The national dietary recommendations are intended to promote dietary habits that enhance the well-being and long-term health of the population (1). Monitoring the dietary intake trends of the population over time and evaluating the percentage of people who do not meet the nutritional targets can help to identify significant disparities between actual and recommended intakes (2). This study aims to evaluate the dietary patterns of school children and their adherence to current Pakistan Dietary Guidelines (PDGs).

In this study, compliance with PDGs (3) was evaluated in school-aged children through a situational analysis survey from Faisalabad City. A total of 540 school-going children aged 6 to 10 years were selected from schools belonging to different socio-economic statuses categorized as private (High SES), public (Low SES) and semi-private (Middle SES). Dietary data from the participants was primarily collected through a retrospective tool (4). Dietary information was recorded using 24-hour dietary recall method for 5 consecutive days (5). Food items consumed were categorized into 7 food groups (cereal, meat, lentils, fruits, vegetables, milk, and others) based on PDGs. A statistical analysis was performed using the Chi-square test, based on the frequency distribution and percentage of the collected data.

Cereal group showed the most compliance (>50%) in all three schools while lowest compliance was found in lentil group. Extremely poor compliance was recorded in the public school (5%) for meat group. The semi-private school showed the best compliance in milk group with 85% students consuming the recommended servings. All schools had more than 50% compliance in the vegetable group, with semi-private schools exhibiting highest rate at 76%. Lentil group showed extremely poor compliance with 6%, 13%, and 16% in Private, Semi-private, and Public Schools respectively. Public schools showed the lowest compliance with fruit group intake at 34.2%, while both private and semi-private schools were approximately 60% compliant. Moreover, a high intake of processed foods was recorded (>85%) in private school. A significant proportion of students was also observed consuming one or more servings of beverages (>50%) in all three schools. In contrast, a low percentage of students (<50%) consumed sweets in all three schools. Variation between three schools for all food groups was found to be statistically highly significant (p < 0.05) which shows differences in their consumption patterns.

Results show a relative match of food groups including cereals, vegetables and milk with PDGs was low to moderate whereas poor intake was recorded for food groups including meat, lentils and fruits. Consumption of processed foods as well as beverages was high in comparison to the rest of the food groups. Hence, the adherence to PDGs was poor and there is a need to bring behavior changes via school nutrition program focusing on nutrition education.

Mental health disorders including depression and anxiety are major contributors to global disease burden. Evidence indicates that nutrition may play a role in supporting mental health, with most investigations centred on one-carbon metabolism related B-vitamins (1). Recently it has been reported that polyphenol supplementation, particularly those high in anthocyanins (such as blueberries) may improve mood states, including depressive symptoms and anxiety (2). This pilot study aimed to investigate the influence of a combined multivitamin and blueberry extract multinutrient (Vitals+, Heights, UK) on B-vitamin biomarkers and mental wellbeing in healthy adults.

14 healthy adults (8 males, mean age ±SD 38 ±10 yrs) were recruited. Exclusion criteria were: coeliac disease, mental health condition, pregnancy or breastfeeding or taking nutritional supplements in the past 3 months. Participants received an 8-month supplementation of Vitals+ once a day. The supplement contained, among other nutrients, thiamine (B1), riboflavin (B2) and vitamin B6 at a dose of 30mg each, 500μg of 5-Methyltetrahydrofolate (B9) and 25μg methylcobalamin (B12) alongside 80mg blueberry extract. B-vitamin biomarker status and mental state were assessed pre-post intervention.

Functional biomarkers of vitamin B1, B2 and B6 were measured using the Erythrocyte Transketolase (ETKac), Erythrocyte Glutathione Reductase (EGRac) and Erythrocyte Glutamic Oxaloacetic Trans-aminase (EGOTac) activation coefficient assays, respectively. Folate was measured in red blood cells (RBCF) and holotranscobalamin in serum was utilised for B12 assessment. Mental wellbeing was assessed using three validated questionnaires: the Profile of Mood States (POMS), Perceived Stress Scale (PSS) and the General Health Questionnaire-12 (GHQ-12). Differences in outcome measure were assessed pre-post intervention using paired samples t-tests (p<0.05 was considered significant).

At baseline 71% of participants had suboptimal/deficient thiamine status (ETKac ≤ 1.25) whereas 50% were riboflavin deficient (EGRac ≥1.40). Mean values ±SD for EGOTac, RBCF and holotranscobalamin were above the threshold for deficiencies, (1.37±0.12), (654±203 nmol/L) and (70±35 pmol/L) respectively, with no cases of deficiency for these nutrients. There was a significant improvement in thiamine (p=0.024), riboflavin (p<0.001), folate (p<0.001) and B12 (p=0.021) status post intervention but no change in vitamin B6 (p=0.167) biomarker status. For mental wellbeing outcomes, a trend towards significant improvement by 4-points was reported in the GHQ-12 (p=0.062), with a 30% reduction in participants fulfilling the criteria suggestive of psychological distress. There was no significant change in PSS (p=0.179) or total POMS (p=0.167). However, when subdomains of POMS were investigated, significant decreases in fatigue (p=0.028), confusion (p=0.017), self-esteem (p=0.022) and tension (p=0.047) were observed.

At baseline B6, folate and B12 status was adequate however thiamine and riboflavin deficiencies were prevalent. Vitals+ normalised thiamine and riboflavin status and further improved biomarker status of other one-carbon metabolism related B-vitamins. The multinutrient may present an easily accessible intervention to improve B-vitamin status and mental health and wellbeing in adults.

Malacological surveys were conducted in 2021 in the Kimpese region of Central Kongo Province, west of the Democratic Republic of Congo (DRC). Snail specimens were collected following a standardised protocol, identified using morphological and molecular methods, and tested for schistosome infection using a diagnostic PCR assay. Positive snail samples were sequenced to characterise the infecting schistosome species. Partial mitochondrial cytochrome c oxidase subunit 1 (COX1) gene sequences were used in phylogenetic analyses to explore the evolutionary position of these snail species within the broader African context. At least four intermediate snail hosts were identified: Bulinus truncatus, Bulinus forskalii, Biomphalaria pfeifferi, and a Biomphalaria species belonging to the Nilotic species complex (tentatively named Biomphalaria cf sudanica), of which the species identity needs to be confirmed. A total of 37 out of 1,196 snails (3.1%) tested positive for schistosome infection, with an infection prevalence of 7.4% for B. truncatus with Schistosoma haematobium and 1.5% for Biomphalaria spp. with Schistosoma mansoni. The S. mansoni sequence retrieved from these samples formed a basal clade relative to Zambian isolates, whereas S. haematobium grouped with the most frequently characterised haplotype cluster previously identified across mainland Africa. It is important to note that no animal schistosome species were identified in this study. Both the sequences from the snail hosts and the parasites represent novel contributions from the DRC. Additionally, the findings update the current knowledge of schistosomiasis transmission in the Kimpese region by providing insight into the phylogenetic placement, species diversity, and infection status of local snail populations.

Climate change and other anthropogenic stressors are reshaping Earth’s biodiversity, motivating efforts to monitor changing faunal diversity. Canada is home to 80 documented species of mosquitoes, 38 of which are reported in New Brunswick. Using Centers for Disease Control and Prevention miniature CO2 light traps, three adult mosquito collection surveys were performed to encompass 43 trapping sites across New Brunswick, Canada. Study one took place from 21 July 2022 to 9 September 2022, study two took place from 29 May 2023 to 24 October 2023, and study three took place from 15 May 2024 to 19 September 2024. Among the specimens collected, a total of 18 Uranotaenia sapphirina (Osten Sacken) (Diptera: Culicidae) were identified from five separate trapping sites. This species, previously documented only in Ontario, Quebec, and Manitoba, is considered rare in Canada and is known for its specialisation in feeding on annelids rather than vertebrates. Our detection of Ur. sapphirina in New Brunswick, where it has been absent in earlier surveys, suggests a recent range expansion, possibly driven by climate change. This observation highlights the need for ongoing surveillance to monitor the impacts of environmental changes on mosquito distribution.

Background: Nipocalimab (a fully human, effectorless anti-neonatal Fc receptor (FcRn) monoclonal antibody) may ameliorate gMG disease manifestations by selectively targeting FcRn IgG recycling and lowering IgG, including pathogenic autoantibodies in generalized myasthenia gravis (gMG). The objective was to evaluate the effectiveness and safety of intravenous nipocalimab added to background standard-of-care therapy in adolescents with gMG. Methods: Seropositive patients (12-<18 years) with gMG (MGFA Class II-IV) on stable therapy but inadequately controlled, were enrolled in a 24-week open label study. Nipocalimab was administered as a 30 mg/kg IV loading dose followed by 15 mg/kg IV every 2 Weeks. Results: Seven adolescents were enrolled; 5 completed 24-weeks of dosing. The mean(SD) age was 14.1(1.86) years; seven were anti-AChR+, six were female. Mean(SD) baseline MG-ADL/QMG scores were 4.29(2.430)/12.50(3.708). Nipocalimab showed a significant reduction in total serum IgG at week-24; the mean(SD) change from baseline to week-24 for total serum IgG was -68.98%(7.561). The mean(SD) change in MG-ADL/QMG scores at week-24 was -2.40(0.418)/-3.80(2.683); 4 of 5 patients achieved minimum symptom expression (MG-ADL score 0-1) by week-24. Nipocalimab was well-tolerated; there were no serious adverse events. There were no clinically meaningful laboratory changes. Conclusions: Nipocalimab demonstrated efficacy and safety in this 6-month trial in seropositive adolescents with gMG.

Background: Traumatic brain injury (TBI) patients exhibit variable post-injury recovery trajectories. Days at Home (DAH) is a patient-centered measure that captures healthcare transitions and offers a more nuanced understanding of recovery. Here, we use DAH to characterize longterm recovery trajectories for moderate to severe TBI (msTBI) survivors. Methods: This multicenter retrospective cohort study utilized population health data from Ontario to identify adults sustaining isolated msTBI hospitalized between 2009-2021. DAH were calculated in distinct 30-day intervals from index admission to 3 years post-injury; latent class mixed modeling identified unique recovery trajectories and trajectory attributes were quantified. Results: There were 2,510 patients eligible for latent class analysis. Four DAH trajectories were identified: early recovery (69.9%), intermediate recovery (11.4%), late recovery (2.9%), and poor recovery (15.8%). Patients in the poor recovery group were older, more frail, and had lower admission GCS scores, while those in early recovery exhibited lower acute care needs. Intermediate and late recovery groups exhibited protracted transitions home, with near-complete reintegration by 24 months. A prediction model distinguished unfavorable trajectories with good accuracy (C-index=0.824). Conclusions: Despite high initial institutional care requirements, 85% of patients reintegrated into the community within three years of msTBI. These findings shed light on post-injury care requirements for brain-injured patients.

Background: Vestibular schwannoma (VS) are the most common tumour of the CPA with an annual incidence of 17.4/1 million. They typically demonstrate slow growth over time and as such, observation is a reasonable approach to management. A portion of these tumour remain static and approximately 5-10% of these tumours will demonstrate spontaneous regression while under observation, including those associated with neurofibromatosis type-2.

Previous case series (N= 13-14) have attempted to identify predictive factors for tumour growth and regression, but few have reached significance or demonstrated reproducible findings. Methods: Using a clinical database of VS treated by one team at our institution, we identified 40 patients who have demonstrated significant spontaneous regression or complete resolution of their VS. All patients received a survey by mail and telephone. Results: Radiographic descriptions were collected on 40 patients. Surveys were completed by 18 participants and an additional 18 control patients who demonstrated growth and underwent surgical resection. Conclusions: This is the largest case series we know of to date describing radiographic and clinical presentations of patients shrinking vestibular schwannoma. It is also the only study known to date to consider patient factors by survey in an attempt to identify protective factors.

Background: The complement component C5 inhibitor, ravulizumab, is approved in Canada for the treatment of adults with AQP4-Ab+ NMOSD. Updated efficacy and safety results from the ongoing CHAMPION-NMOSD (NCT04201262) trial are reported. Methods: Participants received IV-administered, weight-based dosing of ravulizumab, with loading on day 1 and maintenance doses on day 15 and every 8 weeks thereafter. Following a primary treatment period (PTP; up to 2.5 years), patients could enter a long-term extension (LTE). Outcome measures included safety, time to first adjudicated on-trial relapse (OTR), risk reduction, and disability scores. Results: 56/41 patients entered/completed the LTE as of June 14, 2024. Median follow-up was 170.3 weeks (186.6 patient-years). No patients experienced an OTR. 94.8% (55/58 patients) had stable or improved Hauser Ambulation Index scores. 89.7% (52/58 patients) had no clinically important worsening in Expanded Disability Status Scale scores. Treatment-emergent adverse events (98.4%) were predominantly mild and unrelated to ravulizumab. Serious adverse events occurred in 25.9% of patients. Two cases of meningococcal infection occurred during the PTP, and none in the LTE. One unrelated death (cardiovascular) occurred during the LTE. Conclusions: Ravulizumab demonstrated long-term clinical benefit in AQP4-Ab+ NMOSD relapse prevention while maintaining or improving disability measures, with no new safety concerns.

Background: Efgartigimod, a human immunoglobulin (Ig)G1 antibody Fc fragment, blocks the neonatal Fc receptor, reducing IgGs involved in chronic inflammatory demyelinating polyneuropathy (CIDP). The multi-stage, double-blinded, placebo-controlled ADHERE (NCT04281472) and open-label extension ADHERE+ (NCT04280718) trials (interim analysis cutoff: February 16, 2024) assessed efgartigimod PH20 SC in participants with CIDP. Methods: Participants with active CIDP received open-label, weekly efgartigimod PH20 SC 1000 mg during ≤12-week run-in (stage-A). Responders were randomized (1:1) to efgartigimod or placebo for ≤48 weeks (stage-B). Participants with clinical deterioration in stage-B or who completed ADHERE entered ADHERE+. Week 36 changes from run-in baseline (CFB) in adjusted Inflammatory Neuropathy Cause and Treatment (aINCAT), Inflammatory Rasch-built Overall Disability Scale (I-RODS), and grip strength scores were evaluated. Results: Of 322 stage-A participants, 221 were randomized and treated in stage-B, and 99% entered ADHERE+. Mean CFB (SE) in aINCAT, I-RODS, and grip strength scores were -1.2 (0.15) and 8.8 (1.46) and 17.5 (2.02), respectively, at ADHERE+ Week 36 (N=150). Half the participants with clinical deterioration during ADHERE stage-B restabilized on efgartigimod from ADHERE+ Week 4. Conclusions: Interim results from ADHERE+ indicate long-term effectiveness of efgartigimod PH20 SC in clinical outcomes in participants with CIDP.

Background: Efgartigimod, a human immunoglobulin (Ig)G1 antibody Fc fragment, blocks the neonatal Fc receptor, reducing IgGs involved in chronic inflammatory demyelinating polyneuropathy (CIDP), a rare, progressive, immune-mediated disease that can lead to irreversible disability. The multi-stage, double-blinded, placebo-controlled ADHERE (NCT04281472) trial assessed efgartigimod PH20 SC in participants with CIDP. Methods: Participants with active CIDP received open-label, weekly efgartigimod PH20 SC 1000 mg during ≤12-week run-in (stage-A). Responders were randomized (1:1) to weekly efgartigimod or placebo for ≤48 weeks (stage-B). This posthoc analysis evaluated changes from run-in baseline (study enrollment) to stage-B last assessment and items of the Inflammatory Rasch-built Overall Disability Scale (I-RODS). Results: Of 322 participants who entered stage-A, 221 were randomized and treated in stage-B, and 191/221 had data for run-in baseline and post–stage-B timepoints. Mean (SE) I-RODS change at stage-B last assessment vs run-in baseline was 5.7 (1.88) and -4.9 (1.82) in participants randomized to efgartigimod and placebo, respectively. 37/97 (38.1%) and 24/92 (26.1%) participants randomized to efgartigimod and placebo, respectively, experienced ≥4-point improvements in I-RODS score. Efgartigimod-treated participants improved ≥1 point in I-RODS items of clinical interest. Conclusions: Participants who received efgartigimod in stage-B experienced improvements in I-RODS score from study enrollment to stage-B last assessment.

Current liver-stage Plasmodium falciparum models are complex, expensive and largely inaccessible, hindering research progress. Here, we show that a 3D liver spheroid model grown from immortalized HepG2/C3A cells supports the complete intrahepatocytic lifecycle of P. falciparum. Our results demonstrate sporozoite infection, development of exoerythrocytic forms and breakthrough infection into erythrocytes. The 3D-grown spheroid hepatocytes are structurally and functionally polarized, displaying enhanced albumin and urea production and increased expression of key metabolic enzymes, mimicking in vivo conditions – relative to 2D cultures. This accessible, reproducible model lowers barriers to malaria research, promoting advancements in fundamental biology and translational research.

The Australian SKA Pathfinder (ASKAP) offers powerful new capabilities for studying the polarised and magnetised Universe at radio wavelengths. In this paper, we introduce the Polarisation Sky Survey of the Universe’s Magnetism (POSSUM), a groundbreaking survey with three primary objectives: (1) to create a comprehensive Faraday rotation measure (RM) grid of up to one million compact extragalactic sources across the southern $\sim50$% of the sky (20,630 deg$^2$); (2) to map the intrinsic polarisation and RM properties of a wide range of discrete extragalactic and Galactic objects over the same area; and (3) to contribute interferometric data with excellent surface brightness sensitivity, which can be combined with single-dish data to study the diffuse Galactic interstellar medium. Observations for the full POSSUM survey commenced in May 2023 and are expected to conclude by mid-2028. POSSUM will achieve an RM grid density of around 30–50 RMs per square degree with a median measurement uncertainty of $\sim$1 rad m$^{-2}$. The survey operates primarily over a frequency range of 800–1088 MHz, with an angular resolution of 20” and a typical RMS sensitivity in Stokes Q or U of 18 $\mu$Jy beam$^{-1}$. Additionally, the survey will be supplemented by similar observations covering 1296–1440 MHz over 38% of the sky. POSSUM will enable the discovery and detailed investigation of magnetised phenomena in a wide range of cosmic environments, including the intergalactic medium and cosmic web, galaxy clusters and groups, active galactic nuclei and radio galaxies, the Magellanic System and other nearby galaxies, galaxy halos and the circumgalactic medium, and the magnetic structure of the Milky Way across a very wide range of scales, as well as the interplay between these components. This paper reviews the current science case developed by the POSSUM Collaboration and provides an overview of POSSUM’s observations, data processing, outputs, and its complementarity with other radio and multi-wavelength surveys, including future work with the SKA.