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Temporal and spatial trends in the global burden of acne vulgaris among women of reproductive age: A comprehensive analysis and forecast from 1990 to 2040
No full textBackground
Acne is a common, multifactorial skin condition with significant psychosocial and public health impacts. However, its burden among reproductive-age women remains underexplored.
Methods
Using Global Burden of Disease (GBD) 2021 data, we analyzed acne incidence, prevalence, and disability-adjusted life years (DALYs) in females aged 15–49 across 204 countries (1990–2021). Trends were assessed via age-standardized rates and estimated annual percentage change (EAPC). Decomposition and inequality analyses identified contributing factors. Bayesian age-period-cohort (BAPC) modeling projected trends to 2040.
Results
From 1990 to 2021, acne incidence, prevalence, and DALYs rose by 34%, 38%, and 37%, respectively. The greatest increases occurred in low-socio-demographic index (SDI) regions (e.g., Sub-Saharan Africa). The 15–19 age group had the highest burden, but older age groups showed faster growth. Population growth was the key driver. Inequalities narrowed overall but remained complex. Projections show continued burden growth by 2040.
Conclusions
The acne burden among reproductive-age women is increasing globally, especially in low-SDI regions and adolescents, underscoring the need for targeted strategies.peer-reviewe
Participation of children born less than 30 weeks' gestation: A time for action
No full text[No abstract available]peer-reviewe
A comparison of objective structured clinical examinations (OSCEs) for medical students, modified during the COVID-19 pandemic
No full textIntroduction and aims
Objective structured clinical examinations (OSCEs) are an integral part of medical education assessment. The advanced clinical skills (ACS) OSCE examines clinical skills in psychiatry, general practice, obstetrics and gynaecology and paediatrics for fourth-year medical students at the University of Galway. This study compares results between the 2019 OSCE, and two subsequent OSCEs (2020 and 2021) modified to varying degrees secondary to the COVID-19 pandemic. We also examined student’s satisfaction and perspectives regarding both modified OSCEs.
Materials and methods
Anonymised results between the 2019 (128 min), 2020 (56 min) and 2021 (96 min) ACS OSCEs were compared, and student feedback pertaining to the 2020 and 2021 OSCEs was analysed.
Results
A higher total mean mark OSCE result was achieved at the 2020 OSCE (62.95%) compared to the 2019 (59.35%) and 2021 (58.89%) OSCEs (F = 31.83, p < 0.001), with significantly more first-class honours marks attained in 2020 (11.5%) compared to 2019 and 2021 (both 1%) (p < 0.001). Measures of reliability were consistent across all years. A majority of students in both 2020 and 2021 reported the OSCE to be safe, well-coordinated, and fair, but similar numbers of students from both 2020 and 2021 expressed concern that face masks impeded their communication skills.
Conclusion
This study demonstrates the feasibility of conducting a modified reliable OSCE during a pandemic. Conducting a 96-min OSCE demonstrated similar results to the pre-COVID-19 pandemic 128-min OSCE, in contrast to a 56-min OSCE where potentially inflated marks were attained.Open Access funding provided by the IReL Consortium.peer-reviewe
When school discipline meets children’s rights: A systematic literature review of tensions and conflicts in the international literature
No full textIn complex spaces such as schools, it is easy to see how children’s enjoyment of their rights may create rights conflicts where individual rights are claimed in a setting that is inherently collective. This presents tensions and oftentimes discord in decision-making in schools which are rarely debated as human rights concerns. This, perhaps, is because the ‘right to education’ is often understood as a right of access under article 28 of the Convention on the Rights of the Child (CRC), but not the features of a quality education enshrined in article 29 CRC. These features are most visible in an examination of school discipline policies which mediates the relationship between the State’s human rights obligations, duty bearing teachers, and students as rights-holders. This article presents the findings of a systematic literature review of 13 articles employing empirical, conceptual and doctrinal methodologies published between 2000–2024 which examine the human rights tensions and conflicts that arise from school discipline practice. The findings suggest that tensions and conflicts emerge between children’s education rights and school systems of rewards and sanctions, due process, and an absence of criteria for identifying, understanding and resolving human rights conflicts. I conclude by identifying several areas that require further empirical research.AsIAm: Ireland’s Autism Charitypeer-reviewe
Homophobia and transphobia span identification in low-resource languages
No full textOnline platforms have become prevalent because they promote free speech and group discussions. However, they also serve as platforms for hate speech, which can negatively impact the psychological well-being of vulnerable people. This is especially true for members of the LGBTQ＋ community, who are often the targets of homophobia and transphobia in online environments. Our study makes three main contributions: (1) we developed a new dataset with span-level annotations for homophobia and transphobia in Tamil, English, and Marathi; (2) we employed advanced language models using BERT-based architectures, Conditional Random Field (CRF), and Bidirectional Long Short-Term Memory (BiLSTM) layers to enhance span-level detection of harmful content; and (3) we conducted benchmarking to evaluate the effectiveness of monolingual and multilingual models in detecting subtle forms of hate speech. The annotated dataset, which is collected from real-world social media (YouTube) content, provides diverse language contexts and enhances the representation of low-resource languages. The span-based detection approach enables models to detect subtle linguistic nuances, leading to more precise content moderation that accounts for cultural differences. The experimental results show that our models achieve effective span detection, which provides valuable information for creating inclusive moderation tools. Our research leads to the development of AI systems, and we aim to reduce the burden on moderators and improve the quality of online experiences for LGBTQ＋ vulnerable.Author Bharathi Raja Chakravarthi was funded by a research grant from Research Ireland under grant number SFI/12/RC/2289_P2 (Insight) and supported by Google Gemma Awards. This work is also supported by the Centre for Research Training in Artificial Intelligence grant number SFI/18/CRT/6223, as well as a grant from the College of Science and Engineering, University of Galway, Ireland .peer-reviewe
In bed together: Flexible patient and public involvement in the irish national survey of sexual health
No full textThe Irish National Survey of Sexual Health (INISH, www.universityofgalway.ie/inish) will collect nationally representative data on sexual knowledge, attitudes and behaviours of the adult population in Ireland. The study has two Patient and Public Involvement (PPI) Advisory Panels, representing the General Public and Special Populations. The latter involves representatives of organisations who work with, or advocate for, marginalised groups and populations.The INISH study is funded by the Health Service Executive (HSE) Sexual Health Programme.non-peer-reviewe
Regenerative strategies for intervertebral disc degeneration
No full textLow back pain (LBP) is a global health problem, primarily caused by intervertebral disc (IVD) degeneration. Current treatments focus on symptom relief without addressing the underlying degenerative mechanisms. Regenerative strategies have emerged as promising therapies through the use of functional biomaterials and stem cells capable of modulating key signalling pathways to promote tissue regeneration. However, challenges such as efficient delivery systems, long-term survival of transplanted cells, and hostile disc microenvironment remain. This review focuses on recent advances in regenerative approaches using biomaterials, cells, and therapeutic agents of exosomes, and genes to restore IVD structure and function. We discuss the current understanding of IVD anatomy, physiology and degeneration pathophysiology followed by current treatments. We highlight the rationale for regenerative therapy in halting the degenerative hallmarks tailored to mild, moderate to severe IVD degeneration. Our review emphasizes on the functional biomaterials designed for advanced delivery system, therapeutic intervention and IVD tissue engineering. We discuss the cell-based therapy, highlighting various cell sources, therapeutic effects, clinical trials and its obstacles. We discuss the use of therapeutic agents such as the genes and exosome therapies in IVD regeneration. The clinical translational potential of regenerative therapy is vast and promising, driven by advances in cellular therapies, biomaterials, and cell-free approaches like exosomes, which offer new avenues for regenerating degenerative IVDs. While significant progress has been made in developing safe, effective, and scalable treatments, challenges remain in immune compatibility, manufacturing, and regulatory pathways. Emerging innovations in gene editing, 3D bioprinting, and personalized approaches are poised to accelerate the translation of these therapies into mainstream medicine, with interdisciplinary collaboration and global efforts playing a crucial role in overcoming current bottlenecks and realizing the full potential of regenerative medicine to transform patient care. This article offers a comprehensive framework to guide preclinical research and future clinical translation of effective regenerative therapies, aiming at reducing the global burden of LBP and improving long-term patient outcomes.We received funding from the Ministry of Higher Education, Malaysia under the Fundamental Research Grant Scheme (FRGS/1/2022/SKK10/UKM/02/12), Geran Galakan Penyelidik Muda, Universiti Kebangsaan Malaysia (GGPM-2022-029) and Emerging Investigator Award for Health 2022, Healthy Research Board, Ireland (EIA-2022-010, RHR1542 and FF-2023-198).peer-reviewe
What makes a meme a meme? Identifying memes for memetics-aware dataset creation
No full textWarning: This paper contains memes that may be offensive to some readers.
Multimodal Internet Memes are now a ubiquitous fixture in online discourse. One strand of meme-based research is the classification of memes according to various affects, such as sentiment and hate, supported by manually compiled meme datasets. Understanding the unique characteristics of memes is crucial for meme classification. Unlike other user-generated content, memes spread via memetics, i.e. the process by which memes are imitated and transformed into elements used to create new memes. In effect, there exists an ever-evolving pool of visual and linguistic elements that underpin meme culture and are crucial to interpreting the meaning of individual memes. The current approach of training supervised learning models on static datasets, without taking memetics into account, limits the depth and accuracy of meme interpretation. We argue that meme datasets must contain genuine memes, as defined via memetics, so that effective meme classifiers can be built. In this work, we develop a meme identification protocol which distinguishes meme from non-memetic content by recognising the memetic element within it. We apply our protocol to a random sample of the leading 7 meme classification datasets and observe that more than half (50. 4%) of the evaluated samples were found to contain no signs of memetics. Our work also provides a meme typology grounded in memetics, providing the basis for more effective approaches to the interpretation of memes and the creation of meme datasets.This work was conducted with the financial support of the Research Ireland Centre for Research Training in Digitally in Digitally Enhanced Reality (d-real) under Grant No. 18/CRT/6224peer-reviewe
Enhancing anaerobic digestion of complex substrates by powdered activated carbon: System performance, kinetic modeling and ecological analysis
No full textAnaerobic digestion (AD) is a remarkable biotechnology that utilizes facultative anaerobic bacteria to decompose biodegradable materials, potentially aiding in the offset of global warming via renewable energy (biogas CH4) generation. Complex substrates are predominant constituents in most waste and wastewater streams used in anaerobic digestion systems. That is, unlike simple or single-substrate systems, complex substrates encompass a diverse range of organic materials that better reflect real-world waste conditions. However, this diversity indicates heightened complexity with regards to microbial interactions and metabolic pathways. As such, the AD of complex substrates is often faced with substrate induced microbial activity inhibition, volatile fatty acid (VFA) accumulation and process instability. In this regard, a variety of physicochemical and biological techniques including temperature, pH and carbon-to-nitrogen (C/N) ratio regulation, substrate pre-treatment, microbial immobilization and bioaugmentation, etc have been proposed and tested.
The incorporation of conductive materials (CMs), such as powdered activated carbon (PAC), represents an innovative strategy for optimizing anaerobic digestion of complex substrates. PAC supplementation aids in the mitigation of prolonged retention times, biomass loss, and poor microbial syntrophy, which are often encountered during complex substrate digestion. Research focusing on complex substrates is, therefore, essential for developing scalable and efficient waste-to-energy solutions that accommodate the variability and heterogeneity inherent in industrial and municipal waste streams, ultimately enhancing the practical applicability of anaerobic digestion technologies. Moreover, elucidation of the stimulatory mechanisms that underpin PAC-assisted metabolism of complex substrates, encompassing microbial activities and specific metabolic pathways and metagenomics, is crucial.
The objectives of this study were: i) to investigate biomethanation of complex substrate and evaluate the regulation of syntrophic bacteria enrichment via operational mode variation and PAC addition; ii) to elucidate the influence of carbon type and PAC addition on rate-limiting biokinetics (hydrolysis and methanogenesis) for single versus complex substrates, using different kinetic models; and iii) to provide a detailed analysis of the synergistic influence of operational modes and PAC addition on microbial ecology in relation to electron transport, functional genes regulation and energy metabolism.
Operational mode and PAC are key factors facilitating microbial syntrophy and interspecies electron transfer during anaerobic digestion, consequently benefiting process stability and efficient methanogenesis. In this study, continuous-flow reactors (CFR) and sequencing batch reactors (SBR), with and without the addition of PAC, respectively, were operated to examine their effects on system performance and methanogenic activity. Based on the cycle-test result, the PAC-amended CFR (CFRPAC) demonstrated enhanced methanogenic activities, while SBRs exhibited slow methanogenic rates. However, activity assays indicated that SBRs were beneficial for organics removal in batch experiments fed with peptone. Taxonomic and functional analysis confirmed that CFRs were optimal for proliferating oligotrophs (e.g., Geobacter) and SBRs were more suitable for copiotrophs (e.g., Desulfobulbus). Metagenomic analysis revealed that CFRs had efficient acetate metabolic pathways from propionate and ethanol, whereas SBRs did not, resulting in the buildup of propionate. This study confirmed the enhancement of microbial syntrophy via PAC addition as well as the acclimation of electroactive bacteria (e.g., Geobacter) with complex substrates.
Kinetic analysis of the potential rate limiting subprocesses was employed to simulate the anaerobic biodegradation of complex substrate and analyse their response towards differential substrate characteristics and PAC integration. Moreover, owing to the varying degrees of precision when using different kinetic models for the same dataset, multiple kinetic model examinations were conducted to improve the description and reliability of biodigestion kinetics, especially for complex substrates. Similarly, a variety of metrics, in addition to the commonly used correlation coefficient (R2) were also applied to compare the relative performances of these models. Complex substrate AD systems exhibited inter-composition inhibition; hence, poor hydrolytic rates compared to the single substrate systems, irrespective of substrate type and reactor configuration. It was inferred that the initiation of biomethanation was primarily influenced by the operational mode, rather than by PAC supplementation, even though PAC addition led to consistent shortening of the lag phases. Moreover, the kinetic characterization of the compositionally distinct substrates in this study indicates that PAC addition tended to linearize the usually sigmoidal cumulative CH4 curves, thereby reducing model fitness. Additionally, the higher R² values and minimal error function values observed in most experimental scenarios support the conclusion that employing the Modified Bertalanffy model (BTM) for estimating performance parameters exhibited a more precise simulation of both single and complex substrate biomethanation kinetics. Furthermore, the significant recurring under- and overestimation of lag phase (λ) and maximum CH4 production potential (Pmax) by the Modified Transference Model (MRM), despite its high goodness of fit, underscores the inadequacy of relying solely on goodness of fit as an assessment method. Essentially, even though no direct correlation could be established between kh/Rm′ and the methanation performance indicators (Pmax, Rmax and λ), the recorded ≤ 1 kh/Rm′ values, indicated hydrolysis was the rate limiting step except for peptone-fed SBRCON (kh/Rm′ of 1.128).
High-resolution ecological analysis revealed that the majority of the front-end microbiome displayed significant sensitivity to PAC, whereas the back-end anaerobic digestion subprocesses of acetogenesis and methanogenesis were effectively facilitated. Moreover, notable rare taxa exhibiting characteristics and functionalities similar to those of the core microbiome in the respective reactors were identified and classified. The primary pathway in mesophilic complex substrate AD, particularly in CFRs, involved complex substrate hydrolysis followed by the successive acidogenesis of polysaccharides and amino acids, syntrophic acetate oxidization coupled with hydrogenotrophic methanogenesis (SAO-HM), and homoacetogenesis, ultimately producing acetate, H2, CO2, and CH4 as final products. Furthermore, methanogens were the overwhelming contributors of ATPase genes in CFRs while bacteria were primarily responsible for energy metabolism in SBRs. The metagenomic analysis further showed that both direct interspecies electron transfer (DIET) and acetoclastic pathways existed in the PAC-supplemented reactors. Genes involved in the CO2 reduction pathway were assigned to Methanothrix, Methanobacterium and Methanosarcina, indicating their possible involvement in the DIET process. Taken together, the results obtained suggested robust homoacetogenesis and SAO-HM activities despite the predominance of aceticlastic methanogenesis. This was particularly evident in CFRs and to a lesser extent PAC amended SBR.
This study underscores the pivotal role of anaerobic digestion as a transformative biotechnology for the effective valorization of organic waste, contributing to renewable energy generation and climate change mitigation. By elucidating the mechanistic foundations of PAC-assisted biodegradation of complex substrates, this research advances the sustainability and efficiency of anaerobic digestion technologies. The variation of operational modes and the introduction of PAC have been demonstrated as effective strategies for regulating microbial activities, enriching functional microorganisms, promoting efficient electron transfer through ethanol oxidation, and directing key metabolic pathways. Moreover, the implementation of practical optimization strategies, such as a two-stage anaerobic system that spatially and temporally separates hydrolysis and acidogenesis from subsequent acetogenesis and methanogenesis, emerges as a feasible solution for enhancing PAC-assisted biodegradation of complex substrates. Overall, the findings of this study present significant implications for improving anaerobic digestion processes, reinforcing its role in sustainable waste management and renewable energy production.Sustainable Energy Authority of Irelan
KpSC-ID: a multiplex real-time PCR assay for the simultaneous detection of the Klebsiella pneumoniae species complex and specific identification of Klebsiella pneumoniae, Klebsiella quasipneumoniae and Klebsiella variicola
No full textThe Klebsiella pneumoniae species complex (KpSC) comprises five closely related bacterial species, namely Klebsiella pneumoniae, Klebsiella quasipneumoniae, Klebsiella variicola, Klebsiella quasivariicola and Klebsiella africana. The KpSC is ubiquitous in the environment and is also an important human pathogen, particularly associated with healthcare-associated infections. The accurate detection and differentiation of the KpSC is challenging owing to the close phenotypic and genotypic identity (93–95% average nucleotide identity) shared between these members. Current diagnostic assays either fail to detect and identify all KpSC members or misidentify some KpSC members as K. pneumoniae sensu stricto. It is currently estimated that ~20% of human infections are caused by members of the KpSC other than K. pneumoniae. This leads to underreporting of some KpSC members in both clinical and environmental settings, which impacts our understanding of the importance of each species. Furthermore, it limits our understanding of the global and local epidemiological impact of some members of the KpSC. In this study, a rapid multiplex real-time PCR assay (KpSC-ID) was designed and developed to detect all KpSC members while simultaneously identifying the predominant human pathogens K. pneumoniae, K. quasipneumoniae and K. variicola. Assay performance was verified in silico using a panel of over 1,000 publicly available genome sequences and experimentally validated using a panel of genomic DNA extracted from 54 Enterobacteriaceae. The assay displayed excellent specificity against over 1,000 genome sequences tested in silico. During in vitro validation, the pan-KpSC assay detected each (29/29) KpSC species and strains tested. For the species-specific assays, 100% specificity was demonstrated in the K. pneumoniae, K. quasipneumoniae and K. variicola assays, respectively. Sensitivity of 10 genomic equivalents was demonstrated for each assay. Ultimately, the diagnostic assay developed in this study can improve our understanding of the significance of KpSC members, which is important when investigating their routes of transmission and epidemiology.We wish to acknowledge the College of Science and Engineering at University of Galway which has funded GMA’s postgraduate scholarship. This work was supported financially by the MedVetKlebs project from the European Joint Programme One Health, which has received funding from the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement no. 773830.peer-reviewe