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Background: Neck vessel imaging is often performed in hyperacute stroke to allow neurointerventionalists to estimate access complexity. This study aimed to assess clinician agreement on catheterization strategies based on imaging in these scenarios. Methods: An electronic portfolio of 60 patients with acute ischemic stroke was sent to 53 clinicians. Respondents were asked: (1) the difficulty of catheterization through femoral access with a regular Vertebral catheter, (2) whether to use a Simmons or reverse-curve catheter initially, and (3) whether to consider an alternative access site. Agreement was assessed using Fleiss’ Kappa statistics. Results: Twenty-two respondents (7 neurologists, 15 neuroradiologists) completed the survey. Overall there was slight interrater agreement (κ=0.17, 95% CI: 0.10–0.25). Clinicians with >50 cases annually had better agreement (κ=0.22) for all questions than those with fewer cases (κ=0.07). Agreement did not significantly differ by imaging modality: CTA (κ=0.18) and MRA (κ=0.14). In 40/59 cases (67.80%), at least 25% of clinicians disagreed on whether to use a Simmons or reverse-curve catheter initially. Conclusions: Agreement on catheterization strategies remains fair at best. Our results suggest that visual assessment of pre-procedural vessels imaging is not reliable for the estimation of endovascular access complexity.
Current food systems pose risks to both population and environmental health. Reducing the intake of animal-based foods, such as dairy products, and increasing consumption of plant-based foods align with priorities for addressing climate change and promoting overall health. Plant-based alternatives to cow’s milk can be readily substituted for cow’s milk without altering meal patterns and food habits, making them a popular choice among those reducing animal-product consumption. However, plant-based milk alternatives do not necessarily provide the same nutrients as cow’s milk, particularly essential micronutrients like iodine. While national data indicate that the UK is iodine-replete, certain population subgroups (such as pregnant women, women of reproductive age, and vegans) remain at risk of iodine deficiency. Young women are more likely than other age groups to consume plant-based milk alternatives, heightening public health concerns about iodine insufficiency in this demographic. Current consumers of plant-based milk alternatives in the UK have lower iodine intake and status compared to consumers of cow’s milk. Population-level effects of replacing milk with plant-based alternatives vary and depend on factors such as the role of plant-based milk alternatives in the diet (i.e. in addition to, or as a replacement for milk), the presence of other iodine sources in the diet, the consumer’s life stage, and whether the alternatives are fortified with iodine. This review examines the literature on plant-based milk alternatives and iodine intake, focusing on implications of this dietary shift and strategies to improve iodine intake in those opting for plant-based milk alternatives in the UK population.
A primary tenet of punctuated equilibria (PE) is that stasis, that is, little to no net morphological change, characterizes the histories of species. In the past ~50 years since PE was proposed, stasis has been recognized in the evolutionary histories of many species, but consensus has not been reached concerning its causes.
One unresolved issue is whether viable ecological mechanisms for stasis exist. We argue that a promising potential ecological explanation for stasis is coevolutionary alternation, which addresses how antagonists (e.g., predators or parasites and their groups of victims) coevolve over eco-evolutionary time across broad spatial scales. Coevolutionary alternation predicts different patterns of predator preferences and prey defenses within different populations and alternation of high and low levels of prey defenses as predator preferences evolve. The geographic structure of populations experiencing different environmental pressures and coevolutionary dynamics can yield stasis in such traits on the scale of entire species. We suggest that predator–prey coevolutionary alternation could be modeled using coupled stochastic differential equations (SDEs), which have been used to study correlative and causal connections among time series. SDEs can handle irregular sampling intervals, measurement uncertainty, and feedback loops between time series and can incorporate environmental proxies and time series from multiple geographic locations. We advocate developing this approach further to test the role of coevolutionary alternation in stasis and make recommendations for how SDEs might be used to model the coevolutionary feedback of predator(s) and multiple prey populations evolving in response to one another across space in a constantly changing environment.
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.
Traditional foods are increasingly being incorporated into modern diets. This is largely driven by consumers seeking alternative food sources that have superior nutritional and functional properties. Within Australia, Aboriginal and Torres Strait Islander peoples are looking to develop their traditional foods for commercial markets. However, supporting evidence to suggest these foods are safe for consumption within the wider general population is limited. At the 2022 NSA conference a keynote presentation titled ‘Decolonising food regulatory frameworks to facilitate First Peoples food sovereignty’ was presented. This presentation was followed by a manuscript titled ‘Decolonising food regulatory frameworks: Importance of recognising traditional culture when assessing dietary safety of traditional foods’, which was published in the conference proceedings journal(1). These pieces examined the current regulatory frameworks that are used to assess traditional foods and proposed a way forward that would allow Traditional Custodians to successfully develop their foods for modern markets. Building upon the previously highlighted works, this presentation will showcase best practice Indigenous engagement and collaboration principles in the development of traditionally used food products. To achieve this, we collaborated with a collective of Gamilaraay peoples who are looking to reignite their traditional grain practices and develop grain-based food products. To meet the current food safety regulatory requirements, we needed to understand how this grain would fit into modern diets, which included understanding the history of use, elucidating the nutritional and functional properties that can be attributed to the grain, and developing a safety dossier(2) so that the Traditional Custodians can confidently take their product to market. To aid the Traditional Custodians in performing their due diligence, we have systemically analysed the dietary safety of the selected native grain and compared it side-by-side with commonly consumed wheat in a range of in vitro bioassays and chemical analyses. From a food safety perspective, we show that the native grain is equivalent to commonly consumed wheat. The native grain has been shown to be no more toxic than wheat within our biological screening systems. Chemical analysis showed that the level of contaminants are below tolerable limits, and we were not able to identify any chemical classes of concern. Our initial findings support the history of safe use and suggest that the tested native grain species would be no less safe than commonly consumed wheat. This risk assessment and previously published nutritional study(3) provides an overall indication that the grain is nutritionally superior and viable for commercial development. The learnings from this project can direct the future risk assessment of traditional foods and therefore facilitate the safe market access of a broader range of traditionally used foods. Importantly, the methods presented are culturally safe and financially viable for the small businesses hoping to enter the market.
Posttraumatic stress disorder (PTSD) has been associated with advanced epigenetic age cross-sectionally, but the association between these variables over time is unclear. This study conducted meta-analyses to test whether new-onset PTSD diagnosis and changes in PTSD symptom severity over time were associated with changes in two metrics of epigenetic aging over two time points.
Methods
We conducted meta-analyses of the association between change in PTSD diagnosis and symptom severity and change in epigenetic age acceleration/deceleration (age-adjusted DNA methylation age residuals as per the Horvath and GrimAge metrics) using data from 7 military and civilian cohorts participating in the Psychiatric Genomics Consortium PTSD Epigenetics Workgroup (total N = 1,367).
Results
Meta-analysis revealed that the interaction between Time 1 (T1) Horvath age residuals and new-onset PTSD over time was significantly associated with Horvath age residuals at T2 (meta β = 0.16, meta p = 0.02, p-adj = 0.03). The interaction between T1 Horvath age residuals and changes in PTSD symptom severity over time was significantly related to Horvath age residuals at T2 (meta β = 0.24, meta p = 0.05). No associations were observed for GrimAge residuals.
Conclusions
Results indicated that individuals who developed new-onset PTSD or showed increased PTSD symptom severity over time evidenced greater epigenetic age acceleration at follow-up than would be expected based on baseline age acceleration. This suggests that PTSD may accelerate biological aging over time and highlights the need for intervention studies to determine if PTSD treatment has a beneficial effect on the aging methylome.
Quantum field theory predicts a nonlinear response of the vacuum to strong electromagnetic fields of macroscopic extent. This fundamental tenet has remained experimentally challenging and is yet to be tested in the laboratory. A particularly distinct signature of the resulting optical activity of the quantum vacuum is vacuum birefringence. This offers an excellent opportunity for a precision test of nonlinear quantum electrodynamics in an uncharted parameter regime. Recently, the operation of the high-intensity Relativistic Laser at the X-ray Free Electron Laser provided by the Helmholtz International Beamline for Extreme Fields has been inaugurated at the High Energy Density scientific instrument of the European X-ray Free Electron Laser. We make the case that this worldwide unique combination of an X-ray free-electron laser and an ultra-intense near-infrared laser together with recent advances in high-precision X-ray polarimetry, refinements of prospective discovery scenarios and progress in their accurate theoretical modelling have set the stage for performing an actual discovery experiment of quantum vacuum nonlinearity.
Preliminary evidence suggests that a ketogenic diet may be effective for bipolar disorder.
Aims
To assess the impact of a ketogenic diet in bipolar disorder on clinical, metabolic and magnetic resonance spectroscopy outcomes.
Method
Euthymic individuals with bipolar disorder (N = 27) were recruited to a 6- to 8-week single-arm open pilot study of a modified ketogenic diet. Clinical, metabolic and MRS measures were assessed before and after the intervention.
Results
Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg (P < 0.001), mean body mass index fell by 1.5 kg/m2 (P < 0.001) and mean systolic blood pressure fell by 7.4 mmHg (P < 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data (n = 14), there was a positive correlation between daily ketone levels and self-rated mood (r = 0.21, P < 0.001) and energy (r = 0.19 P < 0.001), and an inverse correlation between ketone levels and both impulsivity (r = −0.30, P < 0.001) and anxiety (r = −0.19, P < 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the anterior cingulate cortex (P = 0.025) and fell by 13.6% in the posterior cingulate cortex (P = <0.001).
Conclusions
These findings suggest that a ketogenic diet may be clinically useful in bipolar disorder, for both mental health and metabolic outcomes. Replication and randomised controlled trials are now warranted.
We present a novel scheme for rapid quantitative analysis of debris generated during experiments with solid targets following relativistic laser–plasma interaction at high-power laser facilities. Results are supported by standard analysis techniques. Experimental data indicate that predictions by available modelling for non-mass-limited targets are reasonable, with debris of the order of hundreds of μg per shot. We detect for the first time two clearly distinct types of debris emitted from the same interaction. A fraction of the debris is ejected directionally, following the target normal (rear and interaction side). The directional debris ejection towards the interaction side is larger than on the side of the target rear. The second type of debris is characterized by a more spherically uniform ejection, albeit with a small asymmetry that favours ejection towards the target rear side.
The recent ONS survey reported that 92% of students had been affected by the cost-of-living crisis with 46% revealing their overall mental health and well-being had worsened(1). London Metropolitan University has a unique diverse student population: in 2020-21, 82% of students were mature, 64% of students identified as female, 55% of students were from a minoritised background and 13% had a known disability(2). Furthermore, at least 50% of our students, many of whom have caring responsibilities, reside in the most deprived wards of Islington or other impoverished London boroughs. It has been documented that those students with families, who come from a low income and a minority background are more vulnerable(3) and are more likely to be disproportionately affected by the cost-of-living crisis and at risk of food insecurity. We sought to ease the burden of the cost-of-living crisis with a recipe box scheme, BRITE Box (4) and evaluate its acceptance.
BRITE Box provides a complete set of pre-weighed ingredients for a healthy nutritious meal with an easy-to-follow recipe guide. Each box typically contains two servings of vegetables, meat, bread and dairy, as well as spices, dried and tinned goods to feed a family of five people. We distributed 300 boxes over a period of five months to students primarily with families who had accessed the university hardship fund. Student volunteers and the academic staff pre-weighed the ingredients, prepared and distributed the boxes. The scheme was advertised through Student Services who administer the hardship fund, the Student Union and the intranet. The recipients of the boxes were provided with a QR code linking to a 20-item online survey on demographic characteristics, number of children, acceptability of the box and perceived advantages and disadvantages of the scheme. Ethics was approved by London Metropolitan University.
Thirty-three participants completed the survey, 42% of the recipients identified as female, 55% were from a minority background and 30% had children. The responses showed that students agreed and strongly agreed that the recipe box introduced them to new flavours (52%), and new foods (42%). The majority followed the recipe and will use again (67%). Most importantly, 73% students agreed and or strongly agreed that it helped with the food budget and helped foster a sense of belonging to the university (85%).
The scheme has proved to be popular among the students: “a really cool concept”, “it helped me cook”, “the box provided food for 3 days” and created a buzz around campus on distribution days. It has enhanced the feeling of community and belonging within the university, whilst also alleviating food insecurity and tackling the cost-of-living crisis.
Animal foods, especially dairy products, eggs and fish, are the main source of iodine in the UK. However, the use of plant-based alternative products (PBAP) is increasing owing to issues of environmental sustainability. We previously measured the iodine content of milk-alternatives(1) but data are lacking on the iodine content of other plant-based products and there is now a greater number of iodine-fortified products. We aimed to compare: (i) the iodine concentration of fortified and unfortified PBAP and (ii) the iodine concentration of PBAP with their animal-product equivalents, including those not previously measured such as egg and fish alternatives.
The iodine concentration of 50 PBAP was analysed in March 2022 at LGC using ICP-MS. The products were selected from a market survey of six UK supermarkets in December 2021. Samples of matrix-matched (e.g. soya/oat) fortified and unfortified alternatives to milk (n = 13 and n = 11), yoghurt (n = 2 and n = 7) and cream (n = 1 and n = 5) were selected for analysis, as well as egg- (n = 1) and fish-alternatives (n = 10). We compared the iodine concentration between PBAPs and data on their animal-product equivalents(2).
The iodine concentration of fortified PBAPs was significantly higher than that of unfortified products; the median iodine concentration of fortified vs. unfortified milk alternatives was 321 vs. 0.84 µg/kg (p<0.001) and of fortified and unfortified yoghurt alternatives was 212 µg/kg vs 3.03 µg/kg (p = 0.04). The fortified cream alternative had a higher iodine concentration than the unfortified alternatives (259 vs. 26.5 µg/kg). The measured iodine concentration of the fortified products differed from that of the product label (both lower and higher); overall, the measured iodine concentration was significantly higher than that stated on the label (mean difference 49.1 µg/kg; p = 0.018).
Compared to the animal-product equivalents, the iodine concentration of unfortified PBAPs was significantly lower for milk (p<0.001) and yoghurt (p<0.001), while there was no difference with fortified versions of milk (p = 0.28) and yoghurt (p = 0.09). The egg alternative had an iodine concentration that was just 0.6% of that of chicken eggs (3.38 vs. 560 µg/kg). Three (30%) of the fish alternatives had kelp/seaweed as ingredients and the median iodine concentration of these products was (non-significantly) higher than those without (126 vs 75 μg/kg; p = 0.83). However, the iodine content of all fish-alternative products was ten-times lower than that of fish (median 99 vs. 995 µg/kg; p<0.001).
The majority of PBAP are not fortified with iodine but those that are fortified have a significantly higher iodine concentration than unfortified products and are closer to the value of their animal equivalents. From an iodine perspective, unfortified plant-based alternatives are not suitable replacements and consumers should ensure adequate iodine from other dietary sources. Manufacturers should consider iodine fortification of a greater number of plant-based alternatives.
Objectives: To evaluate the effect and safety of Cannabidiol (CBD) on behavioral and psychological symptoms in elderly with Vascular dementia (VD).
Methods: Double- blind, randomized, placebo-controlled clinical trial involving elderly patients with VD at the psychogeriatrics and vascular dementia outpatient clinic at Hospital das Clínicas de Ribeirão Preto. The intervention evaluated was the use of CBD 300mg/day compared to placebo. The instruments used are: Neuropsychiatric Inventory, Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression Scale, Side Effects Scale, Mini- Mental State Examination, Brief Cognitive Screening Battery, Katz Index of Independence in Activities of Daily Living, Lawton Instrumental Activities of Daily Living Scale, Informant Questionnaire on Cognitive Decline in the Elderly, Zarit Burden Inventory. The included participants were assessed at the beginning of the study (baseline assessment), in the first, second and fourth weeks after the start of the clinicaltrial.
Results: 30 participants were included. The mixed ANOVA with repeated measures showed that there is an effect of the interaction time and group (F (2.12; 59.43) = 4.02; p < 0.05; ηp2 = 0.13) on the total score of the brief scale psychiatric assessment and neuropsychiatric inventory (F (1.58; 44.31) = 3.61; p =0.05; ηp2 = 0.11). The mixed ANOVA of repeated measures showed no effect of the interaction of time and group for the mini-mental state examination, brief cognitive screening battery. Adverse effects were mild and transient, and similar to the placebo group.
Conclusions: In this study, cannabidiol reduced psychological and behavioral symptoms in patients with vascular dementia. Future studies with larger samples are needed to confirm the findings. (F(1.58;44.31) = 3.61; p =0.05; ηp2 = 0.11). The mixed ANOVA of repeated measures showed no effect of the interaction of time and group for the mini-mental state examination, brief cognitive screening battery. Adverse effects were mild and transient, and similar to the placebo group.
The Mediterranean-Dietary Approach to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet is a dietary pattern designed to prevent cognitive decline. Dietary adherence is assessed with the MIND diet scoring system, which is currently based on the American diet and serving sizes. It is known that serving sizes and consumed food products differ between countries. Existing literature lacks reporting on food products included within the MIND diet and weight or volume equivalents corresponding to MIND diet servings, impeding accurate comparisons across studies. This study sought to overcome these limitations by evaluating MIND food products consumed in the Dutch context and developing a scoring system based on consumed quantities in weight or volume amounts rather than in standard serving amounts. The third objective was to modify an existing Dutch brief FFQ (Eetscore-FFQ) to evaluate adherence to the MIND diet. We translated nine of the fifteen MIND food groups directly to grams and volumes using the United States Department of Agriculture measurement conversion table. For the remaining food groups, we employed indirect translation to align them as closely as possible to the original MIND diet. These translated quantities in weight and volumes amounts were subsequently rounded to the nearest Dutch household measures, resulting in the culturally adapted MIND-NL diet scoring. The development of the MIND-NL-Eetscore-FFQ, comprising seventy-two food items (forty-one questions), is described. Our adaption approach is reproducible and can be used to customize the MIND diet scoring system to other cultures.
We present the Pilot Survey Phase 2 data release for the Wide-field ASKAP L-band Legacy All-sky Blind surveY (WALLABY), carried-out using the Australian SKA Pathfinder (ASKAP). We present 1760 H i detections (with a default spatial resolution of 30′′) from three pilot fields including the NGC 5044 and NGC 4808 groups as well as the Vela field, covering a total of $\sim 180$ deg$^2$ of the sky and spanning a redshift up to $z \simeq 0.09$. This release also includes kinematic models for over 126 spatially resolved galaxies. The observed median rms noise in the image cubes is 1.7 mJy per 30′′ beam and 18.5 kHz channel. This corresponds to a 5$\sigma$ H i column density sensitivity of $\sim 9.1\times10^{19}(1 + z)^4$ cm$^{-2}$ per 30′′ beam and $\sim 20$ km s$^{-1}$ channel and a 5$\sigma$ H i mass sensitivity of $\sim 5.5\times10^8 (D/100$ Mpc)$^{2}$ M$_{\odot}$ for point sources. Furthermore, we also present for the first time 12′′ high-resolution images (“cut-outs”) and catalogues for a sub-sample of 80 sources from the Pilot Survey Phase 2 fields. While we are able to recover sources with lower signal-to-noise ratio compared to sources in the Public Data Release 1, we do note that some data quality issues still persist, notably, flux discrepancies that are linked to the impact of side lobes associated with the dirty beams due to inadequate deconvolution. However, in spite of these limitations, the WALLABY Pilot Survey Phase 2 has already produced roughly a third of the number of HIPASS sources, making this the largest spatially resolved H i sample from a single survey to date.
Kokum [Garcinia indica (Thouars) Choisy] is a multi-purpose tree with culinary, cosmetics and pharmaceutical uses found popular in Konkan region of India. ICAR-NBPGR Regional Station, Thrissur made a systematic exploration and collection missions on kokum over a period from 1987–2004 and collected 31 accessions from various parts of Konkan region to characterize them using morphological characters and also to investigate their flowering and fruiting behaviour. Totally, 85 trees planted in Field Gene Bank in which only 67 trees (23 accessions) survived during field establishment. Among them, 32 (47.8%) were male and remaining 25 identified as female (37.3%) and 10 as co-sexual (14.9%). Fruit bearing ability noticed only in both female and co-sexual trees with huge variation in fruits. Morphological characterization of 33 trees with fruiting (23 accessions) for 35 morphological traits revealed presence of considerable amount of variation among them on basis of CV%. Highest positive correlation observed between fresh seed weight and fresh kernel weight (0.92). Cluster analysis formed four major clusters with Cluster I and II comprising male/bisexual genotypes and Cluster III and IV with female genotypes and it clearly distinguished male/bisexual genotypes from female ones. PCA analysis accounted 65.6% of genetic variation present among accessions by first three most informative PCs. Superior accessions identified for important traits will be more useful in industrial aspects of preparing kokum butter and juice. Further, seasonal difference identified in fruiting and maturity of fruits well-before onset of monsoon may be exploited by kokum industries for drying and processing of fruits.
Traditional approaches for evaluating the impact of scientific research – mainly scholarship (i.e., publications, presentations) and grant funding – fail to capture the full extent of contributions that come from larger scientific initiatives. The Translational Science Benefits Model (TSBM) was developed to support more comprehensive evaluations of scientific endeavors, especially research designed to translate scientific discoveries into innovations in clinical or public health practice and policy-level changes. Here, we present the domains of the TSBM, including how it was expanded by researchers within the Implementation Science Centers in Cancer Control (ISC3) program supported by the National Cancer Institute. Next, we describe five studies supported by the Penn ISC3, each focused on testing implementation strategies informed by behavioral economics to reduce key practice gaps in the context of cancer care and identify how each study yields broader impacts consistent with TSBM domains. These indicators include Capacity Building, Methods Development (within the Implementation Field) and Rapid Cycle Approaches, implementing Software Technologies, and improving Health Care Delivery and Health Care Accessibility. The examples highlighted here can help guide other similar scientific initiatives to conceive and measure broader scientific impact to fully articulate the translation and effects of their work at the population level.
New drugs to target different pathways in pulmonary hypertension has resulted in increased combination therapy, but details of this use in infants are not well described. In this large multicenter database study, we describe the pharmacoepidemiology of combination pulmonary vasodilator therapy in critically ill infants.
Methods:
We identified inborn infants discharged home from a Pediatrix neonatal ICU from 1997 to 2020 exposed to inhaled nitric oxide, sildenafil, epoprostenol, or bosentan for greater than two consecutive days. We compared clinical variables and drug utilisation between infants receiving simultaneous combination and monotherapy. We reported each combination’s frequency, timing, and duration and graphically represented drug use over time.
Results:
Of the 7681 infants that met inclusion criteria, 664 (9%) received combination therapy. These infants had a lower median gestational age and birth weight, were more likely to have cardiac and pulmonary anomalies, receive cardiorespiratory support, and had higher in-hospital mortality than those receiving monotherapy. Inhaled nitric oxide and sildenafil were most frequently used, and utilisation of combination and monotherapy for all drugs increased over time. Inhaled nitric oxide and epoprostenol were used in infants with a higher gestational age, earlier postnatal age, and shorter duration than sildenafil and bosentan. Dual therapy with inhaled nitric oxide and sildenafil was the most common combination therapy.
Conclusion:
Our study revealed an increased use of combination pulmonary vasodilator therapy, favouring inhaled nitric oxide and sildenafil, yet with considerable practice variation. Further research is needed to determine the optimal combination, sequence, dosing, and disease-specific indications for combination therapy.
Accurately quantifying all the components of the surface energy balance (SEB) is a prerequisite for the reliable estimation of surface melt and the surface mass balance over ice and snow. This study quantifies the SEB closure by comparing the energy available for surface melt, determined from continuous measurements of radiative fluxes and turbulent heat fluxes, to the surface ablation measured on the Greenland ice sheet between 2003 and 2023. We find that the measured daily energy available for surface melt exceeds the observed surface melt by on average 18 ± 30 W m−2 for snow and 12 ± 54 W m−2 for ice conditions (mean ± SD), which corresponds to 46 and 10% of the average energy available for surface melt, respectively. When the surface is not melting, the daily SEB is on average closed within 5 W m−2. Based on the inter-comparison of different ablation sensors and radiometers installed on different stations, and on the evaluation of modelled turbulent heat fluxes, we conclude that measurement uncertainties prevent a better daily to sub-daily SEB closure. These results highlight the need and challenges in obtaining accurate long-term in situ SEB observations for the proper evaluation of climate models and for the validation of remote sensing products.
In Asian workplaces, effective innovative work behavior (IWB) presents challenges. Knowledge on how Asian leaders can promote employee IWB through their behavioral repertoire is needed. This assumption prompted us to develop and validate the so-called Innovative Leader Survey (ILS), covering a repertoire of leader behaviors by which employee IWB is stimulated in Asia. Study 1 interviewed 60 high-performing leaders and employees on such behaviors, bringing forth three leader-behavioral dimensions and survey items for fostering employee idea generation, promotion, and implementation, labeled Envisioning, Energizing, and Enabling. Study 2 involved 1,037 survey respondents through which we validated these three sets of specific leader behaviors. Study 3, with 287 respondents, established ILS’s discriminant validity while all of its 11 operationalized leader behaviors were found to predict their followers’ IWB after 4 months. Future research with the ILS is proposed to enrich theory and empirical research on the relationship between effective leadership and employees’ IWB in Asian organizations.
Gaming disorder has become a global concern and it could have a variety of health and social consequences. The trauma model has been applied to the understanding of different types of addictions as behavioral addictions can sometimes be conceptualized as self-soothing strategies to avoid trauma-related stressors or triggers. However, much less is known about the relationship between trauma exposure and gaming disorder.
Objectives
To inform prevention and intervention strategies and to facilitate further research, we conducted the first scoping review to explore and summarize the literature on the relationship between trauma and gaming disorder.
Methods
A systematic search was conducted on the Web of Science, Scopus and ProQuest. We looked for original studies published in English that included a measure of trauma exposure and a measure of gaming disorder symptoms, as well as quantitative data regarding the relationship between trauma exposure and gaming disorder.
Results
The initial search generated 412 articles, of which 15 met the inclusion criteria. All of them were cross-sectional studies, recruiting participants from both clinical and non-clinical populations. Twelve of them (80%) reported significant correlations between trauma exposure and the severity of gaming disorder symptoms (r = 0.18 to 0.46, p < 0.010). Several potential mediators, including depressive symptoms and dissociative experiences, have been identified. One study found that parental monitoring moderated the relationship between trauma and gaming disorder symptoms. No studies reported the prevalence of trauma or trauma-related symptoms among people with gaming disorder.
Conclusions
There is some evidence supporting the association between trauma and gaming disorder, at small to medium effect sizes. Future studies should investigate the mediators and moderators underlying the relationship between trauma and gaming disorder. The longitudinal relationship between trauma exposure and the development of gaming disorder should be clarified. A trauma-informed approach may be a helpful strategy to alleviate gaming disorder symptoms.