Timber-concrete composite floor panels offer a lightweight structural floor system that can be used with a panelised construction method.Currently, prefabricated timber-concrete composite (TCC) floor solutions are rare.This is partly due to a lack of knowledge regarding the shear connectors that join the timber and concrete elements and the impact of additional interlayers between the timber and concrete elements is even less well understood.This research project was undertaken as part of the broader

This essay considers the archival traces left by early modern playhouse song. Acknowledging that most extant sources of theatrical song were not actually produced as records of playhouse practice per se, it advocates an approach to such material that is as attentive to the context of the surviving textual witnesses as it is to a song’s dramatic origins. By putting playhouse and wider context in direct conversation, this approach seeks not only to elucidate the cultural life of dramatic songs beyond the playhouse, but also to shed new light on playhouse music itself, based on wider engagements with and transformations of the songs.Taking a case study approach, the essay investigates one song, “Come Follow Your Leader, Follow,” from The Spanish Gypsy, tracing its wide cultural circulation as a ballad tune under the title “The Spanish Jeepsie.” Building on previous work focusing on the song’s dramatic function in the playhouse, the essay argues that the song’s theatrical use as a locus of imaginative identification with marginal subject positions is then taken up in a series of ballads encouraging identification with figures ranging from fairies and drunkards to cobblers and Diggers. [S.S.]

Background This study evaluated cognitive workload in soldiers undertaking a long duration march wearing different loads. Methods Military participants (n=12 men and n=10 women) performed four 3-hour loaded marches (12.25 km at 4.9 km/hour) wearing either 21 kg, 26 kg, 33 kg or 43 kg. During the march, accuracy and response time were measured using the verbal working memory n-back test (0, 1, 2 and 3) and two bespoke Go/No Go tests (visual/auditory) to assess inhibition of a pre-potent response. Results The physical demands of the march increased with load and march duration but remained at moderate intensity. N-back test accuracy ranged from 74% to 98% in men and 62% to 98% in women. Reduced accuracy was observed as load and time increased. Accuracy during the visual Go/No Go test also reduced with load, accuracy ranged from 69% to 89% in men and 65% to 90% in women. No differences due to load or time were observed during completion of the auditory Go/No Go task; accuracy ranged from 93% to 97% in men and 77% to 95% in women. A number of participants were unable to complete the march due to discomfort. Reports of discomfort were more frequent in women, which may have contributed to the greater reductions in accuracy observed. Conclusion These data provide further evidence that cognitive performance of military personnel can be affected during long duration loaded marching. Women reported discomfort from equipment more frequently than men, which may make them more susceptible to declines in cognitive performance. These findings highlight important considerations for equipment procurement.

For many early modern playgoers, music was not a peripheral feature of commercial drama, but a chief attraction of the theatres—sometimes even the primary motivation for playgoing. This chapter explores early evidence of musically interested playgoers and their engagements with practical musical performance at venues like the Globe and Blackfriars. It works with a range of examples before taking The Merchant of Venice as an extended test case in the early modern relationship between drama and music. Through these materials, the chapter offers three core propositions about playhouse engagements with music during Shakespeare’s working life. The first is that musical experience was in itself a significant and widely acknowledged incentive for playgoing that can be traced across the textual record. The second is that playgoers regularly encountered music as an integral element of a play’s dramaturgy, and so their musical experiences need to be understood in the context of their wider engagements with drama. The final suggestion is that playwrights like Shakespeare anticipated the overlap of musical and dramatic experience in playhouse performance by embedding music into their dramaturgical designs, using playhouse responses to music to shape dramatic meaning.

Openness and transparency constitute a foundational principle for research integrity, as set out in the UK Concordat to Support Research Integrity. Openness can promote rigour, constructive scrutiny, accountability and can enable others to build on research. However, it can also bring challenges. Critically, what openness and transparency can and should mean varies across disciplines and fields of study. This is one of a series of case studies in a wide range of disciplines that illustrate these differences. The series is intended to enable researchers to see similarities and differences between fields, and to inform those supporting open research through, for example, training, policies or incentives. It is based on a single interview with a researcher, and is therefore illustrative rather than representative.

Background: Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination. Objectives: To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators. Data sources: We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews. Methods: Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized. Results: In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale. Conclusions: Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.

Objectives To synthesise evidence concerning the range of filtering respirators suitable for patient care and guide the selection and use of different respirator types. Design Comparative analysis of international standards for respirators and rapid review of their performance and impact in healthcare. Data sources Websites of international standards organisations, Medline and Embase, hand-searching of references and citations. Study selection Studies of healthcare workers (including students) using disposable or reusable respirators with a range of designs. We examined respirator performance, clinician adherence and performance, comfort and impact, and perceptions of use. Results We included standards from eight authorities across Europe, North and South America, Asia and Australasia and 39 research studies. There were four main findings. First, international standards for respirators apply across workplace settings and are broadly comparable across jurisdictions. Second, effective and safe respirator use depends on proper fitting and fit testing. Third, all respirator types carry a burden to the user of discomfort and interference with communication which may limit their safe use over long periods; studies suggest that they have little impact on specific clinical skills in the short term but there is limited evidence on the impact of prolonged wearing. Finally, some clinical activities, particularly chest compressions, reduce the performance of filtering facepiece respirators. Conclusion A wide range of respirator types and models is available for use in patient care during respiratory pandemics. Careful consideration of performance and impact of respirators is needed to maximise protection of healthcare workers and minimise disruption to care.

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In the context of covid-19, aerosol generating procedures have been highlighted as requiring a higher grade of personal protective equipment. We investigated how official guidance documents and academic publications have classified procedures in terms of whether or not they are aerosol-generating. We performed a rapid systematic review using preferred reporting items for systematic reviews and meta-analyses standards. Guidelines, policy documents and academic papers published in english or french offering guidance on aerosol-generating procedures were eligible. We systematically searched two medical databases (medline, cochrane central) and one public search engine (google) in march and april 2020. Data on how each procedure was classified by each source were extracted. We determined the level of agreement across different guidelines for each procedure group, in terms of its classification as aerosol generating, possibly aerosol-generating, or nonaerosol-generating. 128 documents met our inclusion criteria; they contained 1248 mentions of procedures that we categorised into 39 procedure groups. Procedures classified as aerosol-generating or possibly aerosol-generating by ≥90% of documents included autopsy, surgery/postmortem procedures with high-speed devices, intubation and extubation procedures, bronchoscopy, sputum induction, manual ventilation, airway suctioning, cardiopulmonary resuscitation, tracheostomy and tracheostomy procedures, non-invasive ventilation, high-flow oxygen therapy, breaking closed ventilation systems, nebulised or aerosol therapy, and high frequency oscillatory ventilation. Disagreements existed between sources on some procedure groups, including oral and dental procedures, upper gastrointestinal endoscopy, thoracic surgery and procedures, and nasopharyngeal and oropharyngeal swabbing. There is sufficient evidence of agreement across different international guidelines to classify certain procedure groups as aerosol generating. However, some clinically relevant procedures received surprisingly little mention in our source documents. To reduce dissent on the remainder, we recommend that (a) clinicians define procedures more clearly and specifically, breaking them down into their constituent components where possible; (b) researchers undertake further studies of aerosolisation during these procedures; and (c) guideline-making and policy-making bodies address a wider range of procedures.

AbstractObjectivesIn the context of the Covid-19 pandemic, to identify the range of filtering respirators that can be used in patient care and synthesise evidence to guide the selection and use of different respirator types.DesignComparative analysis of international standards for filtering respirators and rapid review of their performance and impact in healthcare.Data sourcesWebsites of international standards organisations, Medline and EMBASE (final search 11thMay 2020), with hand-searching of references and citations.Study selectionGuided by the SPIDER tool, we included studies whose sample was healthcare workers (including students). The phenomenon of interest was respirators, including disposable and reusable types. Study designs including cross-sectional, observational cohort, simulation, interview and focus group. Evaluation approaches included test of respirator performance, test of clinician performance or adherence, self-reported comfort and impact, and perceptions of use. Research types included quantitative, qualitative and mixed methods. We excluded studies comparing the effectiveness of respirators with other forms of protective equipment.Data extraction, analysis and synthesisTwo reviewers extracted data using a template. Suitability for inclusion in the analysis was judged by two reviewers. We synthesised standards by tabulating data according to key criteria. For the empirical studies, we coded data thematically followed by narrative synthesis.ResultsWe included relevant standards from 8 authorities across Europe, North and South America, Asia and Australasia. 39 research studies met our inclusion criteria. There were no instances of comparable publications suitable for quantitative comparison. There were four main findings. First, international standards for respirators apply across workplace settings and are broadly comparable across jurisdictions. Second, effective and safe respirator use depends on proper fitting and fit-testing. Third, all respirator types carry a burden to the user of discomfort and interference with communication which may limit their safe use over long periods; studies suggest that they have little impact on specific clinical skills in the short term but there is limited evidence on the impact of prolonged wearing. Finally, some clinical activities, particularly chest compressions, reduce the performance of filtering facepiece respirators.ConclusionA wide range of respirator types and models is available for use in patient care during respiratory pandemics. Careful consideration of performance and impact of respirators is needed to maximise protection of healthcare workers and minimise disruption to the delivery of care.

Percutaneous flexor tenotomy is a minimally invasive procedure that involves cutting one or both flexor digitorum tendons underneath the toe. It is an alternative to open surgical procedures performed in an operating theatre. This project is a prospective case series investigating the utility, effectiveness, and participant satisfaction of the percutaneous flexor tenotomy when performed in the outpatient setting. People with diabetes, digital flexion deformity, and loss of protective sensation with an apical ulcer or preulcerative lesion presenting to the Austin Health Foot Ulcer Specialist Outpatient Clinic were enrolled in the study. The procedure was performed under sterile technique with an 18-gauge needle or fine scalpel blade. Participants were reviewed weekly until the incision and/ or ulcer healed. Participants were then followed up at 3 and 6 months. Time to ulcer healing, reulceration rate, frequency of complications, and patient satisfaction were recorded. There were 11 toe ulcers and 41 preulcerative lesions. A total of 76 tenotomy procedures were performed on the 23 participants across 35 episodes of care. The mean time to ulcer healing following tenotomy was 10.2 ± 4.3 days. There were no recurrences of ulceration. The infection rate per episode of care was 2.8%. There were 11 toes (14.5%) that sustained a transfer lesion post the index procedure. The mean time to development of a transfer lesion was 95.5 ± 98.1 days. All participants strongly agreed that they were satisfied with the outcome of the procedure. The flexor tenotomy is an effective procedure to expedite the healing of apical toe ulcers in people with loss of protective sensation and flexion digital deformity. It has a low infection rate and high patient satisfaction rate when performed in the outpatient setting. There is a moderate risk of transfer preulcerative lesions to an adjacent digit. Levels of Evidence: Level IV: Prospective case series.

Background The COVID-19 pandemic has led to unprecedented demand for personal protective equipment. Shortages of surgical masks and filtering facepiece respirators has led to the extended use or re-use of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices has been questioned. Objectives To summarise guidance and synthesise systematic review evidence on extended use, re-use or reprocessing of single-use surgical masks or filtering facepiece respirators. Methods A targeted search of the World Health Organization, European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites was conducted to identify guidance. Four databases (Medline, Pubmed, Epistemonikos, Cochrane Database of Systematic Reviews) and three preprint repositories (Litcovid, MedRxiv and Open Science Framework) were searched for relevant systematic reviews. Record screening and data extraction was conducted by two reviewers. Quality of included systematic reviews was appraised using the AMSTAR-2 checklist. Findings were integrated and narratively synthesised to highlight the extent to which key claims in guidance documents were supported by research evidence. Results Six guidance documents were identified. All note that extended use or re-use of single-use surgical masks and respirators (with or without reprocessing) should be considered only in situations of critical shortage. Extended use was generally favoured over re-use because of reduced risk of contact transmission. Four high-quality systematic reviews were included: three focused on reprocessing (decontamination) of N95 respirators and one focused on reprocessing of surgical masks. There was limited evidence on the impact of extended use on masks and respirators. Vaporised hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale. Conclusions There is limited evidence on the impact of extended use and re-use of surgical masks and respirators. Where extended use or re-use is being practiced, healthcare organisations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.

Shakespeare | Sense explores the intersection of Shakespeare and sensory studies, asking what sensation can tell us about early modern drama and poetry, and, conversely, how Shakespeare explores the senses in his literary craft, his fictional worlds and his stagecraft.Fifteen substantial new essays by leading Shakespeareans working in sensory studies and related disciplines interrogate every aspect of Shakespeare and sense, from the place of hearing, smell, sight, touch and taste in early modern life, literature and performance culture, through to the significance of sensation in 21st-century engagements with Shakespeare on stage, screen and page.The volume explores and develops current methods for studying Shakespeare and sensation, reflecting upon the opportunities and challenges created by this emergent and influential area of scholarly enquiry. Many chapters develop fresh readings of particular plays and poems, from Hamlet, A Midsummer Night’s Dream, King Lear and The Tempest to less-studied works such as The Comedy of Errors, Venus and Adonis, Troilus and Cressida and Cymbeline.

When considering the behaviour of particulate materials in the environment, it is important to consider resuspension, in which deposited particles leave the ground and become airborne. Despite significant study, models of resuspension typically include no treatment of transient phenomena in the period shortly after release. This paper describes the selection, initial implementation and validation of a resuspension model that is suitable for the stepwise introduction of real-world complexity (such as the effects of humidity, particle shape, roughness or composition), thus enabling it to be developed from simplistic, idealised scenarios to real particles and surfaces. Using an adapted version of the Biasi, de los Reyes, Reeks, and De Santi (2001) implementation of the "Rock'n'Roll" model for resuspension proposed by Reeks and Hall (2001), results for resuspension of hard smooth spherical particles from hard smooth surfaces under dry conditions were modelled. These were found to agree to within an order of magnitude in all cases, and typically within a factor of two, with experimental data for the proportion of particles resuspended as generated using a custom built highly controllable wind tunnel. To the authors' knowledge, this is the first time that reproducible data, suitable for model validation for particles of respirable size under commonly expected environmental conditions, has been collected. As proof of principle of the stepwise approach to the introduction of complexity, the model was adapted and extended to include capillary forces. This enabled experimental confirmation that the model was able to predict correctly the effect of relative humidity on resuspension. Results demonstrated that the level of agreement between model and experiment has been maintained.