Publications

Abstract INTRODUCTION Sleep disturbances are common in older people with cognitive impairment, potentially contributing to negative outcomes. A core outcome set (COS) is required to reduce heterogeneity in clinical trials and promote the development of high‐quality evidence to support clinical management. METHODS A multi‐stage mixed methods study was conducted in accordance with The Core Outcome Set Standards for Development. RESULTS A systematic review identified 287 sleep outcomes from previous clinical trials. Qualitative interviews ensured the COS was informed by what matters most to people with cognitive impairment and their caregivers. A modified Delphi process identified nine outcomes for the COS: total sleep time, sleep onset latency, wakefulness after sleep onset, number of night‐time awakenings, sleep efficiency, and measures of sleep quality, daytime sleepiness, cognition, and mood. DISCUSSION This COS will support researchers to produce more reliable and coherent trial data to guide the management of sleep disturbances in people with neurodegenerative cognitive impairment. Highlights Evidence is lacking regarding the treatment of sleep disturbances in people with cognitive impairment. Heterogeneity of reported outcomes in clinical trials limits data synthesis. A qualitative analysis established what matters most to people with cognitive impairment and their caregivers when determining treatment effectiveness. A Delphi panel of experts agreed upon a core outcome set. This core outcome set will improve the reliability and comparability of data from future trials.

In this perspective on hydrogen carriers, we focus on the needs for the development of robust active catalysts for the release of H<sub>2</sub> from aqueous formate solutions, which are non-flammable, non-toxic, thermally stable, and readily available at large scales at reasonable cost. Formate salts can be stockpiled in the solid state or dissolved in water for long term storage and transport using existing infrastructure. Furthermore, formate salts are readily regenerated at moderate pressures using the same catalyst as for the H<sub>2</sub> release. There have been several studies focused on increasing the activity of catalysts to release H<sub>2</sub> at moderate temperatures, i.e., < 80 °C, below the operating temperature of a proton exchange membrane (PEM) fuel cell. One significant challenge to enable the use of aqueous formate salts as hydrogen carriers is the deactivation of the catalyst under operating conditions. In this work we provide a review of the most efficient heterogeneous catalysts that have been described in the literature, their proposed modes of deactivation, and the strategies reported to reactivate them. We discuss potential pathways that may lead to deactivation and strategies to mitigate it in a variety of H<sub>2</sub> carrier applications. We also provide an example of a potential use case employing formate salts solutions using a fixed bed reactor for seasonal storage of energy for a microgrid application.

Objective If patient engagement is the new ‘blockbuster drug’ why are we not seeing spectacular effects? Studies have shown that activated patients have improved health outcomes, and patient engagement has become an integral component of value-based payment and delivery models, including accountable care organisations (ACO). Yet the extent to which clinicians and managers at ACOs understand and reliably execute patient engagement in clinical encounters remains unknown. We assessed the use and understanding of patient engagement approaches among frontline clinicians and managers at ACO-affiliated practices. Design Qualitative study; 103 in-depth, semi-structured interviews. Participants Sixty clinicians and eight managers were interviewed at two established ACOs. Approach We interviewed healthcare professionals about their awareness, attitudes, understanding and experiences of implementing three key approaches to patient engagement and activation: 1) goal-setting, 2) motivational interviewing and 3) shared decision making. Of the 60 clinicians, 33 were interviewed twice leading to 93 clinician interviews. Of the 8 managers, 2 were interviewed twice leading to 10 manager interviews. We used a thematic analysis approach to the data. Key results Interviewees recognised the term ‘patient activation and engagement’ and had favourable attitudes about the utility of the associated skills. However, in-depth probing revealed that although interviewees reported that they used these patient activation and engagement approaches, they have limited understanding of these approaches. Conclusions Without understanding the concept of patient activation and the associated approaches of shared decision making and motivational interviewing, effective implementation in routine care seems like a distant goal. Clinical teams in the ACO model would benefit from specificity defining key terms pertaining to the principles of patient activation and engagement. Measuring the degree of understanding with reward that are better-aligned for behaviour change will minimise the notion that these techniques are already being used and help fulfil the potential of patient-centred care.

An entry from the Cambridge Structural Database, the world’s repository for small molecule crystal structures. The entry contains experimental data from a crystal diffraction study. The deposited dataset for this entry is freely available from the CCDC and typically includes 3D coordinates, cell parameters, space group, experimental conditions and quality measures.

Abstract Passivity breakdown and pitting behavior in the presence of aggressive Cl − on ultra‐high strength steel Aermet 100, commonly used for landing gear, has been studied, the data are explained in view of the point defect model (PDM). Cyclic potentiodynamic polarization (CPP), electrochemical impedance spectroscopy (EIS), and X‐ray photoelectron spectroscopy (XPS) were examined to observe corrosion progress and corrosion products in the salt spray tests at 4, 8, 12, 16, and 20 days intervals. The breakdown behavior was studied using CPP, whereas scanning electron microscopy (SEM) and digital confocal microscopy were used to explore the micromorphology and depth distribution of pits. The cumulative distribution basically satisfies a normal probabilistic distribution at the different concentrations of chloride and pH, which is consistent with PDM assuming a near‐normal distribution of potential breakdown sites regarding to the cation vacancy diffusivity.

When operating in service of people, robots need to optimize rewards aligned with end-user preferences. Since robots will rely on raw perceptual inputs like RGB images, their rewards will inevitably use visual representations. Recently there has been excitement in using representations from pre-trained visual models, but key to making these work in robotics is fine-tuning, which is typically done via proxy tasks like dynamics prediction or enforcing temporal cycle-consistency. However, all these proxy tasks bypass the human's input on what matters to them, exacerbating spurious correlations and ultimately leading to robot behaviors that are misaligned with user preferences. In this work, we propose that robots should leverage human feedback to align their visual representations with the end-user and disentangle what matters for the task. We propose Representation-Aligned Preference-based Learning (RAPL), a method for solving the visual representation alignment problem and visual reward learning problem through the lens of preference-based learning and optimal transport. Across experiments in X-MAGICAL and in robotic manipulation, we find that RAPL's reward consistently generates preferred robot behaviors with high sample efficiency, and shows strong zero-shot generalization when the visual representation is learned from a different embodiment than the robot's.