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Conjugated bilirubin in chronic liver disease: an underutilised prognostic biomarker?—a narrative review
Get PDFBackground and Objective: Chronic liver disease (CLD) is a major global health burden, often progressing to cirrhosis, decompensation, and hepatocellular carcinoma. Prognostic models typically rely on serum total bilirubin. However, recent evidence suggests that conjugated bilirubin (C-BIL) may offer superior prognostic utility in assessing disease severity and outcomes in CLD. This narrative review aims toexamine the emerging evidence supporting C-BIL as a prognostic and disease stratification biomarker across various clinical contexts, where it has demonstrated enhanced predictive accuracy over traditional measures.Methods: A comprehensive, non-systematic review of the published literature was undertaken using major bibliographic databases and predefined keywords. Relevant studies were selected based on the following criteria: English-language publications, studies conducted in human populations, and articles with clear clinical applicability. Emphasis was placed on studies evaluating C-BIL in prognostic or disease-stratification contexts within chronic liver disease.Key content and findings: Emerging evidence indicates that incorporation of C-BIL into clinical prognostic models may enhance risk stratification and support more informed clinical decision-making in CLD. Elevated C-BIL appears to reflect impaired hepatocellular excretory function and fibrosis-related biliary obstruction. In addition, recent studies suggest that hepatocyte senescence may represent an additional, biologically plausible mechanism underpinning its prognostic relevance.Conclusions: This review highlights the potential clinical utility of C-BIL as a prognostic biomarker in CLD. While existing evidence supports its role in disease stratification and outcome prediction, further prospective validation and mechanistic studies are required before C-BIL can be adopted as a standardcomponent of prognostic assessment in CLD
When Words Meet Visuals: How Content Composition Drives Social Media Engagement for Marketer-Generated Content
Get PDFHow does the balance between text and pictorial content in marketer-generated social media posts affect user engagement? The authors address this question by using computer vision and natural language processing tools to extract the visual and textual features of 34,610 organic brand posts from Facebook and Instagram. Using a confounding-and-cluster-robust causal forests model, they test how the balance of text and picture affects social media engagement across content and visual contexts. Results show that posts with greater emphasis on overlay text over pictorial content tend to have fewer likes and comments. However, the performance of text-oriented posts improves if text is more centered, informative, emotionally positive, and congruent with the pictorial content and if the picture contains fewer prominent objects or less information such as social cues. They quantify how incremental changes in such content composition affect social media engagement. These findings set forth evidence-based principles for optimizing text and picture balance in marketer-generated content and provide actionable guidelines on whether, where, when, and how to present text on an image. This research highlights the potential for transforming content and media creation from an imprecise art form into an empirical science nested within a data-driven visual optimization framework
Genetic subtypes associated with multiple sclerosis severity and response to treatment
Get PDFBackground Predicting response to treatment and long-term disability in multiple sclerosis (MS) remains challenging. In other complex diseases, combining genetic risk variants has enabled the detection of relevant clinical endophenotypes associated with important outcomes, but this strategy has never been applied to MS.Methods We applied unsupervised hierarchical clustering to genomic risk scores in a prospective Welsh MS cohort (n=1455) and replicated the findings in the postmortem Netherlands Brain Bank (NBB) MS (NBB-MS) cohort (n=272). Disease progression was assessed using survival analysis to determine the time to Expanded Disability Status Scale (EDSS) milestones.Results Three genomic clusters were identified, each with similar genetic profiles. Baseline demographics did not differ between clusters. Welsh patients in cluster 1 attained EDSS 6 and EDSS 8 significantly later than clusters 2 and 3 (by 6 years, p=3×10−3 and 13 years, p=0.02, respectively). These findings were replicated in the NBB-MS cohort (6-year delay to EDSS 6 for cluster 1 vs 2, p=0.04). Genomic clustering independently predicted disease progression (HRs 1.3–2.0, all p<0.05), beyond established risk factors. Clusters 2 and 3 showed a greater annual increase in T2 lesion load on serial MR imaging (p=0.04). In cluster 2, patients receiving disease-modifying treatments had delayed progression to EDSS 6 (p=3×10−³), while no such benefit was observed in clusters 1 or 3. Cluster 2 patients also had earlier onset of symptoms, including dysphagia (p=0.02) and spasticity (p=8×10−⁴) in the NBB-MS cohort.Conclusions Genetic clustering reveals clinically meaningful MS subtypes with distinct prognoses and treatment responses, highlighting its potential role in precision medicine for MS management
NETosis in ischemic stroke: Mechanisms, implications, and therapeutic prospects
Get PDFIschemic stroke remains a major global health burden, with secondary mechanisms of injury playing a critical role in initiation and progression of long-term neurological outcomes. Among these, the formation of neutrophil extracellular traps (NETosis) has gained significant traction as a key process that links innate immune activation with thrombotic and inflammatory damage in stroke. Shortly after the onset of cerebral ischemia, neutrophils rapidly infiltrate the affected tissue and undergo NETosis in response to Damage Associated Molecular Pattern (DAMPs) and inflammatory cues, releasing NET structures that interact with platelets, endothelial cells, and coagulation pathways. These NET components promote thrombus formation, enhance its structural stability, and confer resistance to fibrinolytic therapies, all while aggravating blood–brain barrier (BBB) breakdown, neuronal injury, and downstream neuroinflammatory cascades disturbing gut-brain axis and post stroke recovery.Clinical and pre-clinical investigations have shown that NET-related markers such as citrullinated histone H3, Myeloperoxidase (MPO)–DNA complexes, and circulating cell-free DNA are closely associated with stroke severity, infarct burden, and poorer clinical recovery, supporting their use as potential prognostic indicators. Experimental strategies aimed at inhibiting NET formation or accelerating its dissolution, including DNase-I administration, Peptidyl arginine deiminase 4 (PAD4) inhibition, and blockade of MPO activity, have demonstrated neuroprotective effects by reducing infarct size, preserving BBB function, and enhancing functional outcomes in animal models. Despite these encouraging findings, translating NET-targeted therapies into clinical practice remains complex due to the diversity of patient profiles and comorbidities that are weighing down translation efforts. This review highlights the central contribution of NETosis to stroke-related thrombosis, BBB disruption, and sustained inflammation, while emphasising the evolving potential of NET-focused interventions as future therapeutic tools in Ischemic stroke
Police Custody Arrest Reasons: Offence Category Reference Tool
No full textThis reference tool provides a standardised classification of arrest reason descriptions into offence categories, developed through analysis of electronic police custody record data from eight police forces in England and Wales. It is designed to support researchers, police forces, and other agencies working with police custody data to classify arrest reasons consistently and efficiently
“It’s very hard to feel accepted when a whole country screams that they don’t want you here”: Minorities’ Experiences of the UK 2024 Summer Riots
Get PDFResearch on civil unrest often centres on general populations, obscuring minority experiences. Understanding the experiences of marginalised groups becomes imperative when these periods are centred around marginalised identities, as with rising anti-immigration-based unrest. This qualitative study examines how ethnically and religiously minoritised adults in the United Kingdom experienced the Summer 2024 riots, a period marked by widespread anti-immigration sentiments, riots, and intergroup tensions. Twenty-one semi-structured interviews were transcribed and analysed using inductive, reflexive thematic analysis. Four themes captured participants' accounts. First, governing meaning and order: platforms, news, and local networks circulated warnings, rumours, and corrections that shaped expectations and behaviour. Second, living on alert: perceived threat prompted safety planning, curtailed mobility, and other micro-adaptations in daily routines. Third, legible bodies: visibility via phenotype, dress, and religious symbols patterned uneven exposure, while limited ‘passing’ afforded conditional protection. Fourth, conditional belonging: participants narrated ambivalence toward national symbols and calibrated when and how to express Britishness. Across interviews, respondents reported sustained emotional strain, cautious behavioural change, and identity work structured by recognition and visibility. Findings highlight how online and offline environments intertwine to organise everyday life during unrest and suggest implications for platform governance, community safety planning, and culturally responsive mental-health support
Telerehabilitation for early-stage Parkinson's disease: A randomized controlled feasibility trial of individualised real-time physiotherapy delivered via a videoconference platform
Get PDFIntroductionExercise can improve outcomes for people with Parkinson's. Telerehabilitation (TR) may lower costs and maximise clinician time but its efficacy for gait and balance in early Parkinson's is uncertain. We conducted a randomized controlled feasibility trial of individualised real-time physiotherapy delivered via videoconference.MethodsWe recruited people with early (<4 years’ duration) Parkinson's from 2 English NHS hospitals. The TR group had 1 × 60 min, 4 × 30 min video calls and 2 × 10 min calls. These calls occurred within 12 weeks of randomization. Experienced physiotherapists prescribed individualized exercises. The usual care group received standard exercise advice from their physician. Physical activity was measured using Fitbit Inspire. A qualitative process evaluation was undertaken.Results84 people were screened, 64 were eligible and 40 recruited. 21 and 19 were randomized to TR and usual care respectively. 90% of study instruments were completed per protocol.Median [interquartile range; IQR] change in Unified Parkinson's Disease Rating Scale (UPDRS) at six months was −3.5 [−8 to 2.5] for the TR group and 7 [0 to 17] for usual care, effect size (Cohen's D = −0.537). Median [IQR] change in weekly step count was 4215 [−8769 to 19664] for the TR group versus −2185 [−10764 to 3143] for usual care (Cohen's D = 0.198). Participants found the intervention acceptable. Most participants were confident in using the videoconference systems.ConclusionA definitive trial of TR for early Parkinson's is feasible. UPDRS and step count are suitable outcomes
Deteriorating leather bindings: an FTIR and SEM study
Get PDFDeteriorated leathers display greater spatial inhomogeneity of spectral features than undeteriorated leathers when examined non-destructively with attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy. A new ratio of peak heights was developed as a way of numerically categorising the level of deterioration that is applicable to whole leather-bound tomes or strips and scrapings. In addition, ATR-FTIR spectroscopy can be used to distinguish between types of tannins in leathers in a non-destructive way. This could impact on conservation methods and allow identification of the geographic origins of tannins used in the leather trade in the past centuries. Complementary scanning electron microscopy (SEM) analysis revealed for the first time that the characteristic red rot powder is made of short and thin collagen fibres. SEM analysis did not show the grain pattern that could identify the animal origin of a tome. Furthermore, the aspects of red rot deterioration observed with SEM, such as surface erosion, tangling of fibres, and loss of matrix cohesion, appeared very similar to non-red rot deterioration (hydrolysis, oxidation and gelatinisation). Both FTIR and SEM analysis showed that a thick top layer of dye can disguise signs of deterioration, but the fibres below this layer show expected deterioration
Gentrification Everywhere? Delinking Culture‐Led Regeneration From Gentrification
No full textThis paper challenges the prevalent use of “gentrification” (shishen hua [士紳化/仕紳化] or jinshen hua [縉紳化]) as a catch-all critique of culture-led regeneration and neighborhood transformations, including rent increases and shifts in aesthetic and tastes, in Sinophone Asia and beyond. To maintain the critical dimension of gentrification, defined by the displacement of existing poorer people by late-coming wealthier people, this paper argues for a conceptual delinking culture-led regeneration from gentrification by presenting two case studies from Taiwan. These cases demonstrate that new aesthetic-oriented, culture- and creativity-related businesses, rather than existing traditional businesses and residents, are often less resilient toward rent increases. Rather than “gentrification,” rent increases affect the future of heritage remaking and community building. By examining the influx of unregulated street vendors and arcade merchandisers, this paper illustrates how gentrification fails to address the problems regenerated neighborhoods face
Development and optimisation of influenza C and influenza D pseudotyped viruses
No full textTo facilitate the study of influenza C (ICV) and influenza D (IDV) viruses, we generated lentiviral pseudotyped viruses (PVs) expressing the hemagglutinin-esterase fusion (HEF) glycoprotein from ICV (C/Minnesota/33/2015) and IDV (D/Swine/Italy/199724-3/2015, D/Bovine/France/5920/2014, and D/Bovine/Ibaraki/7768/2016). The production of these PVs was optimised using different amount of human airway trypsin-like (HAT) protease to enhance HEF maturation, and the transduction efficiency was evaluated in multiple cell lines. Using these PVs, we established a pseudovirus-based microneutralisation (pMN) assay to measure neutralising antibody responses and adapted an esterase activity assay to evaluate PV. Specific antisera neutralised PVs but failed to inhibit esterase activity. These findings confirm that ICV and IDV PVs provide a scalable, sensitive, and safe tool for antiviral screening, and sero-epidemiological research
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