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MAGGIC risk score and drug-related adverse events of sacubitril/valsartan: Insights from the REVIEW-HF registry
Get PDFAlthough the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score is a validated mortality risk tool in heart failure (HF), its utility in assessing drug-related adverse events (DAEs) associated with sacubitril/valsartan initiation remains unclear. This study evaluated the association between the MAGGIC risk score and DAEs related to sacubitril/valsartan initiation in a Japanese multicenter cohort. We analyzed 787 patients with HF initiated on sacubitril/valsartan 100 mg/day between August 2020 and August 2021. Patients were stratified into tertiles based on MAGGIC risk scores. The primary outcome was DAEs within 90 days of initiation, defined as hypotension, hyperkalemia, renal events, or angioedema. Secondary outcomes included drug discontinuation and clinical outcomes. DAEs occurred in 22.7 % patients. Higher MAGGIC risk scores were significantly associated with increased DAEs (adjusted odds ratio [OR] for highest vs. lowest tertile: 2.64, 95 % confidence interval [CI]: 1.66-4.25, p for trend < 0.001) and sacubitril/valsartan discontinuation (21.3 % of patients; adjusted OR for highest vs. lowest tertile: 2.68, 95 % CI: 1.69-4.32, p for trend < 0.001). Time-dependent Cox proportional hazard analyses revealed that the association between DAEs and clinical outcomes varied across the MAGGIC risk score tertiles, with significant interactions between the composite outcome and hospitalization for HF, particularly in lower-risk groups. The MAGGIC risk score was associated with DAEs risk following sacubitril/valsartan initiation in patients with HF. The impact of DAEs on outcomes varied across risk tertiles, suggesting potential utility for risk stratification and monitoring approaches in HF management
Visualizing strongly focused 3D light fields in an atomic vapor
No full textStructured light, when strongly focused, generates highly confined vectorial electromagnetic field distributions, which may feature a polarization component along the optical axis. Manipulating and detecting such 3D light fields is challenging, as conventional optical elements and detectors do not interact with the axial polarization component. Vector light can, however, be mapped onto atomic polarizations, making electric dipole transitions an ideal candidate to sense such 3D light configurations. Working in the hyperfine Paschen–Back regime, where the electric dipole transitions are spectrally resolved, we demonstrate direct evidence of the axial polarization component of strongly focused radial light. We investigate the influence of various input polarization states, including radial, azimuthal, and higher-order optical vortices, on atomic absorption profiles. Our results confirm a clear mapping between the 3D vector light and the atomic transition strength. This work provides insights into vectorial light–matter interaction and opens avenues for quantum sensing applications
Binary barriers: representing trans and gender diverse populations in censuses and other population surveys
No full textThe first edition of this handbook discussed the demographic representation of transgender populations, focusing on the US. Now, over a decade later, this chapter looks at the representation of trans people in UK population surveys. The 2021/2022 UK censuses represented significant steps forward in the production of population estimates of LGBTI+ people. However, this progress has been hampered by unprecedented controversy, linked to the UK’s climate of transphobia. This chapter summarises these controversies, recognising trans data representation as one factor within the larger discourse surrounding the existence of trans people and fulfilling trans rights. It highlights that, despite being world leading in its representation of LGBTI+ people the latest UK censuses still feature major design limitations and don’t inherently produce positive outcomes for LGBTI+ people. Online focus groups and an online survey of 347 LGBTI+ people in the UK were utilised to identify potential solutions to these methodological design limitations. Showing that representing trans and gender diverse people in data will not hinder our understanding of gender inequality has been one of the approaches adopted by trans inclusive researchers. This chapter goes further by showing how more-inclusive survey methods are essential for gaining a useful understanding of sex and gender. By working with survey respondents, we can understand what makes them want to answer survey questions, enabling reliable and intricate presentations of populations
Psychedelics beyond medicine: treatment, enhancement, hype, consent, and the limits of medicalization
Get PDFThe current revival of interest in classic psychedelics and other psychoactives such as ketamine MDMA, coupled with changes to their regulatory status in many jurisdictions, necessitates rigorous ethical guidelines both within and beyond clinical and scientific contexts. This paper examines crucial ethical, philosophical, and policy considerations needed to ensure psychedelic use across various settings remains equitable, beneficial, consensual, and safe, with appropriate accountability mechanisms for addressing potential harms. We seek to broaden the lens beyond the medical model of psychedelics to include potentially valuable non-medical applications that could benefit individuals, communities, and society. With popular interest in psychedelics growing outside of therapeutic and research settings, there is a need to determine which aspects of any proffered guidelines, or underlying principles, should be applied similarly across contexts and in what ways there should be flexibility and/or context-sensitivity in their interpretation or application. In developing such guidelines, we suggest the “treatment versus enhancement” distinction—and associated debates familiar from bioethics and philosophy of medicine—requires renewed attention. We argue that neglecting non-medical and broad scientific use cases for psychedelics may have important implications for a range of ethical issues surrounding psychedelic use and research, including concerns about psychedelic hype and exceptionalism (both positive and negative), therapeutic touch, informed consent, data-gathering, and balancing access and safety. We conclude with suggestions for future directions in research and policy in the burgeoning area of psychedelic bioethics, stressing the importance of incorporating the perspectives of a diversity of stakeholders and fostering cross-sector collaboration
Letter to the editor of the Brit J Clin Pharmacol on Hartjes et al. 2025 https://doi.org/10.1002/bcp.70176
No full textNo abstract available
Digital conditionality: universal credit and its implications for social citizenship
No full textThe introduction of Universal Credit was a landmark reform to the UK’s benefit system replacing six former benefits with one comprehensive payment. The ‘digital by default’ policy was a core aspect of Universal Credit’s (UC) aim to create an efficient, streamlined and cost-effective system for administering welfare by ensuring the vast majority of claims are managed online. UC revolves around the use of a connected digital device, which relies on a range of linguistic and digital skills. Digital capability is a central condition of accessing benefits, with significant consequences for those excluded. By utilising 12 semi-structured interviews with a range of welfare and benefits advisors, this paper explores how the digital interface of UC has both enhanced and undermined the ability of claimants to access and realise their social rights. The digital by default policy has prompted new forms of interdependent social citizenship by engendering the online-enabled device as a locus of power in the claims process. These findings have implications for the way in which people claiming UC experience agency and control in the digital system, as individuals and members of families and communities
Modulatory effects of Boletus edulis on the gut microbiota in Atlantic salmon (Salmo salar) utilizing an artificial teleost gut model
No full textBackground:
In aquaculture, several functional mushrooms have been efficiently used as prebiotics, impacting gut microbiota, increasing growth, and delivering antioxidant advantages to a variety of finfish species. However, the potential of Boletus edulis, the ‘porcini’ or ‘penny bun’ to influence the gut microbiota of Salmo salar has yet to be studied. Here, we investigated the prebiotic effect of Boletus edulis extract (BEE) on the gut microbiota of farmed Atlantic salmon via an in vitro gut model (SalmoSim).
Results:
Notable changes in the production of short-chain fatty acids and microbial diversity were observed upon the addition of BEE. In particular, increased fiber fermentation was suggested by the decreasing concentrations of ammonia and increasing levels of acetate and propionate. Moreover, the 10% BEE improved the absorption of amino acids and increased the digestibility of crude protein, promoting a more diverse microbial community and reducing the accumulation of nitrogenous waste.
Conclusions:
The results of the present study revealed that the addition of BEE efficiently altered the gut microbiota, increasing microbial diversity, supporting beneficial short-chain fatty acid synthesis, and improving nutritional absorption in Atlantic salmon
First measurement of near-threshold and subthreshold <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline"><mml:mrow><mml:mi>J</mml:mi><mml:mo>/</mml:mo><mml:mi>ψ</mml:mi></mml:mrow></mml:math> photoproduction off nuclei
No full textWe report on the first measurement of J=ψ photoproduction from nuclei in the photon energy range of 7
to 10.8 GeV, extending above and below the photoproduction threshold in the free proton of ∼8.2 GeV.
The experiment used a tagged photon beam incident on deuterium, helium, and carbon, and the GlueX
detector at Jefferson Lab to measure the semi-inclusive A(γ,
𝑒⁺ 𝑒⁻ p) reaction with a dilepton invariant mass
M (𝑒⁺ 𝑒⁻) ~ mⱼ₌ψ = ¼ 3.1 GeV. The incoherent J=ψ photoproduction cross sections in the measured nuclei
are extracted as a function of the incident photon energy, momentum transfer, and proton-reconstructed
missing light-cone momentum fraction. Comparisons with theoretical predictions assuming a dipole form factor allow for extracting a gluonic radius for bound protons of √〈r²〉 = 0.85 ± 0.14 fm. The data also
suggest an excess of the measured cross section for subthreshold production and for interactions with high
missing light-cone momentum fraction protons. The measured enhancement can be explained by modified
gluon structure for high-virtuality bound protons
Segregation: what is in a name? A review of segregation measurement and a prospective framework
Get PDFPrevious studies have attempted to define segregation succinctly but have not reached a consensus. Adding to the unsettled debates was the shift from using place-based to person-based data in segregation studies. Deduced from the literature, the meanings of segregation may be summarized by the two essences of measuring the distribution of and interaction among different population groups, and measures may be characterized by four elements of segregation: dimensions, spatial extent, social extent, and data type. Besides showing a trend from using spatially aggregated place-based data to individual-level person-based data, a review of selected papers confirms the salience of distribution and interaction in measuring segregation and highlights the limitations of existing measures in capturing social interaction between population groups and the impacts of segregation, even in recent studies that utilize person-based data. Finally, we propose a segregation measurement framework to accommodate the increasingly hybrid physical-virtual world using person-based data with three components: distributions of different groups, interactions among groups, and inequality experienced by different groups due to the disparities in accessing resources and opportunities. This review paper charts directions for future studies using segregation measures
An acceptance-based guided self-help program for weight loss maintenance in adults who have previously completed a behavioral weight loss program: The SWiM feasibility study
Get PDFBackground:
Most weight lost during weight-loss programmes is eventually regained. Interventions based on Acceptance and Commitment Therapy (ACT) demonstrate good evidence for long-term weight loss, but are often costly and difficult to scale up. Guided self-help programmes delivered using technology and non-specialist coaches could increase scalability, but it is unclear whether delivering ACT-based interventions in this way is feasible and acceptable.
Methods:
In this feasibility study, 61 people who recently completed a behavioral weight management intervention (BWMI) for weight management were randomly allocated to SWiM (“Supporting Weight Management”: 4-month digital guided self-help ACT-based intervention for weight loss maintenance) or a standard care group (leaflet about maintaining weight loss) using a 2:1 allocation ratio. At baseline and 6 months, participants completed measures of weight, mental health, eating behavior, and other psychosocial variables. Participants completed an intervention evaluation questionnaire. At 3 and 6 months, qualitative interviews were conducted with participants from both trial arms and SWiM coaches. The analysis integrated statistics and thematic analysis, informed by the Medical Research Council (MRC) framework for process evaluations. Since this was a feasibility study, analyses focused on process outcomes instead of interpreting statistical significance.
Results:
Eighty-eight percent (36/41) of participants allocated to SWiM completed at least the first session and 22 (54%) completed all sessions. At 6 months, mean weight change was −2.2 (+/−6.4 SD) kg in SWiM participants and +2.2 (+/−6.6) kg in standard care participants. Descriptively, eating behavior and mental health scores improved in SWiM participants but not in standard care participants. In interviews, SWiM participants noted that they reinforced their existing knowledge while acquiring new skills and strategies, which were felt to contribute to positive behavioral changes.
Conclusion:
The SWiM intervention is practical and well-received, and shows promise in supporting weight loss maintenance, though evaluation in a larger trial is needed to assess effectiveness.
Trial Registration:
ISRCTN1268596
Data sources:
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