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Constraints on coasting cosmological models from gravitational-wave standard sirens
Get PDFAbstract not available
Serum magnesium and outcomes in heart failure with reduced ejection fraction: the GALACTIC-HF trial
No full textBackground and Aims:
The frequency and prognostic significance of abnormalities in serum magnesium concentrations have not been described in a contemporary heart failure (HF) population. The authors evaluated the prognostic significance of magnesium concentrations in patients with HF with reduced ejection fraction (HFrEF) enrolled in GALACTIC-HF trial.
Methods:
GALACTIC-HF was a randomized, double-blind, multicentre, event-driven trial that investigated the efficacy and safety of omecamtiv mecarbil compared with placebo in HF patients with left ventricular ejection fraction ≤ 35%. The primary outcome was the composite of a first worsening HF event or cardiovascular death.
Results:
A total of 6147 outpatients had baseline serum magnesium data. Of these, 1082 (17.6%) had magnesium concentrations below .75 mmol/L, 4410 (71.7%) had concentrations within the normal range, and 655 (10.7%) had concentrations above .95 mmol/L. The incidence rate (per 100 person-years) for the primary composite outcome was highest in patients with hypermagnesaemia (34.9, 95% confidence interval 31.2–39.0), while rates were similar between those with hypomagnesaemia (21.5, 19.4–23.8), and normal magnesium (20.9, 19.9–22.0). Similar trends were observed for the components of the primary outcome and all-cause death. The incidence rate of sudden death and ventricular tachyarrhythmia did not differ among the three magnesium groups, but the risk of death from worsening HF was highest in patients with hypermagnesaemia.
Conclusions:
In GALACTIC-HF, 10.7% of outpatients with HFrEF had hypermagnesaemia, which was associated with a higher risk of the primary outcome compared with normal magnesium concentrations. Abnormal magnesium levels were not associated with a higher risk of sudden death or ventricular tachyarrhythmias. These findings do not support routine correction of hypomagnesaemia
Impact of glucagon-like peptide-1 receptor agonists on knee arthroplasty outcomes
No full textPurpose: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for managing both obesity and diabetes mellitus, two major risk factors for adverse outcomes following total knee arthroplasty (TKA). Despite this, their potential role in pre-operative optimisation remains uncertain. The aim of this systematic review and meta-analysis was to assess whether the use of GLP-1 RAs is associated with improved post-operative outcomes in patients undergoing primary TKA.
Methods: A comprehensive literature search was conducted across MEDLINE, PubMed, Embase, and CENTRAL from inception to 1st June 2025. Eligible studies included adults (aged ≥ 18 years) undergoing primary TKA, comparing outcomes between GLP-1 RA users and non-users. Primary outcomes included surgical and medical complications. Secondary outcomes were hospital-related outcomes, including hospital readmissions and length of stay. Risk of bias and certainty of evidence were assessed using ROBINS-I and GRADE, respectively.
Results: Six retrospective cohort studies met the inclusion criteria which consisted of 20,074 GLP-1 RA users and 55,332 controls. Meta-analysis showed a statistically significant reduction in the odds of 90-day readmissions in comparison with control groups (OR 0.76, 95% CI 0.61–0.94; p = 0.01). No statistically significant associations were found for the remaining outcomes.
Conclusions: GLP-1 RA use was associated with reduced 90-day readmissions following TKA. However, significant heterogeneity limits the clinical applicability of these findings. Further prospective studies are warranted
The experience of body image in people with psychosis and psychotic-like experiences: a co-produced mixed methods systematic review and narrative synthesis
No full textPurpose:
Body image is a transdiagnostic construct that seems poorly understood in psychosis. Poor body image is associated with paranoia, which makes it a theoretically meaningful treatment target in psychosis. We systematically reviewed associations between body image and psychosis symptoms in both the ‘general’ population and people living with psychotic disorders, synthesised known correlates of negative body image in people living with psychotic disorders and performed a meta-synthesis to understand the lived experience of body image in people with psychosis.
Methods:
Ovid MEDLINE, OVID Embase, OVID APA PsycINFO, EBSCOhost Cinahl and the Cochrane Central Register of Controlled Trials were searched in January 2024. The methodological quality and risk of bias were assessed using the mixed-methods appraisal tool.
Results:
20,565 participants were included from 31 studies, of which 2127 (10.3%) were living with psychotic conditions, 18,294 from the general population, 129 people with other conditions being compared to psychosis (such as bipolar disorder) and 15 carers. There were 25 quantitative studies (24 cross-sectional, 1 prospective), 5 qualitative studies and 1 mixed-methods study. Cross-sectional evidence suggests associations between negative body image and psychotic symptoms, especially paranoia, as well as wider mental and physical health outcomes. Potential factors contributing to the persistence of poor body image include psychotic symptoms, worries about appearance-related judgements, negative self-concept, body ambivalence, appearance-related safety-seeking behaviours and traumatic memories.
Conclusions:
Negative body image is relevant to the lives of people with psychosis spectrum conditions. Recommendations to guide and improve future research are reported
Unravelling a new romance: why emigrants support radical right populists
Get PDFThere is mixed evidence regarding the extent to which emigrants support radical right populists in their home countries, and we also know very little about why that support happens. The present article seeks to address this puzzle and aims to explain why emigrants vote for radical right populist candidates and parties. Using semi-structured
interviews with Romanian emigrants after the 2024 presidential and parliamentary elections, it reveals that their support was driven by a protest vote against the mainstream parties that they felt had underperformed in government and failed to introduce reforms for a while, along with a quest for national identity and spirituality in uncertain times, and – to a significantly lower extent – mild sovereigntist and Eurosceptic attitudes. These findings add nuance to, and complement, the burgeoning literature on non-resident citizens’ electoral preferences
Unexpected intraoperative hypoxaemia in a healthy dog undergoing TPLO
No full textA period of hypoxaemia was unexpectedly detected in an otherwise healthy 10-yearold dog undergoing tibial plateau levelling osteotomy surgery. Hypoxaemia developed
approximately 10 minutes after the start of surgery. Simultaneously, the plane of
anaesthesia was persistently light. Lung compliance was subjectively poor. Among
other treatment attempts, an alveolar recruitment manoeuvre was performed, which
resolved the hypoxaemia, probably caused by atelectasis. Once normoxaemic, bradycardia ensued but resolved after administration of atropine. A variety of factors may
have promoted the presentation in this dog, including prolonged recumbency and a leak
around the endotracheal tube. The dog recovered without complications
One school-university partnership model – ten years on
Get PDFSchool experience is a critical element of initial teacher education
and school-university partnerships are central to the effectiveness
of school experience. At the time of writing, the University of
Glasgow has operated a Partnership Model of school experience
for over ten years. This paper describes the development and
evolution of our institution’s specific version of a partnership
model as observed by ten colleagues who undertook a range of
school and university-based roles within the model during the
initial decade. As researchers who have also assumed roles within
the partnership model in recent years, we utilised expert interviews
as a tool to capture the experiences of our colleagues and peers,
where participants were asked a range of open-ended questions.
The qualitative data sets were thematically analysed, with several
key themes emerging: relationships and communication, identity,
teacher learning, and challenges. Ten years on from the creation
and implementation of our Partnership Model, the reflections
gleaned from the participants of this study have highlighted the
benefits obtained and challenges faced in implementation as the
model continues to evolve
Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
Get PDFBackground: Timely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality estimates measured in counts, rates, and years of life lost (YLLs). GBD 2023 aimed to enhance our understanding of the relationship between age and cause of death by quantifying the probability of dying before age 70 years (70q0) and the mean age at death by cause and sex. This study enables comparisons of the impact of causes of death over time, offering a deeper understanding of how these causes affect global populations.
Methods: GBD 2023 produced estimates for 292 causes of death disaggregated by age-sex-location-year in 204 countries and territories and 660 subnational locations for each year from 1990 until 2023. We used a modelling tool developed for GBD, the Cause of Death Ensemble model (CODEm), to estimate cause-specific death rates for most causes. We computed YLLs as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. Probability of death was calculated as the chance of dying from a given cause in a specific age period, for a specific population. Mean age at death was calculated by first assigning the midpoint age of each age group for every death, followed by computing the mean of all midpoint ages across all deaths attributed to a given cause. We used GBD death estimates to calculate the observed mean age at death and to model the expected mean age across causes, sexes, years, and locations. The expected mean age reflects the expected mean age at death for individuals within a population, based on global mortality rates and the population’s age structure. Comparatively, the observed mean age represents the actual mean age at death, influenced by all factors unique to a location-specific population, including its age structure. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 250-draw distribution for each metric.
Findings: are reported as counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2023 include a correction for the misclassification of deaths due to COVID-19, updates to the method used to estimate COVID-19, and updates to the CODEm modelling framework. This analysis used 55 761 data sources, including vital registration and verbal autopsy data as well as data from surveys, censuses, surveillance systems, and cancer registries, among others. For GBD 2023, there were 312 new country-years of vital registration cause-of-death data, 3 country-years of surveillance data, 51 country-years of verbal autopsy data, and 144 country-years of other data types that were added to those used in previous GBD rounds. Findings The initial years of the COVID-19 pandemic caused shifts in long-standing rankings of the leading causes of global deaths: it ranked as the number one age-standardised cause of death at Level 3 of the GBD cause classification hierarchy in 2021. By 2023, COVID-19 dropped to the 20th place among the leading global causes, returning the rankings of the leading two causes to those typical across the time series (ie, ischaemic heart disease and stroke). While ischaemic heart disease and stroke persist as leading causes of death, there has been progress in reducing their age-standardised mortality rates globally. Four other leading causes have also shown large declines in global agestandardised mortality rates across the study period: diarrhoeal diseases, tuberculosis, stomach cancer, and measles. Other causes of death showed disparate patterns between sexes, notably for deaths from conflict and terrorism in some locations. A large reduction in age-standardised rates of YLLs occurred for neonatal disorders. Despite this, neonatal disorders remained the leading cause of global YLLs over the period studied, except in 2021, when COVID-19 was temporarily the leading cause. Compared to 1990, there has been a considerable reduction in total YLLs in many vaccine-preventable diseases, most notably diphtheria, pertussis, tetanus, and measles. In addition, this study quantified the mean age at death for all-cause mortality and cause-specific mortality and found noticeable variation by sex and location. The global all-cause mean age at death increased from 46·8 years (95% UI 46·6–47·0) in 1990 to 63·4 years (63·1–63·7) in 2023. For males, mean age increased from 45·4 years (45·1–45·7) to 61·2 years (60·7–61·6), and for females it increased from 48·5 years (48·1–48·8) to 65·9 years (65·5–66·3), from 1990 to 2023. The highest all-cause mean age at death in 2023 was found in the high-income super-region, where the mean age for females reached 80·9 years (80·9–81·0) and for males 74·8 years (74·8–74·9). By comparison, the lowest all-cause mean age at death occurred in sub-Saharan Africa, where it was 38·0 years (37·5–38·4) for females and 35·6 years (35·2–35·9) for males in 2023. Lastly, our study found that all-cause 70q0 decreased across each GBD super-region and region from 2000 to 2023, although with large variability between them. For females, we found that 70q0 notably increased from drug use disorders and conflict and terrorism. Leading causes that increased 70q0 for males also included drug use disorders, as well as diabetes. In sub-Saharan Africa, there was an increase in 70q0 for many non-communicable diseases (NCDs). Additionally, the mean age at death from NCDs was lower than the expected mean age at death for this super-region. By comparison, there was an increase in 70q0 for drug use disorders in the high-income superregion, which also had an observed mean age at death lower than the expected value.
Interpretation: We examined global mortality patterns over the past three decades, highlighting—with enhanced estimation methods—the impacts of major events such as the COVID-19 pandemic, in addition to broader trends such as increasing NCDs in low-income regions that reflect ongoing shifts in the global epidemiological transition. This study also delves into premature mortality patterns, exploring the interplay between age and causes of death and deepening our understanding of where targeted resources could be applied to further reduce preventable sources of mortality. We provide essential insights into global and regional health disparities, identifying locations in need of targeted interventions to address both communicable and non-communicable diseases. There is an ever-present need for strengthened health-care systems that are resilient to future pandemics and the shifting burden of disease, particularly among ageing populations in regions with high mortality rates. Robust estimates of causes of death are increasingly essential to inform health priorities and guide efforts toward achieving global health equity. The need for global collaboration to reduce preventable mortality is more important than ever, as shifting burdens of disease are affecting all nations, albeit at different paces and scales
Landlords’ and tenants’ pathways into renting: the case of Romania
Get PDFTaking the case of the emerging private rental sector in the world’s
top homeownership society, the paper proposes two theoretical
expansions of broader interest to international housing studies. First,
by drawing on insights from visual-elicitation, life-history interviews, I
return the housing pathway framework to its original social-constructivist
cast in order to expand beyond occupants’ tenure-applications to a
broader, more dynamic perspective of pathways into renting of both
tenants and landlords. Second, by showing how landlords and tenants
became to rent one or several homes, the paper offers an empiricallygrounded reading of rental housing as a service infrastructure of being
and becoming along life-projects of personal/family welfare, social
reproduction/mobility, identity searching and geographical explorations. Describing a social world in which extractivist relations are marginal, the paper unravels some of the diverse economies of renting in
which ways of being and becoming are enmeshed in the long-term
concerns of creating a safe future through education, employment,
ownership and social embeddedness
Exploration of factors that affect engagement with the Experience Sampling Method and servie users' experience of this within the AVATAR2 trial: mixed methods study
No full textBackground:
Experience sampling methodology (ESM) is an assessment method used in psychosis research. Symptom severity and gender may be associated with ESM engagement. Exploring qualitative experiences of using ESM among people with psychosis should aid developing more relevant, accessible digital assessments.
Objective:
This study aimed to examine factors that could affect engagement with ESM, such as associations of completion rates with age, ethnicity, gender, and clinical severity. It also aimed to explore qualitatively service users’ experiences of using this data collection method.
Methods:
Data from 134/207 AVATAR2 trial (ISRCTN55682735) participants were used to evaluate associations between demographic variables, symptom severity, and ESM completion rates. Trial participants were purposively sampled to participate in an interview to discuss their experiences of using ESM or to discuss reasons why they chose not to use it.
Results:
Multiple regression analyses of 134 participants found that age, gender, ethnicity, and clinical severity were not associated with ESM completion rates (F5,128=0.548; P=.74). A thematic analysis of 17 participant interviews found 3 overarching themes: Factors affecting engagement with ESM, Perceived benefits of ESM, and Suggestions for improvement. These themes described how ESM has multiple benefits for people with psychosis, including increasing knowledge and awareness of mental health. ESM was straightforward and easy to use; however, engaging in other activities, experiencing positive symptoms, little experience using technology, and trial involvement impacted engagement. Participant’s decision to use ESM could be influenced by concerns about security and privacy.
Conclusions:
Recommendations are made on how engagement with ESM can be improved, making it easier to use this method with this population, including providing increased support or training when using digital-based assessment or intervention as well as providing information on how digital data are used and recorded
Data sources:
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