More than one third of children (10-11years) are estimated to be overweight or living with obesity (1). A range of public health policies are in place that are intended to assist consumers to make healthier food choices. Point of sale policies include the government-approved voluntary scheme for front of pack Traffic Light Labels (TLL) and the requirement for large out-of-home food outlets to display energy information (calories on menus). There is concern that policies focusing on individual responsibility for calorie restriction may inadvertently increase preoccupation with food and weight. Such policies could therefore lead to increases in disordered eating behaviours and cognitions, particularly among vulnerable groups, such as children and young people (CYP) (2).

The aim of this study was to explore the relative benefits and harms of TLL and calories on menus for CYP, as part of their overall environment.

Focus group discussions were conducted in primary and secondary schools in the southeast of England with children in Years 5-8 (aged 9-13 years). Interviews explored (i) choosing snacks from a range displayed; (ii) choosing items from menus with or without calorie information; (iii) perceptions of the overall food environment including social media and advertising. Interviews were transcribed and analysed using NVivo with framework analysis. Themes were developed deductively and sub-themes inductively.

Focus groups (n=16) took place with CYP (n=80) between December 2023 and June 2024. Sub-themes for theme 1 ‘TLL’ were: (1.1) ‘only red and green make sense’ and (1.2) ‘TLL aren’t for us’. Participants recalled seeing TLL and viewed them as possibly useful for adults or people on special diets but generally not for them. Instead, CYP prioritised visual appeal, marketing, familiarity and taste when choosing food products. Sub-themes for theme 2 ‘calories on menus’ were: (2.1) ‘calories might mean health’; (2.2) ‘I just choose what I like’ and (2.3) ‘it could make people feel bad’. Older participants in particular spoke about potential feelings of guilt or upset in response to seeing calorie information and some spoke about compensatory behaviours. Sub-themes for theme 3 ‘the wider environment’ were: (3.1) ‘TikTok shows ways to become perfect’; (3.2) ‘McDonald’s adverts pop up all the time’ and (3.3) ‘my mum is against sugar’. CYP described being exposed to engaging media and marketing, which prompted immediate desires for food and influenced their food choices. Social media content was also seen as sometimes presenting unhealthy eating behaviours and promoting unrealistic body ideals.

TLL and calories on menus presented limited benefits for CYP and potentially some negative impacts. CYP recognised their wider environment, particularly social media exposure as driving food choices and negatively impacting cognitions relating to eating and body image.

New Zealand ranks among the highest globally for childhood obesity(1). One of the main platforms to maximize the prevention of child excess adiposity is the establishment of healthy diets in early life(2,3). Despite this recommendation, Aotearoa has limited information on children’s whole diet quality and its associations with child healthy weight. This study explored the associations between dietary patterns and indicators of excess adiposity among 4.5-year-olds within the Growing Up in New Zealand birth cohort study (n= 6,048, 98.2% of the children who took part of the 4.5-year data collection wave). At 4.5 years, two dietary patterns were previously derived and described: “Refined, high in sugar, sodium and fat” and “Fruit and vegetables”(4). The indicators of excess adiposity examined at 4.5 years were body-mass-index-for-age (BMI/A) (>+2 z-score) and waist-to-height ratio (WtHR) > 90th percentile. Information on child and maternal sociodemographic and maternal health behaviour characteristics was sourced from the antenatal and the 4.5-year-interviews. Children’s scores in both dietary patterns were ranked in tertiles. Multiple Poisson regressions with robust variance were performed to examine the associations between the dependent variables (BMI/A z-score >+2 and WtHR >90th percentile) and the independent variables (dietary patterns), adjusted by child and mother characteristics (IBM SPSS software). Sensitivity analyses excluding children with outliers for BMI/A (<-5 z-score or >+5 z-score) was also performed. Findings were reported as adjusted risk ratio (RR) and 95% confidence intervals (CIs). Children in the highest tertile of the “Refined high in sugar, salt and fat” dietary pattern were more likely to be overweight/obese (BMI/A) compared to children in the lowest tertile (RR:1.51; 95% CI: 1.20-1.90; p<0.001). This significant association was confirmed in the sensitivity analyses (RR:1.49; 95% CI: 1.18-1.89; p <0.001). There were no significant associations between this dietary pattern and WtHR > 90th percentile nor between the “Fruit and vegetables” dietary pattern and the indicators of child excess adiposity. This study provided nationally generalizable information that poor diet quality in early life is associated with child excess adiposity. National strategies to prevent childhood obesity need to encompass approaches to reduce the availability and intake of refined foods and those high in sodium, sugar and unhealthy fats in children.

This is a proof-of-concept study to compare the effects of a 2-week program of “Remind-to-move” (RTM) treatment using closed-loop and open-loop wearables for hemiparetic upper extremity in patients with chronic stroke in the community. The RTM open-loop wearable device has been proven in our previous studies to be useful to address the learned nonuse phenomenon of the hemiparetic upper extremity. A closed-loop RTM wearable device, which emits reminding cues according to actual arm use, was developed in this study. A convenience sample of 16 participants with chronic unilateral stroke recruited in the community was engaged in repetitive upper extremity task-specific practice for 2 weeks while wearing either a closed-loop or an open-loop ambulatory RTM wearable device on their affected hand for 3 hrs a day. Evaluations were conducted at pre-/post-intervention and follow-up after 4 weeks using upper extremity motor performance behavioral measures, actual arm use questionnaire, and the kinematic data obtained from the device. Results showed that both open-loop and closed-loop training groups achieved significant gains in all measures at posttest and follow-up evaluations. The closed-loop group showed a more significant improvement in movement frequency, hand functions, and actual arm use than did the open-loop group. Our findings supported the use of closed-loop wearables, which showed greater effects in terms of promoting the hand use of the hemiparetic upper extremity than open-loop wearables among patients with chronic stroke.

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.

Background: Late-onset Pompe disease (LOPD) is caused by a deficiency of acid α-glucosidase (GAA), leading to progressive muscle and respiratory decline. Cipaglucosidase alfa (cipa), a recombinant human GAA naturally enriched with bis-mannose-6-phosphate, exhibits improved muscle uptake but is limited by inactivation at near-neutral blood pH. Miglustat (mig), an enzyme stabiliser, binds competitively and reversibly to cipa, enhancing its stability and activity. Methods: In dose-finding studies, Gaa-/- mice were treated with cipa (20 mg/kg) +/- mig (10 mg/kg; equivalent human dose ~260 mg). Clinical study methodologies have been published (Schoser et al. Lancet Neurol 2021:20;1027–37; Schoser et al. J Neurol 2024:271;2810–23). Results: In Gaa-/- mice, cipa+mig improved muscle glycogen reduction more than cipa alone and grip strength to levels approaching wild-type mice. LOPD patients (n=11) treated with cipa alone showed dose-dependent decreases in hexose tetrasaccharide (Hex4) levels by ~15% from baseline, decreasing another ~10% with added mig (260 mg). In a head-to-head study, cipa+mig had a similar safety profile to alglucosidase alfa. Among 151 patients (three trials), mig-related adverse events occurred in 21 (13.9%), none serious. Conclusions: Mig stabilised cipa in circulation, improving cipa exposure, further reducing Hex4 levels and was well tolerated in clinical studies in patients with LOPD. Sponsored by Amicus Therapeutics, Inc.

Background: Referrals to the Stroke prevention clinic with incomplete preliminary investigations decrease clinic capacity due to additional workload and the need for follow-ups. We aimed to improve the efficacy of the initial visit by increasing the completion rate of vascular imaging. Methods: Pre-post quasi-experimental study with three phases: Phase 1: Surveillance; Phase 2: Stakeholder feedback-informed intervention development (physicians and clinic staff); and Phase 3: Implementation. Interventions included a new referral order within the provincial EMR; a specific physician triage form listing required investigations (brain imaging, vascular imaging, cardiac tracing); and a nurse-led pre-visit via telephone. The primary outcome measure was the completion of vascular imaging - assessed with multivariable logistic regression Results: The study’s inclusion criteria were met by 383 patients, mean age of 67.6±13.2 years; 49% were female, 62.5% were diagnosed with vascular events. An increase in vascular imaging before the initial visit was found in Phase 3 (139/184, 75.5%) compared to Phase 1 (121/198, 61.1%, Odds ratio 1.96 95% CI 1.3-3.1; p=0.003). Fewer follow-up visits were required in Phase 3 (22.8%) compared to Phase 1 (31.8%, p=0.049). Conclusions: A uniform referral process, a standard triage process, and a nurse-led pre-visit may improve the completion of essential investigations before the patient visit.

Background: In the Phase 3 MycarinG study (MG0003/NCT03971422), one 6-week cycle of rozanolixizumab significantly improved myasthenia gravis (MG)-specific outcomes versus placebo. After MycarinG, patients could enrol in open-label extension studies (MG0004 then MG0007, or MG0007 directly). Methods: In MG0004 (NCT04124965), patients received once-weekly rozanolixizumab 7mg/kg or 10mg/kg for ≤52 weeks. In MG0007 (NCT04650854), after a cycle of rozanolixizumab 7mg/kg or 10mg/kg, subsequent cycles were based on symptom worsening at the investigator’s discretion. Pooled data are reported across MycarinG, MG0004 (first 6 weeks) and MG0007 (final data) for patients receiving ≥2 symptom-driven cycles (efficacy; ≤13 cycles) or ≥1 cycle (safety). Results: 196 patients received ≥1 rozanolixizumab dose of whom 129 received ≥2 symptom-driven cycles (7mg/kg: n=70; 10mg/kg: n=59). Treatment response was maintained from Cycles 1–13: mean change from baseline to Day 43 in MG-Activities of Daily Living score ranged from -3.2 to -4.9 (7mg/kg) and -3.2 to -6.7 (10mg/kg). Quantitative MG and MG Composite scores also improved. Treatment-emergent adverse events (TEAEs) did not increase with repeated cyclic treatment, and most were mild/moderate; the most common event was headache. Conclusions: Rozanolixizumab showed consistent improvements across MG-specific outcomes up to 13 cycles and repeated cyclic treatment was generally well tolerated. Funding: UCB.

Here, we explore variation in a new record of archaeological house-floor sizes from the southwestern United States relative to spatially explicit time series estimates of local precipitation. Our results show that inequality becomes more severe during periods of high precipitation. This supports the theory suggesting that inequality may emerge where resources are dense, predictable, and clumped within heterogenous and circumscribed environments. Our findings indicate that wealth inequality may emerge among populations with similar subsistence adaptations as a result of local socioenvironmental variation.

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.

Improving neonatal piglet survival is a key driver for improving pig production and enhancing animal welfare. Gestational diabetes is a risk factor for neonatal morbidities in humans, such as hypoglycaemia and respiratory distress(1). There is limited knowledge on the association of gestational diabetes with neonatal survival in commercial pigs. An early study suggested that the diabetic condition of late-gestating sows was positively correlated with the first-week newborn piglet mortality(2). Genetic selection in recent decades for heavier birth weight may have increased the prevalence or severity of gestational diabetes in pigs, considering the positive correlation between gestational diabetes and birth weight. We hypothesised that the diabetic condition of late gestating sows positively correlates with the neonatal piglet mortality rate in sows with modern genetics. Mixed-parity sows (1.5 ± 1.6 parity for mean ± standard deviation (SD); Large White × Landrace) from a commercial piggery in Australia were randomly selected and participated in an oral glucose tolerance test (OGTT) during two seasons (118 sows in winter and 118 sows in summer). On the d109 day of gestation, sows were fed 3.0 g dextrose per kg of metabolic body weight after fasting overnight. Tail blood glucose concentrations were measured using a glucometer (Accu-Chek ®, Roche Diabetes Care Australia Pty) at −10, 0, 10, 20, 30, 40, 50, 60, 70, 80, 90, 105, 120 minutes relative to dextrose feeding. The glucose increment (2.5 ± 1.29 mM for mean ± SD) during OGTT was calculated using the maximum concentration substrating the fasting concentration of blood glucose. The 24-hour piglet mortality rate (5% ± 8.8% for mean ± SD) was calculated as the ratio between piglets that died during the first 24 hours and the total number of born alive on a litter basis. The effect of sow glucose increment, season (winter vs summer), glucose increment × season, number of piglets born alive, and sows parity on the 24-h piglet mortality rate as analysed using a Generalised Linear Model (SPSS 27th Version, IBM SPSS Statistics, Armonk). Results showed that the 24-hour piglet mortality rate was numerically higher in winter than in summer although insignificant (5.7% vs 4.2%, p = 0.41). The glucose increment of gestating sows was positively correlated with the 24-hour piglet mortality rate during winter but not summer, as evidenced by an interaction trend between glucose increment and season (p = 0.059). The regression coefficient suggested that every extra unit (mM) of glucose increment during OGTT corresponded to a 1.4% increase in the 24-hour piglet mortality rate in winter. In conclusion, the diabetic condition of late-gestating sows is a risk factor for neonatal piglet mortality in winter. Developing nutritional strategies to mitigate the diabetic condition of late-gestating sows may benefit neonatal piglet survival.

A growing number of Australians are experiencing challenges accessing and affording healthy food due to climate-related disasters, global supply chain disruptions, and rapid inflation that is affecting the cost of healthy food(1). There is limited understanding of how participation community-based food cooperatives can address these challenges and improve food security and dietary intake. This study investigated the motivations for joining and impact of participation in a community-based food cooperative called Box Divvy on self-reported food security status and intake of fruits and vegetables among a sample of Australian adults. A cross-sectional online survey was conducted among Box Divvy members, that measured sociodemographic characteristics, motivations for joining, self-reported fruit and vegetable intake (serves/week), and food insecurity status (USDA 6-item short form(2)) before and while using Box Divvy. Participants were classified as being food secure, or experiencing marginal, moderate, or severe food insecurity. Logistic regression assessed demographic predictors and self-reported change in food security status, and ANOVA examined changes in dietary intake before joining and while using Box Divvy. Of participants (n = 2764, 37% aged 35–44 years, 83% European ethnicity, 92% New South Wales residents), most joined Box Divvy to support local farmers (87.3%), and save money on healthy foods (70.6%). Around half of respondents (50.8%) reported experiencing food insecurity before joining Box Divvy (24.5% marginal, 18.4% moderate, 7.9% severe food insecurity). Univariate logistic regression identified age, household structure, and income as significant predictors of food insecurity (p < 0.001). Participants experiencing food insecurity reported significantly lower consumption of fruits and vegetables prior to joining Box Divvy compared to those who were food secure (p < 0.001). While using Box Divvy, 28.2% of participants reported experiencing food insecurity (16.6% marginal, 9.6% moderate, 2.1% severe food insecurity). The odds of food insecurity while using Box Divvy were 62% lower than before joining (OR: 0.38; 95% CI 0.34–0.43; p < 0.001). On average, participants reported their fruit intake increased by 2.5 ± 5.6 serves/week (p < 0.001), and vegetable intake increased by 3.3 ± 5.7 serves/week (p < 0.001). The mean increase was significantly greater among moderately food insecure (fruit mean difference 3.2 ± 6.5 serves/week; vegetable mean difference 3.9 ± 6.9 serves/week) and severely food insecure groups (fruit mean difference 4.4 ± 6.9 serves/week; vegetable mean difference 5.5 ± 7.7 serves/week; p < 0.001). Participation in Box Divvy significantly improved self-reported food security status and fruit and vegetable intake among a large sample of Australian adults. Notably, fruit and vegetable intake significantly increased among those experiencing moderate and severe food insecurity. This underscores the potential of community-based food cooperatives to improve food security and promote healthier eating habits among Australian adults, especially households experiencing food insecurity.