London South Bank University

Introduction Distal biceps brachii tendon disorders predominantly result from repetitive use and eccentric loading. High-resolution ultrasound has emerged as a preferred diagnostic tool due to its dynamic imaging capabilities, accessibility, and cost-effectiveness. Topic Description This paper introduces the Radial arc technique, a didactic and systematic ultrasound scanning method from a medial approach designed to facilitate the identification of the distal biceps brachii tendon insertion in the long-axis view. The technique is a five-step sonographic approach navigating sonographers and clinicians through a series of landmarks to address the often-complex sonographic examination of the distal biceps brachii tendon insertion. The paper also provides detailed anatomical insights into the biceps brachii muscle and the distal tendinous complex, highlighting key morphological features critical for accurate ultrasound interpretation. Discussion The proposed approach is tailored to support the educational development of undergraduate and postgraduate students specialising in musculoskeletal sonography and enhance the practical skills of early-career and experienced sonographers and clinicians utilising point-of-care ultrasound. The anatomical framework provided offers a deeper understanding of the distal biceps brachii tendinous complex, supporting diagnostic accuracy for distal biceps brachii tendon-related conditions that are critical for guiding patient management. Conclusion The systematic nature of the Radial arc technique aims to standardise practices not only in clinical settings but also in the design and execution of research studies involving the assessment of the distal biceps brachii tendon integrity with ultrasound. Future research should focus on assessing the reproducibility of the Radial arc technique in diverse clinical settings and among different practitioners and operators, crucial for its adoption in sonographic diagnostics.

Over a century of research has focused on the consistency and inconsistency of human moral decision preferences. We proposed and found that moral decision preferences are flexible and shift towards newly learned moral rules when their application leads to utilitarian choices. Hence, decision-makers’ psychological concept of morality is continually under construction (on the fly); based on learning, informed by changes in moral rules and specific moral contexts. Accordingly, in two experiments we developed and employed a two-stage supervised learning task, where participants learned novel moral rules based on corrective feedback of their moral decisions. Our empirical findings revealed that participants learn new moral rules, transfer these rules to tasks where no feedback is provided. However, participants make decisions based on the principle of maximizing utility rather than a learned rule when the rule conflicts with this principle, demonstrating further the flexibility of moral decision-making. In light of our proposal and findings that decision-makers’ psychological concept of morality is continually under construction, moral decision-making researchers should integrate learning into their respective models and predictions.

Cervical cancer remains a significant global public health challenge, affecting over half a million women annually, with a mortality rate of approximately 60%, especially in resource-limited regions. This study presents an advanced methodology for cervical cancer diagnosis through deep learning techniques. Utilizing a publicly available cervical cancer image dataset, the research introduces a novel classification framework that integrates a Neural Feature Extractor (NFE) based on a pre-trained VGG16 architecture and an AutoInt model for automatic feature interaction learning. The extracted features are processed through machine learning classifiers such as KNN, LGBM, Extra Trees, and others for classification tasks. Among these classifiers, KNN achieved the highest accuracy of 99.96%, followed closely by LGBM at 99.92%. This study also assesses the computational complexity of various models, demonstrating that simpler models like LDA exhibit faster prediction times, while more complex models, such as KNN and LGBM, provide higher accuracy. These findings highlight the potential of deep learning frameworks in improving cervical cancer classification accuracy, especially in resource-limited environments.

Despite well‐matching indoor illumination spectra, the performance of wide bandgap perovskite solar cells (WB‐PSCs) for indoor photovoltaics (i‐PV) is hindered by photo‐induced halide phase segregation and trap‐assisted non‐radiative recombination. Herein, a Triple Passivation Treatment (TPT) reassembly strategy is presented to simultaneously suppress bulk and surface defects. TPT induces a transition in perovskite surface energetics from n‐type to p‐type and remarkably increases the photoluminescence quantum yield from 0.5 to 2.1%, creating a more favorable band alignment for hole extraction whilst substantially reducing halide phase segregation. As a result, 1.75 eV WB‐PSCs achieve an indoor Power Conversion Efficiency (iPCE) of 37.6% under 1000 lux illumination. Under standard sunlight conditions, the devices reach a Power Conversion Efficiency (PCE) of 20.1% and a fill factor of 78.5%, among the best performance parameters for this bandgap. Importantly, the passivated devices exhibit excellent shelf stability, retaining 92% of their initial performance after 3200 h. Under ambient air conditions at 55 °C, the unencapsulated devices maintained 76% of their initial PCE after 300 h continuous light soaking. The findings represent a significant breakthrough in the development of stable WB‐PSCs for i‐PV applications, with minimized nonradiative losses and enhanced performance.

Background/Objective To describe the introduction of highly allergenic foods in a UK population sample, and to determine whether the introduction of highly allergenic foods differed in infants with family history of allergy. Subjects/Methods A population birth cohort study recruited eligible pregnant women while they were attending an antenatal ultrasound clinic appointment at a UK city hospital. Parent-reported family history of allergy and infant diet were collected through structured interviews at recruitment and postal questionnaires. Parents reported on their infants’ diet and introduction of highly allergenic foods at around 6 months (n = 216) and around 12 months (n = 193), and infant diet around 24 months of age (n = 139). Results Most highly allergenic foods were introduced to infants at around 6–9 months. However, nut and egg were introduced much later, and 21% of children had not been exposed to egg and 35% of infants had not been exposed to nuts by 12 months. Family history of allergy did not predict late introduction of any of the highly allergenic foods but infants with a family history of allergy were more likely to have diets that avoided foods due to allergy (most commonly dairy, soya, egg and nuts). Conclusions The introduction of egg and nuts was delayed beyond one year of age in a large proportion of infants, and infants with a family history of allergy were more likely to have diets that avoided foods due to allergy. These could be modifiable risk factors for allergy development.

Objectives Various psychological concepts have been proposed over time as potential solutions to improving patient safety and quality of care. Psychological safety has been identified as a crucial mechanism of learning and development, and one that can facilitate optimal patient safety in healthcare. We investigated the quantitative evidence on the relationship between psychological safety and objective patient safety outcomes. Methods We searched 8 databases and conducted manual scoping to identify peer reviewed quantitative studies published up to February 2024. Objective patient safety outcomes of any type were eligible. The findings were analysed descriptively and discussed in a narrative synthesis. Results Nine papers were selected for inclusion which reported on heterogeneous patient safety outcomes. Five studies showed a significant relationship between psychological safety and patient safety outcomes (e.g., ventilator associated events, reported medical errors). The majority of studies reported on the experiences of nurses working in healthcare from the USA. Patient safety is consistently characterised as the absence of harm rather than a culture that creates a safe environment. Conclusions No clear conclusions can be extracted regarding the relationship between psychological safety and patient safety. For example, reporting patient safety problems in a team can be an indication of both high and low psychological safety. Patient safety may be contradictory to elements of psychological safety, as the absence of harm is not congruent with a safety environment approach. Systematic review registration: This systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD4202347829).

Purpose Hamstring injuries, particularly in the proximal Biceps femoris long head (BFlh), remain frequent in sports involving sprints and accelerations despite extensive research. Non-uniform muscle activity may contribute to these injuries by causing uneven load distribution. This study examines spatial homogeneity of muscle activity and amplitude in the proximal and distal BFlh at different knee flexion torque levels and muscle-tendon unit (MTU) lengths under controlled isometric conditions. Methods Fifteen male recreational athletes performed unilateral isometric knee flexion contractions at three MTU lengths (0°, 45°, 90° hip flexion) and torque levels (30% MVC90, 60% MVC90, 90%MVC90) with high-density surface electromyography (HDsEMG) assessing proximal and distal activity. Results The proximal BFlh exhibited lower spatial homogeneity and amplitude compared to the distal region across all conditions, with the largest homogeneity differences at lower torques and longer MTU lengths. Proximal homogeneity increased with torque and decreased with MTU length, while the distal region remained consistent. Amplitudes were lower proximally and decreased with MTU length in both regions. Conclusion The proximal–distal differences in spatial homogeneity and amplitude within the BFlh reflect non-uniform activation patterns along the BFlh and the proximal regions lower spatial homogeneity and amplitude of activation reflect non-uniform patterns, possibly contributing to injury risk.

Objectives The purpose of this study was to identify which, and to what extent, demographic and operational factors are indicative of likelihood for a new call handler or paramedic to remain in role within the first two years of employment at an ambulance trust using data held in the trust’s bespoke data warehouse. Design The study uses a retrospective observational cohort design using routinely collected data. Setting One ambulance trust focused on a large, predominantly urban area in the UK. Participants The study used the data of all employees of the trust who started employment as call handlers (869) or paramedics (1672) between 1 January 2018 and 31 July 2023. Primary and secondary outcome measures ‘Time-to-event’ analysis of ‘likelihood to remain in post within the first two years of employment’ as call handlers or paramedics via accelerated failure time regression. Results Several factors showed a significant contribution to the likelihood of remaining in post within an ambulance National Health Service Trust. Among the findings, short-term sick leave in the first two years of employment was associated with increased retention for paramedics (0.040, 95% CI 0.030, 0.060). In addition, female call handlers were found to have increased retention (0.29, 95% CI 0.043, 0.54), and paramedic retention increased with time outside of ‘job cycle time’ (JCT) activities (ie, activities other than responding to calls) (0.097, 95% CI 0.057, 0.14). Conclusions This study presents a method for extracting new insights from routinely collected operational data, identifying common drivers and specific predictors for retention among the ambulance NHS workforce. It emphasises the importance of workforce-centred retention strategies, highlighting the need for non-JCT time, which in turn would allow paramedics to have time to reflect and recuperate to avoid burnout and attrition. The study also suggests that a lack of sick leave might indicate a lack of trust and self-care culture, potentially leading to paramedic staff attrition. Our approach to retention analytics provides a new mechanism for trusts to monitor and respond to their attrition risks in a timely, proactive fashion.

This research explores the interaction between inter-organizational trust, marketing channels, and market and financial performance (FP) in establishing sustainable global marketing channels using Industry 4.0 technologies. It is conducted within the relational exchange theory (RET) framework and transaction cost economics (TCE). The sample (N = 131) was collected through the marketing research firm Centiment. PLS-SEM and Necessary Condition Analysis (NCA) were utilized as statistical methods. All hypotheses except the relationship between marketing channel operational performance and FP were accepted. This research highlights the vital role of inter-organizational trust in enhancing operational efficiency, profitability, and sustainability. It finds that trust fosters collaboration in global distribution channels, improving performance across multiple dimensions. Specifically, trust positively impacts marketing channel operations, boosting market performance. Nevertheless, all exogenous constructs were essential—“must-have” conditions for the endogenous FP construct. Applying the novel NCA is distinctive, primarily as it demonstrates that the relationship between marketing channel operational performance and FP is a necessary “must-have” condition, despite the insignificant path coefficient between the constructs. This is a crucial finding, as further investment in marketing channel operational performance and other antecedents of FP may be futile if the necessary conditions have not been met.

This study investigates the integration of adaptive thermal comfort and indoor air quality (IAQ) systems in modern vehicles, emphasizing their impact on occupant well‐being and automotive design innovation. The research examines state‐of‐the‐art advancements in vehicle climate control technologies, from past developments to emerging smart thermal management solutions. It explores how artificial intelligence (AI), biometric monitoring, and energy‐efficient climate control systems are transforming in‐car comfort, ensuring dynamic adaptation to occupant needs while improving energy efficiency. A qualitative research methodology was adopted, incorporating explanatory and descriptive analysis. Data was collected through an extensive review of archival records, technical specifications, industry reports, and photographic sources to assess the evolution and effectiveness of thermal comfort technologies. The findings indicate that innovative HVAC and IAQ systems significantly enhance both driver and passenger comfort, leading to higher consumer demand for vehicles equipped with these technologies. Furthermore, the study highlights that future thermal comfort solutions will align with evolving user expectations, regulatory standards (such as ASHRAE‐55 and EN‐16798), and global sustainability goals. By bridging automotive engineering, human‐centered design, and energy‐efficient climate control, this study provides valuable insights into the next generation of intelligent vehicle comfort systems. The results offer a framework for optimizing thermal regulation strategies and demonstrate the potential of integrating adaptive climate control with AI‐driven environmental sensing to enhance in‐car experiences. Future research should focus on expanding AI‐based climate personalization models and evaluating user perceptions of smart comfort technologies in real‐world driving conditions.

Featured Application Devices for microwave mammography could soon appear in clinical practice. The significant result of this study is the demonstration of the high safety of a microwave imaging system in terms of heating induced in biological tissues. Abstract The impact of breast cancer on public health is serious, and due to risk/benefit assessment, screening programs are usually restricted to women older than 49 years. Microwave imaging devices offer advantages such as non-ionizing radiation, low cost, and the ability to distinguish between cancerous and healthy tissues due to their electrical properties. Ensuring the safety of this technology is vital for its potential clinical application. To estimate the temperature increase in breast tissues from a microwave imaging scanner, cases of healthy, benign, and malignant breast tissues were analyzed using three digital models and adding two healthy breast models with varying densities. Virtual experiments were conducted using the Sim4Life software (version 7.2) with a system consisting of a horn antenna in transmission and a Vivaldi antenna in reception. Temperature increases were estimated based on the Specific Absorption Rate distributions computed for different configurations and frequencies. The highest temperature increase obtained in this analysis is lower than 60 μK in fibroglandular tissue or skin, depending on the frequency and breast density. The presence of a receiving antenna acting as a scatterer modifies the temperature increase, which is almost negligible. Microwave examination can be performed without harmful thermal effects due to electromagnetic field exposure.

Ultrasonic Welding was successfully carried out to join the current collector plate and positive battery terminal of a cylindrical battery cell by optimizing weld energy into safe energy input varying various weld variables. The success of these welds is justified by balancing the occurrence of desired dynamic recrystallization and undesired material ejection. The welds were carried out on dissimilar aluminum alloys of 1060 of 0.2 mm and 3003 of 3 mm thicknesses at a constant frequency of 20 kHz and welding time of 0.12 s by varying weld amplitude and pressure. An in-depth electron and laser confocal analysis revealed that the dynamic recrystallization increased with increasing weld energy input. However, exceeding 20 J of energy input, the enhancement of DRX failed to boost the joints’ peak load (PL) consistently due to excess material ejection, and below 9 J, the joints exhibited nugget shear failure, defining a region of safe energy input (SEI) experimented weld parameter window. The correlation of PL deterioration with other weld attributes, as analyzed by laser confocal microscopy, high-speed camera observation accompanied with scanning electron microscopy revealed that bond depth achieved over 340 µm enforces an excess amount of material ejection in the form of particles and solid strips, reducing the effective joint length and causing degradation of PL even though DRX occurred.

Introduction The primary objective of the paper was to compare semantic domains reported by drinkers and policymakers in their alcohol consumption narratives. The research question was ‘How do drinkers and policymakers use semantic domains to construct alcohol consumption narratives?’. Design Secondary analysis of open‐ended survey responses (The Drinker Corpus: TDC) and three English alcohol policies (The Policy Corpus: TPC). Methods Wmatrix software was used to identify semantic domains that appeared more frequently in our corpora compared to general usage. Wmatrix outputs a log‐likelihood (LL) score; a score of 6.63 corresponds to a p value of 0.05, indicating frequently used domains. Results Five domains appeared more frequently in both corpora than general usage: ‘Cause & Effect/Connection’; ‘Disease’; ‘Drinks and Alcohol’; ‘Excessive drinking’; ‘Knowledge’ (LL >226.68 for all). Domains were represented differently in the two corpora; the TPC focused on long‐term health consequences, like liver disease, whereas the TDC talked about short‐term consequences like hangovers. The ‘Emotional actions’ domain appeared in the TDC more than expected (LL = 231.26). Drinkers reported experiencing positive and negative emotions following drinking. The ‘Social actions/states/processes’ domain was used more frequently in the TPC than expected (LL = 408.17). Policymakers talked about changing ‘behaviour’ in partnership with organisations rather than working with drinkers. Discussion and Conclusions This study shows that while drinker and policymaker alcohol consumption narratives draw on the same semantic domains, how these domains are used to construct these narratives differs. To improve the effectiveness of policy initiatives, we recommend greater dialogue between policymakers and drinkers.

Purpose Globally, haematology is recognised as a highly specialised field of practice that deals with the diagnosis, treatment, and management of blood disorders. To meet the demand of increased service delivery, the workforce needs to be able to adapt and respond to challenges. Specialists and organisations require specific intelligence to understand their workforce, the demand for labour, and plan for the future. This study aimed to understand wellbeing among the haematology workforce across the multidisciplinary team. Methods A mixed methods explanatory sequential design was used to collect data on wellbeing. Stage 1 online questionnaire was distributed through membership networks. Descriptive statistics were used to analyse the data. Stage 2, data were collected through online semi-structured interviews and analysed thematically. Ethical approval was gained through University Ethics Panel. Results Haematology professionals face multiple stressors due to exposure of emotive situations. This study found high levels of burnout and frustration, with professionals saying that, they were exhausted after each shift. The increasing demands of the haematology service contribute to the overall pressure experienced by staff, making them feel overwhelmed. Inadequate staffing was a defining challenge in providing adequate service delivery, meeting patients’ needs whilst attempting to maintain wellbeing. Working hours /schedule and on-call for many participants reflected their efforts to meet the changing demands within services. Conclusion This is the first study to focus exclusively on a range of healthcare professionals within haematology. The diverse and demanding nature of work, as well as the complexities of managing haematology patients, emphasised the need for a high level of expertise, adaptability, and resilience within the workforce. Supportive work environments are needed to allow professionals to establish and uphold personal boundaries and disengage with work to ensure a sustainable work–life balance.

The optimization of colloidal quantum dot (CQD) materials, synthesis routes and processing methods are complex challenges that are ripe for automation and artificial intelligence (AI) to have a great impact. These optimization challenges are seldom oriented to a single target, therefore it is vital that autonomous systems can handle multiple objectives. In this work, we present an autonomous CQD synthesis system that successfully performs multi-objective optimization (MOO) via Bayesian optimization-based algorithms. We demonstrate the efficacy of the system through three distinct synthesis challenges, based on one, two and three objective optimization problems, in the synthesis of cesium lead halide perovskite CQDs. Objectives included maximizing fluorescence brightness, minimizing particle size dispersity, and targeting of specific energy bandgaps and particle diameters. The tri-objective challenge achieved simultaneous targeting of specific CQD sizes and band gaps independently via reaction tuning and halide doping, while minimizing the particle size dispersity. To the best of our knowledge, this is the first demonstration of AI-assisted multi-objective targeting and dynamic synthesis of targeted colloidal CQDs using exciton energy analysis of absorption spectra infer both size and bandgap. This work presents an accessible, automated, and data-driven platform for CQD discovery and optimization—both for single and multiple objectives—highlighting the promise of widespread integration of AI-guided strategies into CQD R&D.

Introduction Cross-cultural training programs are widely used to enhance cultural competence and cultural intelligence (CQ) across various professional fields. This narrative systematic literature review examines training strategies from various fields to identify the most effective approaches for application in sports. It addresses two key research questions: (1) What training components have been used in the delivery of these training programs? (2) What is their effectiveness in improving cultural intelligence and cultural competence? Methods A systematic search was conducted to identify qualitative and quantitative studies published between 2000 and 2023. A total of 27 articles met the inclusion criteria. These articles describe the type of training program delivered, the activities performed, and their outcomes on participants’ cultural competence and/or cultural intelligence. Programs were categorized on delivery methods (didactic, experiential, or mixed) and information was extracted on training content, participants, duration, and timing. Results Most programs used mixed delivery methods that combined lectures, educational tasks and experiential activities. They showed positive, though not always statistically significant, impact on participants’ cultural competence and/or cultural intelligence. Discussion In sports, tailored programs that address culture- and sport-relevant knowledge, skills and communication may help coaches navigate cultural differences.