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The future challenges for neurorespiratory medicine are significant with respect to the consequences of medical progress, demographic changes and epidemiological forecasts. The treatment of a variety of neurological diseases like genetic disease, inflammatory diseases and stroke improves steadily, and life supporting technologies and care structures are undergoing an evolution, too. To agree on a subset of principles of care, to define professions and qualifications needed to care for patients with respiratory impairment due to neurological disease and to strive for further medical and technological progress are key necessities. These are discussed in this chapter, and a number of suggestions for further research are advanced.
Distinguishing early domesticates from their wild progenitors presents a significant obstacle for understanding human-mediated effects in the past. The origin of dogs is particularly controversial because potential early dog remains often lack corroborating evidence that can provide secure links between proposed dog remains and human activity. The Tumat Puppies, two permafrost-preserved Late Pleistocene canids, have been hypothesized to have been littermates and early domesticates due to a physical association with putatively butchered mammoth bones. Through a combination of osteometry, stable isotope analysis, plant macrofossil analysis, and genomic and metagenomic analyses, this study exploits the unique properties of the naturally mummified Tumat Puppies to examine their familial relationship and to determine whether dietary information links them to human activities. The multifaceted analysis reveals that the 14,965–14,046 cal yr BP Tumat Puppies were littermates who inhabited a dry and relatively mild environment with heterogeneous vegetation and consumed a diverse diet, including woolly rhinoceros in their final days. However, because there is no evidence of mammoth consumption, these data do not establish a link between the canids and ancient humans.
The First Large Absorption Survey in H i (FLASH) is a large-area radio survey for neutral hydrogen in and around galaxies in the intermediate redshift range 0.4 < z < 1.0, using the 21-cm H i absorption line as a probe of cold neutral gas. The survey uses the ASKAP radio telescope and will cover 24,000 deg2 of sky over the next five years. FLASH breaks new ground in two ways – it is the first large H i absorption survey to be carried out without any optical preselection of targets, and we use an automated Bayesian line-finding tool to search through large datasets and assign a statistical significance to potential line detections. Two Pilot Surveys, covering around 3000 deg2 of sky, were carried out in 2019-22 to test and verify the strategy for the full FLASH survey. The processed data products from these Pilot Surveys (spectral-line cubes, continuum images, and catalogues) are public and available online. In this paper, we describe the FLASH spectral-line and continuum data products and discuss the quality of the H i spectra and the completeness of our automated line search. Finally, we present a set of 30 new H i absorption lines that were robustly detected in the Pilot Surveys, almost doubling the number of known H i absorption systems at 0.4 < z < 1. The detected lines span a wide range in H i optical depth, including three lines with a peak optical depth τ > 1, and appear to be a mixture of intervening and associated systems. Interestingly, around two-thirds of the lines found in this untargeted sample are detected against sources with a peaked-spectrum radio continuum, which are only a minor (5-20%) fraction of the overall radio-source population. The detection rate for H i absorption lines in the Pilot Surveys (0.3 to 0.5 lines per 40 deg2 ASKAP field) is a factor of two below the expected value. One possible reason for this is the presence of a range of spectral-line artefacts in the Pilot Survey data that have now been mitigated and are not expected to recur in the full FLASH survey. A future paper in this series will discuss the host galaxies of the H i absorption systems identified here.
Ever since Rodrigo Duterte was sworn into office in 2016, until the end of his term in 2022, his so-called “drug war” has claimed 12,000–30,000 lives. Over 150 victims were children. Seventeen-year-old Kian de los Santos, mistakenly identified as a drug addict, was gunned down on the evening of 16 August 2017. His death prompted a group of teachers and students to express themselves through empathic creative writing. What started as an assignment grew into a community of writers, activists, artists, journalists, and curators from diverse disciplines, generations, and social classes. Four years later, the project found a name: Triggered: Creative Responses to the Extrajudicial Killings in the Philippines—an illustrated young adult fiction collection with a dimension of outreach towards an orphanage. The Triggered project illustrated three key features of public humanities, especially during a time of impunity: first, an imperfect but self-reflexive and reciprocal collaboration between the academe and the field; second, the book’s non-elitist accessibility in both content and material; and third, the funds of the book went to an orphanage.
This study aimed to evaluate the effects of acetyl-L-carnitine on follicle survival and growth, stromal cell density and extracellular matrix, as well as on the expression of mRNA for nuclear factor erythroid 2-related factor (NRF2), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX) and peroxiredoxin 6 (PRDX6) in cultured bovine ovarian cortical tissues. Ovarian fragments (3 × 3 × 1 mm) were cultured for 6 days in α-MEM+ alone or supplemented with 10, 50 or 100 μM acetyl-L-carnitine at 38.5°C with 5% CO2 in humidified air. Before (non-cultured tissues) and after culture, the ovarian fragments were fixed in 4% paraformaldehyde for 12 h for histological analysis or stored at –80ºC for mRNA expression analysis of NRF2, SOD, CAT, PRDX6 and GPX1. The results showed that 100 μM acetyl-L-carnitine increased the percentages of morphologically normal follicles and stromal cell density in cultured ovarian tissues. On the other hand, acetyl-L-carnitine did not influence the percentage of collagen in ovarian tissue nor the expression of mRNAs for NRF2, SOD, CAT, PRDX6 and GPX1. In conclusion, 100 μM acetyl-L-carnitine increased follicle survival and stromal cell density in cultured bovine ovarian tissues but does not influence collagen fibre distribution or the expression of mRNAs for NRF2, SOD, CAT, PRDX6 and GPX1.
The stars of the Milky Way carry the chemical history of our Galaxy in their atmospheres as they journey through its vast expanse. Like barcodes, we can extract the chemical fingerprints of stars from high-resolution spectroscopy. The fourth data release (DR4) of the Galactic Archaeology with HERMES (GALAH) Survey, based on a decade of observations, provides the chemical abundances of up to 32 elements for 917 588 stars that also have exquisite astrometric data from the Gaia satellite. For the first time, these elements include life-essential nitrogen to complement carbon, and oxygen as well as more measurements of rare-earth elements critical to modern-life electronics, offering unparalleled insights into the chemical composition of the Milky Way. For this release, we use neural networks to simultaneously fit stellar parameters and abundances across the whole wavelength range, leveraging synthetic grids computed with Spectroscopy Made Easy. These grids account for atomic line formation in non-local thermodynamic equilibrium for 14 elements. In a two-iteration process, we first fit stellar labels to all 1 085 520 spectra, then co-add repeated observations and refine these labels using astrometric data from Gaia and 2MASS photometry, improving the accuracy and precision of stellar parameters and abundances. Our validation thoroughly assesses the reliability of spectroscopic measurements and highlights key caveats. GALAH DR4 represents yet another milestone in Galactic archaeology, combining detailed chemical compositions from multiple nucleosynthetic channels with kinematic information and age estimates. The resulting dataset, covering nearly a million stars, opens new avenues for understanding not only the chemical and dynamical history of the Milky Way but also the broader questions of the origin of elements and the evolution of planets, stars, and galaxies.
Diseases of the nervous system and muscles often cause problems with breathing, coughing and swallowing. Profound knowledge is required to interpret and treat these conditions correctly, while lack of it results in treatment decisions which are burdensome or outright dangerous for the patients. Taking the reader through the neuroanatomy and neurophysiology of breathing, swallowing and coughing, this comprehensive text clarifies the diagnosis and treatment of respiratory impairments from diseases of the brain, spinal cord, peripheral nervous system and muscles. Practical advice is offered on treatment in neurological, medical, intensive care and palliative care units as well as in rehabilitation and long-term care. Written by renowned neurologists, with decades of experience, clinicians and healthcare professionals working in neurology, pulmonology, anaesthesiology, intensive care and paediatrics will find this guide indispensable.
Cardiovascular diseases (CVDs) are the leading cause of death worldwide(1). As poor diet quality is a major contributor to CVD burden; dietary intervention is recommended as a first-line approach to CVD prevention and management(2). Personalised nutrition (PN) refers to individualised nutrition care based on genetic, phenotypic, medical, and/or behavioural and lifestyle characteristics(3). Medical nutrition therapy by dietitians shares many of these principles and can be categorised as PN(4). PN may be beneficial in improving CVD risk factors and diet, however, this has not previously been systematically reviewed. The aim of this systematic review was to evaluate the effectiveness of PN interventions on CVD risk factors and diet in adults at elevated CVD risk. A comprehensive search was conducted in March 2023 across Embase, Medline, CINAHL, PubMed, Scopus and Cochrane databases, focusing on randomised controlled trials (RCTs) published after 2000 in English. Included studies tested the effect of PN interventions on adults with elevated CVD risk factors (determined by anthropometric measures, clinical indicators, or high overall CVD risk). Risk of bias was assessed using the Academy of Nutrition and Dietetics Quality Criteria checklist. Random-effects meta-analysis were conducted to explore weighted mean differences (WMD) in change or final mean values for studies with comparable data (studies with dietary counselling interventions), for outcomes including blood pressure (BP), blood lipids, and anthropometric measurements. Sixteen articles reporting on 15 unique studies (n = 7676) met inclusion criteria and were extracted. Outcomes of participants (n = 40–564) with CVD risk factors including hyperlipidaemia (n = 5), high blood pressure (n = 3), BMI > 25kg/m2 (n = 1) or multiple factors (n = 7) were reported. Results found potential benefits of PN on systolic blood pressure (SBP) (WMD −1.91 [95% CI −3.51, −0.31] mmHg), diastolic blood pressure (DBP) (WMD −1.49 [95% CI −2.39, −0.58] mmHg), triglycerides (TG) (WMD −0.18 [95% CI −0.34, −0.03] mmol/L), and dietary intake in individuals at high CVD risk. Results were inconsistent for plasma lipid and anthropometric outcomes. Dietary counselling PN interventions showed promising results on CVD risk factors in individuals at-risk individuals. Further evidence for other personalisation methods and improvements to methodological quality and longer study durations are required in future PN interventions.
The world is facing multiple interconnected crises, from climate change and economic instability to social inequalities and geopolitical tensions. These crises do not occur in isolation; instead, they interact, reinforce each other, and create unexpected ripple effects – forming what is known as a polycrisis. Traditional ways of analysing problems often fail to grasp these interdependencies, making it difficult to find effective responses. We draw on system archetypes to describe and exemplify three polycrisis patterns. These provide a structured way to analyse how multiple crises unfold and interact, as well as insights into how to navigate such complexity.
Technical summary:
The concept of a polycrisis describes the complex interconnections between global issues, which can lead to unexpected emergent behaviours and the possible convergence of undesirable impacts. Understanding these dynamics is crucial for anticipating compounded effects and for identifying leverage points for effective intervention. We propose that system archetypes – generic structures in system dynamics that capture recurring patterns of behaviour – can serve as a useful analytical tool to study polycrises. Specifically, we reinterpret three key system archetypes in this context: Converging Constraints (based on the Limits to Growth system archetype), Deepening Divides (based on Success to the Successful system archetype), and Crisis Deferral (drawing from the Policy Resistance system archetype). These patterns illustrate how resource limitations, structural inequalities, and short-term solutions can sustain or worsen crisis dynamics. Using real-world examples, we show how polycrisis patterns can be employed to map feedback structures between interacting crises and to guide effective interventions. Our work contributes to a more structured and systemic understanding of polycrises, by providing a tool to help researchers and policymakers better anticipate, navigate, and mitigate their effects.
Social media summary:
‘Polycrisis patterns reveal how crises like climate change, economic instability, and inequality interact, amplifying their impacts’.
Both gender and ethnicity have received increasing scholarly attention in British elections. But surprisingly little is published on whether there is a gender gap among ethnic minority voters, although intersectional perspectives suggest that this matters a great deal. We analyse data from Understanding Society to test whether there is such a gender gap among the five main ethnic minority groups with high levels of electoral eligibility and participation. We show that there is a positive gender gap with women in Pakistani and Bangladeshi ethnic groups more likely to support Labour than the Conservatives, but that there is not a gender gap among other ethnic minority groups. We further show that these gender gaps do not change in magnitude when socio-economic characteristics or political attitudes are taken into account. Our results suggest that further work is needed to explain gender gaps in vote choice among ethnic minority voters in Britain.
The cestode Gerbillitaenia psammomi (Cyclophyllidea: Catenotaeniidae: Skrjabinotaeniinae) was found parasitizing fat sand rats (Psammomys obesus) in the south of Tunisia. The species was found previously in P. obesus from Egypt and in Meriones shawi from Morocco. The present finding constitutes the first record of the species in Tunisia. In the present study, G. psammomi was morphologically characterized using light microscopy and compared to previous records of the species. The main differentiating morphological features of G. psammomi with respect to other skrjabinotaenines of North African Gerbillinae murids are, in particular, the shape of strobila, size of suckers, number of testes, absence of an antero-poral ovarian lobe, length of the central uterine stem, and number of primary uterine branches. Negative density-dependent growth (crowding effect) has also been reported. Molecular analysis based on 28S rDNA was performed for G. psammomi and for Skrjabinotaenia oranensis. Thus, both species are grouped in a clade with other species of the subfamily Skrjabinotaeniinae and are clearly separated from the clade that includes species of the subfamily Catenotaeniinae. The molecular study confirmed the previously postulated synonymy of Meggittina numida with S. oranensis.
In many areas of The Gambia, West Africa, population crowding in a degraded environment has forced close interactions of diurnal primate species with humans. We assessed intestinal parasitic infection prevalence and diversity in 4 diurnal non-human primate (NHP) species, Chlorocebus sabaeus, Erythrocebus patas, Papio papio and Piliocolobus badius across 13 sampling sites. The effect of human activity, determined by the human activity index, and NHP group size on parasite richness was assessed using a generalized linear mixed model (GLMM). The most common protozoa identified were Entamoeba coli (30%) and Iodamoeba buetschlii (25%). The most common helminths were Strongyloides fuelleborni (11%), Oesophagostomum spp. (9%) and Trichuris trichiura (9%). Two of six (6%) Cyclospora spp. infections detected sequenced as Cyclospora cercopitheci (both in C. sabaeus). The more arboreal P. badius trended towards a lower prevalence of intestinal parasites, although this was not statistically significant (χ2P = 0.105). Human activity or group size did not have any significant effect on parasite richness for P. badius (P = 0.161 and P = 0.603) or P. papio (P = 0.817 and P = 0.607, respectively). There were insufficient observations to fit a GLMM to E. patas or C. sabaeus. Our reports present the richness and diversity of intestinal parasites in 4 diurnal NHPs in The Gambia, West Africa. Despite desertification and habitat loss, our results indicate that the prevalence and diversity of intestinal parasites in Gambian NHPs are seemingly unaffected by human activity. Further investigation with a larger dataset is required to better elucidate these findings.