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Honest yet unacceptable research practices: when research becomes a health risk
No full textBackgroundExamples of poor research practices have received much attention in academic and public arenas. Such practices persist and threaten the health of the public and the reputation and impact of research and researchers.ObjectiveIn this article, we argue that research-though intended to improve health-can lead to patient harm through the proliferation of honest (though occasionally dishonest) yet unacceptable research practices.Summary of key argumentsWe argue that deliberate dishonest research practices-termed questionable research practices-are widely prevalent and insidious and influenced by both individual and cultural factors. Drawing on credible conceptualisations of poor research practices, we define honest yet unacceptable research practices to be different from questionable research practices involving dishonesty, but just as serious due to their wide prevalence and damaging impacts. Finally, we present recommendations for people and organisations to better protect patients' interests from honest yet unacceptable research practices.ConclusionOur recommendations can serve as the basis for preventing honest yet unacceptable poor research practices to safeguard public trust in health professions, researchers and practices
Experiences of care home staff in the delivery of heart failure care: a grounded theory
No full textBackgroundHeart failure is a complex syndrome affecting 64 million people globally, with an average patient age of 76 years. Management challenges include medication titration difficulties and patient self-management issues. Care homes, housing approximately 20% of residents with heart failure, face unique challenges in managing this condition. This study aimed to investigate care home staff experiences in supporting residents with heart failure.MethodsA Glaserian grounded theory approach was employed to explore perceptions, challenges, and strategies used by care home staff in supporting residents with heart failure. Twenty care home staff members from Northern Ireland, with varied roles and experience levels, participated in online semi-structured interviews. These interviews were audio-recorded and transcribed verbatim. Data collection and analysis occurred concurrently, following theoretical sampling principles, between February 2023 and March 2024. A three-stage coding process (open, axial, and selective) was used for analysis. Rigour was ensured through member checking, data source triangulation, and reflexivity. Ethical approval was obtained prior to data collection.ResultsThree main categories were developed from the data: (1) Training, (2) Support, and (3) Communication. Training revealed that care home staff received limited education on heart failure management, primarily focused on acute settings rather than the chronic care needed in care homes. Support highlighted the various facilitators and barriers staff faced in making clinical decisions regarding heart failure care. Communication addressed the experiences of staff in engaging residents and their families about managing heart failure. These categories linked to the core category of (C) Empowerment, which encompassed the challenges staff faced in training, support, and communication. Empowerment illustrated how staff navigated these obstacles to provide effective heart failure care within the unique context of care homes.DiscussionThis study highlights significant challenges in managing heart failure in care homes, including inadequate training, limited professional development, and insufficient support systems. Key barriers include a lack of specialist education tailored to long-term care settings and restricted access to heart failure specialists. Effective communication and proactive care were identified as critical needs, alongside holistic care approaches. Addressing these gaps through targeted education, specialist integration, and evidence-based strategies could empower staff, optimise care quality, and potentially improve outcomes for residents.<br/
Satellite data indicates recent Arctic peatland expansion with warming
No full textNorthern peatlands are an important carbon store in mid to high latitudes, but become increasingly discontinuous in the higher latitudes, associated with temperature and precipitation limits on plant growth. During the last four decades, mean annual temperatures in the Arctic have increased on average by ~3 °C. Warmer temperatures and longer growing seasons likely drive increases in plant productivity throughout northern latitudes, but it is not clear whether warming has resulted in lateral spread of Arctic peatlands. Using long time-series Landsat satellite data, coupled with information gathered from fieldwork in situ, we show that Arctic peatlands have likely undergone lateral expansion over the last 40 years. On 21 transects from the edges of 16 extant peatlands in the European and Canadian Arctic (both high and low Arctic locations from 62 to 79°N), over two thirds of the peatland edges we studied showed statistically significant peak-summer greening (as Normalised Difference Vegetation Index) in the last 15 to 20 years, compared to the period 1985–1995. Peak summer moisture (as normalised Difference Moisture Index) levels remained stable or increased at most study sites. The lateral expansion of Arctic peatlands suggests they are an increasingly important natural carbon sink, at least in the near term.</p
Competing axes of power in the global plastics treaty: Understanding the politics of progress and setbacks in negotiating a high-ambition agreement
No full textHeadlines in December 2024 proclaimed the “collapse” and “failure” of United Nations plastics treaty negotiations in Busan, South Korea. This is, however, an overly simplistic and pessimistic portrayal. Progress on less contentious issues was made, and the meeting was adjourned with a commitment to continue negotiating in 2025 on the basis of the “Chair’s text.” Significantly, at the closing plenary, a majority of states voiced support for a “high-ambition” treaty covering the full life cycle of plastics, drawing clear red lines on the necessity of legally binding measures to phase out hazardous plastics, regulate chemicals in plastics, and finance just transitions. Delegates from developing countries such as Rwanda, Panama, and Mexico were especially steadfast in demanding an “ambitious” treaty to end plastic pollution, including in marine ecosystems. Yet there were also setbacks, as multiple, intersecting axes of pro-plastics power – comprising loose alliances of petrostates and business interests profiting from rising plastics production – sought to thwart high-ambition obligations. Industry actors lobbied against stringent commitments and endeavored to narrow the treaty’s scope to downstream waste management. Petrostates such as Russia and Saudi Arabia, meanwhile, stalled discussions and bracketed high-ambition text. Divisions between developing and developed countries also emerged over the appropriate financing mechanism. Despite this turbulence, achieving a strong treaty remains possible. But this will require strengthening the high-ambition axis of power, enhancing transparency and accountability, and ensuring the meaningful inclusion of rights holders, local communities, and civil society
Robust sensing-assisted secure communication via cooperative base stations
No full textIntegrated sensing and communication (ISAC) can ensure the secure transmission through sensing the eavesdroppers. However, the information obtained by a single base station (BS) is difficult to accurately track the moving eavesdroppers. In this paper, we investigate the sensing-assisted secure communication, where multiple BSs cooperatively sense an unmanned aerial vehicle (UAV) target, also regarded as an aerial eavesdropper. We propose a two-stage scheme to ensure the secure transmission. In the first stage, we estimate the current location and velocity of the UAV through fusing the sensing information from these BSs, to further predict the location in the next time slot. Meanwhile, the prediction variance is derived to bound the errors. In the second stage, we tackle the robust optimization with the prediction errors. Considering the tradeoff between the security and sensing performance, the weighted sum of secrecy rate and radar mutual information rate is maximized via jointly designing the user scheduling and beamforming, which is non-convex. Thus, we decompose it into two subproblems, where the scheduling is obtained via the branch and bound algorithm and the beamforming vectors are optimized by the successive convex approximation. In the end, we design a robust algorithm to address the original problem. Simulation results are shown to prove the efficiency of the proposed scheme.<br/
The ribosomal RNA transcription landscapes of Plasmodium falciparum and related apicomplexan parasites
No full textRibosome biogenesis is essential for the rapid proliferation and life cycle transitions of Plasmodium falciparum, the causative agent of malaria. In eukaryotes, ribosomal RNA synthesis is carried out by RNA polymerase I (Pol I), highly specialized transcriptional machinery. This review provides a comparative analysis of Pol I transcription apparatus in yeast and humans, serving as a reference framework to examine its evolutionary divergence in P. falciparum and related apicomplexans and alveolates. Bioinformatic analyses revealed that some of these organisms lack any identifiable homologues or orthologs of several canonical eukaryotic transcription factors essential for Pol I-mediated transcription, including initiation factor RRN3, activator UBF, and all specific subunits of the promoter recognition complexes. Interestingly, the parasite retains core Pol I subunits, incorporating unique parasite-specific structural domains characterized through AI-based protein complex modeling of P. falciparum Pol I. These adaptations may compensate for the absence of traditional regulatory factors, enabling the parasite to employ distinct mechanisms for promoter recognition and transcription initiation. The substantial differences between parasite and host Pol I transcription machinery create potential targets for therapeutic intervention with parasite-specific elements representing potential drug targets. By integrating evolutionary, structural, and functional perspectives, this review advances our understanding of Pol I transcription in alveolates and its implications for the development of novel antimalarial strategies.</p
Dynamics of insertion and extraction of hollow pyramidal microneedles: experiments and numerical modelling
No full textThe present study aimed to investigate the dynamics of HMNs’ insertion and extraction utilising HMN fabrication, laboratory experiments and numerical simulations. In particular, the study aims to develop an experimentally validated mathematical model to investigate the mechanics of the insertion and extraction of hollow pyramidal MNs, considering the nonlinear material behaviour of HMNs and skin. This study reveals good consistency between the experimental and computational results, providing confidence on the validity of the developed mathematical model. The model was then used to conduct detailed numerical simulations of the insertion and extraction of hollow pyramidal MN within a multi-layered skin model under different conditions, allowing us to assess the impacts of several key parameters (e.g., the base radius, length, and tip radius of HMNs) on the insertion and extractions dynamics of the HMNs. Overall, the findings of this paper indicate that HMN length <600 µm, base diameter <300 µm, tip diameter <30 µm, needle spacing >800 µm, and number of HMNs <9 can significantly lower the forces required for insertion and extraction for the chosen pyramidal MN, while maintaining their mechanical and structural integrity
Provision of follow-up services for survivors of COVID-19 critical illness: A UK national survey
No full textBackground:Intensive care unit (ICU) survivors in the United Kingdom (UK) can receive support from ICU follow-up services in their process of recovery and rehabilitation. However, it is unclear whether the COVID-19 pandemic impacted the ability of UK hospitals to provide follow-up. The objective of this study was to evaluate the provision of follow-up services in the UK for adult survivors of COVID-19 critical illness.Methods:All adult National Health Service (NHS) ICUs in the UK were invited to participate. Intensive care clinicians aware of follow-up services offered at their site were invited to complete a self-administered online electronic survey. Free text answers were thematically analysed.Results:174 of 242 (71.9%) NHS hospitals responded to the survey. 140 (80.5%) of the respondent hospitals had an ICU follow-up service for survivors of COVID-19 critical illness. A new service was created at 28 (16.1%) hospitals during the COVID-19 pandemic. ICU follow-up services were mostly delivered by nurses (125/140, 89.3%), ICU doctors (111/140, 79.3%), physiotherapists (88/140, 62.9%) and psychologists (59/140, 42.1%). Where ICU follow-up services already existed, changes were made in 111 (79.3%) hospitals during the pandemic and these were maintained in 89 (80.2%) hospitals. Funding was a commonly reported reason for whether follow-up services were offered.Conclusions:There was an expansion in the number of ICU follow-up clinics, and the multidisciplinary team delivering post-ICU care to patients who survived COVID-19 critical illness. Many changes to clinic operations introduced during the pandemic persisted, including the use of virtual and hybrid follow-up clinic models