A case study in statistical software development for advanced evidence synthesis: the combined value of analysts and research software engineers

Background Since 2015, the Complex Reviews Synthesis Unit (CRSU) has developed a suite of web-based applications (apps) that conduct complex evidence synthesis meta-analyses through point-and-click interfaces. This has been achieved in the R programming language by combining existing R packages that conduct meta-analysis with the shiny web-application package. The CRSU apps have evolved from two short-term student projects into a suite of eight apps that are used for more than 3,000 h per month. Aim Here, we present our experience of developing production grade web-apps from the point-of-view of individuals trained primarily as statisticians rather than software developers in the hopes of encouraging and inspiring other groups to develop valuable open-source statistical software whilst also learning from our experiences. Key challenges We discuss how we have addressed challenges to research software development such as responding to feedback from our real-world users to improve the CRSU apps, the implementation of software engineering principles into our app development process and gaining recognition for non-traditional research work within the academic environment. Future developments The CRSU continues to seek funding opportunities both to maintain and further develop our shiny apps. We aim to increase our user base by implementing new features within the apps and building links with other groups developing complementary evidence synthesis tools.</p

Cardiac function and mechanics in systemic sclerosis: a systematic review and meta-analysis

Objectives The study aimed to evaluate differences in conventional, tissue Doppler imaging (TDI) and speckle-tracking echocardiographic (STE) parameters of all cardiac chambers between SSc patients and healthy controls. Methods A study search strategy based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed. MEDLINE, Scopus and Web of Science were searched using the following keywords: “speckle tracking”, “global strain”, “longitudinal strain”, “circumferential strain”, “radial strain”, “atrial strain”, “right ventricular strain”, or “left ventricular strain” and “systemic sclerosis”. Primary pooled analyses were performed on each cardiac parameter independently to determine the weighted mean difference (WMD) between SSc and controls. Further independent subgroup analyses were performed to compare symptomatic vs asymptomatic SSc and diffuse vs limited SSc. Results The systematic review and meta-analysis included 41 case–control eligible reports studies with a pooled sample size of 2497 SSc cases and 1439 controls. Significant weighted mean differences (WMD) between SSc patients and healthy controls were identified in septal S’ wave (WMD 0.343 cm/s, CI [− 0.540–0.145], I2: 36%, p = 0.001), lateral S’ wave (WMD 0.795 cm/s, CI [− 1.394–0.197], I2: 0%, p = 0.009), tricuspid S’ wave (WMD 1.137 cm/s, CI [− 1.784–0.489], I2: 84%, p = 0.001), septal e’ wave (WMD 1.398 cm/s, CI [− 2.272–0.523], I2: 82%, p = 0.002) and lateral e’ wave (WMD 3.545 cm/s, CI [− 4.990–2.100], I2: 71%, p < 0.001) velocities. STE parameters were attenuated in patients with SSc, with impairment of left ventricular global longitudinal (WMD 2.765%, CI [− 3.482–2.049], I2: 91%, p < 0.001), circumferential (WMD 3.145%, CI [− 4.181–2.109], I2: 79%, p < 0.001), and radial (WMD 4.044%, CI [− 6.199–1.889], I2: 0%, p < 0.001) strain, right ventricular free wall (WMD 4.492%, CI [− 6.048–2.937], I2: 76%, p < 0.001) and right ventricular global longitudinal strain (WMD 2.843%, CI [− 3.290–2.396], I2: 32%, p < 0.001), as well as left (WMD − 8.317%, CI [− 11.873–4.761], I2: 82%, p < 0.001) and right (WMD 7.346%, CI [− 10.536–4.156], I2: 26%, p < 0.001) atrial reservoir strain. Conclusion SSc is associated with significantly impaired cardiac function and mechanics compared to healthy individuals, even in the absence of symptoms or pulmonary hypertension. Graphical Abstract</p

Tree ring isotopes reveal an intensification of the hydrological cycle in the Amazon

Over recent decades the Amazon region has been exposed to large-scale land-use changes and global warming. How these changes affect Amazonia’s hydrological cycle remains unclear as meteorological data are scarce. We use tree ring oxygen isotope records to confirm that the Amazon hydrological cycle has intensified since 1980. Diverging isotopic trends from terra firme and floodplain trees from distinct sites (approximately 1000 km apart) in Western Amazon indicate rainfall amounts increased during the wet season and decreased during the dry season at large-scale. Using the Rayleigh distillation model, we estimate that wet season rainfall increased by 15–22%, and dry season rainfall decreased by 8–13%. These diverging trends provide evidence, independent from existing climate records, that the seasonality of the hydrological cycle in the Amazon is increasing. Continuation of the observed trends will have a pervasive impact on Amazon forests and floodplain ecosystems, and strongly affect the livelihoods of the regional riverine communities.</p

Prevalence and patterns of multiple long-term conditions among lymphatic filariasis patients in Odisha, India: a community-based cross-sectional study

Introduction: Neglected tropical diseases (NTDs), such as lymphatic filariasis, mimic other chronic conditions and share common risk behaviors with parallel health system issues that require unique interventions. Multiple long-term conditions (MLTCs or multimorbidity), defined as two or more chronic conditions has become increasingly common in low- and middle-income countries (LMICs) such as India. However, data on the prevalence of the interface between NTDs and other chronic conditions are lacking. We estimated the prevalence and correlates of MLTC, assessed the commonly occurring patterns, and investigated the association between self-rated health (SRH) and the number of chronic conditions among patients with lymphatic filariasis. Methods: A cross-sectional study was conducted in Odisha, India, using a prevalidated MLTC assessment tool. We employed systematic random sampling to recruit 584 participants aged ≥ 18 years having lymphatic filariasis. MLTC was defined as the coexistence of one or more chronic conditions along with lymphatic filariasis. A multivariable logistic regression model was used to identify the correlates presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). A hierarchical cluster analysis was conducted to identify the major clusters of chronic conditions. An ordinal regression model was used to assess the association between SRH and the number of chronic conditions. Results: The overall prevalence of MLTC was 68.8% (95% CI: 64.9–72.6), while the mean number of chronic conditions was 2 ± 2.3. The chance of having MLTCs was greater among males [AOR: 3.9 (95% CI: 2.1–7.3)] than females. Participants with education at the primary and secondary school levels had greater odds of having MLTC [AOR: 2.2 (95% CI: 1.3–3.7)] and [AOR: 2.3 (95% CI: 1.3–3.8)], respectively. The commonly observed triad was lymphatic filariasis with arthritis and peptic ulcer disease (1.5%), while the most common tetrad was lymphatic filariasis, hypertension, diabetes and peptic ulcer disease (0.7%). There was a per unit decrease in SRH with each additional chronic condition. Conclusion: We observed a high prevalence of MLTC among people with lymphatic filariasis. The findings of this study will not only be useful for both resource and planning in India but also in similar LMICs with a high burden of lymphatic filariasis.</p

Pulmonary rehabilitation healthcare professionals understanding and experiences of the protected characteristics of service users: A qualitative analysis

Background Health inequalities can affect access and uptake to pulmonary rehabilitation (PR). An individual’s protected characteristics (age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation) may contribute to health inequalities. Healthcare professionals (HCPs) experiences of the inclusivity and representativeness of PR services and knowledge of protected characteristics are unknown, however are vital for the identification and resolution of health inequalities. This qualitative study explored HCPs understanding of protected characteristics and their perception of the inclusivity, representativeness and equitable benefit of their PR services. Methods Semi-structured qualitative interviews were conducted in person or via videoconferencing with HCPs involved in PR from two healthcare providers. Interviews were analysed using reflexive thematic analysis. Results 12 interviews were conducted with physiotherapists ( n = 6), occupational therapists ( n = 2), nurses ( n = 2) and exercise physiologists ( n = 2). Participants had a median (IRQ) age of 43 (13) and 75% ( n = 9) were female. Four themes were generated. 1: ‘I don’t really know as much as I should’ [about protected characteristics]; 2: It’s uncomfortable collecting protected characteristics…; 3: ‘I don’t think [service users] are as representative as they could be’; 4: A conventional rehabilitation programme does not meet the needs of all. Conclusions This study highlighted several challenges in HCPs understanding of protected characteristics and the representativeness of PR that must be addressed to ensure equity. Strategies, to understand barriers in accessing PR that limit representativeness should be explored.</p

Ideological Production, Organisational Structures, and Promotional Strategies of Crypto-asset and Web3 Platform Players

No description supplied</p

The role of multisystemic resilience in fostering critical agency: UK adolescents during the COVID-19 Pandemic

Critical agency (CA) refers to an individual’s feeling of power in relation to social inequalities. Research has demonstrated that high CA is associated with positive adolescent outcomes, however, less is known about what supports are important for its development. Moreover, a large majority of the literature is based on studies from the US and various countries in Africa; although the UK is saturated with inequalities there is little research within a UK context. In this paper we examine (a) the validity of using an existing measure of CA with a sample of UK adolescents and (b) the extent to which resilience supports account for variance in CA. Our analysis identified two distinct factors of CA: justice-oriented and community-oriented. High CA in both factors was explained by resilience supports associated with peer relationships (p </p

Assessing the impact of Nile water level fluctuations on the structural stability of the Philae Temples in Aswan, Egypt

The ancient Egyptian temples at the Philae UNESCO World Heritage Site in Aswan face conservation challenges due to fluctuating water levels, which threaten their building material resistance. Following a summary review of the hydrological changes to the natural responses of the Nile caused by the construction of the Aswan dam, our research employs a novel approach, combining remote sensing data analysis, literature review, fieldwork, and multiple high-specification materials analyses, to assess the impact of these changes on the temples in Philae. The new data permit the identification of the most at-risk areas and inform the long-term monitoring and conservation of Philae. Our approach enhances understanding of the causes and effects of building material decay and underscores the urgent need for conservation strategies to mitigate ongoing water-induced deterioration. The research highlights the impact of human-induced hydrological changes, offering a case study that informs future climate change effects. It is clear that tough decisions will be required for the long term heritage conservation of the Philae temples in the face of modern infrastructural developments and climate change, and that cultural heritage management guidelines before and after dam construction is urgently required. The issues identified, are not unique to the Philae Temples so the results and recommendations are relevant to other World Heritage sites that are currently facing similar environmental and conservation challenges.</p

A mixed-methods exploration of regular consumers’ experiences of plant-based meat alternatives (PBMA) in Singapore and the United Kingdom

Research on plant-based meat alternatives (PBMA) often focuses on its initial acceptance among new consumers with limited investigation into consumers who regularly incorporate PBMA in their diets. This study used a mixed methods approach to investigate PBMA consumption patterns, including motivations and barriers to sustained consumption, among 404 regular consumers (defined as PBMA consumption of at least once a week) in Singapore and the UK (SG: n=228; UK: n=176; 57.9 % women; 69.8 % aged 21–40 years old). Quantitative results showed similar PBMA consumption between Singapore and the UK (p=.498) but motives and barriers to sustained consumption and their consumer characteristics (i.e., food choice motives, food neophobia) were significantly different (p<.001). UK consumers showed greater agreement with motivational statements and were more sustainability-driven while Singapore consumers showed greater agreement with barrier statements and valued the impact of food on their body more. Product-related motives (β=0.22, p<.001) and accessibility barriers (β=0.15, p=.024) predicted overall PBMA consumption in both countries. Qualitative results suggest that whilst UK and Singapore consumers were satisfied with PBMA, they wanted higher nutritional quality, greater accessibility to affordable options and a wider variety. Further improvements in these areas could encourage repeated purchases and support the long-term adoption of PBMA.</p

Non-stationary modes of suction and an external free-stream for the boundary-layer flow over a rotating disk

This study is dedicated to examining how traveling modes influence the flow of a boundary layer over a rotating disk in an axial fluid system under suction. It is understood that non-stationary modes become evident in the boundary layer of a rotating disk characterized by highly polished and exceptionally smooth surfaces. Our primary focus is on an asymptotic analytical method we used to solve the governing equations and output the waveangle and wavenumber of the system. Then, it is followed by comparing data from asymptotic and numerical analyses concerning types I and II. We further examine how variations in traveling mode frequencies impact the critical Reynolds number for type I instabilities in axial flow scenarios with suction applied to the rotating disk. Additionally, an energy balance analysis is performed to evaluate the influence of traveling mode frequencies on type I instabilities. Our findings reveal that increasing the frequency destabilizes the viscous wall type II modes while the inviscid cross-flow type I modes become more stable. This study enhances our understanding of the effects of axial flow direction and strength, as well as suction, on stability in fixed axial flow conditions.</p