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Executive summary: the 2025 British Society for Rheumatology management recommendations for ANCA-associated vasculitis
No full textAnti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) are heterogeneous, multisystem disorders characterized by inflammation and necrosis of small and medium-sized blood vessels with unknown aetiology. Three distinct clinico-pathological syndromes have been identified: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA) associated with autoantibodies directed against neutrophil granular proteins, proteinase 3 and myeloperoxidase. These conditions are uncommon with incidence and prevalence rates of 25/million population and 200/million, respectively [1]. Despite significant advances in treatment,mortality rates remain elevated, 2.3 times that of the general population [2]. Early diagnosis, instituting appropriate immunosuppression swiftly, and limiting toxicity from treatment is key to mitigating mortality and damage from AAV
Dynamics of spatially-developing turbulent/turbulent interfaces in the absence of mean shear
No full textSpatially-evolving turbulent/turbulent interfaces (TTI) in the absence of mean shear are studied using direct numerical simulations (DNS). To this end, a novel approach was
developed, allowing for six (6) different TTIs to be created with a Taylor-based Reynolds number between 146 ≲ Re ≲ 296. The analysis of classical statistics of turbulence intensity, fluctuating vorticity, and integral length scale clearly indicates that one of the two distinct turbulent regions bounding the interface tends to dominate the other one. The halfwidth thickness is found to be dependent on the turbulent properties of each layer, ultimately suggesting that the large-scale quantities dictate the spreading of each turbulent region. Furthermore, conditional profiles of small and large-scale quantities are used to understand the turbulence dynamics separating the two turbulent regions. In contrast, the large-scale properties of the flow do not modify the enstrophy statistics. Additionally, when taking
the difference of fluctuating vorticity levels on each layer ad extremum, profiles typical of turbulent/non-turbulent interfaces (TNTIs) are observed. The budget terms of enstrophy and rate-of-strain magnitude support these findings
Enhancing autophagy by redox regulation extends lifespan in Drosophila
No full textDysregulation of redox homeostasis is implicated in the ageing process and the pathology of age-related diseases. To study redox signalling by H2O2 in vivo, we established a redox-shifted model by manipulating levels of the H2O2-degrading enzyme catalase in Drosophila. Here we report that ubiquitous over-expression of catalase robustly extends lifespan in females. As anticipated, these flies are strongly resistant to a range of oxidative stress challenges, but interestingly are sensitive
to starvation, which could not be explained by differences in levels of energy reserves. This led us to explore the contribution of autophagy, which is an important mechanism for organismal survival in response to starvation. We show that autophagy is essential for the increased lifespan upon catalase up-regulation, as the survival benefits are completely abolished upon global
autophagy knock-down. Furthermore, using a specific redox-inactive knock-in mutant, we highlight the in vivo role of a key regulatory cysteine residue in Atg4a, which is required for the lifespan extension in our catalase model. Altogether, these findings confirm the redox regulation of autophagy in vivo as an important modulator of longevity
2D vs 3D markers in hip templating: a systematic review and meta-analysis
No full textPre-operative templating in total hip arthroplasty helps restore hip biomechanics, reduce complications and improve implant longevity. This study aimed to assess the
accuracy of different templating methods in predicting femoral and acetabular component size, comparing 2D and 3D techniques and digital versus analogue methods
Beyond Disciplines – strengthening boundary crossing through geography to address urgent environmental challenges
No full textNurse prescribing for selected UTIs in Spain: a challenging step forward
No full textThis paper examines the implications of Spain’s recent legislative reform enabling nurses to prescribe antibiotics for uncomplicated urinary tract infections (UTIs) in women, positioning it as a critical development in antimicrobial stewardship (AMS) and nursing practice. The paper aims to assess how this policy aligns with international models of nurse prescribing, evaluating its potential to enhance workforce flexibility, and identifying some challenges and opportunities regarding its implementation. While this reform may reduce pressures on general practitioners and optimize primary care delivery, it raises questions regarding diagnostic accuracy, restricted formularies and the need for rigorous surveillance. The viewpoint highlights the importance of robust training in diagnostic and clinical reasoning, regular updates to antibiotic formularies and comprehensive auditing mechanisms to ensure safe and effective prescribing. Additionally, we explore broader considerations, such as professional incentives and inter-professional collaboration, essential for the sustained impact of nurse prescribing. By centring the discussion on nursing leadership in AMS, we highlight an underexplored area of policy implementation, with implications for other countries considering similar reforms
Reconfigurable DNA origami hinges for nanopore detection of microRNA
No full textThe advancement of biosensor technology is driving the development of ultrasensitive detection methods, with single-molecule sensing emerging as a particularly promising approach. Nanopore sensing enables the detection of biomarkers at the single-molecule level, offering high sensitivity and specificity for biological sample analysis. In this study, we designed a reconfigurable DNA origami hinge as a molecular carrier for nanopore-based detection of miRNA-141-3p, a biomarker associated with prostate cancer. The hinge undergoes a controlled transition from a closed to an extended state upon binding to miRNA-141-3p, with distinct ionic current signatures recorded before and after reconfiguration during nanopore translocation experiments. Our approach demonstrates detection sensitivity down to the nanomolar level and exhibits excellent selectivity, effectively distinguishing miRNA-141-3p from closely related sequences. These findings highlight the potential of DNA nanostructure-based nanopore sensing for ultrasensitive and selective biomarker detection in biological samples
The future of stroke care: how telestroke is bridging the gap in stroke care
No full textIn recent years, telestroke technology has emerged as a cornerstone for delivering high-quality stroke care in remote and underserved regions across the globe. While this editorial draws on experience and data from Europe, many of the challenges and opportunities discussed are shared across international healthcare systems(1). This innovative healthcare solution connects patients with specialized neurologists in real time, thereby facilitating accurate diagnosis and timely intervention with a focus on the critical early stages of stroke care. Given that stroke is a time-sensitive condition where every minute counts, telestroke represents a pivotal tool for reducing treatment delays, morbidity, and mortality (2).
This editorial explores the potential of telemedicine to bridge gaps in stroke care and argues for its initial application to remain focused exclusively on stroke rather than broader neurological conditions
Patient activation levels are low in patients undergoing revascularisation for lower limb arterial disease but do not correlate with 30-day clinical outcomes
No full textBackground
Patient activation refers to the ability of individuals to engage in their healthcare. Studies have shown a positive association between patient activation and improved clinical outcomes in some patient groups.
Objective
This study aims to characterise the level of activation in patients with peripheral arterial disease (PAD) undergoing revascularisation procedures and to determine if patient activation is associated with 30-day clinical outcomes.
Methods
This is a single-centre, prospective, observational study (ethics reference: 23/NS/0078). Patients undergoing planned lower limb revascularisation within a 5-month period were invited to participate and to complete the Patient Activation Measure (PAM) survey prior to their surgery. Responses were scored on a Likert scale and an overall PAM score produced between 1 and 100 (lowest to highest activation). The relationship between baseline characteristics and PAM score was evaluated using linear regression. Spearman’s rank-order correlation and logistic regression was conducted to examine the relationship between PAM scores and 30-day clinical outcomes.
Results
Eighty patients were included in this study. The median age was 71 years (IQR 3 years) and 70% were male. The median PAM score was 53 (IQR 16). Current smokers and patients with type 2 diabetes had significantly lower PAM scores than non-smokers (p<0.05) and non-diabetics (p<0.001). Multivariate regression revealed age and type 2 diabetes were significant predictors of PAM score. There was no association between PAM score and any 30-day clinical outcomes.
Conclusions
Patient activation is low in our sample of PAD patients undergoing revascularisation procedures. This suggests more work is needed to educate and engage patients in self-management of this long-term condition. Patient activation was not correlated with 30-day clinical outcomes, but further research is warranted to determine whether it is related to medium or long-term clinical outcomes