Perinatal women were particularly impacted during the pandemic, with documented consequences for both mothers’ and infants’ well-being. This study investigated the longitudinal relationships between COVID-19-related experiences during the peripartum and women’s depression and anxiety symptoms at long-term follow-up. We explored the moderating role of long COVID for the first time, along with perceived partner support and maternal self-efficacy. A sample of 190 US perinatal women completed a survey from May 21, 2020, to September 15, 2021 (T1), and again between December 14, 2022, and February 14, 2024 (T2). The survey assessed COVID-19-related experiences, mental health, long COVID, maternal self-efficacy, partner support, and life events. Anxiety was associated with both long COVID and decreased partner support, and both depression and anxiety were linked to lower self-efficacy. A larger number of COVID-19-related experiences during the peripartum period was associated with higher levels of later depression and anxiety symptoms. Long COVID exacerbated these links, while partner support buffered them. Maternal self-efficacy dampened the association between COVID-19-related experiences and subsequent depression, but not anxiety. Findings suggest that COVID-19 has lasting effects on perinatal women’s mental health, with partner support and maternal self-efficacy acting as resilience factors, highlighting the potential benefit of targeted interventions to enhance these modifiable factors.

Background: The complement C5 inhibitor (C5IT), ravulizumab, is approved in Canada for the treatment of anti-acetylcholine receptor antibody-positive (AChR-Ab+) generalized myasthenia gravis (gMG). Updated effectiveness and safety results from the ongoing MG SPOTLIGHT Registry (NCT04202341) are reported. Methods: MGFA classification and MG-ADL total scores were assessed in patients who received ravulizumab only (ravu-only) or transitioned from eculizumab to ravulizumab (ecu-to-ravu), with data available prior to C5IT initiation (“pre-C5IT”) and ≥1 assessment post-initiation (“post-ravu”). Results: Of 52 patients with 2 post-ravu assessments, average treatment duration was 10.4 months at last assessment (LA). Mean±SD MG-ADL scores improved (pre-C5IT: 7.6±3.6; LA: 3.4±3.3), as did the proportions of patients with minimal symptom expression (MSE, MG-ADL≤1) (pre-C5IT: 1/52 [2%]; LA: 17/52 [33%]) and MGFA classification 0-II (pre-C5IT: 18/45 [40%]; LA: 40/45 [89%]). In the ravu-only subgroup, outcomes improved (pre-C5IT vs LA): MG-ADL, 6.3±3.0 vs 4.0±3.4; MGFA 0-II, 9/14 [64%] vs 12/14 [86%]. The ecu-to-ravu subgroup sustained continued gradual improvement from last eculizumab assessment to LA: MG-ADL, 4.4±4.2 vs 3.0±2.8; MGFA 0-II, 19/21 [90%] vs 20/21 [95%]. Ravulizumab was well tolerated; no meningococcal infections were reported. Conclusions: These results demonstrate the long-term effectiveness and safety of ravulizumab in routine clinical practice in patients with gMG.

Background: Meningiomas are the most common intracranial tumors. Radiotherapy (RT) serves as an adjunct following surgical resection; however, response varies. RTOG-0539 is a prospective, phase 2, trial that stratified patients risk groups based on clinical and pathological criteria, providing key benchmarks for RT outcomes. This is the first study that aims to characterize the molecular landscape of an RT clinical trial in meningiomas. Methods: Tissue from 100 patients was analyzed using DNA methylation, RNA sequencing, and whole-exome sequencing. Copy number variations and mutational profiles were assessed to determine associations with meningioma aggressiveness. Tumors were molecularly classified and pathway analyses were conducted to identify biological processes associated with RT response. Results: High-risk meningiomas exhibited cell cycle dysregulation and hypermetabolic pathway upregulation. 1p loss and 1q gain were more frequent in aggressive meningiomas, and NF2 and non-NF2 mutations co-occurred in some high-risk tumors. Molecular findings led to the reclassification of several cases, highlighting the limitations of histopathologic grading alone. Conclusions: This is the first study to comprehensively characterize the molecular landscape of any RT trial in meningioma, integrating multi-omic data to refine treatment stratification. Findings align with ongoing genomically driven meningioma clinical trials and underscore the need for prospective tissue banking to enhance biomarker-driven treatment strategies.

Background: Ischemic stroke is a major cause of morbidity and mortality in Canada. Since 2015, mechanical thrombectomy has been the standard of care for eligible large vessel occlusions (LVOs), though anesthetic strategies remain variable. Methods: We conducted a single-center retrospective review of patients undergoing mechanical thrombectomy for anterior circulation LVOs between 2021 and 2023. Patients were categorized by anesthetic strategy (general anesthesia vs. conscious sedation), and outcomes, including time to recanalization, angiographic results (mTICI), and 90-day functional status (mRS), were compared. Statistical analyses included Student’s t-test, Mann-Whitney U-test, and Fisher’s exact test. Results: Among 226 patients, 177 (78%) received general anesthesia and 49 (22%) underwent conscious sedation. Baseline characteristics including sex, age, NIHSS, ASPECTS, collaterals, and laterality were similar between groups. Conscious sedation was associated with a statistically significant shorter time from arrival to the angiography suite to groin puncture (p=0.007), but no differences in time to recanalization (p=0.893), angiographic outcomes (p=0.987), or 90-day functional status (p=0.795) were observed. Conclusions: Conscious sedation led to faster procedural initiation, though no difference in clinical or radiographic outcome was observed. Anesthetic choice should be individualized based on patient and physician factors in acute mechanical thrombectomy.

Background: The WHO grade of meningioma was updated in 2021 to include homozygous deletions of CDKN2A/B and TERT promotor mutations. Previous work including the recent cIMPACT-NOW statement have discussed the potential value of including chromosomal copy number alterations to help refine the current grading system. Methods: Chromosomal copy number profiles were inferred from from 1964 meningiomas using DNA methylation. Regularized Cox regresssion was used to identify CNAs independenly associated with post-surgical and post-RT PFS. Outcomes were stratified by WHO grade and novel CNAs to assess their potential value in WHO critiera. Results: Patients with WHO grade 1 tumours and chromosome 1p loss had similar outcomes to those with WHO grade 2 tumours (median PFS 5.83 [95% CI 4.36-Inf] vs 4.48 [4.09-5.18] years). Those with chromosome 1p loss and 1q gain had similar outcomes to those with WHO grade 3 cases regardless of initial grade (median PFS 2.23 [1.28-Inf] years WHO grade 1, 1.90 [1.23-2.25] years WHO grade 2, compared to 2.27 [1.68-3.05] years in WHO grade 3 cases overall). Conclusions: We advocate for chromosome 1p loss being added as a criterion for a CNS WHO grade of 2 meningioma and addition of 1q gain as a criterion for a CNS WHO grade of 3.

Background: Meningiomas exhibit considerable heterogeneity. We previously identified four distinct molecular groups (immunogenic, NF2-wildtype, hypermetabolic, proliferative) which address much of this heterogeneity. Despite their utility, the stochasticity of clustering methods and the requirement of multi-omics data limits the potential for classifying cases in the clinical setting. Methods: Using an international cohort of 1698 meningiomas, we constructed and validated a machine learning-based molecular classifier using DNA methylation alone. Original and newly-predicted molecular groups were compared using DNA methylation, RNA sequencing, whole exome sequencing, and clinical outcomes. Results: Group-specific outcomes in the validation cohort were nearly identical to those originally described, with median PFS of 7.4 (4.9-Inf) years in hypermetabolic tumors and 2.5 (2.3-5.3) years in proliferative tumors (not reached in the other groups). Predicted NF2-wildtype cases had no NF2 mutations, and 51.4% had others mutations previously described in this group. RNA pathway analysis revealed upregulation of immune-related pathways in the immunogenic group, metabolic pathways in the hypermetabolic group and cell-cycle programs in the proliferative group. Bulk deconvolution similarly revealed enrichment of macrophages in immunogenic tumours and neoplastic cells in hypermetabolic/proliferative tumours. Conclusions: Our DNA methylation-based classifier faithfully recapitulates the biology and outcomes of the original molecular groups allowing for their widespread clinical implementation.

Background: The combination of PARP inhibitor and immune checkpoint inhibitors have been proposed as a potentially synergistic combinatorial treatment in IDH mutant glioma, targeting dysregulated homologous recombination repair pathways. This study analyzed the cell-free DNA methylome of patients in a phase 2 trial using the PARP inhibitor Olaparib and the PD-1 inhibitor Durvalumab. Methods: Patients with recurrent high-grade IDH-mutant gliomas were enrolled in a phase II open-label study (NCT03991832). Serum was collected at baseline and monthly and cell-free methylated DNA immunoprecipitation and high-throughput sequencing (cfMeDIP-seq) was performed. Binomial GLMnet models were developed and model performance was assessed using validation set data. Results: 29 patients were enrolled between 2020–2023. Patients received olaparib 300mg twice daily and durvalumab 1500mg IV every 4 weeks. The overall response rate was 10% via RANO criteria. 144 plasma samples were profiled with cfMeDIP-seq along with 30 healthy controls. The enriched circulating tumour DNA methylome during response periods exhibited a highly specific signature, accurately discriminating response versus failure (AUC 0.98 ± 0.03). Additionally, samples that were taken while on treatment were able to be discriminated from samples off therapy (AUC 0.74 ± 0.11). Conclusions: The cell-free plasma DNA methylome exhibits highly specific signatures that enable accurate prediction of response to therapy.

With numerous applications of coilable masts in high-precision space application scenarios, there are also greater demands on the accuracy of their dynamic modelling and analysis. The modelling of hinges is a critical issue in the dynamic modelling of coilable masts, which significantly affects the accuracy of the dynamic response analysis. For coilable masts, the rotational effect is the most important problem in hinge modelling. However, few studies have focused on this topic. To address this problem, the concept of hinge equivalent rotational stiffness is proposed in this paper to describe the rotational effect of the coilable mast hinges. After that, a new coilable mast dynamic model containing the undetermined hinge equivalent rotational stiffness is introduced, and an identification method for the hinge equivalent rotational stiffness based on the hammer test is proposed. Finally, the dynamic modelling method is validated through an actual coilable mast example, and the analysis and test results show that the accuracy of the dynamic model established by the proposed method in this paper is greater than that of the traditional model.

Discretionary foods that are energy-dense and nutrient-poor contribute to over one third of total energy intake in Australian children and adults, and the typical portion sizes of many discretionary foods have increased significantly in the last two decades(1). The portion size norms (described as a typical perception of how much of a given food people choose to eat at a single eating occasion) are likely to have increased concurrently, with larger sizes now being considered the new normal(2). Public health interventions are urgently needed to reduce the portion size norms and consumption of discretionary foods(3), but the acceptability of such interventions remains unknown. Therefore, this qualitative study aimed to gain insights into consumers’ attitudes towards potential interventions targeted at promoting portion control of discretionary foods. Four online focus group sessions were conducted via Zoom with healthy Australian adults who regularly consume discretionary foods. A question guide was developed to gather participants’ perspectives around four potential public health interventions; reduction of the default serving sizes, increasing serving size options, changes to package sizes, and improving serving size labelling. A female facilitator moderated all focus groups, with a second moderator present to capture other relevant details. Collected data were analysed using a hybrid approach combining deductive and inductive thematic analyses. A total of 35 participants completed the study (19 females, mean age 38 ± 14 years). Participants identified the current food environment as promoting overconsumption; larger serving sizes were reported to be more ubiquitous and better value for money than smaller size options. An overall positive attitude towards the proposed interventions was noted. Out of the four proposed interventions, participants considered the most acceptable intervention to be providing a wider range of serving size options while maintaining a consistent unit price. Other acceptable interventions included reducing the default serving sizes with concurrent price reduction; education and clear guidance around portion size selection (for example, the involvement of health professionals to promote portion control, along with relevant recommendations of appropriate portion sizes from health authorities); more practical on-pack serving size suggestions; and innovative package designs that enable better portion control without contributing to food and plastic waste. In conclusion, participants identified a need for and were in support of interventions aimed at the portion control of discretionary foods. Further research should focus on examining the feasibility and effectiveness of the potential interventions to reduce the purchasing and consumption of large serving sizes. More efforts from public health authorities are required to develop practical and tailored recommendations for consumers around appropriate portion sizes for discretionary foods. Collaboration with the food industry and policy makers is also necessary for implementing public health interventions to reduce the excessive intake of discretionary foods.

A distributed cooperative guidance law without numerical singularities is proposed for the simultaneous attack a stationary target by multiple vehicles with field-of-view constraints. Firstly, the vehicle engagement motion model is transformed into a multi-agent model. Then, based on the state-constrained consensus protocol, a coordination control law with field-of-view (FOV) constraints is proposed. Finally, the cooperative guidance law has been improved to make it more suitable for practical application. Numerical simulations verified the effectiveness and robustness of the proposed guidance law in the presence of acceleration saturation, communication delays and measurement noise.

Aiming at the problem of fast and consensus obstacle avoidance of multiple unmanned aerial systems in undirected network, a multi-quadrotor unmanned aerial vehicles UAVs (QUAVs) finite-time consensus obstacle avoidance algorithm is proposed. In this paper, multi-QUAVs establish communication through the leader-following method, and the formation is led by the leader to fly to the target position automatically and avoid obstacles autonomously through the improved artificial potential field method. The finite-time consensus protocol controls multi-QUAVs to form a desired formation quickly, considering the existence of communication and input delay, and rigorously proves the convergence of the proposed protocol. A trajectory segmentation strategy is added to the improved artificial potential field method to reduce trajectory loss and improve the task execution efficiency. The simulation results show that multi-QUAVs can be assembled to form the desired formation quickly, and the QUAV formation can avoid obstacles and maintain the formation unchanged while avoiding obstacles.

This meta-analysis and trial sequential analysis (TSA) of randomized controlled trials (RCTs) on the psychological treatment of body dysmorphic disorder (BDD) was conducted to evaluate the intervention effects and robustness of the evidence. This study included 15 RCTs up until 15 June 2024, with 905 participants. Results showed significant improvements in BDD symptoms (g = −0.97), depression (g = −0.51), anxiety (g = −0.72), insight/delusion (g = −0.57), psychosocial functioning (g = 0.45), and quality of life (g = 0.44), with effects sustained from 1 to 6 months follow-up. RCTs with a waitlist/inactive control reported larger effect sizes for post-intervention BDD symptoms compared to those with a placebo/active control group. In addition, studies with low risk of bias demonstrate larger effect sizes for post-intervention psychosocial functioning compared to studies with some concerns. Notably, the presence of exposure and response prevention in the treatment, as well as the mode of delivery (face-to-face or digital), did not have a significant impact on the intervention outcomes. Females exhibited greater effect sizes in post-intervention BDD symptoms and psychosocial functioning than males. With increasing age, the effect size for insight/delusion symptoms diminished. Longer session duration was associated with larger effect sizes for BDD symptoms, depression at post-treatment, and depression at follow-up. TSA indicated robust evidence for depression at post-treatment and BDD symptoms, while the remaining outcome variables did not meet the desired level of evidence. In conclusion, this study underscores the effectiveness of psychological treatments in reducing BDD symptoms and improving related outcomes, highlighting the need for further research to confirm the impact of these therapies on other outcomes.

In order to improve the performance of $k - \omega $ SST model in turbomachinery, previous studies have used the machine-learning (ML) technique to obtain turbulence models (for example, the ML-RANS EQ model). However, these models do not lead to satisfactory results in complex flows in turbomachinery. In this study, we use non-equilibrium training dataset to obtain a new turbulence model (i.e., the ML-RANS TR-NE-EQ model). Calculations in various cases of turbine cascade flows show that ML-RANS TR-NE-EQ model performs obviously better than ML-RANS EQ model as well as $k - \omega $ SST model.

Objectives: Activities that require active thinking, like occupations, may influence cognitive function and its change over time. Associations between retirement and dementia risk have been reported, however the role of retirement age in these associations is unclear. We assessed associations of occupation and retirement age with cognitive decline in the US community-based Atherosclerosis Risk in Communities (ARIC)cohort.

Methods: We included 14,090 ARIC participants, followed for changes in cognition during up to 21 years. Information on current or most recent occupation was collected at ARIC baseline (1987–1989; participants aged 45–64 years) and categorized according to the 1980 US Census protocols and the Nam-Powers-Boyd occupational status score. Follow-up data on retirement was collected during 1999–2007 and classified as retired versus not retired at age 70. Trajectories of global cognitive factor scores from ARIC visit 2 (1990–1992) to visit 5 (2011–2013) were presented, and associations with occupation and age at retirement were studied using generalized estimating equation models, stratified by race and sex, and adjusted for demographics andcomorbidities.

Results: Mean age (SD) at first cognitive assessment was 57.0 (5.72) years. Higher occupational status and white- collar occupations were significantly associated with higher cognitive function at baseline. Occupation was associated with cognitive decline over 21 years only in women, and the direction of the effect on cognitive function differed between black and white women: in white women, the decline in cognitive function was greater in homemakers and low status occupations, whereas in black women, less decline was found in homemakers and low (compared to high) occupational status. Interestingly, retirement on or before age 70 was associated with less 21-year cognitive decline in all race-sex strata, except for blackwomen.

Conclusions: Associations between occupation, retirement age and cognitive function substantially differed by race and sex. Further research should explore reasons for the observed associations and race-sex differences.