14 research outputs found
Controlling the thermoelectric properties of organo-metallic coordination polymers through backbone geometry
Poly(nickel-benzene-1,2,4,5-tetrakis(thiolate)) (Ni-btt), an organometallic coordination polymer (OMCP) characterized by the coordination between benzene-1,2,4,5-tetrakis(thiolate) (btt) and Ni2+ ions, has been recognized as a promising p-type thermoelectric material. In this study, we employed a constitutional isomer based on benzene-1,2,3,4-tetrakis(thiolate) (ibtt) to generate the corresponding isomeric polymer, poly(nickel-benzene-1,2,3,4-tetrakis(thiolate)) (Ni-ibtt). Comparative analysis of Ni-ibtt and Ni-btt reveals several common infrared (IR) and Raman features attributed to their similar square-planar nickel–sulfur (Ni–S) coordination. Nevertheless, these two polymer isomers exhibit substantially different backbone geometries. Ni-btt possesses a linear backbone, whereas Ni-ibtt exhibits a more undulating, zig-zag-like structure. Consequently, Ni-ibtt demonstrates slightly higher solubility and an increased bandgap in comparison to Ni-btt. The most noteworthy dissimilarity, however, manifests in their thermoelectric properties. While Ni-btt exhibits p-type behavior, Ni-ibtt demonstrates n-type carrier characteristics. This intriguing divergence prompted further investigation into the influence of OMCP backbone geometry on the electronic structure and, particularly, the thermoelectric properties of these materials
The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy
Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations.
Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves.
Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p 90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score.
Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care
Self management, joint protection and exercises in hand osteoarthritis: a randomised controlled trial with cost effectiveness analyses
Background: There is limited evidence for the clinical and cost effectiveness of occupational therapy (OT)
approaches in the management of hand osteoarthritis (OA). Joint protection and hand exercises have been
proposed by European guidelines, however the clinical and cost effectiveness of each intervention is unknown.
This multicentre two-by-two factorial randomised controlled trial aims to address the following questions:
• Is joint protection delivered by an OT more effective in reducing hand pain and disability than no joint
protection in people with hand OA in primary care?
• Are hand exercises delivered by an OT more effective in reducing hand pain and disability than no hand
exercises in people with hand OA in primary care?
• Which of the four management approaches explored within the study (leaflet and advice, joint protection, hand
exercise, or joint protection and hand exercise combined) provides the most cost-effective use of health care
resources
Methods/Design: Participants aged 50 years and over registered at three general practices in North Staffordshire
and Cheshire will be mailed a health survey questionnaire (estimated mailing sample n = 9,500). Those fulfilling the
eligibility criteria on the health survey questionnaire will be invited to attend a clinical assessment to assess for the
presence of hand or thumb base OA using the ACR criteria. Eligible participants will be randomised to one of four
groups: leaflet and advice; joint protection (looking after your joints); hand exercises; or joint protection and hand
exercises combined (estimated n = 252). The primary outcome measure will be the OARSI/OMERACT responder
criteria combining hand pain and disability (measured using the AUSCAN) and global improvement, 6 months
post-randomisation. Secondary outcomes will also be collected for example pain, functional limitation and quality
of life. Outcomes will be collected at baseline and 3, 6 and 12 months post-randomisation. The main analysis will
be on an intention to treat basis and will assess the clinical and cost effectiveness of joint protection and hand
exercises for managing hand OA.
Discussion: The findings will improve the cost-effective evidence based management of hand OA
Urban exploration as deviant leisure
Recreational trespass or ‘urban exploration’ is the practice of researching, gaining access to and documenting forbidden, forgotten or otherwise off-limits places, including abandoned buildings, high-rise construction sites and infrastructure systems. Over the past two decades a global subculture has coalesced around this activity. More recently, however, the practice has begun to transform along divergent lines. As numerous corporations have sought to cash in on what they see as the latest edgy urban branding opportunity in an attempt to market their products to young urban consumers, new and increasingly image-centric, spectacular and conformative variants of the practice have emerged. Based on ongoing (auto)ethnographic research and in-depth interviews with urban explorers, this chapter considers how processes of commodification and corporate sponsorship, in conjunction with the emergence of new social media platforms, have drastically altered both the firsthand experience of the practice and the dynamic of the subculture more generally. The chapter suggests that urban exploration has been thoroughly assimilated into a dominant neoliberal culture of spectacular consumption, exhibiting the kinds of individualistic, competitive and risk-taking behaviours valued within the current social conjuncture, and asks: to what extent, if any, can urban explorers recuperate the practice’s transgressive potential? It is my hope that the potential of urban exploration, and of other similar practices that engage with urban spaces in novel and informal ways, as genuinely prosocial forms of leisure can be realised. However, we must first recognise and understand the myriad harms associated with commodified leisure more broadly
Alguns dados sobre o comportamento parasitológico das linhagens humana e silvestre do Schistosoma mansoni, no Vale do Rio Paraíba do Sul, SP (Brasil)
Health Technology Assessment in Osteoporosis.
We review the various aspects of health technology assessment in osteoporosis, including epidemiology and burden of disease, and assessment of the cost-effectiveness of recent advances in the treatment of osteoporosis and the prevention of fracture, in the context of the allocation of health-care resources by decision makers in osteoporosis. This article was prepared on the basis of a symposium held by the Belgian Bone Club and the discussions surrounding that meeting and is based on a review and critical appraisal of the literature. Epidemiological studies confirm the immense burden of osteoporotic fractures for patients and society, with lifetime risks of any fracture of the hip, spine, and forearm of around 40 % for women and 13 % for men. The economic impact is also large; for example, Europe's six largest countries spent 31 billion on osteoporotic fractures in 2010. Moreover, the burden is expected to increase in the future with demographic changes and increasing life expectancy. Recent advances in the management of osteoporosis include novel treatments, better fracture-risk assessment notably via fracture risk algorithms, and improved adherence to medication. Economic evaluation can inform decision makers in health care on the cost-effectiveness of the various interventions. Cost-effectiveness analyses suggest that the recent advances in the prevention and treatment of osteoporosis may constitute an efficient basis for the allocation of scarce health-care resources. In summary, health technology assessment is increasingly used in the field of osteoporosis and could be very useful to help decision makers efficiently allocate health-care resources
Co-Construction of Experiences During Co-Creation: A Conceptual Framework and a Research Agenda
Roadmap on energy harvesting materials
Abstract
Ambient energy harvesting has great potential to contribute to sustainable development and address growing environmental challenges. Converting waste energy from energy-intensive processes and systems (e.g. combustion engines and furnaces) is crucial to reducing their environmental impact and achieving net-zero emissions. Compact energy harvesters will also be key to powering the exponentially growing smart devices ecosystem that is part of the Internet of Things, thus enabling futuristic applications that can improve our quality of life (e.g. smart homes, smart cities, smart manufacturing, and smart healthcare). To achieve these goals, innovative materials are needed to efficiently convert ambient energy into electricity through various physical mechanisms, such as the photovoltaic effect, thermoelectricity, piezoelectricity, triboelectricity, and radiofrequency wireless power transfer. By bringing together the perspectives of experts in various types of energy harvesting materials, this Roadmap provides extensive insights into recent advances and present challenges in the field. Additionally, the Roadmap analyses the key performance metrics of these technologies in relation to their ultimate energy conversion limits. Building on these insights, the Roadmap outlines promising directions for future research to fully harness the potential of energy harvesting materials for green energy anytime, anywhere