Showing papers by "University of Huddersfield published in 2021"

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients : the DecubICUs study

Abstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.

The effect of face masks and sunglasses on identity and expression recognition with super-recognizers and typical observers.

Abstract: Face masks present a new challenge to face identification (here matching) and emotion recognition in Western cultures. Here, we present the results of three experiments that test the effect of masks, and also the effect of sunglasses (an occlusion that individuals tend to have more experienced with) on (i) familiar face matching, (ii) unfamiliar face matching and (iii) emotion categorization. Occlusion reduced accuracy in all three tasks, with most errors in the mask condition; however, there was little difference in performance for faces in masks compared with faces in sunglasses. Super-recognizers, people who are highly skilled at matching unconcealed faces, were impaired by occlusion, but at the group level, performed with higher accuracy than controls on all tasks. Results inform psychology theory with implications for everyday interactions, security and policing in a mask-wearing society.

A Survey of Autonomous Vehicles: Enabling Communication Technologies and Challenges.

Abstract: The Department of Transport in the United Kingdom recorded 25,080 motor vehicle fatalities in 2019. This situation stresses the need for an intelligent transport system (ITS) that improves road safety and security by avoiding human errors with the use of autonomous vehicles (AVs). Therefore, this survey discusses the current development of two main components of an ITS: (1) gathering of AVs surrounding data using sensors; and (2) enabling vehicular communication technologies. First, the paper discusses various sensors and their role in AVs. Then, various communication technologies for AVs to facilitate vehicle to everything (V2X) communication are discussed. Based on the transmission range, these technologies are grouped into three main categories: long-range, medium-range and short-range. The short-range group presents the development of Bluetooth, ZigBee and ultra-wide band communication for AVs. The medium-range examines the properties of dedicated short-range communications (DSRC). Finally, the long-range group presents the cellular-vehicle to everything (C-V2X) and 5G-new radio (5G-NR). An important characteristic which differentiates each category and its suitable application is latency. This research presents a comprehensive study of AV technologies and identifies the main advantages, disadvantages, and challenges.

Cycling in the Era of COVID-19: Lessons Learnt and Best Practice Policy Recommendations for a More Bike-Centric Future

Abstract: The COVID-19 pandemic has affected our cities in monumental ways with no sector likely being more severely impacted than transport. Lockdowns, physical spacing, transport restrictions and stay-at-home guidelines have transformed personal mobility and highlighted the mistakes of an unbalanced pro-car culture that defined a century of urban planning. One immediate effect of the virus in relation to travel demand and supply was the emergence of active travel modes because of their unique ability to provide a socially distanced way of transport. Cycling is one of the modes that has enjoyed significant attention. Numerous cities have reallocated street and public space to cyclists and introduced pro-bike interventions like pop-up cycle lanes, e-bike subsidies, free bike-share use and traffic calming measures. This newly found outbreak-induced momentum creates an opportunity to establish a new ethos that allows the promotion of potentially permanent strategies that may help cycling to be (re-)established as a robust, mainstream and resilient travel mode for inner city trips and not as a second-class alternative operating under the automobile’s giant shadow. This paper provides a state-of-the-art description of the anti-COVID cycling-friendly initiatives that have been introduced globally, the successes and failures of these initiatives, the lessons learnt that can help us redefine the bicycle’s role in local societies today and a best cycling practice policy guide for planning a more bike-centric future.

Multi-dimensional Circular Supply Chain Management: A Comparative Review of the State-of-the-art Practices and Research

Abstract: The circular economy (CE) concept has gained wide attention in practice as well as in academia in recent years. This paper reviews the state-of-the-art practices and research in “circular supply chain management” (CSCM), i.e., the integration of CE thinking into supply chain management (SCM) with the goal of achieving “zero wastes”. The review covers 68 real-life CE implementation cases collected by the Ellen MacArthur Foundation and 124 publications in well-established, high-ranking academic journals in operations and supply chain management. The comparative review shows that CSCM encompasses multiple dimensions, including closed-loop SCM, reverse SCM, remanufacturing SCM, recycling SCM, and industrial symbiosis. A multi-dimensional CSCM (MD-CSCM) framework is developed to synthesize their interrelationships and to categorize academic publications into multiple research themes. Based on the identified research-practice gaps and pressing research needs, this study discusses important directions for future studies to advance supply chain circularity.

Tourists’ Pro-environmental Behaviors: Moral Obligation or Disengagement?

Abstract: We study the formation of pro-environmental behaviors (PEBs) by integrating both the promoting (moral obligation) and inhibiting (moral disengagement) PEB mechanisms. Results of a sample of 285 tourists at a National Nature Reserve in China affirm that moral obligation positively affects PEB intention, while moral disengagement has significant negative impact. There is little difference in the relative importance of moral obligation and moral disengagement in affecting PEB intention. Social influence plays an important role in regulating the impacts of moral variables on PEB intentions. This study also broadens knowledge of the structure of PEB, by unveiling low-effort PEB intention as a precursor to high-effort PEB intention, and a mediator between moral obligation / moral disengagement and high-effort PEB intention. This study provides insights and implications for tourism practitioners and policy makers, and opens up future research exploration of the paradox of the promoting and inhibiting PEB mechanisms.

The impact and mechanism of fintech on green total factor productivity

Abstract: The key to balancing economic transformation and improving quality development is financial supporting green development. The relationship between financial technology (fintech) and green development has gradually emerged recently. Based on the data of 35 major cities in China from 2015 to 2019, the fintech development index and green total factor productivity (GTFP) are obtained by adopting web crawler technology and Bootstrap-SBM-GML model respectively; further, the impact of urban fintech level on GTFP is also revealed by taking the financial support policy index (FSP) as the instrumental variable. The empirical research shows the following results. First, the level of fintech and financial support policy indicators show a steady upward trend in the study period; whereas the tendency of GTFP is not obvious. Second, the urban fintech level has a significant promoting effect on GTFP through FE, MM-QR and 2SLS models. Specifically, the promoting effect mainly comes from the promotion of technological change (TC) of the GTFP decomposition index; the promoting effect will be greater in the lower cities of green development level. Third, industrial structure upgrading (UIS) and technological innovation (TI) play an intermediary role in the green development effect of fintech. Four, the green development effect of fintech is heterogeneous. Specifically, the green development effect of fintech on GTFP is larger in the central and western regions and low-level cities; whereas it is smaller in the eastern part regions and high-level cities.

Mortality risk with preadmission metformin use in patients with COVID-19 and diabetes: A meta-analysis.

Abstract: The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently the biggest threat to the public health and an enormous challenge to the healthcare systems across the world This article is protected by copyright All rights reserved

The effects of regional trade integration and renewable energy transition on environmental quality: Evidence from South Asian neighbors?

Abstract: Improving environmental quality across South Asia has become one of the utmost important policy agendas of the concerned governments. The susceptibility of the majority of the South Asian countries to multifaceted climate change adversities has motivated the need to identify the factors that can function to ensure environmental sustainability within this region. Although several studies have highlighted the importance of globalization and cleaner energy use in tackling the environmental woes of the South Asian countries, very little is known regarding the impacts of regional trade and renewable energy transition in this regard. Hence, this paper aims to scrutinize the effects of enhancing intra-regional trade integration and undergoing renewable energy transition on per capita carbon dioxide emissions in the context of six South Asian nations between 1990 and 2016. Besides, the impacts of economic growth, financial development, and urbanization on carbon dioxide emissions are also examined. The results from the recently developed cross-sectionally augmented autoregressive distributed lag regression approach, accounting for cross-sectional dependency and slope heterogeneity issues, reveal that facilitating trade among the South Asian neighbors reduces carbon emissions both in the short-and long run. Moreover, enhancing the share of renewable energy in the aggregate energy consumption figures is also found to reduce carbon dioxide emissions in both the short-and long-run. Furthermore, both regional trade integration and renewable energy transition are found to jointly reduce carbon dioxide emissions in South Asia. The results also authenticate the existence of the environmental Kuznets curve hypothesis while financial development and urbanization are found to boost carbon dioxide emissions only in the long run. Hence, the findings from this study impose key policy takeaways concerning environmental sustainability within South Asia.

Foreign Direct Investments, Renewable Electricity Output, and Ecological Footprints: Do Financial Globalization Facilitate Renewable Energy Transition and Environmental Welfare in Bangladesh?

Abstract: Phasing out fossil fuel dependency to adopt renewable energy technologies is pertinent for both ensuring energy security and for safeguarding the well-being of the environment. However, financial constraints often restrict the developing countries, in particular, from undergoing the renewable energy transition that is necessary for easing the environmental hardships. Against this background, this study makes a novel attempt to evaluate the impacts of FDI inflows on enhancing renewable energy use and attaining environmental sustainability in Bangladesh between 1972 and 2015. Using the autoregressive distributed lags with structural break approach to estimate the short- and long-run elasticities, it is found that FDI inflows enhance the share of renewable electricity output in the total electricity output levels of the country. Besides, FDI inflows are also evidenced to directly hamper environmental quality by boosting the ecological footprints figures of Bangladesh. Hence, it can be said that FDI promotes renewable electricity generation in Bangladesh but transforms the nation into a pollution haven. However, although FDI inflows cannot directly reduce the ecological footprints, a joint ecological footprint mitigation impact of FDI inflows and renewable electricity generation is evidenced. Besides, the findings also verify the authenticity of the Environmental Kuznets Curve hypothesis in Bangladesh’s context. Therefore, economic growth can be referred to as being both the cause and the panacea to the environmental problems faced by Bangladesh. These results, in a nutshell, calls for effective measures to be undertaken for attracting the relatively cleaner FDI in Bangladesh whereby the objectives of renewable energy transition and environmental sustainability can be achieved in tandem. In line with these findings, several appropriate financial globalization policies are recommended.

Efficacy of Reduced-Intensity Chemotherapy With Oxaliplatin and Capecitabine on Quality of Life and Cancer Control Among Older and Frail Patients With Advanced Gastroesophageal Cancer: The GO2 Phase 3 Randomized Clinical Trial.

Abstract: Importance Older and/or frail patients are underrepresented in landmark cancer trials. Tailored research is needed to address this evidence gap. Objective The GO2 randomized clinical trial sought to optimize chemotherapy dosing in older and/or frail patients with advanced gastroesophageal cancer, and explored baseline geriatric assessment (GA) as a tool for treatment decision-making. Design, Setting, and Participants This multicenter, noninferiority, open-label randomized trial took place at oncology clinics in the United Kingdom with nurse-led geriatric health assessment. Patients were recruited for whom full-dose combination chemotherapy was considered unsuitable because of advanced age and/or frailty. Interventions There were 2 randomizations that were performed: CHEMO-INTENSITY compared oxaliplatin/capecitabine at Level A (oxaliplatin 130 mg/m2on day 1, capecitabine 625 mg/m2twice daily on days 1-21, on a 21-day cycle), Level B (doses 0.8 times A), or Level C (doses 0.6 times A). Alternatively, if the patient and clinician agreed the indication for chemotherapy was uncertain, the patient could instead enter CHEMO-BSC, comparing Level C vs best supportive care. Main Outcomes and Measures First, broad noninferiority of the lower doses vs reference (Level A) was assessed using a permissive boundary of 34 days reduction in progression-free survival (PFS) (hazard ratio, HR = 1.34), selected as acceptable by a forum of patients and clinicians. Then, the patient experience was compared using Overall Treatment Utility (OTU), which combines efficacy, toxic effects, quality of life, and patient value/acceptability. For CHEMO-BSC, the main outcome measure was overall survival. Results A total of 514 patients entered CHEMO-INTENSITY, of whom 385 (75%) were men and 299 (58%) were severely frail, with median age 76 years. Noninferior PFS was confirmed for Levels B vs A (HR = 1.09 [95% CI, 0.89-1.32]) and C vs A (HR = 1.10 [95% CI, 0.90-1.33]). Level C produced less toxic effects and better OTU than A or B. No subgroup benefited from higher doses: Level C produced better OTU even in younger or less frail patients. A total of 45 patients entered the CHEMO-BSC randomization: overall survival was nonsignificantly longer with chemotherapy: median 6.1 vs 3.0 months (HR = 0.69 [95% CI, 0.32-1.48],P = .34). In multivariate analysis in 522 patients with all variables available, baseline frailty, quality of life, and neutrophil to lymphocyte ratio were independently associated with OTU, and can be combined in a model to estimate the probability of different outcomes. Conclusions and Relevance This phase 3 randomized clinical trial found that reduced-intensity chemotherapy provided a better patient experience without significantly compromising cancer control and should be considered for older and/or frail patients. Baseline geriatric assessment can help predict the utility of chemotherapy but did not identify a group benefiting from higher-dose treatment. Trial Registration isrctn.org Identifier:ISRCTN44687907

Drug Shortage: Causes, Impact, and Mitigation Strategies.

Abstract: Drug shortage is a global issue affecting low, middle, and high-income countries. Many countries have developed various strategies to overcome the problem, while the problem is accelerating, affecting the whole world. All types of drugs, such as essential life-saving drugs, oncology medicines, antimicrobial drugs, analgesics, opioids, cardiovascular drugs, radiopharmaceutical, and parenteral products, are liable to the shortage. Among all pharmaceutical dosage forms, sterile injectable products have a higher risk of shortage than other forms. The causes of shortage are multifactorial, including supply issues, demand issues, and regulatory issues. Supply issues consist of manufacturing problems, unavailability of raw materials, logistic problems, and business problems. In contrast, demand issues include just-in-time inventory, higher demand for a product, seasonal demand, and unpredictable demand. For regulatory issues, one important factor is the lack of a unified definition of drug shortage. Drug shortage affects all stakeholders from economic, clinical, and humanistic aspects. WHO established global mitigation strategies from four levels to overcome drug shortages globally. It includes a workaround to tackle the current shortage, operational improvements to reduce the shortage risk and achieve early warning, changes in governmental policies, and education and training of all health professionals about managing shortages.

Sustainability implementation challenges in food supply chains: a case of UK artisan cheese producers

Abstract: Food supply chains are receiving increased attention due to rapid depletion of natural resources, increasing quality standards and rising food safety and security concerns. Implementing sustainability practices in food supply chains is believed to overcome such emerging challenges. However, limited studies address sustainability implementation concerns, particularly in cold food supply chains. Thus, this study attempts to identify factors hindering sustainability implementation in cold food chain networks by considering a case of UK artisan cheese producers. Survey data is utilised to identify and prioritise barriers for implementing sustainability following fuzzy analytic hierarchy process and sensitivity analysis. The analysis identified several key barriers, including initial investment cost, firm size and unawareness of government regulations. The internal barriers significantly dominate the implementation of sustainability practices in comparison to external barriers. Lack of consensus regarding the concept of sustainability by different stakeholders is observed to be an issue negatively affecting the level of integration in SMEs. Findings will help food and dairy SME's in gaining competitive advantage through the successful implementation of sustainability practices.

Reported COVID-19 vaccines side effects among Jordanian population: a cross sectional study.

Abstract: Concerns about the safety and side effects of coronavirus SARS CoV2 vaccines have been raised among many communities worldwide. The aim of this study was to describe the side effects reported by vaccinated individuals in Jordan. A cross-sectional survey was used to recruit responses from participants who were vaccinated with either one dose or both doses of any of the administered vaccines in Jordan (AstraZeneca, Pfizer, Sinopharm). A total of 1,086 participants were enrolled in the study. Most of participants have not been infected with SARS CoV2 before receiving the vaccine (77.2%). Larger proportion of the study population received Pfizer vaccine (40.6%) followed by the AstraZeneca vaccine (33.0%), and Sinopharm vaccine (26.4%). Side effects after receiving the first dose of the vaccine were reported by most participants (89.9%) and included pain at the injection site (78.4%), fatigue (51.8%), myalgia (37.6%), headache (33.1%), and chills (32.3%). To a lesser extent, there were gastrointestinal side effects such as nausea (15.1%), loss of appetite (9.4%), and diarrhea (6.4%). More side effects were significantly associated with AstraZeneca vaccine (P < .001). Only one case for each of second dose of Pfizer and Sinopharm vaccines reported that their side effects required hospitalization. In this study, we found that people in Jordan experienced more side effects with AstraZeneca vaccine followed by Pfizer vaccine and the least one is Sinopharm vaccine. Our study showed that these side effects are not severe and should not be an obstacle against the successful control of the pandemic in Jordan.

Metamaterial-Inspired Antennas: A Review of the State of the Art and Future Design Challenges

Abstract: Metamaterials are artificial structures with the ability of exhibiting unusual and exotic electromagnetic properties such as the realisation of negative permittivity and permeability. Due to their unique characteristics, metamaterials have drawn broad interest and are considered to be a promising solution for improving the performance and overcoming the limitations of microwave components and especially antennas. This paper presents a detailed review of the most recent advancements associated with the design of metamaterial-based antennas. A brief introduction to the theory of metamaterials is provided in order to gain an insight into their working principle. Furthermore, the current state-of-the-art regarding antenna miniaturisation, gain and isolation enhancement with metamaterials is investigated. Emphasis is primarily placed on practical metamaterial antenna applications that outperform conventional methods and are anticipated to play an active role in future wireless communications. The paper also presents and discusses various design challenges that demand further research and development efforts.

Insights into Blockchain Implementation in Construction: Models for Supply Chain Management

Abstract: The interest in the implementation of distributed ledger technologies (DLTs) is on the rise in the construction sector. One specific type of DLT that has recently attracted much attention i...

Is corporate environmental disclosure associated with firm value? A multicountry study of Gulf Cooperation Council firms

Abstract: Several studies have found a relationship between corporate social and environmental disclosure and firm value (FV) or accounting profitability. Where environmental disclosure has been the focus, though, only single‐country studies have been published, and most of the previous research concerns the developed world. This study examines the association between corporate environmental disclosure (CED) and FV in the Gulf Cooperation Council (GCC) countries, where CED has been increasing from its previous low base. Findings from a multicountry sample of 500 firm‐year observations using a 55‐item unweighted environmental disclosure index suggest that CED is significantly and positively related to FV as measured by Tobin's Q (TBQ). The relationship is robust to using a weighted version of the disclosure index, individual countries and environmental disclosure subindices. Some evidence of a positive relationship between CED and return on assets is also found, but even where statistically significant, the relationship is much weaker than in the case of TBQ. For empirical and theoretical reasons, we recommend that future studies pay greater attention to market‐based proxies, if possible, when investigating the value relevance of CED in both developed and developing countries. Our results suggest that both managers and policymakers in GCC countries should take a positive view of expanded CED.