site) and End Point (387 m from the Spill Site) and with no indication of contamination at Brownsea Island located in the heart of the harbour. By October 2023, n- alkane and 4–5 ring PAH concentrations had declined to background levels, highlighting the combined effects of the remediation response and natural hydrocarbon biodegradation at the Spill Site. Clear changes in bacterial community structure were observed in the seven months following the spill, with notable hydrocarbon-degrading bacteria i.e. Anaerolinea, Thiobacillus and Dechloromonas favouring the Spill Site, suggesting a significant increase in anaerobic biodegradation occurred as a result of significant increase in assA (anaerobic alkylsuccinate synthase) , abcA (anaerobic benzene carboxylase) and ahyA (anaerobic alkane hydroxylase) genes. Overall, 24 alkane and aromatic hydrocarbon degradation genes, from both aerobic and anaerobic degradation pathways, were identified from contigs throughout the study site, being present within 48 out of 221 Metagenome-Assembled Genomes (MAGs), highlighting the sites capacity for hydrocarbon biodegradation under both aerobic and anaerobic conditions.</p
What factors influence the choice of a UK undergraduate degree programme by Malaysian students?
No full textHistorically, Malaysia has been a strong recruitment market for UK Higher Education institutions, but the number of Malaysian students attending UK universities has decreased by 30% over the past five years. Several studies of the decision-making process of international students have been conducted, however these focused on other nationality groups and were carried out post enrolment at university. The purpose of this study was to investigate the factors that influence Malaysian students' decisions when choosing an undergraduate degree program in the UK. It sought to fill the gap in understanding of their decision-making and any effects the COVID-19 pandemic had on this.The study used an abductive approach, with an initial conceptual model built from existing research which was then tested and refined during the research phase using thematic analysis of in-depth qualitative interviews. The interviews were conducted with 13 Malaysian students during their decision-making period before they attended university.It was found that the Malaysian students decision-making model consisted of two stages, an initial stage of the ‘Decision to Study Abroad’, followed by a second stage that includes the interdependent decisions of ‘Choice of host country’, ‘Selection of institution’ and ‘Selection of programme’. The second stage decisions are taken in no set order, with the initial choice of programme, institution or country, having the potential of significantly impacting the others and this contrasts to previous studies. The importance of the choice of programme in the Malaysian students’ decision-making was identified, together with the factors influencing each decision stage, using the ‘push-pull’ model, developed initially by Mazzarol and Soutar(2002), combined with the theory of consumption values (Sheth, Newman and Gross, 1991).My work makes several contributions to knowledge. It identified that the initial decision to study abroad is taken separately, often much earlier or even implicitly, to the other decisions for my subject group. It confirmed the importance of ‘Selection of programme’ within the decision-making process and found that the students may enter the second decision-making stage at any one of the three choices of country, programme or institution. Finally, it showed that the COVID-19 pandemic had little effect on their decision-making in choosing the UK as a study destination.In practice the results of the study can be used by education providers to make decisions about continued investment in recruiting Malaysian students to attend UK Institutions. It will aid in the development of targeted marketing strategies to recruit Malaysian students to attend a UK undergraduate degree programme.While my study's size and focus limits the generalisability of its findings to specific decision making factors in other student populations, the observed dynamic in the decision-making process may have implications for the approach to recruiting international students to the UK more widely.</p
Assessment of prevalence and factors associated with perceived lower back pain among the bicycle rickshaw pullers in Dhaka
No full textLower back pain (LBP) is a prevalent issue affecting individuals globally. This study explored factors associated with LBP among rickshaw pullers in Dhaka, Bangladesh. A cross-sectional study was conducted with 299 bicycle rickshaw pullers in Mirpur from July to November 2019. Data were collected using a pilot-tested semi-structured questionnaire employing convenience sampling, and analyzed with SPSS. All the participants were males (mean age: 36.69 ± 9.61 years; age ranges: 18–58 years). 33% of the participants self-reported LBP. The LBP was significantly associated with older age (>40 years), lower educational qualification, stressful working environment, heavy object lifting, and mental stress during work. There is a need for strategies to prevent and manage LBP, especially in those who are older that could include more training on better postures and lifting heavy loads, improvements in vehicles, and enhanced health and wellbeing.</p
A Comparison of Physical Characteristics in Different Brands and Staining Techniques in a Brand of Lissamine Green Strips
No full textBackgrounds/Objectives: The aim of this study was to compare differences in the physical characteristics of lissamine green (LG) strips and the outcomes of using different staining techniques. Methods: Two separate complementary investigations were conducted. Physical study: Differences between four LG strips were evaluated in terms of material, dye concentration, and dye absorption. In vivo study: Bulbar conjunctival staining was compared for four application methods of I-DEW LG strips presented in a randomized order for twenty-two participants: (1) single application 5 s after wetting (also repeated using GreenGlo for comparison), (2) single application using two strips held together, 5 s after wetting, (3) two applications using a single LG strip 5 s after wetting, 1 minute apart, (4) the same as method 3, with a single fluorescein strip in between LG applications. White light imaging was performed immediately following application and after 30, 60, 90, and 300 s. Three masked practitioners independently evaluated the randomized staining images for spot count and staining intensity. Results: Physical study: Strip paper fibres demonstrated visible similarities, with no difference in saline absorption (p > 0.05). LG concentration increased as saline retention duration increased (F = 964.1, p 0.05); however, staining intensity was significantly higher following two applications of I-DEW, 1 min apart, compared to a single application (p = 0.042). Both spot count and staining intensity decreased with time (p </p
An Optimized Hybrid Approach to Denoising of EEG Signals Using CNN and LMS Filtering
No full textSleep is a physiological signal which plays a vital role in maintaining human health and well-being. Polysomnographic records provide insights into the various changes occurring during sleep, and hence its study is important in diagnosing various disorders including sleep disorders. As polysomnographic records encapsulate several biological signals, an extraction of EEG signals requires efficient denoising. Thus, a reliable tool for artifact removal is essential in the field of biomedical applications. The CNN is used for its feature extraction and robustness and the least mean square filter for its noise suppression. As the techniques complement one another, a combination of both leads to a better denoised EEG signal. In this approach, CNN is used for the precise removal of artifacts and then an LMS filter is used for its effective adaptation in real-time. The hybridization of both techniques in a hardware-based environment is largely. unexplored. As a result, this study proposes an integration of convolutional neural networks and least mean square filtering for an efficient denoising of EEG signals. Both techniques are optimized to tailor the design to hardware requirements. CNN is refined using the Strassen–Winograd algorithm. The Strassen–Winograd algorithm simplifies matrix multiplication, contributing to a more hardware-optimized design. In this study LMS filtering is analyzed and optimized using several optimizations. The optimizations are two’s complement distributed arithmetic algorithm, offset binary coding-based distributed arithmetic, offset binary coding Radix 4-based distributed arithmetic, as well as a Coordinate Rotation Digital Computer. The CNN with offset binary radix 4 distributed arithmetic-based LMS filter has resulted in a decrease in area of 77% and a decrease in power by 69.1%. But, in terms of Signal to Noise Ratio, Mean Squared Error and Correlation Coefficient, the CNN with offset binary coding distributed arithmetic-based LMS filter has shown better performance. The design was synthesized and implemented in Vivado 19.1. The power and area reduction in this study makes it even more suitable for wearable devices.</p
Combination strategies with PARP inhibitors in BRCA-mutated triple-negative breast cancer: overcoming resistance mechanisms
No full textTriple-negative breast cancer (TNBC) is a particularly aggressive breast cancer subtype, characterised by a higher incidence in younger women, rapid metastasis, and a generally poor prognosis. Patients with TNBC and BRCA mutations face additional therapeutic challenges due to the cancer’s intrinsic resistance to conventional therapies. Poly (ADP-ribose) polymerase inhibitors (PARPis) have emerged as a promising targeted treatment for BRCA-mutated TNBC, exploiting vulnerabilities in the homologous recombination repair (HRR) pathway. However, despite initial success, the efficacy of PARPis is often compromised by the development of resistance mechanisms, including HRR restoration, stabilisation of replication forks, reduced PARP1 trapping, and drug efflux. This review explores latest breakthroughs in overcoming PARPi resistance through combination therapies. These strategies include the integration of PARPis with chemotherapy, immunotherapy, antibody-drug conjugates, and PI3K/AKT pathway inhibitors. These combinations aim to enhance the therapeutic efficacy of PARPis by targeting multiple cancer progression pathways. The review also discusses the evolving role of PARPis within the broader treatment paradigm for BRCA-mutated TNBC, emphasising the need for ongoing research and clinical trials to optimise combination strategies. By tackling the challenges associated with PARPi resistance and exploring novel combination therapies, this review sheds light on the future possibilities for improving outcomes for patients with BRCA-mutated TNBC.</p
Profit and pleasure: English change ringing and its impact on the soundscape of Cambridge
No full textThis thesis challenges the prevailing consensus that change ringing societies in the eighteenth and nineteenth centuries were primarily concerned with recreation and sociability. Through detailed analysis of the financial and other records of the leading bellringing company in Cambridge, it demonstrates that the members were equally, if not more, concerned with the pursuit of profit and that the sums they earned could be considerable. The scale of their recreational and social activities was enabled by that income. Tracing the pattern of occasions for which the bells rang from the bellringers’ own accounts reveals that they made a more frequent contribution to the urban soundscape than has previously been appreciated. Commonly used sources of evidence for the use of church bells, such as parish records and newspaper reports, significantly understate both how often they rang and the types of occasion on which they were heard. For much of the period paid ringing overwhelmingly celebrated personal rather than public occasions and a significant proportion of the ringing was initiated by the ringers themselves in the hope of subsequent financial reward. It was entirely associated with secular occasions and never with religious worship. Taking account of the frequency with which the bells rang, the prevalence of speculative ringing, and the often personal nature of events celebrated, it is suggested that much change ringing may have had little direct meaning or significance to those who heard it. Whilst recognising that further studies are needed to confirm whether the profit motive was equally important in other urban locations, it is suggested that evidence of bells ringing should be treated with caution if it is used as an indicator of wider popular sentiment or public engagement. The distorting effect of the ringers’ pursuit of profit may lead to a re-evaluation of previous studies and should be factored into new ones.</p
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