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Does the Integration of Fintech and Green Finance Enhance Sustainability Performance in the Banking Sector? Information Technology Governance as Moderator
No full textThis paper investigates the impact of Fintech and green finance on enhancing sustainability performance through information technology governance. We collected questionnaires from 611 banking institutions in Nigeria, Ghana, and Cameroon from May to October 2024 and analyzed them with Partial Least Squares-Structural Equation Modeling and PROCESS models. The empirical findings show that (1) both Fintech, green finance, and IT governance positively influence sustainability performance; (2) Fintech has a positive effect on green finance and (3) IT governance acts as a significant moderator between Fintech and sustainability performance. Moreover, we find similar results at the country level, with Nigeria showing a greater impact of Fintech on sustainable performance than Ghana and Cameroon, while Ghana presents a larger effect of green finance and IT governance on sustainable performance than Nigeria and Cameroon. The paper highlights the significance of integrating Fintech and green finance in banking institutions for sustainability and IT governance in emerging markets, offering valuable insights for policymakers and practitioners.</p
Duplex UltraSound afTer Endo Revascularisation (DUSTER): protocol for a randomised controlled feasibility trial
No full textIntroduction Endovascular therapy is the main treatment for chronic limb-threatening ischaemia in the UK. Despite a restenosis risk of 50% over 2 years, reintervention rates are low, potentially resulting in preventable amputations. European guidelines recommend ultrasound surveillance to facilitate early treatment of restenosis. This study will investigate the use of duplex ultrasound after endo revascularisation (DUSTER). The aim is to assess the feasibility, acceptability and impact on clinical decision-making of a 1-year integrated ultrasound surveillance programme after lower limb endovascular therapy.Methods and analysis DUSTER is a mixed-methods study. Phase I is a three-site, feasibility, open-label, randomised controlled trial. The standard of care, the control arm, is standard clinical surveillance by a vascular specialist at 1, 6 and 12 months. The intervention arm will receive integrated ultrasound (ankle-brachial pressure index, toe pressure and duplex) plus standard clinical surveillance. Primary outcomes are rates of attendance and completion of ultrasound surveillance tests, as well as the percentage of participants undergoing reintervention for restenosis. Secondary outcomes are limb salvage, amputation-free survival, reasons for amputation, complications, serious adverse events and mortality.Phase II comprises independent semistructured interviews with intervention arm participants. The interviews will explore barriers and facilitators to ultrasound surveillance and the effect of ultrasound surveillance on patients’ lives.Phase III has two separate focus groups for participants and clinical stakeholders to identify which outcomes matter most in any subsequent large-scale effectiveness trials.</p
Arterial Stiffness and Subendocardial Viability Ratio: Temporal Responses to Ultra-Endurance Exercise
No full textUltra-endurance exercise causes significant cardiovascular stress, yet the vascular responses during recovery remain incompletely understood. This study examined the short- (12-18 hours) and longer-term (7 and 28 days) effects of a long-distance triathlon on arterial stiffness and subendocardial viability ratio (SEVR) in novice triathletes. Eleven participants (2 females, 9 males), novice to long-distance exercise events, completed cardiovascular assessments at baseline (pre-race), 12-18 hours post-race, and 7- and 28-days post-race. Measures included carotid-femoral pulse wave velocity (PWV), augmentation index (Aix) and SEVR, obtained via applanation tonometry. PWV remained unchanged at all post-exercise time points (P = 0.310). Aix showed significant reduction at 7 days post-event (P = 0.024), though this effect was abolished after normalizing values to a heart rate of 75 beats per minute (Aix75, P = 0.162). SEVR decreased significantly 12-18 hours post-race (P </p
Tensorized Anchor Alignment for Incomplete Multi-View Clustering
No full textIncomplete Multi-View Clustering (IMVC) focuses on uncovering the consensus and complementary information present in datasets with multiple incomplete views. However, existing IMVC methods face several limitations. First, many approaches exhibit high computational complexity. Second, anchor misalignment across views remains a challenge. Third, higher-order correlations among views are often overlooked. To address these challenges, the paper introduces a novel framework called Tensorized Anchor Alignment for Incomplete Multi-View Clustering (TAA-IMC). Specifically, the view-specific anchor graphs are constructed to reduce computational complexity while preserving the diversity of information among views. Then, to mitigate the issue of anchor misalignment, a binary alignment matrix is introduced, ensuring proper correspondence between anchors across different views. Moreover, the aligned anchor graphs are integrated into a tensor representation with a low-rank constraint, enabling the extraction of high-order correlation information. Finally, the proposed TAA-IMC is solved using an alternating update method, showcasing effectiveness through memory and time complexity analyses. Extensive comparative experiments conducted on seven benchmark datasets validate the effectiveness and superiority of TAA-IMC over state-of-the-art methods.</p
Transgressive fiction: the accuser theory
No full textThe Accuser Theory is the term this thesis awards a new trope of transgressive fiction. The principles of the trope are explained throughout via an examination of post-millennial transgressive novels for discourses that privilege male sexualized violence. To this, the project asks how does male sexualized violence construct woman in transgressive fiction and how can she be radicalised in the current digitised era? This is answered through a 75-per-cent textual analyses of prominent transgressive novels of a late Western capitalist context followed by a creative critique which radicalises woman through sexuality by turning the novelist’s transgressive frame back on itself. The aim of the thesis is to theoretically and creatively illustrate the aspects of woman that are transgressed in ‘transgressive’ novels under study that derive of what is the newly coined sex-buyer ideology, a way of seeing that’s become prevalent in the early twenty-first century Western landscape.Bret Easton Ellis, Irvine Welsh and Chuck Palahniuk ‘write transgressive fiction’ says Douglas Keesey in Understanding Chuck Palahniuk (2016:11). The mode, Robin Mookerjee in Transgressive Fiction: The New Satiric Tradition says ‘make[s] a socially relevant statement’ (2013:1). Imperial Bedrooms by Ellis (2011), Snuff by Palahniuk (2008) and Sex Lives of Siamese Twins by Welsh (2014) are selected because they offer a window into the contemporary heteronormative lens which is altered by a new, more brutally pervasive sex industry. These writers are known for their earlier transgressive works. However, a change has arisen, notable when compared with their later less radical works which articulate greater apathy towards the violence against women taboo. The deconstruction reveals inward shifts in the fiction that are more in thrall to a phallocentric capitalist patriarchy which maintain hegemony. The thesis links this literary structural alteration to a rechannelling of conservativism – a response to masculine identity in flux in postmodern times.Woman’s renewed object status in these books represents the operations of taboo and transgression through themes of punishment and control. The critical discussion is accompanied by a 25 % practice-led creative component – a transgressive novella – which offer inverted masculinist visions of transgression, departing from the rigid constructs which centre the three novels under study toward new pathways out of a language that’s split in half through the anchorage of discourse. A Hatred That Smiles is a creative response to the latest instalment of this split. Through opening the inextricable link between form and content using the experimental form to transgress her, meaning which confines her to discourse is breeched.The key to unlocking the transgressive window (transgressive fiction’s link with the novel’s point of production) is discourse. This link is concretized by the transgression and taboo process that regulates women’s sexuality in culture and thus creates the semantic borders of how we make sense of her today. By using Teun Van Dijk’s ideological approach (2011) together with Norman Fairclough’s Critical Discourse Analysis (2014), the ways of seeing that shape woman in transgressive fiction become available. The immersion of digital media to unprecedented levels have created a new sex industry which has impacted the subject in profound ways and directly inform what woman means within industrial forms of sexuality. Van Dijk proved discourse structures prevalent in society are revealed through the modal verb operators in text - which point to cultural obligatory ways of seeing – and can detect the presence of ideology governing the lens in which the fiction is told. Locating woman in the transgressive novels emerge from the rogue narrator’s use of taboos and Mookerjee’s ‘confrontation with death’ (2013:3) - the transformative trope – and thus reveal if the oppressive ideology is at play as transgressive fiction is characterized by its ‘zero moral optic’ (2013:1) says Mookerjee.Through Julia Kristeva’s Powers of Horror (1982) in Ellis, Michel Foucault’s Preface to Transgression (1963) in Welsh, and George’s Bataille’s Eroticism (1928) to Palahniuk - it is possible to approach these works as products of a new culture - from deeper philosophical estates. Transgression, Bataille says, ‘has a limited character...and does not affect the intangible stability of the [taboo] since [it is] its expected compliment’ (1928:65). However, when the literary articulation of death is present, transformation takes place, promoting ‘equality rather than hierarchy’, says Kaja Silverman in Flesh of my Flesh (2009:2), the meta-aim of the novella.Informed by a Western twenty-first-century sex industry context, the classic theories are re-historized to the present because of their perennial ability to engage taboo and transgression; the stratums of which are more visible today than ever. Additionally, the study is more fully rounded by the critique of Emily Spiers who comparatively examines novels from queer feminist authors in Pop-Feminist Narratives: The Female Subject under Neoliberalism in North America, Britain, and Germany (2018). Spiers considers successful twenty-first-century feminist writers such as Michelle Tea of Valencia (2012) and Maggie Nelson of Argonauts (2018) with some late twentieth century ones. The feminist strand operates at the borders of transgression by virtue of its political frontier to offer greater contextualization to the transgressive literary landscape whilst simultaneously exposing cultural shifts in the articulation of the sex industry of big tech. The thesis concludes in a literary radicalisation which transgresses beyond the brittle bounds of a late capitalist patriarchy - in a culture where transgression has become commercialised - to find woman’s inexorable sexuality.</p
Evaluating the Impact of an integrated clinical decision support tool intended to support earlier cancer diagnosis in primary care in Ipswich and East Suffolk CCG
No full textThis report details findings of a qualitative evaluation assessing the impact of C the Signs, the newly introduced clinical decision support tool intended to improve the recognition and early referral rates of cancer in the Suffolk and Northeast Essex (SNEE) CCG and Primary Care Network (PCN). This was an independent evaluation of C the Signs, commissioned by the Eastern Academic Health Science Network (EAHSN) in 2021, and carried out by Pamela Knight-Davidson and Sara Spear at Anglia Ruskin University between 2021-2023. The evaluation was informed by an initial quantitative survey designed in collaboration with the researchers and undertaken by Ipswich and East Suffolk CCG. Findings of this initial survey are also detailed in this report.
The reported findings are based on factors known to support or hinder uptake and use of technological innovations and services in healthcare settings, including: perceived usefulness and benefits; perceived effort (ease of use); and, social (peer) influence.1 We also provide findings related to the actual usage of C the Signs, as reported by clinicians.
Summary of findings
The findings are summarised below, and in the main report, as factors supporting adoption, and factors limiting adoption, of C the Signs. We also provide findings relating to our insights about practice procedures for 2WW (two week wait) referrals and safety netting procedures, which we anticipate will be useful for clinicians, the PCN and for the further development of C the Signs.
Factors supporting adoption of C the Signs
• C the Signs is rated as a highly effective and reliable clinical decision support tool for its intended
purpose, by most clinicians. It is also viewed as easy-to-use, with an improved user interface and
user experience (compared to the previous system).
• C the Signs is useful for supporting clinical decisions through prompts and suggestions.
This is especially useful for making decisions regarding the lesser-known cancers.
• The robustness of C the Signs, compared to the previous system, may mitigate potential errors
in 2WW referrals.
• Useful features of C the Signs were highlighted:
– a dashboard showing all referrals, facilitating better in-house tracking of referrals, in-house
auditing and PCN auditing;
– automatic population of patient information from SystmOne;
– automatic sending of follow-up information to patients, viewed as a useful safety netting feature.
2.1.2
Factors limiting adoption of C the Signs
• Clinicians reported having high familiarity and confidence in referral pathways and in recognising
cancer signs and symptoms. This had implications for the ways in which they evaluated and used
C the Signs. For example, some predictive and auto-population features were viewed as ‘irrelevant’
or surplus, ‘getting in the way’, or ‘taking longer’, (although in other instances auto population of
patient information might be considered to be useful), where this was the case, it resulted in
clinicians and:
– cutting corners, by going straight to the referral proforma for speed;
( reverting to clinical judgement)
– using SystemB’s referral form to check some referral criteria;
– using C the Signs interchangeably with SystemB.
• Some, clinicians reported that they were not using C the Signs to its full potential due to unfamiliarity
and lack of understanding of some features. As well as the reported greater reliance and confidence
in clinical acumen than on clinical decision tools, indicated above, motivation to become more
familiar with C the Signs might also have been affected by:
– time constraints;
– (potentially) reduced confidence/familiarity with technology.
• The added value of C the Signs (compared to SystemB) was not obvious to some clinicians and
impacted upon its usage.
• Some challenges encountered when using C the Signs, were reported. These suggested reduced
workflow and were reported as risks to adoption in the PCN. For example:
– ‘duplication’ of information between the clinical system (SystmOne) and C the Signs; a need for
‘integration into SystmOne’.
– reliance on good internet connection and speed, (although this was also noted to be a challenge
when using SystemB)
• Peer adoption (how colleagues use C the Signs) might be implicated in low usage. Some clinicians
reported that they were not using C the Signs at all, as it was not embraced in some practices or not
used by colleagues.
Other insights
• Some steps in the 2WW referral and safety netting processes can potentially lead to delays in
sending referrals and/or diagnosis. It is not clear whether these issues are addressed by C the Signs.
• Safety netting procedures are not standardised across the PCN, presenting opportunity to promote
and further develop the safety netting capabilities of C the Signs.
Key conclusions and recommendations
Our findings suggest that, overall, C the Signs is viewed as an effective, reliable and useful tool,
which has potential to improve upon the procedures and support offered to clinicians for making
2WW referrals and for safety netting. It is also viewed as easy to use and, as having an improved user interface compared to previous systems. Our findings also point to several factors limiting the adoption of C the Signs, however. These relate to users (e.g., reduced motivation to familiarise with it); to the device itself (e.g., perception that some features take longer) and to system limitations (e.g., time constraints limiting familiarisation and adaption) and result in reticence to use C the signs consistently, or in some cases not at all. These limitations could be addressed through strategies that support clinicians to adapt and this is reflected in recommendations 1, 2 and 3 below. Although not specific to C the Signs, other insights gathered whilst carrying out this study, point to a potential for delays in the 2WW referral and limitations to effective safety netting, which might be addressed at PCN level. Recommendations, 4 and 5 address these.
Recommendations
1. More support is required for clinicians to adapt and become more acquainted with C the Signs.
Utilising ‘innovation champions’ to work alongside clinicians and offer trouble-shooting support
might be useful within a period of transition and adjustment (ability to use both systems), followed
by a period of implementation (ability to use C the Signs only).
2. During the transition period to using C the Signs, clinicians could be allocated protected time after
2WW consultations, to enable them to familiarise themselves with the new system and consult with
colleagues and ‘innovation champions’ on its use, as required.
3. Peer endorsement (trusted peers who are first adopters) might be utilised to demonstrate the added
value of C the Signs: i.e., how it complements clinical acumen and workflow, and how it enhances the
2WW referral process.
4. Uncertainties in the process of sending a 2WW referral could be addressed through focused training
and, for example, a ‘task to admin’ confirmation receipt, and confirmation of receipt of referrals from
the referral site.
5. Safety netting procedures should be standardised across the PCN, and unsecured safety netting
procedures should be phased out. The introduction of C the Signs presents opportunity for the
PCN to maximise the potential for monitoring results and referrals outside consultations, towards
more standardised safety netting. The PCN might also encourage a culture whereby direct
responsibility for safety netting is the norm for all practice staff. Other insights
• Some steps in the 2WW referral and safety netting processes can potentially lead to delays in
sending referrals and/or diagnosis. It is not clear whether these issues are addressed by C the Signs.
• Safety netting procedures are not standardised across the PCN, presenting opportunity to promote
and further develop the safety netting capabilities of C the Signs.
Key conclusions and recommendations
Our findings suggest that, overall, C the Signs is viewed as an effective, reliable and useful tool,
which has potential to improve upon the procedures and support offered to clinicians for making
2WW referrals and for safety netting. It is also viewed as easy to use and, as having an improved user interface compared to previous systems. Our findings also point to several factors limiting the adoption of C the Signs, however. These relate to users (e.g., reduced motivation to familiarise with it); to the device itself (e.g., perception that some features take longer) and to system limitations (e.g., time constraints limiting familiarisation and adaption) and result in reticence to use C the signs consistently, or in some cases not at all. These limitations could be addressed through strategies that support clinicians to adapt and this is reflected in recommendations 1, 2 and 3 below. Although not specific to C the Signs, other insights gathered whilst carrying out this study, point to a potential for delays in the 2WW referral and limitations to effective safety netting, which might be addressed at PCN level. Recommendations, 4 and 5 address these.
Recommendations
1. More support is required for clinicians to adapt and become more acquainted with C the Signs.
Utilising ‘innovation champions’ to work alongside clinicians and offer trouble-shooting support
might be useful within a period of transition and adjustment (ability to use both systems), followed
by a period of implementation (ability to use C the Signs only).
2. During the transition period to using C the Signs, clinicians could be allocated protected time after
2WW consultations, to enable them to familiarise themselves with the new system and consult with
colleagues and ‘innovation champions’ on its use, as required.
3. Peer endorsement (trusted peers who are first adopters) might be utilised to demonstrate the added
value of C the Signs: i.e., how it complements clinical acumen and workflow, and how it enhances the
2WW referral process.
4. Uncertaintie</p
Temporal Entanglements, Fragmented Spaces: Planning, Politics, and Place Rhythms
No full textWhat does it mean for urban planners and designers to shape places through and with time? The 2020 public health restrictions highlighted the relevance of Carlos Moreno’s et al. (2021) 15-minute-city concept, which outlined the need for a “chrono-urbanism” incorporating societal resilience micro-infrastructures. Notions of temporal planning, however, have deeper roots; Kevin Lynch’s classic imageability (1964) and place-timing studies (1972) highlighted Planning as a temporal art, distinct from arts such as music, and his urban theorization (1984) identified three epochs of city form (the cosmic, organic, and mechanical) as successively dominant, spatiotemporal paradigms. More recently, Christopher Alexander’s (2002) analyses on the “nature of order” drew attention to the importance of time and geometry for the appropriate unfolding of complexity across domains from the arts and crafts to the scales of built form. Time is implicated in Planning’s capacity to effectively harness space in meeting societal needs and challenges. Given the “temporal turn” in urban planning and design, this is an appropriate juncture to reflect upon technical assumptions underlying varied approaches to place-shaping. This issue explores how currently dominant, linear-temporal modes might be influencing spatial planning and design practices, and how inclusion of diverse, forgotten, and hidden spatiotemporal narratives including from the global South could aid development of alternative theories, tools, practices, and forms. Contributions also address implications digital modes may have for education, praxis, or resilient, city visions, and what might be the contribution of temporal perspectives in addressing the slow and out-of-sight violence created by toxic geographies or urban transformations.</p
Advanced drone routing and scheduling for emergency medical supply chains in Essex
No full textRapid access to defibrillators, blood products, and time-critical medicines can improve survival, yet urban congestion and fragmented infrastructure delay deliveries. We present and evaluate an end-to-end framework for beyond-visual-line-of-sight (BVLOS) UAV logistics in Essex (UK), integrating (I) strategic depot placement, (II) a hybrid obstacle-aware route
planner, and (III) a time-window-aware (TWA) Mixed-Integer Linear Programming (MILP) scheduler coupled to a battery/temperature feasibility model. Four global planners—Ant Colony Optimisation (ACO), Genetic Algorithm (GA), Particle Swarm Optimisation (PSO),
and Rapidly Exploring Random Tree* (RRT*)—are paired with lightweight local refiners, Simulated Annealing (SA) and Adaptive Large-Neighbourhood Search (ALNS). Bench-marks over 12 destinations used real Civil Aviation Authority no-fly zones and energy constraints. RRT*-based hybrids delivered the shortest mean paths: RRT* + SA and RRT*+ ALNS tied for the best average length, while RRT* + SA also achieved the co-lowest runtime at v = 60 km h−1. The TWA-MILP reached proven optimality in 0.11 s, showing that a minimum of seven UAVs are required to satisfy all 20–30 min delivery windows in a single wave; a rolling demand of one request every 15 min can be sustained with three UAVs if each sortie (including service/recharge) completes within 45 min. To validate against a state-of-the-art operations-research baseline, we also implemented a Vehicle Routing Problem with Time Windows (VRPTW) in Google OR-Tools, confirming that our hybrid planners generate competitive or shorter NFZ-aware routes in complex corridors.
Digital-twin validation in AirborneSIM confirmed CAP 722-compliant, flyable trajectories under wind and sensor noise. By hybridising a fast, probabilistically complete sampler (RRT*) with a sub-second refiner (SA/ALNS) and embedding energy-aware scheduling,
the framework offers an actionable blueprint for emergency medical UAV networks.</p
Feasibility of a centralized sub-regional system for screening non-physical disability and quality of life in out-of-hospital cardiac arrest survivors - the REVIVE project
No full textNo description supplied</p
MATES: A tool for appraising the completeness with which a meta-analysis has been reported
No full textMeta-analysis is commonly a core component of systematic reviews and has become an important method to reconcile conflicting findings, increase statistical power, and chart new research directions. However, poor reporting practices make it challenging to evaluate the validity of meta-analyses. Despite the existence of reporting checklists, a specifically designed tool has yet to be developed to appraise the completeness with which a meta-analysis has been reported. To bridge this gap, we introduce the Meta-analysis Appraisal Tool for Environmental Sciences (MATES). To develop MATES, we adapted a Delphi process involving experts in meta-analysis methodologies, researchers with experience in guideline/appraisal tool development, and editors of relevant journals. The Delphi process had five steps, including three workshops (11–16 participants), a survey (193 participants), and a validation task (30 participants). This iterative development process resulted in a 14-item appraisal tool that reflects the environmental science and research syntheses community’s consensus on essential elements to appraise the completeness with which a meta-analysis has been reported. Validation across 50 meta-analyses demonstrated that the tool is repeatable (average agreement rate: 88.97 %) and time-efficient to implement (17.00 ± 12.23 min). We also outline guidance for interpreting MATES results, describe its potential applications, and reflect on the development process. The authors provide practical implementation guidance for each MATES item, illustrated with real examples in the supplementary material. We also report an extended development methodology to support reproducibility. Finally, we built created a ShinyApp that includes both a training module and an application tool to enhance the usability of MATES ( https://kylemorrisonisshiny99.shinyapps.io/MATES_shiny/ ). Overall, MATES provides authors, readers, stakeholders, and editors with a reliable and accessible tool for appraising the completeness with which a meta-analysis in environmental sciences has been reported.</p
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