143174 research outputs found
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Disentangling patterns of community malaria transmission and burden using malaria prevalence among pregnant women attending antenatal care: a modelling study
No full textBackground Malaria prevalence measured among pregnant women at first antenatal care (ANC1) provides longitudinal estimates of malaria burden in pregnancy and correlates well with cross-sectional community prevalence, but additional analysis is required to estimate community incidence. We aimed to test whether ANC1-based malaria prevalence can, via an open-source, mechanistic, model-based framework, recover seasonal patterns of clinical incidence suitable for sub-regional programmatic decision-making.
Methods We conducted a modelling study using monthly ANC1 malaria prevalence data from six previously published studies of malaria in pregnancy in six sub-Saharan African countries between May 2010 and August 2014. An extended, validated, age-structured malaria transmission model was fitted to monthly ANC1 malaria prevalence using particle Markov Chain Monte Carlo (pMCMC) to infer monthly clinical incidence and seasonality metrics. Agreement between model-derived incidence and independently observed time series was assessed using Markham Seasonality Index (MSI) and peak timing with concordance correlation coefficients (CCC) and 95% confidence intervals (CI).
Findings Across the six ISTp datasets, total ANC1 sample sizes and positivity were: Ghana 622/1298 (47.9%); Burkina Faso 592/1413 (41.9%); Mali, 284/1308 (21.7%); The Gambia 105/1194 (8.8%); Kenya 323/1528 (21.1%); and Malawi 291/1825 (15.9%). Strong agreement was observed between model-derived incidence and independent cohort data for MSI (CCC = 0.82; 95% CI 0.31–0.97) and for peak timing (CCC = 0.98; 95% CI 0.87–0.997).
Interpretation A mechanistic pMCMC framework applied to routine ANC1 data can recover clinically relevant seasonality in incidence for the broader community, enabling sub-regional timing of seasonal interventions (like seasonal malaria chemoprevention). These capabilities are especially valuable where high-quality case surveillance is limited, and household surveys are under-funded. Our work operationalises recent World Health Organization guidance highlighting ANC1 as an opportunity to strengthen malaria surveillance.
Funding Bill & Melinda Gates Foundation (INV-005289); MRC Centre for Global Infectious Disease Analysis (reference MR/X020258/1
Polyunsaturated lipids kill senescent cells by ferroptosis
No full textIn a recent issue of Cell Press Blue, Zhang et al. identify two polyunsaturated lipids that selectively eliminate senescent cells by inducing ferroptosis, uncovering this iron-dependent cell death pathway as a new vulnerability for senescent cells. Their findings position ferroptosis induction as a promising strategy for targeting senescence and ageing-associated diseases
Get a grip: how hand anthropometrics, grip strength and sex influence power tool use in orthopaedics
No full textIntroduction:
Female surgeons typically have smaller hands, report negative perceptions and experience pain and discomfort related to instrument design. The aims of this study were to determine whether orthopaedic surgeons receive teaching on power-tool handling, identify power-tool grips used, evaluate whether grip strength and hand anthropometrics influence grip choice, and examine the impact of sex on power tool perceptions.
Methods:
Orthopaedic surgeons (residents and attendings) were surveyed on their power tool perceptions and teaching methods. An objective assessment was carried out which included the categorisation of power tool grips, measurement of grip strength and anthropometric measurements of the hand.
Results:
Forty-six orthopaedic surgeons (12 female, 34 male) were recruited with a response rate of 96%. No orthopaedic surgeon reported formal teaching on power tool handling. Female surgeons reported more negative experiences using the wire driver and drill. Participants demonstrated two variations in power tool posture, with an equal split, determined by the index finger position on either the top or bottom trigger. The index finger bottom position was associated with reduced grip strength, female sex and smaller hand and palm length compared to the index finger top position.
Conclusion
Surgeons with smaller hands or lower grip strength, particularly females, were more likely to use an index finger supported grip, likely as a compensatory strategy. There is the need for early training in power-tool ergonomics and grip techniques, as well as grip strengthening initiatives. The current one size fits all approach is inadequate, manufacturers should ensure designs accommodate a wide range of hand sizes, accounting for palm length and overall hand length, to accommodate all users
An ultrasound-guided minimally invasive treatment for vaginal vault collections following major gynaecological surgery: a case series
No full textIntroduction:
Post-hysterectomy vaginal vault collections, often infected haematomas, cause significant morbidity
requiring resource-intensive and invasive management. Our proposed method for vault drainage, a
novel ultrasound-guided technique, aims to provide a minimally invasive treatment for refractory
collections. This is a proof-of-concept case series that describes the technique and evaluates its
potential efficacy.
Methods:
Retrospective case series of nine patients with vaginal vault collections (eight infected haematomas,
one lymphocyst) refractory to, or unsuitable for conservative management with intravenous
antibiotics. Transvaginal drainage with blunt sponge holding forceps was performed under transabdominal ultrasound-guidance, taking 3 to 5 minutes with minimal discomfort. Prior transvaginal ultrasound was performed to confirm collection anatomy. The primary outcomes were symptom resolution and inflammatory marker reduction. All patients were seen and treated at
Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
Results:
All patients had their vaginal vault collection successfully drained with subsequent resolution of their
symptomatic illness (e.g. pyrexia, pain, discharge). One patient required repeat drainage. Inflammatory markers decreased significantly post-drainage. No procedure-related complications
occurred.
Discussion:
The proposed procedure treated all patients’ vaginal vault collections. This technique offers a minimally invasive, ultrasound-guided alternative to interventional radiology or surgery. This may particularly benefit high-risk patients such as we describe (e.g. high BMI, complex surgery, cancer diagnoses) who are less suitable for invasive intervention.
Conclusions:
We present an ultrasound-guided, minimally invasive technique for the treatment of refractory post-
hysterectomy vaginal vault collections that avoids the need for sharp instruments or surgical
intervention
Random controlled differential equations
No full textWeintroduce a training-efficient framework for time-series learning that combines random features with controlled differential equations (CDEs). In this approach, large randomly parameterized CDEs act as continuous-time reservoirs, mapping input paths to rich representations. Only a linear readout layer is trained, resulting in fast, scalable models with strong inductive bias. Building on this foundation, we propose two variants: (i) Random Fourier CDEs (RF-CDEs): these lift the input signal using random Fourier features prior to the dynamics, providing a kernel-free approximation of RBF-enhanced sequence models; (ii) Random Rough DEs (R RDEs): these operate directly on rough-path inputs via a log-ODE discretisation, using log-signatures to capture higher-order temporal interactions while remaining stable and efficient. We prove that in the infinite-width limit, these models induce the RBF-lifted signature kernel and the rough signature kernel, respectively, offering a unified perspective on random-feature reservoirs, continuous-time deep architectures, and path-signature theory. We evaluate both models across a range of time-series benchmarks, demonstrating competitive or superior performance. These methods provide a practical alternative to explicit signature computations, retaining their inductive bias while benefiting from the efficiency of random features
Conflicts of interest in United States food and drug administration advisory committees: a systematic literature review
No full textObjectives
To systematically review empirical evidence on the prevalence and influence of conflicts of interest (COIs) among members and public speakers of US Food and Drug Administration (FDA) advisory committees.
Methods
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE, PubMed, and Cochrane Library from inception to November 2024 for peer-reviewed studies reporting quantitative data on COIs in FDA advisory committees. Eligible studies examined prevalence, type, or impact of COIs among voting members or public speakers. Data extraction and quality assessment were conducted independently by 2 reviewers using the Joanna Briggs Institute checklist for cross-sectional studies.
Results
Eighteen studies published between 2006 and 2022 were included, covering committee activity from 1997 to 2022. COIs among voting members ranged from 15% to over 70% of meetings, whereas 25% of public speakers disclosed financial COIs, most commonly consulting fees, research funding, and stock ownership. Evidence linking member COIs to voting outcomes was mixed, with some studies finding no significant association. In contrast, public speakers with financial COIs were consistently more likely to deliver favorable testimony, with odds ratios ranging from 3.0 to 6.1. Several studies suggested a decline in member COI prevalence after the 2007 FDA Amendments Act, but no similar trend was observed among public speakers.
Conclusions
COIs remain prevalent in FDA advisory committees, particularly among public speakers, for which they are strongly associated with favorable testimony. These findings underscore the need for stronger and more consistent COI disclosure and management policies that include both committee members and public speakers to protect decision-making integrity
Modeling the impact of malaria chemoprevention with sulphadoxine-pyrimethamine on the spread of plasmodium falciparum dhps a581G mutation
No full textSulfadoxine-pyrimethamine (SP) is a key antimalarial used in chemoprevention strategies, including intermittent preventive treatment in pregnancy (IPTp); intermittent preventive treatment in infants (IPTi); seasonal malaria chemoprevention (SMC); and mass drug administration (MDA). Malaria chemoprevention using sulfadoxine-pyrimethamine (SP) has shown a positive impact in preventing millions of malaria cases in the setting were it has widely been implemented. However, the spread of SP resistance in Plasmodium falciparum, particularly the emergence of the dhps A581G mutation which confers fully resistance to SP, threatens its long-term effectiveness. This study uses a mathematical modeling approach to evaluate how different chemoprevention strategies could influence the spread of SP-resistant genotypes in settings where dhps K540E mutation is already near fixation (highly prevalent). We developed a deterministic age-structured compartmental model incorporating both human and mosquito populations. The study simulates malaria transmission dynamics and the competition between dhps K540E and resistant dhps A581G parasite strains under varying chemoprevention coverage levels and treatment cycles. Simulations were carried out considering the settings where dhps K540E is most prevalent and is already near fixation, while dhps A581G is rising in prevalence. Two intervention scenarios were examined: three monthly chemoprevention cycles and five monthly cycles per transmission season, with coverage levels varrying from 0% to 80%. Model simulations demonstrate that chemoprevention coverage and frequency significantly affect the spread of dhps A581G. At 45% chemoprevention coverage, dhps A581G increased from 11% to 20.6% (three cycles) to 27.8% (five cycles). ANOVA was performed, followed by a partial eta-squared to quantify the size effects of coverage levels and the number of treatment cycles while controlling for other variables in the model. Results revealed that both the chemoprevention coverage levels and the number of treatment cycles influence the spread of resistance, with 58% of the spread of resistance explained by the chemoprevention coverage level, making coverage level the most influential factor affecting the spread of resistance. The number of treatment cycles per year also matters, but its influence on the spread of resistance is relatively smaller, only 9.3% of the spread of resistance is explained by the number of treatment cycles. The interaction between chemoprevention coverage levels and the treatment cycles influences the spread of resistance by 9.0%,
. Our findings highlight a trade-off between immediate public health gains from high chemoprevention coverage and the long-term risk of accelerating SP resistance. While chemoprevention using SP influences the spread of the dhps A581G mutation, careful policy planning, decisions, and ongoing molecular surveillance are essential to optimize the benefits of chemoprevention while minimizing the risk of the spread of the dhps A581G mutation
The Decarbonisation of a 300-Home Neighbourhood: A Business Case to support Local Area Energy Plan delivery
No full textThis report presents a business case for the transition of a 300-home neighbourhood to low-carbon technology (LCT), specifically focusing on the integrated installation of Air Source Heat Pumps (ASHPs), Solar Photovoltaics (PV), and Battery Energy Storage Systems (BESS). While the technical viability of such a project is well-established, this analysis argues that its success is fundamentally contingent on robust governance, financial credibility, and dedicated human resources to manage risk effectively and deliver a high-quality, scalable outcome that aligns with the strategic objectives of for large-scale retrofitted as highlighted through Local Area Energy Plans (LAEPs). This document puts forward a suggested process, incorporating political commitment, extensive public engagement, delivery by a Community Interest Company in partnership with local government and blended financing models
Ergonomically Designed Assistive Robots: Where and How to Bring Comfort, Safety, and Independence to Elderly Care
No full textThe file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.The aging population worldwide presents significant challenges to elderly care, particularly in maintaining their comfort, safety, and independence. Ergonomically designed assistive robots offer a promising solution to address these challenges by providing personalized support that aligns with the physical and cognitive needs of older adults. This review paper will explore the role of elderly assistive robots in elderly care, focusing on their ergonomic design, functionality, and impact on enhancing the well-being of elderly individuals. Key design principles such as user-centered ergonomics, adaptability to various physical conditions, ease of interaction, and safety features will be discussed. Additionally, the review paper will highlight the integration of advanced technologies such as AI, machine learning, and sensor systems, which enable robots to assist with daily activities, mobility, medication management, and social interaction. Through case studies and recent advancements, we will examine the potential of these robots to improve elderly care by fostering independence, preventing injuries, and providing companionship. The session will conclude with an outlook on future research and the ongoing development of assistive robots to meet the evolving needs of the aging population
Anthropogenic emissions of volatile Cd detected in western tropical North Atlantic surface seawater
No full textThe Cd concentrations and isotope compositions of open ocean surface waters are generally thought to be governed by internal cycling, and particularly by the balance between upwelling of more Cd-rich deeper water masses and Cd uptake by phytoplankton. Here we present a new dataset of coupled Cd isotope compositions and concentrations for seawater depth profiles
sampled in the western tropical Atlantic Ocean during Leg 2 of the GEOTRACES GA02 section. A box model for the Cd source and sink fluxes of the oligotrophic surface waters of the study area shows that the observed light Cd isotope compositions and low Cd concentrations are a consequence of biological Cd uptake and atmospheric deposition of isotopically light anthropogenic Cd. Aerosols enriched in anthropogenic Cd thereby contributed at least 19%, and possibly more than 45%, to the dissolved surface water Cd inventory during the sampling period. This reveals that anthropogenic emissions of volatile Cd
can have a key impact on the distribution of Cd in open ocean surface waters