179566 research outputs found
Sort by
Ten questions concerning the future of residential indoor air quality and its environmental justice implications
Get PDFHumans spend a large proportion of their time at home, where exposure to poor indoor air quality has detrimental – and often inequitably distributed – impacts on health and wellbeing. Unprecedented changes to residential indoor environments are expected in the coming decades, especially in order to meet net zero energy and greenhouse gas emissions targets. However, it is unclear how these changes will affect indoor air quality, and to what extent they will differentially impact different social groups. In this paper, we pose and address ten questions concerning the future of residential indoor air quality and its environmental justice implications. We pay attention to environmental justice in relation to indoor air quality, including distributive, procedural, recognition, capabilities, and epistemic dimensions. The ten questions specifically address: social gradients in health and exposure, and how changes in climate, policies, behaviours, technologies, populations, and demographics might affect residential indoor air quality and environmental justice. We also highlight the role that transdisciplinary research can play in improving residential indoor air quality in a more environmentally just way.</p
A Cost-Effectiveness Analysis of Abemaciclib in Combination with Adjuvant Endocrine Therapy for HR+, HER2–, Node-Positive, High-Risk Early Breast Cancer
Get PDFIntroductionThe monarchE trial demonstrated that the addition of 2 years of abemaciclib to adjuvant endocrine therapy (ET) significantly reduced the risk of disease recurrence in patients with hormone receptor positive (HR+), and human epidermal growth factor receptor 2–negative (HER2–), node-positive early breast cancer (EBC) at high risk of disease recurrence. Abemaciclib meets a critical unmet need for more effective adjuvant therapy for this patient population. This study evaluates the cost-effectiveness (CE) of abemaciclib plus ET compared to ET alone.MethodsA five-state cohort transition model, which presents a United Kingdom (UK) perspective, is parameterized using data from the monarchE trial and literature. Cost-effectiveness results are presented in terms of cost/quality-adjusted life year (QALY) over a lifetime time horizon. Various assumptions were tested through sensitivity and scenario analyses and uncertainty was assessed through probabilistic analysis.ResultsPatients receiving abemaciclib plus ET were predicted to experience higher QALYs (11.16 compared to 10.42) at an increased cost (£87,541 compared to £48,625), leading to an incremental cost-effectiveness ratio (ICER) of £52,317 per QALY gain compared to ET alone. The increased costs associated with the addition of abemaciclib were partially offset by a reduction in distant disease recurrence and associated costs. The scenario and sensitivity analyses supported robust base case results.ConclusionDespite the ICER exceeding usual willingness-to-pay (WTP) levels in the UK, a consequence of using list prices, the CE model utilizing the latest data cut from the monarchE trial, demonstrated that the upfront cost of abemaciclib reduces the risk of a terminal breast cancer prognosis and its associated cost and quality of life impact. The addition of 2 years of abemaciclib provides an option for the treatment of HR+, HER2–, node-positive, high-risk EBC
RFFI Protocols Using Antenna Mutual Coupling and Power Amplifier Nonlinear Memory Effects
Get PDFThis letter presents a radio frequency fingerprinting identification (RFFI) protocol in wireless links with multi-antenna array transmitters. Multi-antenna systems are widely used in wireless communication systems for diversity and/or multiplexing. The mutual coupling (MC) effects arising from electromagnetic interactions between adjacent array elements can influence the RF characteristics of the transmitter and eventually the performance of the established links. In this letter, a novel RFF strategy is proposed to expand the differences in the RFF characteristics among wireless devices from the same vendor, with the goal of massively improving RFF classification accuracy in low to medium signal-to-noise ratio (SNR) channel conditions. Experimental results show that when classifying six power amplifiers (PAs) from the same vendor, 21% to 62% average classification accuracy improvement can be achieved by enlarging the RFF feature differences arising from the PA nonlinearity arising from the array coupling.</p
Composition of plant-based diets and the incidence and prognosis of inflammatory bowel disease:a multinational retrospective cohort study
Get PDFBACKGROUND: Many currently proposed diets for inflammatory bowel disease (IBD) focus on increasing plant-based foods, although a vegetarian diet can still contain products such as emulsifiers and refined grains that are believed to negatively impact IBD incidence and progression. To better inform dietary management in IBD, we investigated the association between plant-based diets and the incidence and complications of IBD.METHODS: We leveraged data from the UK Biobank (UKB, 2009-2022) including 187,888 participants free of IBD at baseline and the European Prospective Investigation into Cancer and Nutrition (EPIC, 1991-2010) cohort including 341,539 individuals free of IBD across centres among Denmark, France, Germany, Greece, Italy, the Netherlands, Sweden and UK. Healthy and unhealthy diets were characterised using plant-based diet indexes (PDIs); in individual participants, these were based on the 24-h dietary recalls for UKB and food frequency questionnaires for EPIC. The primary outcome was the incidence of IBD; secondary outcomes evaluated endpoints of disease prognosis (IBD-related surgery, diabetes, cardiovascular diease, and all-cause mortality). Cox regression was applied to estimate hazard ratios (HRs).FINDINGS: In the UKB (925 incident IBD, median follow-up 11.6 years, IQR 1.3 years), higher adherence to healthy PDI was associated with a lower IBD risk (HR 0.75, 95% CI 0.60-0.94), while higher alignment to an unhealthy PDI associated with an increased risk (HR 1.48, 95% CI 1.21-1.82) when comparing extreme quintiles of PDIs. Among individuals with established IBD, healthy PDI was inversely associated (HR 0.50, 95% CI 0.30-0.83) and unhealthy PDI was positively associated (HR 2.12, 95% CI 1.30-3.44) with need for IBD-related surgery. We did not observe significant associations between PDIs and risk of cardiovascular disease, diabetes mellitus or mortality. In the EPIC study (548 incident IBD, median follow-up 14.5 years, IQR 7.0 years), the HR of incident IBD for healthy PDI was 0.71 (95% CI 0.59-0.85) and for unhealthy PDI was 1.54 (95% CI 1.30-1.84).INTERPRETATION: We provide evidence that the composition of a plant-based diet may be an important determinant of the risk of developing IBD, and of disease course after diagnosis. Further research is needed to explore the mechanistic pathways linking plant-based diets and IBD incidence and prognosis.FUNDING: National Natural Science Foundation of China, Natural Science Fund for Distinguished Young Scholars of Zhejiang Province, National Undergraduate Training Program for Innovation and Entrepreneurship, CRUK Career Development Fellowship, The "Co-PI" project, Natural Science Fund for Excellent Young Scholars of Hunan Province.</p
Effects of non-uniform rebar corrosion on the seismic behaviour of RC Columns
Get PDFRebar corrosion is one of the significant challenges faced by marine concrete structures during long-term service. Under seismic loading, rebar corrosion can lead to premature failure of reinforced concrete (RC) components or structures due to degraded strength and deformation capacities. To investigate the effects of corrosion on the seismic performance of RC columns, cyclic loading tests were conducted on four RC columns, three of which were corroded using an artificial pre-cracking method to simulate corrosion damage scenarios that may occur during service life. After the tests, all corroded rebar were extracted, and detailed corrosion distribution data were obtained through 3D scanning. The failure modes, residual lateral load-bearing capacity and deformability of the RC columns are analysed in conjunction with the corrosion distribution and the residual mechanical properties of the rebar. The results demonstrate that corrosion markedly impairs the seismic performance of RC columns and significantly affects their failure modes. The peak lateral load-bearing capacity of corroded RC columns tends to be governed by the combined maximum degree of corrosion in adjacent bars, while the lateral deformability is controlled by the residual deformability of the most severely corroded rebar within the plastic hinge region. The proposed simplified analysis for the peak strength and ultimate deformation shows satisfactory predictions when compared with the experimental results
A core outcome set for future male infertility research: development of an international consensus
No full textObjective: To develop a core outcome set for male infertility trials. Design: A two-round Delphi survey and consensus development workshop were undertaken with healthcare professionals, researchers and clinicians globally. Subjects: 334 participants from 39 countries participated in the Delphi Survey, while 44 participants from 21 countries participated in the consensus development workshop. Exposure: NA Main Outcome Measures: The core outcome set for male infertility trials has been developed by the inclusion of specific male-factor outcomes in addition to the general infertility core outcome set which focuses on female-factor outcomes. Results: The outcomes identified include assessment of semen using the World Health Organisation recommendations for semen analysis; viable intrauterine pregnancy confirmed by ultrasound (accounting for singleton, twin and higher multiple pregnancies); pregnancy loss (accounting for ectopic pregnancy, miscarriage, stillbirth and termination of pregnancy); live birth; gestational age at delivery; birthweight; neonatal mortality; and major congenital anomaly. Although not a requirement as part of the core outcome set, other outcomes were identified as potentially useful in certain study settings. Conclusion: Embedding the core outcome set within RCTs and systematic reviews should ensure the comprehensive selection, collection and reporting of core outcomes, which are inconsistently reported at present. Research funding bodies, the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement, and over 80 specialty journals, including the Cochrane Gynaecology and Fertility Group, Fertility and Sterility and Human Reproduction, have committed to implementing this core outcome set for male infertility trials. Trial Registration Number: Core Outcome Measures in Effectiveness Trials (COMET) initiative registration No: 1586. Available at www.comet-initiative.org/Studies/Details/1586.</p
Cost-consequence analysis of an e-health intervention to reduce distress in dementia carers: results from the iSupport randomised controlled trial
No full textObjective: The use of e-health interventions has grown in demand due to their accessibility, low implementation costs and their potential to improve the health and well-being of people across a large geographical area. Despite these potential benefits, little is known about the cost-effectiveness of self-guided e-health interventions. The aim of the study was to compare the cost and consequences of ‘iSupport’, an e-health intervention to reduce mental health issues in dementia carers.Design: A cost-consequence analysis (CCA) of a multi-centre, single-blind randomised controlled trial of iSupport. The CCA was conducted from a public sector (National Health Service, social care and local authority) perspective plus a wider societal perspective. Delivery costs of iSupport were collected using a bottom-up micro-costing approach.Setting: 352 participants were recruited from three centres in England, Wales and Scotland.Participants: Participants eligible for inclusion were adults over the age of 18 years who self-identified as an unpaid carer with at least 6 months of experience caring for an individual with a diagnosis of dementia. Between 12 November 2021 and 31 March 2023, 2332 carers were invited to take part in the study. 352 participants were randomised: 175 randomised to the iSupport intervention group and 177 to the usual care control group. The mean age of participants in the intervention and control groups was 63 and 62, respectively.Main outcome measures: The CCA presented the disaggregated costs and health-related quality of life measured using the EuroQol five-dimension.Results: There was no significant difference in generic health-related quality of life measured using the EQ-5D-5L (p=0.67). Both groups reported higher mean costs between baseline and 6 months, but the change in costs was significantly lower in the intervention group. Between baseline and 6 months, the mean change in total resource use costs from the public sector perspective was significantly different between groups (p=0.003, r=−0.161) reporting a mean change per participant of £146 (95% CI: −33 to 342) between the intervention and control groups. From the wider societal perspective, there was no significant difference (p=0.23) in the mean change in total resource use and informal care costs between the two groups from baseline to 6 months.Conclusion: Use of iSupport was associated with reduced health and social care resource use costs for carers compared with care-as-usual. Self-guided e-health interventions for dementia carers may have the potential to reduce health and social care resource use and wider societal costs, but evidence relating to their effectiveness and cost-effectiveness is lacking.Trial registration number: ISRCTN17420703
Where does the money flow? An exploratory study on the financial structures of serious organised crime linked to child sexual exploitation
Get PDFThis scoping review represents the first comprehensive examination of the economic and financial structures of serious crime organisations (SCOs) linked to child sexual exploitation (CSE). By synthesising academic and grey literature published between 2014 and 2024, alongside expert interviews conducted in Colombia, South America, this research provides crucial insights into the financial features, transactional characteristics, and supply-demand dynamics that fuel this illicit market. The study aims to inform criminal investigations and policy development by illuminating the operational economic patterns of SCOs engaged in CSE. The findings reveal the diverse structures of these organisations, ranging from small, localised groups to sophisticated transnational networks. The study also highlights the prevalence of business-like models employed by SCOs, their interconnectedness with other illicit markets, the preference for types of transactions that prioritise anonymity, the supply and demand influencing factors, and the critical need for a comprehensive, preventative approach to combatting CSE
Contracts:Reterritorialising the (global) exercise of authority
Get PDFContemporary practices of authority by states and non-state actors alike are at odds with international law’s orthodox time-spaces, causing disciplinary anxiety. As a result, although there is a sense of the importance of global value chains (GVCs), these are invisible to the disciplinary gaze. This is not limited to international law; neo-formalist contract law and private international law suffer the same fate. There is for some a turn to ‘the global’ to understand alterity. In this paper, I argue that understanding the time-spaces created by the practice of contracting can offer important reflection on, among other things, what ‘the global’ is. The paper explores the practice of exercising authority through contractual relations at the level of the individual contract, the chain as a whole, and the use of standardised contractual clauses and model contracts. The article suggests these contractual relations are constitutive not only of spatiality but of territoriality. As such, it is possible to reterritorialise global phenomena, and ‘the global’, that have until now been understood to have deterritorialised from state or international legal orders
The Diffuse Solid Method for Wetting and Multiphase Fluid Simulations in Complex Geometries
Get PDFWe develop a diffuse solid method that is versatile and accurate for modeling wetting and multiphase flows in highly complex geometries. In this scheme, we harness N + 1-component phase field models to investigate interface shapes and flow dynamics of N fluid components, and we optimize how to constrain the evolution of the component employed as the solid phase to conform to any pre-defined geometry. Implementations for phase field energy minimization and lattice Boltzmann method are presented. Our approach does not need special treatment for the fluid-solid wetting boundary condition, which makes it simple to implement. To demonstrate its broad applicability, we employ the diffuse solid method to explore wide-ranging examples, including droplet contact angle on a flat surface, particle adsorption on a fluid-fluid interface, critical pressure on micropillars and on Salvinia leaf structures, capillary rise against gravity, Lucas-Washburn's law for capillary filling, and droplet motion on a sinusoidally undulated surface. Our proposed approach can be beneficial to computationally study multiphase fluid interactions with textured solid surfaces that are ubiquitous in nature and engineering applications
Access Repository Dashboard
Do you manage Edinburgh Research Explorer? Access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard!