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The impact of childhood emotional maltreatment on adulthood smoking behaviour:A systematic review and narrative synthesis
Get PDFBackgroundChildhood emotional maltreatment (CEM) has been linked to adulthood smoking behaviour (ASB). However, variability in how these are defined has hindered understanding of their specific relationship.ObjectiveThe aim of this systematic review was to valuate evidence for the association between two different forms of CEM – emotional abuse and emotional neglect – and various types of ASB.Participants and SettingEligible studies included adults aged 18 to 70 who experienced CEM before age 18 and reported any form of tobacco use after age 18. A total of 34 studies (N = 534,104) were included.MethodsA systematic review of studies published between 1997 and 2024 was conducted, and narratively synthesised. This review was registered on PROSPERO (CRD42024572290).ResultsFindings are reported in seven outcome categories, based on different aspects of smoking behaviour. Emotional abuse was most frequently associated with increased smoking outcomes, whereas associations with emotional neglect were mostly non-significant, though the paucity of studies that directly examine neglect limits interpretation, as does variation in study design and operationalisation of key concepts.ConclusionsThese findings indicate that exposure to CEM – particularly emotional abuse – is linked to smoking behaviour in adulthood. Future research should: examine the role of mediating factors; address clarity in conceptualisations of both CEM and ASB; and redress underrepresentation of non-Western populations. This review highlights the need for trauma-informed approaches that account for the long-term impacts of emotional maltreatment on tobacco use
Aberrant NSUN1 Activity Connects m5C RNA Modification to TDP-43 Neurotoxicity in ALS/FTD
Get PDFIn amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), the nuclear RNA-binding protein TDP-43 mislocalises to the cytoplasm and forms insoluble aggregates, but the mechanisms controlling this remain unclear. We define a native TDP-43 interactome in human SH-SY5Y cells and identify proteins linked to the 5-methylcytosine (m5C) RNA modification as highly enriched. Using a Drosophila model of TDP-43 pathology, we show that aberrant activity of m5C-RNA methyltransferases Nsun1 drives TDP-43-induced m5C-RNA hypermethylation, whereas Nsun1 down-regulation alleviates TDP-43-induced degeneration, lifespan deficits, and cytoplasmic accumulation. In human cells, TDP-43 selectively interacts with NSUN1 isoform 3 independently of RNA. Furthermore, NSUN1 is nucleolar and TDP-43 is largely nucleoplasmic, yet they interact in both compartments, suggesting functional roles beyond their predominant localisations. In ALS/FTD postmortem frontal cortex, NSUN1 isoform 3 persists, whereas the shorter isoform is reduced, suggesting that a pool of NSUN1 capable of contributing to pathological TDP-43 interactions remains in disease. These findings suggest that TDP-43 neurotoxicity is coupled to NSUN1 activation and m5C-RNA methylation, revealing a potential therapeutic axis in ALS/FTD.</p
5-Aminolevulinic acid (5-ALA) in paediatric brain tumour surgery—a systematic review and exploration of fluorophore alternatives
No full textPurpose: Paediatric brain tumours represent the most common solid malignancies in children, with extent of resection being a critical prognostic factor. Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) is well-established for adult high-grade gliomas, but its efficacy and safety in paediatric populations remain unclear. This systematic review evaluates the utility of 5-ALA fluorescence-guided surgery in paediatric brain tumours and explores alternative fluorophores. Methods: A systematic review was conducted according to PRISMA guidelines, analysing studies from MEDLINE and EMBASE published up to October 2024. Data on patient demographics, tumour fluorescence patterns, surgical outcomes, and adverse effects were extracted. Statistical analyses assessed fluorescence differences across tumour types and administration parameters. Results: Twenty-three studies, including 281 paediatric patients (mean age, 10 years), were analysed. The most common tumours included pilocytic astrocytomas (n = 45), medulloblastomas (n = 45), glioblastomas (n = 35), and ependymomas (n = 27). Strong fluorescence was observed more frequently in high-grade gliomas compared to low-grade gliomas (p < 0.00001), non-glioma tumours (p < 0.00001), and high-grade non-glioma tumours (p = 0.000485). Adverse effects were mostly transient; rare complications included transaminitis and dermatologic reactions. Conclusion: 5-ALA fluorescence-guided surgery shows promise in the resection of high-grade gliomas in paediatric patients, improving intraoperative visualisation. However, limited fluorescence in low-grade and non-glioma tumours underscores the need for tumour-specific approaches. Emerging alternatives, such as fluorescein sodium and tozuleristide, offer potential advantages. Future research should focus on optimising 5-ALA dosing, refining timing protocols, and conducting robust prospective trials to establish efficacy and safety in paediatric populations.</p
Does the cost of borrowing increase for firms that are socially and environmentally irresponsible?
No full textThe research problemThis study aims to determine the financial repercussions for firms that engage in Irresponsible Environmental, Social, and Governance (IESG) practices. Specifically, it examines whether these practices influence the cost of debt through increased borrowing costs imposed by lending institutions.MotivationAmid growing scrutiny over corporate behaviour and its broader impacts, understanding how irresponsible practices affect corporate finance is crucial for stakeholders, including investors, policymakers, and regulators. This research is driven by the need to explore beyond the often-studied beneficial impacts of positive ESG practices, focusing on the consequences of their negative counterparts.HypothesesThe current study makes three hypotheses as follows: First: ceteris paribus, there is a positive association between firms’ IESG practices and their cost of debt. Second, ceteris paribus, the anticipated positive impact of IESG practices on the cost of debt is more pronounced in countries with low levels of corruption. Finally, ceteris paribus, the anticipated positive impact of IESG practices on the cost of debt is more pronounced among firms in sinful industries.SampleThe analysis covers a broad international sample of 50,281 firm-year observations from non-financial listed firms across 44 countries, covering the years 2002 to 2022. This comprehensive dataset allows for generalised insights across various geographic and industrial contexts.Adopted methodologyMultivariate analysis is employed, based on pooled regression with standard errors clustered at the firm level to account for intra-firm correlations and potential heteroskedasticity. A two-stage instrumental variable approach is also employed to address potential endogeneity issues, providing a robust framework for examining the causal impact of IESG practices on the cost of debt.AnalysesThe analyses focus on evaluating the direct impact of IESG practices on borrowing costs, alongside assessing the moderating effects of the corruption perception index (CPI) and differentiating between industry types (sinful vs. non-sinful). Sensitivity tests are conducted to ensure the robustness of the findings against various model specifications and potential biases.Findings and ImplicationsThe findings indicate a universally significant positive relationship between IESG practices and the cost of debt, confirming that firms engaged in irresponsible practices face higher borrowing costs. This effect is particularly pronounced in countries with lower levels of corruption, emphasising the critical role of national governance in influencing corporate behaviour. Moreover, the analysis reveals no significant differences between sinful and non-sinful industries, suggesting uniform financial penalties for irresponsible practices across sectors. These results are robust across a range of sensitivity analyses, affirming the reliability of the conclusions. The study offers valuable insights for lending institutions, firms, and credit rating agencies about the financial implications of irresponsible corporate practices. It highlights the importance for policymakers and regulators to enforce comprehensive ESG guidelines that encourage substantive disclosures and responsible behaviours
Intrauterine devices and gynaecological malignancies - an umbrella review of systematic reviews and meta-analyses
No full textBackground and aims: The intrauterine device (IUD) is globally recognised as a safe, cost-effective, and reliable contraceptive. This umbrella review and meta-analysis synthesises current evidence regarding the association between IUD usage and incidence of gynaecological and breast malignancies. Materials and methods: A comprehensive search of PubMed, Cochrane Library, and Ovid databases was conducted for systematic reviews and meta-analyses examining any type of IUD in relation to gynaecological and breast cancers. The screening and data extraction processes adhered to PRISMA guidelines, and random-effects meta-analysis was employed for data synthesis. Results: 323 titles and abstracts were screened, leading to the review of 41 full texts and the inclusion of 17 articles. Analyses of these articles and of their 32 primary sources indicated a decreased risk of cervical, endometrial and ovarian cancer for ever-users of IUD (respective OR: 0.63 [95% CI 0.48–0.82], 0.41 [0.31–0.54], and 0.71 [0.59–0.86]; all p < 0.001). Our analysis did not yield any statistically significant association between IUD use and breast cancer risk (OR 1.00 [0.70–1.41], p = 0.99). Conclusion: IUD use is associated with a reduced risk of ovarian, endometrial, and cervical cancers, while no link was found with breast cancer. These findings can inform patient counselling on the benefits and risks of IUD use.</p
Advancing precision medicine for asthma by focusing on type 2 cytokines and alarmins
No full textPurpose of reviewAsthma is a heterogeneous disease encompassing distinct phenotypes and endotypes. Advances in elucidating the pathogenic role of type 2 (T2) cytokines and epithelial-derived alarmins have profoundly reshaped our understanding of airway inflammation in asthma. This review provides an updated perspective on how these mediators contribute to asthma pathobiology and examines their integration into emerging precision medicine strategies.Recent findingsBiologic agents targeting T2 cytokines (IL-4, IL-5, and IL-13) and alarmins (TSLP and IL-33) have demonstrated efficacy across a broad spectrum of severe asthma phenotypes. Recent evidence underscores the central role of alarmins in orchestrating both innate and adaptive immune responses within the airways. In parallel, the development of alarmin-associated molecular and clinical biomarkers is expanding patient stratification beyond traditional eosinophilic and allergic profiles.SummaryAdvancing our understanding of alarmins and T2 cytokines offers new opportunities to refine asthma endotyping, personalize therapeutic decisions, and pursue sustained disease remission. Future directions include the integration of multiomics, real-world evidence, and novel biomarker platforms to consolidate the next phase of precision medicine in asthma and optimize long-term disease modification strategies.</p
Spiritual Midwifery:Lessons for Our Future
No full textFor many midwives, Ina May Gaskin’s classic Work, Spiritual Midwifery, 1 offered an insight into ways of knowing and practising outside of the boundaries of medicalised maternity care. The book was radical in its time, being an exploration, primer and guidebook for practitioners that focused on out-of-hospital, holistic and spiritual birthing care, driven by a message of love. In this article, three midwives discuss the impact and messages of the book, and its relevance today.</p
Afamelanotide in Managing Cutaneous Phototoxicity in Erythropoietic Protoporphyria:a Scottish Perspective
No full textCorrigendum to “A pipeline for harmonising NHS Scotland laboratory data to enable national-level analyses”. (Journal of Biomedical Informatics (2025) 162, (S1532046424001898), (10.1016/j.jbi.2024.104771))
No full textOBJECTIVE: Medical laboratory data together with prescribing and hospitalisation records are three of the most used electronic health records (EHRs) for data-driven health research. In Scotland, hospitalisation, prescribing and the death register data are available nationally whereas laboratory data is captured, stored and reported from local health board systems with significant heterogeneity. For researchers or other users of this regionally curated data, working on laboratory datasets across regional cohorts requires effort and time. As part of this study, the Scottish Safe Haven Network have developed an open-source software pipeline to generate a harmonised laboratory dataset.METHODS: We obtained sample laboratory data from the four regional Safe Havens in Scotland covering people within the SHARE consented cohort. We compared the variables collected by each regional Safe Haven and mapped these to 11 FHIR and 2 Scottish-specific standardised terms (i.e., one to indicate the regional health board and a second to describe the source clinical code description) RESULTS: We compared the laboratory data and found that 182 test codes covered 98.7 % of test records performed across Scotland. Focusing on the 182 test codes, we developed a set of transformations to convert test results captured in different units to the same unit. We included both Read Codes and SNOMED CT to encode the tests within the pipeline.CONCLUSION: We validated our harmonisation pipeline by comparing the results across the different regional datasets. The pipeline can be reused by researchers and/or Safe Havens to generate clean, harmonised laboratory data at a national level with minimal effort.</p
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