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Almost 12 % of the human population have insufficient access to food and hence are at risk from nutrient deficiencies and related conditions, such as anaemia and stunting. Ruminant meat and milk are rich in protein and micronutrients, making them a highly nutritious food source for human consumption. Conversely, ruminant production contributes to methane (CH4) emissions, a greenhouse gas (GHG) with a global warming potential (GWP) 27–30 times greater than that of carbon dioxide (CO2). Nonetheless, ruminant production plays a crucial role in the circular bioeconomy in terms of upcycling agricultural products that cannot be consumed by humans, into valuable and nutritional food, whilst delivering important ecosystem services. Taking on board the complexities of ruminant production and the need to improve both human and planetary health, there is increasing emphasis on developing innovative solutions to achieve sustainable ruminant production within the ‘One Health’ framework. Specifically, research and innovation will undoubtedly continue to focus on (1) Genetics and Breeding; (2) Animal nutrition and (3) Animal Health, to achieve food security and human health, whilst limiting environmental impact. Implementation of resultant innovations within the agri-food sector will require several enablers, including large-scale investment, multi-actor partnerships, scaling, regulatory approval and importantly social acceptability. This review outlines the grand challenges of achieving sustainable ruminant production and likely research and innovation landscape over the next 15 years and beyond, specifically outlining the pathways and enablers required to achieve sustainable ruminant production within the One Health framework.
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.
In May 2024, ICRC and 12 Red Cross-National Societies combined efforts to open a field hospital in Rafah, Gaza, to help address the overwhelming health needs emanating from the ongoing armed conflict. The hospital complements and supports the essential work performed by the Palestine Red Crescent Society (PRCS) in providing urgent care.
Objectives:
MHPSS is an essential part of emergency response, but it is still seen as an optional ‘nice to have’ intervention and therefore not always integrated within emergency health response in a timely manner. ICRC, in line with the International Red Cross and Red Crescent Movement MHPSS Policy and World Health Assembly MHPSS Resolution, decided early on to integrate MHPSS within the health services being provided by the field hospital.
Method/Description:
Presentation and discussion on:
How was MHPSS integrated within the hospital services, including mass casualty management and triage?
What impact has early access to MHPSS had for patients and their families?
What do EMTs need to know about MHPSS?
What were the challenges and lessons learnt from this deployment?
Sustainable approaches to ensuring MHPSS service provision within emergency health settings
Results/Outcomes:
ICRC and Danish Red Cross (DRC) highlighted the importance of early integration of MHPSS into emergency health services and share best practice examples and case stories from the field hospital in Gaza.
Conclusion:
Early and appropriate access to MHPSS saves lives.
Parametric oscillations of an interface separating two fluid phases create nonlinear surface waves, called Faraday waves, which organise into simple patterns, such as squares and hexagons, as well as complex structures, such as double hexagonal and superlattice patterns. In this work, we study the influence of surfactant-induced Marangoni stresses on the formation and transition of Faraday-wave patterns. We use a control parameter, $B$, that assesses the relative importance of Marangoni stresses as compared with the surface-wave dynamics. Our results show that the threshold acceleration required to destabilise a surfactant-covered interface through vibration increases with increasing $B$. For a surfactant-free interface, a square-wave pattern is observed. As $B$ is incremented, we report transitions from squares to asymmetric squares, weakly wavy stripes and ultimately to ridges and hills. These hills are a consequence of the bidirectional Marangoni stresses at the neck of the ridges. The mechanisms underlying the pattern transitions and the formation of exotic ridges and hills are discussed.
During the coronavirus pandemic in the United Kingdom, media outlets shifted their focus from divisive political issues to more neutral topics like lifestyle, sports, and entertainment. This study explores how this change in media content relates to partisan divides in satisfaction with democracy. Using data from a representative survey of 201,144 individuals, we linked respondents’ perceptions of democratic performance to their daily media exposure. We did so by analysing 1.5 million tweets from British newspapers using a topic modelling algorithm to identify shifts in topic salience and sentiment using sentiment analysis. Our findings reveal a decline in partisan media exposure during the pandemic, associated with increased satisfaction with democracy at both individual and collective levels, and a narrowing of cross-party divides. These results contribute to discussions on affective polarization, the winner-loser gap in democratic evaluation, and media framing effects, highlighting the potential influence of depoliticized news coverage on democratic attitudes.
This paper reports an expansion of the English as a second language (L2) component of the Multilingual Eye Movement Corpus (MECO L2), an international database of eye movements during text reading. While the previous Wave 1 of the MECO project (Kuperman et al., 2023) contained English as a L2 reading data from readers with 12 different first language (L1) backgrounds, the newly collected dataset adds eye-tracking data on English text reading from 13 distinct L1 backgrounds (N = 660) as well as participants’ scores on component skills of English proficiency and information about their demographics and language background and use. The paper reports reliability estimates, descriptive statistics, and correlational analyses as means to validate the expansion dataset. Consistent with prior literature and the MECO Wave 1, trends in the MECO Wave 2 data include a weak correlation between reading comprehension and oculomotor measures of reading fluency and a greater L1-L2 contrast in reading fluency than reading comprehension. Jointly with Wave 1, the MECO project includes English reading data from more than 1,200 readers representing a diversity of native writing systems (logographic, abjad, abugida, and alphabetic) and 19 distinct L1 backgrounds. We provide multiple pointers to new venues of how L2 reading researchers can mine this rich publicly available dataset.
Several metrics exist for matching the size of donor to recipient in paediatric cardiac transplantation. Different centres employ different metrics for size-matching to determine the viability of donor hearts. Inconsistent evidence exists, with limited consensus as to the metric for size-matching that is most predictive of outcomes after cardiac transplantation. Furthermore, any metric must function within the tight timeline available for the assessment of the suitability of the donor. At the time of the writing of this paper, the most commonly used metric for size-matching in paediatric cardiac transplantation is the donor-to-recipient body weight ratio. In this article, we review published literature evaluating commonly used metrics for size-matching in paediatric cardiac transplantation, including weight, height, body surface area, and imaging parameters.
We reviewed outcomes in all 36 consecutive children <5 kg supported with the Berlin Heart pulsatile ventricular assist device at the University of Florida, comparing those with acquired heart disease (n = 8) to those with congenital heart disease (CHD) (n = 28).
Methods:
The primary outcome was mortality. The Kaplan-Meier method and log-rank tests were used to assess group differences in long-term survival after ventricular assist device insertion. T-tests using estimated survival proportions were used to compare groups at specific time points.
Results:
Of 82 patients supported with the Berlin Heart at our institution, 49 (49/82 = 59.76%) weighed <10 kg and 36 (36/82 = 43.90%) weighed <5 kg. Of 36 patients <5 kg, 26 (26/36 = 72.22%) were successfully bridged to transplantation. (The duration of support with ventricular assist device for these 36 patients <5 kg was [days]: median = 109, range = 4–305.) Eight out of 36 patients <5 kg had acquired heart disease, and all eight [8/8 = 100%] were successfully bridged to transplantation. (The duration of support with ventricular assist device for these 8 patients <5 kg with acquired heart disease was [days]: median = 50, range = 9–130.) Twenty-eight of 36 patients <5 kg had congenital heart disease. Eighteen of these 28 [64.3%] were successfully bridged to transplantation. (The duration of support with ventricular assist device for these 28 patients <5 kg with congenital heart disease was [days]: median = 136, range = 4–305.) For all 36 patients who weighed <5 kg: 1-year survival estimate after ventricular assist device insertion = 62.7% (95% confidence interval = 48.5–81.2%) and 5-year survival estimate after ventricular assist device insertion = 58.5% (95% confidence interval = 43.8–78.3%). One-year survival after ventricular assist device insertion = 87.5% (95% confidence interval = 67.3–99.9%) in acquired heart disease and 55.6% (95% confidence interval = 39.5–78.2%) in CHD, P = 0.036. Five-year survival after ventricular assist device insertion = 87.5% (95% confidence interval = 67.3–99.9%) in acquired heart disease and 48.6% (95% confidence interval = 31.6–74.8%) in CHD, P = 0.014.
Conclusion:
Pulsatile ventricular assist device facilitates bridge to transplantation in neonates and infants weighing <5 kg; however, survival after ventricular assist device insertion in these small patients is less in those with CHD in comparison to those with acquired heart disease.
Publicly available health information is increasingly important for patients and their families. While the average US citizen reads at an 8th-grade level, electronic educational materials for patients and families are often advanced. We assessed the quality and readability of publicly available resources regarding hypoplastic left heart syndrome (HLHS).
Methods:
We queried four search engines for “hypoplastic left heart syndrome”, “HLHS”, and “hypoplastic left ventricle”. The top 30 websites from searches on Google, Yahoo!, Bing, and Dogpile were combined into a single list. Duplicates, commercial websites, physician-oriented resources, disability websites, and broken links were removed. Websites were graded for accountability, content, interactivity, and structure using a two-reviewer system. Nonparametric analysis of variance was performed.
Results:
Fifty-two websites were analysed. Inter-rater agreement was high (Kappa = 0.874). Website types included 35 hospital/healthcare organisation (67.3%), 12 open access (23.1%), 4 governmental agency (7.7%), and 1 professional medical society (1.9%). Median total score was 19 of 39 (interquartile range = 15.8–25.3): accountability 5.5 of 17 (interquartile range = 2.0–9.3), content 8 of 12 (interquartile range = 6.4–10.0), interactivity 2 of 6 (interquartile range = 2.0–3.0), and structure 3 of 4 (interquartile range = 2.8–4.0). Accountability was low with 32.7% (n = 17) of sites disclosing authorship and 26.9% (n = 14) citing sources. Forty-two percent (n = 22) of websites were available in Spanish. Total score varied by website type (p = 0.03), with open access sites scoring highest (median = 26.5; interquartile range = 20.5–28.6) and hospital/healthcare organisation websites scoring lowest (median = 17.5; interquartile range = 13.5–21.5). Score differences were driven by differences in accountability (p = 0.001) – content scores were similar between groups (p = 0.25). Overall readability was low, with median Flesch–Kincaid Grade Level of 11th grade (interquartile range = 10th–12th grade).
Conclusions:
Our evaluation of popular websites about HLHS identifies multiple opportunities for improvement, including increasing accountability by disclosing authorship and citing sources, enhancing readability by providing material that is understandable to readers with the full spectrum of educational background, and providing information in languages besides English, all of which would enhance health equity.
Diversification of the medical and cardiothoracic surgical workforce represents an ongoing need. A congenital cardiac surgery shadowing programme for undergraduate students was implemented at the University of Florida Congenital Heart Center.
Methods:
Students shadowing in the Congenital Heart Center from 17 December 2020 through 20 July 2021 were sent a survey through Qualtrics to evaluate the impact of their shadowing experience. The main objectives of the survey were to determine the personal relationship(s) of the students to physicians prior to shadowing, how the presence or absence of physicians in the family of a given student related to the exposure of the student to a medical setting prior to shadowing, and the interest of the students in medicine and cardiothoracic surgery prior to and after the shadowing experience. Survey responses included “Yes/No” questions, scaled responses using a Likert scale, selection lists, and free text responses. When applicable, t-tests were utilised to assess differences between student groups.
Results:
Of the 37 students who shadowed during the study period, 26 (70%) responded. Most students were female (58%, n = 15), and the mean age was 20.9 ± 2.4 years. Students spent a mean duration of 95 ± 138 hours shadowing providers as part of the shadowing programme. Likert scale ratings of interest in the professions of medicine, surgery, and cardiothoracic surgery all increased after the shadowing experience (p < 0.01). Students with a family member in medicine had more clinical exposure prior to the shadowing programme (p < 0.01).
Conclusion:
A surgical shadowing programme at a Congenital Heart Center may have an important formative impact on the views of undergraduate students regarding potential careers in surgery and medicine. Additionally, students without family members in medicine tend to have less prior exposure to medicine and could likely benefit more from this type of shadowing programme.
We examine the long-term stability (on decade-like timescales) of optical ‘high polarisation’ (HP) state with ${p_{opt}}$${> 3\%}$, which commonly occurs in flat-spectrum (i.e., beamed) radio quasars (FSRQs) and is a prominent marker of blazar state. Using this clue, roughly a quarter of the FSRQ population has been reported to undergo HP $\leftrightarrow$ non-HP state transition on year-like timescales. This work examines the extent to which HP (i.e., blazar) state can endure in a FSRQ, despite these ‘frequent’ state transitions. This is the first attempt to verify, using purely opto-polarimetric data for a much enlarged sample of blazars, the recent curious finding that blazar state in individual quasars persists for at least a few decades, despite its changing/swinging observed fairly commonly on year-like timescales. The present analysis is based on a well-defined sample of 83 radio quasars, extracted from the opto-polarimetric survey RoboPol (2013–2017), for which old opto-polarimetric data taken prior to 1990 could be found in the literature. By a source-wise comparison of these two datasets of the same observable ($p_{opt}$), we find that $\sim$90% of the 63 quasars found in blazar state in our RoboPol sample, were also observed to be in that state about three decades before. On the other hand, within the RoboPol survey itself, we find that roughly a quarter of the blazars in our sample migrated to the other polarisation state on year-like timescales, by crossing the customary $p_{opt}$ = 3% threshold. Evidently, these relatively frequent transitions (in either direction) do not curtail the propensity of a radio quasar to retain its blazar (i.e., HP) state for at least a few decades. The observed transitions/swings of polarisation state are probably manifestation of transient processes, like ejections of synchrotron plasma blobs (VLBI radio knots) from the active nucleus.
In a large healthcare worker cohort, we quantified the association between behaviors and risk of coronavirus disease 2019 (COVID-19) during different pandemic phases, adjusting for prior infection and vaccination. Individual characteristics, including personal concerns, were associated with these behaviors. Public health messaging should target high-risk populations and behaviors as the pandemic evolves.
Rates of ventilator-associated pneumonia (VAP) in low- and middle-income countries (LMIC) are several times above those of high-income countries. The objective of this study was to identify risk factors (RFs) for VAP cases in ICUs of LMICs.
Design:
Prospective cohort study.
Setting:
This study was conducted across 743 ICUs of 282 hospitals in 144 cities in 42 Asian, African, European, Latin American, and Middle Eastern countries.
Participants:
The study included patients admitted to ICUs across 24 years.
Results:
In total, 289,643 patients were followed during 1,951,405 patient days and acquired 8,236 VAPs. We analyzed 10 independent variables. Multiple logistic regression identified the following independent VAP RFs: male sex (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.16–1.28; P < .0001); longer length of stay (LOS), which increased the risk 7% per day (aOR, 1.07; 95% CI, 1.07–1.08; P < .0001); mechanical ventilation (MV) utilization ratio (aOR, 1.27; 95% CI, 1.23–1.31; P < .0001); continuous positive airway pressure (CPAP), which was associated with the highest risk (aOR, 13.38; 95% CI, 11.57–15.48; P < .0001); tracheostomy connected to a MV, which was associated with the next-highest risk (aOR, 8.31; 95% CI, 7.21–9.58; P < .0001); endotracheal tube connected to a MV (aOR, 6.76; 95% CI, 6.34–7.21; P < .0001); surgical hospitalization (aOR, 1.23; 95% CI, 1.17–1.29; P < .0001); admission to a public hospital (aOR, 1.59; 95% CI, 1.35-1.86; P < .0001); middle-income country (aOR, 1.22; 95% CI, 15–1.29; P < .0001); admission to an adult-oncology ICU, which was associated with the highest risk (aOR, 4.05; 95% CI, 3.22–5.09; P < .0001), admission to a neurologic ICU, which was associated with the next-highest risk (aOR, 2.48; 95% CI, 1.78–3.45; P < .0001); and admission to a respiratory ICU (aOR, 2.35; 95% CI, 1.79–3.07; P < .0001). Admission to a coronary ICU showed the lowest risk (aOR, 0.63; 95% CI, 0.51–0.77; P < .0001).
Conclusions:
Some identified VAP RFs are unlikely to change: sex, hospitalization type, ICU type, facility ownership, and country income level. Based on our results, we recommend focusing on strategies to reduce LOS, to reduce the MV utilization ratio, to limit CPAP use and implementing a set of evidence-based VAP prevention recommendations.
In late 2019, a novel coronavirus was detected in Wuhan, China, that caused a pandemic by September 2021, resulting in 224,180,411 cases and more than 4,600,000 deaths worldwide. In response to the pandemic, the Autonomous Kurdistan Regional Government of Iraq (KRG) imposed strict infection control measures at its borders for all travelers from neighboring countries, wherein each traveler was subjected to a mandatory reverse transcription polymerase chain reaction (RT-PCR) test on arrival to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected travelers. The aim of this study is to determine the rate of infection with SARS-CoV-2 among the travelers entering Kurdistan region through Ibrahim Al-Khalil crossing point with Turkey as a predictor for the upcoming infection waves.
Methods:
The data of RT-PCR tests to detect SARS-CoV-2 in all travelers arriving at the Ibrahim Al-Khalil Border Crossing between Iraq and the Republic of Turkey were reviewed from August 21, 2020 to August 21, 2021.
Results:
It was found that there were 9873 cases of SARS-CoV-2 infections among 1,082,074 travelers during the study period.
Conclusions:
This study shows the importance of mass testing of travelers at border crossings to control the spread of SARS-CoV-2 infection.
During the Late Cretaceous Andean orogeny, the compressive deformation associated with the shallowing of the subducting slab caused the development of the arc-related igneous rocks known as the Naunauco Belt. This study presents petrographic, mineralogical and anisotropy of magnetic susceptibility data for the Varvarco Intrusives (the Varvarco Tonalite, Butalón Tonalite and Radales Aplite), which crop out in the Cordillera del Viento, Neuquén Province, Argentina. The assembly of plutons was formed by mafic magma episodic injection. Amphibole and biotite compositions suggest that the Varvarco Tonalite is related to calc-alkaline, I-type magmas, typical of subduction environments. Different geothermobarometers based on amphibole and plagioclase compositions for the Varvarco Tonalite suggest shallow emplacement conditions (∼2–3 kbar, equivalent to ∼12 km depth). Apatite fission-track analyses give exhumation ages of 67.5 ± 8 Ma for the Varvarco Tonalite and 50.3 ± 5.9 Ma for the Butalón Tonalite. A calculated continuous fast exhumation rate of at least 330 °C Ma−1 is consistent with the shallow emplacement conditions, textural data and geobarometric estimations. In agreement with the thermal profile, the magmatic system was exhumed by ∼12 km within c. 2.1 Ma implying a geothermal gradient of ∼62.5 °C km−1. The last step of exhumation occurred between ∼65.3 and 56.9 Ma. The magmatic fabrics observed in the studied plutons reflect mostly magma chamber processes. The Varvarco Intrusives represent satellite calc-alkaline plutons of the North Patagonian Batholith which were emplaced syn- to post-tectonically with respect to a major deformation stage of the Southern Central Andes.
Yasui procedure is surgical repair intended to preserve biventricular function for patients with left ventricle outflow tract obstruction associated with aortic arch lesions and ventricular septal defect.
Methods:
Retrospective chart review analysis of all patients who had Yasui procedure (2008–2020) comparing midterm outcome of one versus two stage repair.
Results:
Twenty patients (70% female) underwent Yasui procedure in our center. Eight patients (40%) had left ventricle outflow tract obstruction /interrupted aortic arch, 7 patients (35%) had left ventricle outflow tract obstruction /coarctation of aorta, 3 patients (15%) had double outlet ventricle and ventricular septal defect that were unattainable for tunneling to one of the semilunar valves without creating obstruction, and 2 patients (10%) had aortic atresia with hypoplastic aortic arch. All patients had associated ventricular septal defect. Fifteen patients (75%) had one-stage repair and 5 patients (25%) had two-stage repair. Means age and weight for one and two-stage repair were 1.3 ± 2 months, 13.4 ± 11.5 months and 3.3 ± 0.6 kg, 7.8 ± 3.4 kg, respectively. During follow up, 8 patients (40%) required re- intervention, mainly for right ventricle–pulmonary artery conduit either dilation or replacement. The average duration of follow up was 5 years with nil mortality.
Conclusion:
Yasui procedure is effective approach for children who have left ventricle outflow tract obstruction associated with aortic arch anomalies and ventricular septal defect. Survival rate with single or staged repair is comparably good. During the first 5 year of follow up, nearly 40% of operated patients required re-intervention.
Brown-Vialetto-Van Laere syndrome, a rare disorder associated with motor, sensory and cranial nerve neuropathy, is caused by mutations in riboflavin transporter genes SLC52A2 and SLC52A3. Hearing loss is a characteristic feature of Brown-Vialetto-Van Laere syndrome and has been shown in recent studies to be characterised by auditory neuropathy spectrum disorder.
Method
This study reports the detailed audiovestibular profiles of four cases of Brown-Vialetto-Van Laere syndrome with SLC52A2 and SLC52A3 mutations. All of these patients had auditory neuropathy spectrum disorder.
Results
There was significant heterogeneity in vestibular function and in the benefit gained from cochlear implantation. The audiological response to riboflavin therapy was also variable, in contrast to generalised improvement in motor function.
Conclusion
We suggest that comprehensive testing of vestibular function should be conducted in Brown-Vialetto-Van Laere syndrome, in addition to serial behavioural audiometry as part of the systematic examination of the effects of riboflavin.
The field of linguistic landscape (LL) is concerned with monolingual and bi/-multilingual patterns and practices enacted on ‘public road signs, advertising billboards, street names, place names, commercial shop signs, and public signs on government buildings’ (Landry & Bourhis, 1997: 25). Since the publication of Landry and Bourhis’ (1997) research study, much more attention has been paid towards LL research, especially after the appearance of a Linguistic Landscape special issue of the International Journal of Multilingualism 3(1) (2006) (reproduced as the book Linguistic Landscape: A New Approach to Multilingualism [Gorter, 2006]). There has also been increased discussion of specific locations, such as multilingualism in Tokyo (Backhaus, 2007), English in the neighbourhoods of Johor Bahru City in Malaysia (McKiernan, 2019), and Jawi, an endangered orthography in the Malaysian LL (Coluzzi, 2020).
Introduction. Smoking cessation after a cancer diagnosis can significantly improve treatment outcomes and reduce the risk of cancer recurrence and all-cause mortality. Aim. We sought to measure the association between cancer diagnosis and subsequent smoking cessation. Methods. Data was sourced from the Population Assessment of Health and Tobacco (PATH) study, a representative population-based sample of United States adults. Our analytic sample included all adult smokers at Wave I, our baseline. The exposure of interest was either a tobacco-related cancer diagnosis, nontobacco-related cancer diagnosis, or no cancer diagnosis (the referent) reported at Wave II or III. The primary outcome was smoking cessation after diagnosis, at Wave IV. Results/Findings. Our sample was composed of 7,286 adult smokers at the baseline representing an estimated 40.9 million persons. Smoking cessation rates after a diagnosis differed after a tobacco-related cancer (25.9%), a nontobacco-related cancer (8.9%), and no cancer diagnosis (17.9%). After adjustment, diagnosis with a tobacco-related cancer was associated with a higher odds of smoking cessation (OR 1.83, 95% CI 1.00-3.33) compared to no cancer diagnosis. Diagnosis with a nontobacco-related cancer was not significantly linked to smoking cessation (OR 0.52, 95% CI 0.48-1.45). Conclusion. Diagnosis with a tobacco-related cancer is associated with greater odds of subsequent smoking cessation compared to no cancer diagnosis, suggesting that significant behavioral change may occur in this setting.