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Providing support to increase adherence to self-isolation requirements during a public health emergency
No full textIsolating infected individuals plays a crucial role in controlling highly infectious diseases. However adherence to self-isolation mandates can be low. This paper uses data from three studies (total N = 1002) conducted during the COVID-19 pandemic to examine how the provision of support to individuals can facilitate increased adherence to self-isolation measures. In two experimental studies we manipulated the levels of hypothetical support provided by the UK Government and the local community, and in a survey, we collected data on actual support received from family members while self-isolating. Taken together, our results indicate that providing support for self-isolation increases both self-isolation intentions and actual behaviour. However, the effects of support were dependent on the type of support offered, the type of self-isolation required (either between households or within the household), the source of support, and the ways that all these addressed participants’ personal circumstances (in particular, caring responsibilities). For support for self-isolation to be most effective in future pandemic management, therefore, it should be tailored to address specific barriers individuals face when required to self-isolate.</p
A neglected Armenian source of the late Umayyad era:the <i>Martyrdom of Vahan of Gołt‘n</i>
No full textThe Armenian Martyrdom of Vahan of Gołt‘n, composed in 744 CE, offers a fresh perspective from which to study the Umayyad caliphate. A sophisticated literary composition assembled in a monastic context, the Martyrdom traces contemporary networks of power, communication, and knowledge within and beyond Armenia. As a product of the late Umayyad world, it constitutes a work of major significance for the study of the Umayyad caliphate at large and the caliphal North in particular during the first half of the eighth century. The Martyrdom reveals contemporary Armenian perceptions of Umayyad hegemony, including ʿaṭā (stipend) payments, public executions, conversions, apostasy, contemporary apologetics, and the nature of Caliph Hishām’s court at Ruṣāfa. At the same time, it portrays members of the Armenian elite, lay and clerical, reacting in different ways to new political circumstances. The present article provides the first annotated English translation and extensive thematic introduction to the Martyrdom of Vahan of Gołt‘n, with the aim of making the text accessible to Islamicists and thereby integrating this rich source into discussions of the late Umayyad era
Decolonising the 'red' reflex test:transitioning from terminology based on colour to anatomy
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The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer:results from the IDENTIFY study
No full textObjectives To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy. Patients Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy.Methods We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer-associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious-looking red patch (as reported by the cystoscopist). Sub-analysis of these by clinical role and experience was performed.Results A total of 1110 patients with isolated de novo red patches were included. 41.5% (n = 461) were biopsied, with a malignancy rate of 12.8% (59/461), which was significantly higher in suspicious versus non-suspicious red patches (19.1% vs. 2.81%, p < 0.01). There was a significant association between bladder cancer and age (OR 1.04, 95% CI 1.01–1.07, p = 0.01), smoking history (OR 2.62, 95% CI 1.09–6.27, p = 0.03) and suspicious-looking patch (OR 6.50, 95% CI 2.47–17.1, p < 0.01). The majority of malignancies were in over 60-year-olds. Malignancy rates in suspicious versus non-suspicious red patches did not differ significantly between clinical roles or experiences. Limitations included subjectivity in classifying a suspicious patch and selection bias as not all patches were biopsied.Conclusions Many patients still undergo unnecessary biopsies under general anaesthetic for isolated de novo red patches. Clinicians should consider the patient's age, smoking status and how suspicious-looking the patch is, before deciding on surveillance versus biopsy to improve cancer diagnostic yield
Mind the gap! Steric-driven reductive desymmetrisation of malononitriles
No full textHuang and coworkers recently demonstrated that a cobalt(I)-hydride complex, ligated with a finely tuned chiral bisoxazoline ligand, can selectively reduce disubstituted malononitriles by discriminating between enantiotopic nitrile groups. This reductive desymmetrisation strategy utilises the bulk industrial feedstock malononitrile to access nitrogen-rich enantioenriched products
Explainable artificial intelligence to identify follicles that optimize clinical outcomes during assisted conception
No full textInfertility affects one-in-six couples, often necessitating in vitro fertilization treatment (IVF). IVF generates complex data, which can challenge the utilization of the full richness of data during decision-making, leading to reliance on simple ‘rules-of-thumb’. Machine learning techniques are well-suited to analyzing complex data to provide data-driven recommendations to improve decision-making. In this multi-center study (n = 19,082 treatment-naive female patients), including 11 European IVF centers, we harnessed explainable artificial intelligence to identify follicle sizes that contribute most to relevant downstream clinical outcomes. We found that intermediately-sized follicles were most important to the number of mature oocytes subsequently retrieved. Maximizing this proportion of follicles by the end of ovarian stimulation was associated with improved live birth rates. Our data suggests that larger mean follicle sizes, especially those >18 mm, were associated with premature progesterone elevation by the end of ovarian stimulation and a negative impact on live birth rates with fresh embryo transfer. These data highlight the potential of computer technologies to aid in the personalization of IVF to optimize clinical outcomes pending future prospective validation
Urban waste piles are reservoirs for human pathogenic bacteria with high levels of multidrug resistance against last resort antibiotics:a comprehensive temporal and geographic field analysis
No full textInadequate waste management and poor sanitation practices in Low- and Middle-Income Countries (LMICs) leads to waste accumulation in urban and peri-urban residential areas. This increases human exposure to hazardous waste, including plastics, which can harbour pathogenic bacteria. Although lab-based studies demonstrate how plastic pollution can increase the persistence and dissemination of dangerous pathogens, empirical data on pathogen association with plastic in real-world settings are limited. We conducted a year-long spatiotemporal sampling survey in a densely populated informal settlement in Malawi, quantifying enteric bacterial pathogens including ESBL-producing E. coli, Klebsiella pneumoniae, Salmonella spp., Shigella spp., and Vibrio cholerae. Culture-based screening and molecular approaches were used to quantify the presence of each pathogen, together with the distribution and frequency of resistance to antibiotics. Our data indicate that these pathogens commonly associate with urban waste materials. Elevated levels of these pathogens precede typical infection outbreaks, suggesting that urban waste piles may be an important source of community transmission. Notably, many pathogens displayed increased levels of AMR, including against several 'last resort' antibiotics. These findings highlight urban waste piles as potential hotspots for the dissemination of infectious diseases and AMR and underscores the need for urgent waste management interventions to mitigate public health risks. [Abstract copyright: Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.
Optimizing flexible zeolite Rho for unrivalled argon purification
No full textThe preparation of pure Ar from air requires removal of O2 from a crude Ar stream produced by cryogenic distillation. Whereas their similar boiling points make further separation by distillation expensive, the difference in their molecular sizes makes separation by flexible zeolites an attractive route to kinetic separation. Modifying the cation content of the flexible and cubic zeolite Rho enables precise tuning of a single window size for unprecedented kinetic separation of O2 from Ar. Li-Rho (unit cell Li9.8Al9.8Si38.2O96) is a very selective adsorbent due to its small pore size, but the highly distorted framework results in very slow O2 diffusion. By replacing some of the Li+ with H+, Cs+, or Zn2+, the window can be enlarged and in some cases the window cation occupancy reduced, increasing O2 diffusion rates whilst retaining high O2/Ar selectivity. The optimum unit cell composition among those examined was found to be Li6.2Zn1.8-Rho (O2/Ar selectivity = 813, D/r2(O2) = 0.37 s-1)