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Global, regional, and national burden of chronic kidney disease in adults, 1990–2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackgroundChronic kidney disease (CKD) is common and ranks among the leading causes of mortality and morbidity. This analysis aimed to present global CKD estimates using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 to inform evidence-based policies for CKD identification and treatment.MethodsThis analysis focused on adults aged 20 years and older over the period 1990 to 2023, from 204 countries and territories. Data sources used were published literature, vital registration systems, kidney failure treatment registries, and household surveys. Estimates of CKD burden, including deaths, incidence, prevalence, and disability-adjusted life-years (DALYs), were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool. A comparative risk assessment approach estimated the proportion of cardiovascular deaths attributable to impaired kidney function and estimated risk factors for CKD.FindingsGlobally, in 2023, 788 million (95% uncertainty interval 743–843) people aged 20 years and older were estimated to have CKD, up from 378 million (354–407) in 1990. The global age-standardised prevalence of CKD in adults was 14·2% (13·4–15·2), a relative rise of 3·5% (2·7–4·1) from 1990. The region with the highest age-standardised prevalence was north Africa and the Middle East (18·0%; 16·9–19·4). Most people had stage 1–3 CKD, with a combined prevalence of 13·9% (13·1–15·0). In 2023, CKD was the ninth leading cause of death globally, accounting for 1·48 million (1·30–1·65) deaths, and the 12th leading cause of DALYs, with an age-standardised DALY rate of 769·2 (691·8–857·4) per 100 000. Impaired kidney function as a risk factor accounted for 11·5% (8·4–14·5) of cardiovascular deaths. High fasting plasma glucose, body-mass index, and systolic blood pressure were all leading risk factors for CKD DALYs.InterpretationCKD is a major global health issue, with rising prevalence and increasing importance as a cause of death and as a risk factor for cardiovascular death. A better understating of aetiology, appropriate screening, and implementation programmes are needed to translate advances in CKD treatment into improved patient outcomes
Interventions for promoting physical activity in people with newly diagnosed Parkinson’s disease: scoping review
No full textBackground: There is increasing evidence to suggest that physical activity can slow Parkinson’s progression. There is also increasing interest in non-pharmacological interventions to alleviate Parkinson’s symptoms. This scoping review aimed to map and describe the evidence for interventions that promote physical activity in people with newly diagnosed Parkinson’s. Methods: Studies conducted since 2011, on adults with Parkinson’s (≥ 18 years), investigating the effects of non-pharmacological interventions to promote physical activity and/or exercise were considered. Interventions needed to be conducted in healthcare or healthcare-related settings for people within 5 years of Parkinson’s diagnosis. Published or unpublished full-text articles since 2011 were searched in November 2023, using online focused, broad, and grey literature databases. JBI scoping review methodology was used and results presented in table format accompanied by a narrative review. Results: A total of 22 articles with a variety of research designs were included with 14 randomized trials, one single-site, prospective, single-arm study, two retrospective cohort studies, one case series, two case reports, and two qualitative reports. Many studies (n = 7) were conducted in outpatient clinics with the majority of interventions (n = 17) involving physiotherapists. Interventions varied widely, including aerobic exercise, balance exercise, dance, and yoga. The duration of intervention varied from 4 weeks to 8 years. Dosage of interventions varied widely from 30 to 90 min, and from twice weekly to seven times weekly. Several different outcome measures related to physical activity levels and/or physical fitness were used. The most frequent clinician/researcher reported outcome measure was the 6-min walk test (in nine studies) and the most frequently used participant/patient reported outcome measure was the 39-item Parkinson’s Disease Questionnaire (PDQ-39) (also in nine studies). The review showed limited research in identifiable cohorts with newly diagnosed Parkinson’s. Sample sizes were predominantly small. In all but one study, authors interpreted their results as favoring interventions to promote physical activity for people with newly diagnosed Parkinson’s. All authors recommended further studies. Conclusions: There is a need for more research with larger sample sizes and standardized reporting to inform the evidence base for interventions that promote physical activity in people with newly diagnosed Parkinson’s. Systematic review registration: https://pearl.plymouth.ac.uk/ (http://hdl.handle.net/10026.1/20098
A potential new sea surface temperature proxy based on isomeric highly branched isoprenoid lipid biomarkers: EZ25
No full textTwo tri-unsaturated and isomeric (E/Z) highly branched isoprenoid (HBI) diatom lipid biomarkers were quantified in 228 water column samples collected from the English Channel, West Svalbard (Arctic), the Scotia Sea (Southern Ocean) and East Antarctica. We found that the relative amounts of the two HBIs correlate well with water temperatures taken at the time of sampling. Based on these findings and some other HBI data reported previously, we suggest that the proportion of the HBI E-isomer (termed EZ25) may serve as a new proxy for palaeo sea surface temperatures, including in the polar regions. Next steps will involve determination of EZ25 in surface and downcore sediments to ascertain whether the temperature response described herein translates well to the geological record
Past intrusion of Circumpolar Deep Water in the Ross Sea: Impacts on the ancient Ross Ice Shelf
No full textThe Ross Ice Shelf, Antarctica’s largest by area, may face increased instability under future warming, threatening the Antarctic Ice Sheet. Understanding its past response to climate change is critical for anticipating future sea-level rise. We present a multi-proxy reconstruction of ocean and cryosphere conditions in the Ross Sea over the past 40,000 years. Our data show that warm Circumpolar Deep Water reached the JOIDES Trough in the western Ross Sea shortly after the Last Glacial Maximum, coinciding with the retreat of an ancestral ice shelf. This oceanic warming aligns with a southward shift of both the westerly and easterly wind belts, indicating a large-scale atmospheric mechanism driving regional ocean changes. The timing and nature of these processes reveal the tight coupling between atmospheric circulation, ocean heat transport, and ice shelf dynamics. These interactions led to reduced ice shelf extent, highlighting the role of ocean-atmosphere coupling in the Pacific sector of the Southern Ocean during deglaciation
LandWorks Evaluation 1 April 2023-31 March 2024: A \u27desistance-supporting\u27 community which offers \u27living proof of active hope\u27
No full textThis year marked the 10th anniversary of LandWorks, which was established in 2013 and became an independent charity in 2016. The ‘Annual Supporters Day’, which was held on the 14th July, was used to celebrate this milestone anniversary and 275 supporters, volunteers and partners attended. LandWorks produced a new book to commemorate the occasion, and a copy of this book can be found here: 10 Years of Land Works in 10 Numbers (https://www.landworks.org.uk/wp-content/uploads/2023/05/10-years-of-LandWorks-in-10-numbers.pdf)
SME Globalisation and Supply Chain Finance: Factors to Adoption of Technology-based Solutions
No full textThe increasing globalisation of Small and Medium Enterprises (SMEs) has necessitated the development of robust Supply Chain Finance (SCF) solutions to enhance financial resilience and operational efficiency. Despite the growing necessity of technology-based SCF solutions, such as blockchain and Bank Payment Obligation (BPO), SMEs face substantial barriers to adoption due to limited financial resources, risk aversion, and lack of awareness. While these solutions offer significant benefits—improving cash flow, reducing transaction risks, and enhancing financial resilience—overcoming these challenges remains critical for widespread adoption. This study explores the adoption factors of technology-based SCF solutions within the context of SME globalisation, traditional SCF adoption, and technology adoption, while also examining the interrelationships among these factors. This study employs a mixed-methods approach. Firstly, a literature review and semi-structured interviews were conducted to identify key adoption factors. These factors were subsequently prioritised using the Analytic Hierarchy Process (AHP), followed by an Interpretive Structural Modelling (ISM)-MICMAC approach to determine their interdependencies. Data were collected from Korean SMEs and academic experts to ensure the validity and reliability of insights. Key findings indicate that technological trust, innovation, financial cost, supplier pressure, and prior experience and knowledge for globalisation are critical determinants influencing SMEs’ adoption decisions. Furthermore, the study identifies SME resistance factors and proposes that open innovation strategies, such as knowledge-sharing networks and collaborative innovation ecosystems, can mitigate adoption barriers. By integrating external expertise and financial technologies, SMEs can strengthen their SCF capabilities and competitiveness in international markets.Theoretically, the study contributes by integrating behavioural, relational and institutional lenses, demonstrating how resistance factors and network-based enablers jointly shape adoption behaviour. By combining Resistance Theory with Network Theory, the research offers a more comprehensive explanation of SME decision-making in technology-based SCF environments than existing models. This integrated framework strengthens the conceptual foundations for understanding digital SCF adoption in global supply chains. By integrating external expertise and financial technologies, SMEs can strengthen their SCF capabilities and competitiveness in international markets The findings contribute to both academia and practice by providing empirical evidence on SCF adoption, offering insights for policy formulation, and recommending strategies for technology providers and financial institutions. Future research should explore open innovation frameworks to address SME resistance and enhance technology-driven SCF solutions in global supply chains
Exploration Psychology: Preparing explorers more effectively for expeditions.
No full textExploration environments expose individuals and teams to prolonged uncertainty, physical risk, and cognitive strain. Despite advances in expedition technology and logistics, psychological preparation for extreme environments remains comparatively underdeveloped. This presentation introduces the concept of exploration psychology as an applied framework for preparing individuals and teams to function effectively in high-risk and unpredictable expedition contexts. Drawing on research from performance psychology, stress physiology, and cognitive science, the talk outlines how psychological mechanisms underlying fear, attention, and decision-making influence behaviour in extreme environments. Fear responses involve rapid amygdala activation followed by potential top-down regulation through prefrontal cognitive appraisal, shaping behavioural responses such as avoidance, panic, or task-focused action. The presentation discusses practical training methods that translate these mechanisms into expedition preparation, including stress simulation, imagery-based cognitive reframing, graduated exposure training, heart-rate variability biofeedback, and purpose-driven motivational framing. Beyond individual regulation, the talk also considers team dynamics and role-based functioning through a proposed expedition archetype framework that highlights complementary psychological strengths such as navigation, decision-making, emotional stabilisation, and innovation. Integrating these perspectives suggests that psychological preparation can enhance adaptability, decision agility, emotional regulation, and group cohesion in extreme environments. The aim is to demonstrate how structured psychological training can move expedition preparation beyond physical and technical readiness toward a more integrated model of human performance in exploration settings. Implications for expedition leadership, team selection, and training design are discussed
