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The Intergovernmental Negotiating Committee (INC) on plastic pollution are United Nations member states who will convene for the second part of the fifth session of the Intergovernmental Negotiating Committee in Geneva (INC5.2) 5-14 August, 2025 to negotiate a global plastics treaty. The Scientists’ Coalition for an Effective Plastics Treaty (‘The Scientists’ Coalition’) is an international network of independent scientific and technical experts who have been contributing robust science to treaty negotiators since INC1 in 2022. The Scientists’ Coalition established a series of working groups following INC5.1 in Busan, Korea 25 November – 1 December 2024. Each working group has produced science-based responses to the selected articles of ‘the Chair’s text’ (the latest version of the draft global plastics treaty text). This Letter to the Editor summarises those responses.
Hypertensive heart disease and hypertrophic cardiomyopathy both lead to left ventricular hypertrophy despite differing in aetiology. Elucidating the correct aetiology of the presenting hypertrophy can be a challenge for clinicians, especially in patients with overlapping risk factors. Furthermore, drugs typically used to combat hypertensive heart disease may be contraindicated for the treatment of hypertrophic cardiomyopathy, making the correct diagnosis imperative. In this review, we discuss characteristics of both hypertensive heart disease and hypertrophic cardiomyopathy that may enable clinicians to discriminate the two as causes of left ventricular hypertrophy. We summarise the current literature, which is primarily focused on adult populations, containing discriminative techniques available via diagnostic modalities such as electrocardiography, echocardiography, and cardiac MRI, noting strategies yet to be applied in paediatric populations. Finally, we review pharmacotherapy strategies for each disease with regard to pathophysiology.
The European Clozapine Task Force is a group of psychiatrists and pharmacologists practicing in 18 countries under European Medicines Agency (EMA) regulation, who are deeply concerned about the underuse of clozapine in European countries. Although clozapine is the most effective antipsychotic for people with treatment-resistant schizophrenia, a large proportion of them do not have access to this treatment. Concerns about clozapine-induced agranulocytosis and stringent blood monitoring rules are major barriers to clozapine prescribing and use. There is a growing body of evidence that the incidence of clozapine-induced agranulocytosis is very low after the first year of treatment. Maintaining lifelong monthly blood monitoring after this period contributes to unjustified discontinuation of clozapine. We leverage recent and replicated evidence on the long-term safety of clozapine to call for the revision and updating of the EMA’s blood monitoring rules, thus aiming to overcome this major barrier to clozapine prescribing and use. We believe the time has come for relaxing the rules without increasing the risks for people using clozapine in Europe.
Background: Interest in artificial intelligence (AI) and machine learning (ML) has been growing in neuroradiology, but there is limited knowledge on how this interest has manifested into research and the field’s trends, challenges, and future directions. Methods: The American Journal of Neuroradiology was queried for original research articles published since inception (Jan. 1, 1980) to Sept. 19, 2022 that contained any of the following key terms: “machine learning”, “artificial intelligence”, or “radiomics”. Articles were screened, categorized into Statistical Modelling (Type 1), AI/ML Development (Type 2), or End-user Application (Type 3) and then bibliometrically analyzed. Results: A total of 124 articles were identified with 85% being non-integration focused (Type 1 n = 41, Type 2 n = 65) and the remaining (n = 18) being Type 3. The total number of articles published grew two-fold in the last five years, with Type 2 articles mainly driving this growth. While most (66%) Type 2 articles were led by a radiologist with 55% possessing a postgraduate degree, a minority of Type 2 articles addressed bias (15%) and explainability (20%). Conclusions: The results of this study highlight areas for improvement but also strengths that stakeholders can consider when promoting the shift towards integrating practical AI/ML solutions in neuroradiology.
This chapter discusses some of the existing beliefs about juror decision-making and the jury process at three distinct phases of a trial: before the trial, during the trial, and at the trial’s conclusion. Before the trial, there are beliefs surrounding the jury process, including jury duty, jury size, and jury selection (i.e. voir dire). During the trial, there are common beliefs surrounding courtroom factors that influence jury decision-making, including attitudes, beliefs, and expectations regarding attorneys, expert witnesses, confession evidence, and emotion-evoking evidence. Finally, at the end of trial, there is the existing belief that juries make extreme and unpredictable decisions in civil and criminal court. This chapter uses current research and empirical evidence within law and behavioral sciences to examine these myths, showing support for some of these beliefs, while also showing that others are simply myths about jury decision-making. Finally, the chapter discusses future research to address such myths.
The considerable amount of original and generic types of skinfold calipers available is a source of systematic measurement error. This study is a brief report that critically examines the original and illustrated structural configuration of the three main types of skinfold calipers. For more than half a century, the Harpenden®, Lange® and Slim Guide® skinfolds calipers have been widely used in clinical and research settings. It is well established that the physical, mechanical and functional specificity of each type of skinfold caliper makes its interchangeable use impossible. Our report suggests that commercially available technical specifications are insufficient to judiciously choose a skinfold caliper. The area of the jaws, the coefficient of spring and the static and dynamic downward pressure of each type of skinfold caliper must be determined in the metrological laboratory and added to the technical user manual. Choosing a type of skinfold caliper for regular use, without conflict of commercial interest, requires a critical understanding of the physical, mechanical and functional characteristics that configure it. Therefore, a new downward static calibration test and the first eligibility flowchart for a skinfold caliper have been proposed. Finally, the information gathered in this report may be useful for manufacturers of anthropometric instruments and health professionals who use the skinfold technique as a tool for diagnosis and nutritional control.
A robust understanding of the impact of anthropogenic activities on high-altitude tropical aquatic ecosystems is key for the conservation and protection of the Tropical Andean biodiversity hot spot. We present the results of a multiproxy study of lake sediments from the high Andean páramo of El Cajas National Park, a UNESCO biosphere reserve in Ecuador. The main site, Laguna Pallcacocha, is well known for recording El Niño–driven clastic flood layers that are triggered by high-intensity rainfall anomalies from the eastern Pacific. The second site, Laguna El Ocho, does not contain clastic laminations, providing a control. The records show abrupt shifts in diatom assemblages ca. AD 1991 in both high-elevation Andean lakes accompanied by local changes in páramo composition that suggest a sudden nutrient enrichment of the environment. The diatom assemblages from Laguna Pallcacocha, in relation to the clastic input events, are remarkably stable and do not show evident El Niño signals at the analysed resolution. Based on comparison with the nonlaminated El Ocho record, we deduce the main source of this nutrient enrichment to be the construction of a heavily transited road that runs through the park, while climate warming played secondary role by amplifying its effects.
The role of interpersonal relationship functioning in trauma recovery is well-established. However, much of this research has been done with cross-sectional samples, often years after trauma exposure, using self-report methodology only, and is focused on intimate relationship adjustment.
Methods
The current study investigated the longitudinal associations between interpersonal (intimate and non-intimate) relationship functioning and clinician- and self-reported posttraumatic stress disorder (PTSD) symptoms in 151 recently (within the past 6 months) traumatized individuals. Participants were assessed at four time points over 1 year.
Results
Approximately 53% of the sample was diagnosed with PTSD at initial assessment, with declining rates of diagnostic status over time to 16%. Latent difference score (LDS) modeling revealed nonlinear declines in both clinician-assessed and self-reported PTSD symptom severity, with faster declines in earlier periods. Likewise, LDS models revealed nonlinear declines in negative (conflict) aspects of interpersonal relationship functioning, but linear declines in positive (support, depth) aspects. The relationship between PTSD and relationship functioning differed for clinician- and self-reported PTSD. Bivariate LDS modeling revealed significant cross-lagged effects from relationship conflict to clinician-assessed PTSD, and significant cross-lagged effects from self-reported PTSD to relationship conflict over time.
Conclusions
These results highlight that the variability in prior results may be related to the method of assessing PTSD symptomatology and different relational constructs. Implications for theory and early intervention are discussed.
The coronavirus disease 2019 (COVID-19) pandemic has resulted in shortages of personal protective equipment (PPE), underscoring the urgent need for simple, efficient, and inexpensive methods to decontaminate masks and respirators exposed to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). We hypothesized that methylene blue (MB) photochemical treatment, which has various clinical applications, could decontaminate PPE contaminated with coronavirus.
Design:
The 2 arms of the study included (1) PPE inoculation with coronaviruses followed by MB with light (MBL) decontamination treatment and (2) PPE treatment with MBL for 5 cycles of decontamination to determine maintenance of PPE performance.
Methods:
MBL treatment was used to inactivate coronaviruses on 3 N95 filtering facepiece respirator (FFR) and 2 medical mask models. We inoculated FFR and medical mask materials with 3 coronaviruses, including SARS-CoV-2, and we treated them with 10 µM MB and exposed them to 50,000 lux of white light or 12,500 lux of red light for 30 minutes. In parallel, integrity was assessed after 5 cycles of decontamination using multiple US and international test methods, and the process was compared with the FDA-authorized vaporized hydrogen peroxide plus ozone (VHP+O3) decontamination method.
Results:
Overall, MBL robustly and consistently inactivated all 3 coronaviruses with 99.8% to >99.9% virus inactivation across all FFRs and medical masks tested. FFR and medical mask integrity was maintained after 5 cycles of MBL treatment, whereas 1 FFR model failed after 5 cycles of VHP+O3.
Conclusions:
MBL treatment decontaminated respirators and masks by inactivating 3 tested coronaviruses without compromising integrity through 5 cycles of decontamination. MBL decontamination is effective, is low cost, and does not require specialized equipment, making it applicable in low- to high-resource settings.
Diet has a major influence on the composition and metabolic output of the gut microbiome. Higher-protein diets are often recommended for older consumers; however, the effect of high-protein diets on the gut microbiota and faecal volatile organic compounds (VOC) of elderly participants is unknown. The purpose of the study was to establish if the faecal microbiota composition and VOC in older men are different after a diet containing the recommended dietary intake (RDA) of protein compared with a diet containing twice the RDA (2RDA). Healthy males (74⋅2 (sd 3⋅6) years; n 28) were randomised to consume the RDA of protein (0⋅8 g protein/kg body weight per d) or 2RDA, for 10 weeks. Dietary protein was provided via whole foods rather than supplementation or fortification. The diets were matched for dietary fibre from fruit and vegetables. Faecal samples were collected pre- and post-intervention for microbiota profiling by 16S ribosomal RNA amplicon sequencing and VOC analysis by head space/solid-phase microextraction/GC-MS. After correcting for multiple comparisons, no significant differences in the abundance of faecal microbiota or VOC associated with protein fermentation were evident between the RDA and 2RDA diets. Therefore, in the present study, a twofold difference in dietary protein intake did not alter gut microbiota or VOC indicative of altered protein fermentation.
Purposeful qualitative modelling of embodiment function relations is a challenge in embodiment design. This contribution investigates the applicability and usefulness of the Contact and Channel Approach as a qualitative modelling approach in a survey study. From 23 development and research projects, advantages and challenges regarding applicability and usefulness are identified. A further result is that many different models are used additionally to the Contact and Channel Approach. Based on the findings, research potential for optimization and development of links to other models emerges.
Bulimia nervosa (BN) is a highly disabling disorder with severe health consequences. In a stepped care approach the NICE (National Institute of Clinical Excellence) guidelines recommend the application of guided self-help as a first step in the treatment of bulimia nervosa before continuing with face-to-face psychotherapy. Most of the self-help supports - available as books, CD-Rom or on an Internet surface - are based on cognitive behavioural concepts and have been proven to be effective. In this workshop we will present advantages of this treatment approach and provide you with a survey of research work implementing new technologies in the treatment of BN. We will give you an insight into the treatment modules involved in SALUT - BN developed by Netunion in cooperation with the University of Geneva and present the latest results and longterm outcome of a RCT comparing Internet-based Self program for BN with bibliotherapy.
Surface based MRI methods are a promising approach for the identification of cerebral shape alterations in schizophrenia [1]. In particular, investigating gyrification might offer important evidence for disturbed neurodevelopmental mechanisms in schizophrenia.
Objective
The present study is the first to compare on a vertex - wise basis mean curvature as a sensitive parameter for the identification of local gyrification changes in first episode schizophrenia.
Methods
54 patients with first-episode schizophrenia and 54 healthy control subjects underwent high-resolution T1-weighted MRI scans. Surface extraction and mean curvature calculation was performed using the Freesurfer Software package. Statistical cortical maps were created to estimate gyrification differences between groups.
Results
A significantly increased gyrification was detected in patients relative to controls in a large right parahippocampal-lingual cortex area. A further analysis of cortical thickness of this cluster revealed concurrent significant reduced cortical thickness in patients.
Conclusions
This is the first study to reveal an aberrant gyrification of the medial surface in first episode schizophrenia on basis of a vertex - wise analysis of local gyrification changes of the entire cortex. Both affected areas, the parahippocampal and the lingual cortex, are of high pathophysiological relevance for schizophrenia. Thus, our data provided new in vivo evidence for an early maturational deficit of these cortical areas in schizophrenia [2].
The aim of this study was to detect longitudinal differences in white matter brain structures in adults with schizophrenia compared to healthy controls.
Methods
Twenty adult patients with multi-episode schizophrenia under stable antipsychotic medication and twenty-two age- and sex-matched healthy subjects were included in the study. Diffusion Tensor Imaging (DTI) was applied at baseline (t1), after 6weeks (t2) and after 3months (t3) and data processing was done with tract-based spatial statistics (p<0.05, corrected). Two subjects in the schizophrenic sample dropped out at t2 and one healthy subject at t3. Clinical and neuropsychological variables were measured and correlated with the most significant DTI findings.
Results
Compared with healthy age- and sex-matched controls schizophrenic patients showed widespread decreases in mean fractional anisotropy values (p<0.05, corrected). The most obvious FA decrease in the long-term was found in the anterior part of the corpus callosum (p<0.005, corrected), the left temporal lobe (p<0.004, corr.) and the mid-cingulate gyrus bilateral (p<0.004, corr.). Correlations to demographic variables, clinical rating scales (PANSS, CGI and GAF), verbal learning and memory and working memory will be presented.
Conclusion
Magnetic resonance imaging was able to detect altered structural connectivity in patients with multi-episode schizophrenia in a longitudinal design.
Although male and female patients with major depression (MDD) differ in psychopathology and other illness characteristics, a potentially confounding effect of gender has not been systematically controlled or investigated in most of the previous neuroimaging studies.
Objectives
We investigated activation patterns during processing of ambiguous stimuli in MDD by functional MRI.
Aims
We aimed at examining potential activation differences between male and female patients.
Methods
A matching task was employed in which two stimuli with varying degrees of perceptual uncertainty had to be compared with respect to their sameness. Eighteen patients meeting DSM-IV criteria of MDD and eighteen healthy control subjects participated in this study.
Results
Whereas on the level of behavioral performance no significant group differences could be detected we found distinct disorder- and gender-related differences in the brain activation. Patients activated significantly stronger in superior parietal, prefrontal and cingulate regions. Gender specific analyses revealed that the hyperactivity in the patient group was mainly attributable to hyperactivity in the male patients who activated significantly stronger than the female patients in an extensive fronto-temporo-limbic network, which partly overlapped with the network we found when comparing patients and healthy controls.
Discussion
Our results indicate that male patients seem to be reliant on a significantly stronger metabolism in task-relevant regions to maintain an equal level of performance.
Conclusion
The present results provide evidence for gender-related differences in the functional organization of the brain in patients with MDD. Gender differences should be taken into consideration when investigating the neural correlates of MDD.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Gene × environment (G × E) interactions in eating pathology have been increasingly investigated, however studies have been limited by sample size due to the difficulty of obtaining genetic data.
Objective
To synthesize existing G × E research in the eating disorders (ED) field and provide a clear picture of the current state of knowledge with analyses of larger samples.
Method
Complete data from seven studies investigating community (n = 1750, 64.5% female) and clinical (n = 426, 100% female) populations, identified via systematic review, were included. Data were combined to perform five analyses: 5-HTTLPR × Traumatic Life Events (0–17 events) to predict ED status (n = 909), 5-HTTLPR × Sexual and Physical Abuse (n = 1097) to predict bulimic symptoms, 5-HTLPR × Depression to predict bulimic symptoms (n = 1256), and 5-HTTLPR × Impulsivity to predict disordered eating (n = 1149).
Results
The low function (s) allele of 5-HTTLPR interacted with number of traumatic life events (P < .01) and sexual and physical abuse (P < .05) to predict increased likelihood of an ED in females but not males (Fig. 1). No other G × E interactions were significant, possibly due to the medium to low compatibility between datasets (Fig. 1).
Conclusion
Early promising results suggest that increased knowledge of G × E interactions could be achieved if studies increased uniformity of measuring ED and environmental variables, allowing for continued collaboration to overcome the restrictions of obtaining genetic samples.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Determine the impact of an automated hand hygiene monitoring system (AHHMS) plus complementary strategies on hand hygiene performance rates and healthcare-associated infections (HAIs).
Hand hygiene compliance rates were estimated using direct observations. An AHHMS, installed on 4 nursing units in a sequential manner, determined hand hygiene performance rates, expressed as the number of hand hygiene events performed upon entering and exiting patient rooms divided by the number of room entries and exits. Additional strategies implemented to improve hand hygiene included goal setting, hospital leadership support, feeding AHHMS data back to healthcare personnel, and use of Toyota Kata performance improvement methods. HAIs were defined using National Healthcare Safety Network criteria.
Results:
Hand hygiene compliance rates generated by direct observation were substantially higher than performance rates generated by the AHHMS. Installation of the AHHMS without supplementary activities did not yield sustained improvement in hand hygiene performance rates. Implementing several supplementary strategies resulted in a statistically significant 85% increase in hand hygiene performance rates (P < .0001). The incidence density of non–Clostridioies difficile HAIs decreased by 56% (P = .0841), while C. difficile infections increased by 60% (P = .0533) driven by 2 of the 4 study units.
Conclusion:
Implementation of an AHHMS, when combined with several supplementary strategies as part of a multimodal program, resulted in significantly improved hand hygiene performance rates. Reductions in non–C. difficile HAIs occurred but were not statistically significant.
The characterization of modern pollen rain assemblages along environmental gradients is an essential prerequisite for reliable interpretations of fossil pollen records. In this study, we identify pollen-vegetation relationships using modern pollen rain assemblages in moss polsters (n = 13) and lake sediment surface samples (n = 11) along a steep temperature gradient of 7°C (3100–4200 m above sea level) on the western Andean Cordillera, Ecuador. The pollen rain is correlated to vascular plant abundance data recorded in vegetation relevées (n = 13). Results show that pollen spectra from both moss polsters and sediment surface samples reflect changes in species composition along the temperature gradient, despite overrepresentation of upper montane forest taxa in the latter. Estimated pollen transport distance for a lake (Laguna Llaviucu) situated in a steep upper montane forest valley is 1–2 km, while a lake (Laguna Pallcacocha) in the páramo captures pollen input from a distance of up to 10–40 km. Weinmannia spp., Podocarpus spp., and Hedyosmum sp. are indicators of local upper montane forest vegetation, while Phlegmariurus spp. and Plantago spp. are indicators for local páramo vegetation.