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Psychological screening in cardiovascular care
No full textApproximately one in three patients with cardiovascular disease experience psychological distress, often with an associated poor prognosis. Early detection and intervention can improve patients’ heart and mental health, yet minimal guidance on psychological screening is offered for clinicians working in cardiovascular care. This paper describes a pragmatic approach to conducting psychological screening during routine clinical care, including when and how to screen and what to do in the case of a positive screen. A psychological screening protocol is proposed to enable clinicians to assess and, where necessary, intervene or refer for further evaluation.</p
A pecking order of household finance
No full textHow do households cope with economic shocks? In this article, I provide empirical evidence and theoretical grounding for a pecking order of coping methods using data from the UK Understanding Society COVID-19 Study. I find that there is a typical household finance ordering of responses to income loss. Almost two-thirds (65 per cent) of households first reduce spending then these households typically proceed to draw down savings (59 per cent) and their most common next response is relying on family and friends (21 per cent). Deviations from this ordering occur because certain coping methods are often unavailable—those households not reducing spending are already struggling and those without savings have nothing to drawdown. Receiving financial assistance from family and friends is also more common than some authors suggest. Lastly, I find that the costs of informal borrowing are influenced by plausible social factors. My results are informative for policies to promote resilience during crises.<br/
Children, paternalism and respect
No full textThis paper explores the moral and philosophical tension between paternalism toward children and the respect owed to their views. While adults are typically granted autonomy in self-regarding matters, children are often denied this liberty based on presumed developmental incapacity. This essay examines the ethical basis for this distinction and critiques views that frame children’s voices as merely consultative. Drawing on Article 12 of the UN Convention on the Rights of the Child, it argues that children capable of forming views should be granted content-independent respect for those views, even if not full decisional authority. It defends a conception of respect that goes beyond instrumental or epistemic justification and asserts that children’s freely expressed views must carry moral weight in adult decision-making. This rethinking of paternalism challenges dominant models and repositions children as moral agents deserving of recognition and serious consideration.<br/
‘What’s in a name? Fit-for-purpose bacterial nomenclature’: meeting report
No full textRapid and economical DNA sequencing has resulted in a revolution in phylogenomics. The impact of changes in nomenclature can be perceived as an absolute necessity of scientific rigour, coupled with the slight inconvenience of needing to re-learn names. In relation to practical aspects of microbiology, for example, infectious disease diagnosis, there may, however, be potential dangers. Historically, prokaryote classification has been based on multiple metabolic, physiological, biochemical and descriptive characteristics combined with the environmental source. Whole-genome sequence data have transformed our ability to determine evolutionary relationships. In addition, metagenomic and metataxonomic sequencing have resulted in the discovery of novel microbes, many of which are yet to be cultured. As a result, occasional name changes and additional prokaryote discoveries have accelerated at an unprecedented pace. Herein is a report of a Microbiology Society supported meeting of representatives of the communities of specialist taxonomists, phylogeneticists and applied microbiologists. Discussion included: recent advances in phylogenomics and the potential impact of nomenclature change on practical microbiology, e.g. plant pathology, food security, industrial microbiology, clinical microbiology and infectious diseases; the need, or lack thereof, for wider consideration and consultation prior to nomenclature change proposals which impact on practical microbiology; the application of the intricate and highly necessary rules of prokaryote nomenclature, which sometimes appear unfathomable to the non-specialist; and genome-based phylogenomics and the relationship with the International Code of Nomenclature of Prokaryotes. The meeting resulted in the formation of the Ad Hoc Committee for Mitigating Changes in Prokaryotic Nomenclature under the auspices of the International Committee on Systematics for Prokaryotes.<br/
The DELHPIRE Study 2025: health profession students to improve the prevention, recognition and management of delirium in Ireland
No full textDelirium is a frequent yet under-recognised neuropsychiatric syndrome among acutely ill hospital patients, largely due to inconsistent detection and limited education among healthcare professionals. The DelHPIre study, co‑led by Gary Mitchell and Alice Coffey, outlines the study for developing and evaluating an interdisciplinary digital resource aimed at undergraduate health profession students across Ireland (Queen’s University Belfast and University of Limerick). Using a three‑phase design based on a logic model, Workstream 1 comprises a systematic review, stakeholder focus groups, and a Delphi survey to identify priority educational content. Workstream 2 entails co‑design workshops with students, clinicians, and individuals with lived delirium experience to develop the digital intervention. Workstream 3 involves a mixed‑methods evaluation assessing changes in students’ delirium knowledge, self‑efficacy, and user experience. The study aims to foster prevention, recognition, and management of delirium through interprofessional digital education. Poster presentation presented on behalf of team by Dr Pauline Boland (University of Limerick
The Type I superluminous supernova catalogue – II. Spectroscopic evolution in the photospheric phase, velocity measurements, and constraints on diversity
No full textHydrogen-poor superluminous supernovae (SLSNe) are among the most energetic explosions in the universe, reaching luminosities up to 100 times greater than those of normal supernovae. This paper presents the largest compilation of SLSN photospheric spectra to date, encompassing data from the advanced Public ESO Spectroscopic Survey of Transient Objects (ePESSTO+), the Finding Luminous and Exotic Extragalactic Transients (FLEET) search, and all published spectra up to December 2022. The data set includes a total of 974 spectra of 234 SLSNe. By constructing average phase binned spectra, we find SLSNe initially exhibit high temperatures (10 000–11 000 K), with blue continua and weak lines. A rapid transformation follows, as temperatures drop to 5000–6000 K by 40 d post-peak, leading to stronger P-Cygni features. Variance within the data set is slightly reduced when defining the phase of spectra relative to explosion, rather than peak, and normalising to the population’s median e-folding decline time. Principal Component Analysis (PCA) supports this, requiring fewer components to explain the same level of variation when binning data by scaled days from explosion, suggesting a more homogeneous grouping. Using PCA and K-means clustering, we identify outlying objects with unusual spectroscopic evolution and evidence for energy input from interaction, but find no support for groupings of two or more statistically significant subpopulations. We find Fe II λ5169 line velocities closely track the radius implied from blackbody fits, indicating formation near the photosphere. We also confirm a correlation between velocity and velocity gradient, which can be explained if all SLSNe are in homologous expansion but with different scale velocities. This behaviour aligns with expectations for an internal powering mechanism
Molnupiravir or nirmatrelvir–ritonavir plus usual care versus usual care alone in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
No full textBACKGROUND: Molnupiravir and nirmatrelvir-ritonavir are oral antivirals that have shown efficacy in preventing disease progression in outpatients with COVID-19. We aimed to evaluate these treatments for patients hospitalised with COVID-19 pneumonia, for whom data on these antivirals are scarce.METHODS: The RECOVERY trial is a randomised, controlled, open-label, adaptive platform trial testing treatments for COVID-19. In this study we report the molnupiravir and nirmatrelvir-ritonavir comparisons from the RECOVERY trial. In each comparison, participants aged 18 years and older were randomly allocated (1:1) to the relevant antiviral (5 days of molnupiravir 800 mg twice daily or 300 mg nirmatrelvir and 100 mg ritonavir twice daily) in addition to usual care, or to usual care alone. The molnupiravir comparison was conducted at 75 hospitals in the UK, two in Nepal, and two in Indonesia; the nirmatrelvir-ritonavir comparison was conducted at 32 hospitals in the UK. Participants could take part in both comparisons. The primary outcome was 28-day mortality, and secondary outcomes were time to discharge alive from hospital and progression to invasive ventilation or death. Analysis was by intention to treat. Both comparisons were stopped because of low recruitment. This study is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.FINDINGS: From Jan 24, 2022, to May 24, 2023, 923 participants were recruited to the molnupiravir comparison (445 allocated to molnupiravir and 478 to usual care), and from March 31, 2022, to May 24, 2023, 137 participants were recruited to the nirmatrelvir-ritonavir comparison (68 allocated to nirmatrelvir-ritonavir and 69 to usual care). More than three-quarters of participants were vaccinated and had antispike antibodies at randomisation, and more than two-thirds were receiving other SARS-CoV-2 antivirals. In the molnupiravir comparison, 74 (17%) participants allocated to molnupiravir and 79 (17%) allocated to usual care died within 28 days (hazard ratio [HR] 0·93 [95% CI 0·68-1·28], p=0·66). In the nirmatrelvir-ritonavir comparison, 13 (19%) participants allocated to nirmatrelvir-ritonavir and 13 (19%) allocated to usual care died within 28 days (HR 1·02 [0·47-2·23], p=0·96). In neither comparison was there evidence of any difference in the duration of hospitalisation or the proportion of participants progressing to invasive ventilation or death.INTERPRETATION: Adding molnupiravir or nirmatrelvir-ritonavir to usual care was not associated with improvements in clinical outcomes. However, low recruitment meant a clinically meaningful benefit of treatment could not be ruled out, particularly for nirmatrelvir-ritonavir.FUNDING: UK Research and Innovation (UK Medical Research Council), the National Institute for Health and Care Research, and the Wellcome Trust.</p
Evaluating the short-term effects of dance on motor and non-motor outcomes in people living with Parkinson’s: a crossover study
No full textPurposeTo investigate the short-term effects of a single dance class on motor and non-motor outcomes in people living with Parkinson’s.MethodsA crossover design was used. Nineteen people participated. All participants took part in both dance and lecture control conditions seven days apart in a counterbalanced order. Outcomes of gait, balance, functional mobility, and aspects of cognition were measured before and after each condition. A visual analogue scale evaluated self-perceived changes in fatigue, energy, depression, anxiety, concentration, and movement. Statistical analyses were performed using 2x2 repeated-measures ANOVAs with time (pre vs. post) and condition (dance vs. lecture) as factors.ResultsResults showed functional mobility (measured by the Timed Up and Go) improved to a greater extent after dance compared to the lecture. Significant improvements after both dance and lecture sessions were demonstrated for other outcomes measuring balance, cognition, and anxiety, indicating either both conditions had a comparable impact or practice effects may have influenced results.ConclusionsFurther research is needed to confirm the presence and strength of the short-term effect of dance on functional mobility, to assess the impact of dancing on aspects of cognition and anxiety, and to hone the approach to studying the short-term effects of dance.<br/
Am I more stressed because I'm aware of being a woman? The impact of gender identity salience on women's cardiovascular responses to stress
No full textObjectives: This study aimed to investigate how which social identity is salient affects physiological responses to stress in women. Specifically, we examined whether gender identity salience, compared to university student identity salience, would lead to significant differences in cardiovascular responses during a math stress task. Design: We conducted a between-subjects experiment, where participants were randomly assigned to either a gender identity salience condition or a university student identity salience condition. Methods: Ninety-six female participants completed the math stress task. Blood pressure (systolic and diastolic) and heart rate were measured to assess physiological responses to stress. Results: Women in the gender identity condition exhibited significantly higher systolic and diastolic blood pressure responses compared to those in the student identity condition. No significant differences in heart rate were observed between conditions. Conclusions: These findings suggest that gender identity salience amplifies physiological stress responses in women, providing insights into how group-related processes impact health outcomes. This study highlights the importance of considering identity salience in understanding women's cardiovascular response to stress.</p
Progress in the production of nanocrystals through miniaturized milling methods
No full textObjectivesThe pharmaceutical industry continually seeks efficient strategies to translate research into clinical applications, particularly for poorly water-soluble drugs that present formulation challenges. Nanocrystals (NCs) technology has emerged as a promising solution to enhance bioavailability, with top-down nanomilling playing a central role. However, traditional methods often require large quantities of active pharmaceutical ingredients (APIs), limiting their practicality in early stage development. This review aims to highlight miniaturized nanomilling approaches capable of producing NCs using <5 g of API to support cost-effective formulation screening and scalability.MethodsRelevant research articles were selected from Scopus and PubMed, focusing on top-down NCs synthesis using minimal drug quantities. Special attention was given to studies employing modifications of conventional technologies and novel methods aimed at reducing material use and improving throughput.Key findingsTechniques such as 96-well plate milling, dual asymmetric centrifugation, and miniaturized vial-based systems were identified as effective small-scale strategies. These methods demonstrated reproducibility, high-throughput capabilities, and potential for scale-up. Some studies successfully produced NCs using as little as 0.7 mg of API. Temperature-controlled milling further enhanced performance by maintaining consistency and reducing material waste.ConclusionsMiniaturized nanomilling, combined with stabilizer optimization, offers a scalable and cost-effective route for NCs production. These innovations hold strong potential for accelerating pharmaceutical development, though further refinement is needed to enable widespread industrial application.<br/