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Intersectoral action to transform health equity for women and girls globally
Get PDFWorldwide, women and girls continue to face unfair barriers to equal access to education, jobs, and healthcare. These barriers profoundly affect their health and well-being. One of the most overlooked injustices is the gender health gap, which corresponds to the unfair differences in health outcomes between women and men. This gap exists because most medical research on women’s unique health needs is under-researched, underfunded, and ignored due to wider global political and social forces. To change this, we need a coordinated effort across society, not just reforming healthcare. Here we discuss key methods to achieve this: putting more women in leadership roles, especially in politics and healthcare, to help shape fair health policies; supporting women’s education and economic independence to establish equal positions in their society so they can advocate for their right to equitable healthcare; raising public awareness to build collective action and tailor research to women’s health needs that can help close the long-standing gender health gap; and building healthcare systems that work for women
Reality monitoring across disorders of reality:Systematic and narrative reviews of dissociation and psychosis
Get PDFReality monitoring is the ability to remember whether information was internally- or externally-generated and is often impaired in clinical populations. Though an altered sense of reality characterizes both dissociation and psychosis, no review has compared reality monitoring between them. This paper compares these fields to inform the relation between dissociation and psychosis and the role of reality monitoring in mental health. First, a systematic review identified four eligible high-quality papers (according to Kmet and Lee's Quantitative Checklist; n = 482) which measured dissociation directly and tested reality monitoring experimentally. Meta-analysis indicated a small significant negative association between reality monitoring and dissociation (Correlation = -0.013, [-0.22, -0.04]), implying reality monitoring impairment in dissociation. Papers were identified from inception to May 15, 2025 through searching Web of Science, Scopus, PsycINFO, PsycARTICLES, EMBASE, and MEDLINE. Next, a narrative review of psychosis and reality monitoring, covering pre-existing systematic reviews and original articles, indicated variation across the clinical spectrum. While clinical psychosis was robustly associated with impaired reality monitoring ability and externalising bias, results at non-clinical and sub-clinical levels were mixed. Finally, the reviews were compared to understand how reality monitoring and research practices vary across dissociation and psychosis. This indicated that both dissociation and psychosis are associated with impaired reality monitoring. Though this suggests a shared cognitive basis, no papers on dissociation included clinical presentations or bias towards internalising/externalising the item's source, meaning any comparison is incomplete. Future research should consider clinical dissociation, reality monitoring bias in dissociation, and compare dissociation and psychosis directly.</p
The elevate study – identifying innovative models of urgent care in rural coastal areas in England:A mixed methods study protocol
No full textIntroduction Urgent and emergency care (UEC) systems in England face unprecedented pressures, with record A&E attendances, persistent breaches of ambulance response targets, and poorer outcomes for time-sensitive conditions. National UEC recovery plans have introduced multiple innovations—such as Same Day Emergency Care, virtual wards, and specialty hubs— to expand capacity and improve patient flow. Rural coastal areas are particularly vulnerable to excessive demand due to higher levels of deprivation, older populations with complex health needs, seasonal surges that generate unpredictable demand, and challenges in attracting and retaining staff. Following the Chief Medical Officer’s 2021 Annual Report, funding research and developing bespoke solutions to manage UEC demand and address geographical disparities has been recognised as a national priority. The Elevate Study responds to this priority by identifying and evaluating innovative models of UEC in rural coastal communities in England.Methods and analysis The Elevate study is a 30-month, mixed-methods evaluation that comprises three interlinked work packages:1. National service mapping – Outlining provision of innovative models of UEC in rural coastal areas of England. This will be developed through document review and interviews with regional and national service leaders.2. Quantitative analysis – Quasi-experimental and longitudinal approaches will use NHS England’s Emergency Care Data Set and linked routine NHS datasets to evaluate the impact of UEC models on health and process outcomes. Standard and bespoke metrics will be developed and used to assess performance.3. Qualitative case studies – Up to 12 case studies of UEC models in rural coastal communities. Interviews with patients and staff and non-participant observation will explore how and why different UEC models influence patient experience, clinical outcomes, resource use, and the workforce.Findings will be integrated using the Consolidated Framework for Implementation Research (CFIR) to identify components of UEC models that are effective, scalable, and sensitive to local context.Ethics and disseminationEthical approval for qualitative components was granted by the North of Scotland Research Ethics Committee (25/NS/0099). Dissemination will include peer-reviewed publications, policy briefs, creative media, and community engagement activities to ensure findings are communicated inclusively and effectively to policymakers, health and social care practitioners and the public.Strengths and limitations· This study will provide evidence to ensure future national UEC directives are informed by solutions that are designed to address local needs and reduce geographical inequalities.· The mixed-methods design will provide a comprehensive assessment of which innovative models of care are likely to be most effective at reducing UEC demand in rural coastal areas to maximise performance, reduce workforce pressures and improve patient outcomes.· Reliance on external, routine datasets may limit completeness and timeliness of quantitative analysis.· Heterogeneity of local adaptations poses challenges for scalable policy change/development and comparative evaluation
Models of Care and Interventions to Improve Person-Centred Care for Older People in Long-Term Care Facilities:A Mixed Methods Systematic Review
Get PDFAimsTo critically appraise and synthesise the evidence about the effects and experiences of care models and interventions to improve person-centred care for older people in long-term care facilities.DesignA mixed methods systematic review, following the Joanna Briggs Institute guidance and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Data SourcesMEDLINE, PubMed, CINAHL, PsycINFO, Embase, Web of Science, Cochrane Library, and Thaijo were searched to identify relevant primary research published in English and Thai from January 2000 to February 2024.Review MethodsAll relevant primary research with quantitative, qualitative, and mixed methods design was included. A convergent synthesis approach was used to synthesise and integrate findings.Results4070 records were identified, of which 30 studies were retained: 12 quantitative, nine qualitative, and nine mixed methods studies. The evidence revealed five themes: (1) personalised preference, social engagement, and well-being; (2) autonomy and dignity; (3) a home-like environment; (4) family involvement and satisfaction; and (5) organisational and staff support.ConclusionThis review indicated that person-centred care models and interventions could improve residents' quality of life, autonomy, and promote individual care provision, create an environment based on individual needs, and involve families in care, although challenges such as staff shortages and lack of managerial support may hinder successful implementation. Future work is required to evaluate and identify effective strategies to strengthen organisational support, including leadership development, staff retention, and resource allocation, and evaluate how organisational culture influences the adoption and success of person-centred care practices.ImpactThe review provides valuable insights and a comprehensive understanding of the care models and interventions specifically designed to improve person-centred care and enhance the quality of life for older people in long-term care facilities.Patient or Public ContributionNot applicable.Trial RegistrationThe protocol was registered with the PROSPERO (CRD42024509504)</div
The metabolic consequences of evoked spreading depolarization in brain slices
No full textSpreading depolarization is a wave of neuronal and glial depolarization that propagates through brain tissue, triggering neuropeptide release and altered blood flow. It has been observed in ischemic stroke, traumatic brain injury, subarachnoid haemorrhage, epilepsy, and migraine aura. Spreading depolarization imposes a high energetic demand, and recovery impaired under metabolic substrate deficiency. Despite its clinical relevance, metabolic responses remain poorly understood, limiting therapeutic progress. We investigated metabolic effects of spreading depolarisation using an ex vivo brain slice model, aiming to characterise changes in intracellular calcium signalling, mitochondrial function, and central carbon metabolism, and to assess the impact of glucose deprivation. We further tested whether coenzyme Q10 could improve recovery under metabolically compromised conditions. Spreading depolarization increased mitochondrial activity and shifted metabolism toward anaerobic respiration and glycolysis. Glucose deprivation impaired recovery, inducing mitochondrial dysfunction and accumulation intermediates indicative of tricarboxylic acid cycle stalling and disrupted central carbon metabolism. Supplementing glucose-deprived brain slices with coenzyme Q10 shortened spreading depolarization repolarization duration, indicating enhanced metabolic recovery. These findings demonstrate that spreading depolarization imposes a significant metabolic burden, particularly under glucose limitation, and that mitochondrial-targeted interventions such as coenzyme Q10 may enhance tissue resilience in neurological disorders
Observation of <sup>+</sup><sub></sub> →ℎ<sup>+</sup>ℎ<sup>−</sup> Decays
Get PDFSearches are presented for + →ℎ+ℎ− decays, where is a charmed meson and ℎ± is a charged pion or kaon, using collision data collected by the LHCb experiment corresponding to an integrated luminosity of 9 fb−1. The decays + →++−, + →*++−, and + →++− are observed for the first time. Their branching fractions, expressed as ratios relative to that of the + →0+ decay, are determined to be ℛ(+→++−) = (1.96 ± 0.23 ± 0.08 ± 0.10) × 10−3, ℛ(+→*++−) = 3.67 ± 0.55 ± 0.24 ± 0.20) × 10−3, ℛ(+→++−) = 1.61 ± 0.35 ± 0.13 ± 0.07) × 10−3, where the first uncertainty is statistical, the second is systematic, and the third is due to the limited precision on the -meson branching fractions. The decay channels proceed primarily through excited 0 or 0 resonances or mesons, and open a new avenue for studies of charge-parity violation in beauty mesons
Unveiling the Dynamics of Eye Movement Patterns in Second Language Reading:The Roles of L2 Proficiency and Exposure
No full textThis study investigates how second-language (L2) proficiency and exposure shape online reading behaviour in Chinese learners of English, using eye-tracking to capture moment-to-moment processing. Seventy-nine participants (39 Chinese L2 readers; 40 native English readers) read short English passages while their eye movements were recorded. We examined first fixation duration (FFD), gaze duration (GD), and total reading time (TRT), focusing on word length and frequency at the currently fixated word (N), the previous word (N−1), and the next word (N+1). Chinese participants were grouped through principal component analysis and k-means clustering on IELTS reading scores, vocabulary size, and months in the UK, representing proficiency and exposure, with reading order (Chinese-first vs English-first) controlled for familiarisation. Results showed that advanced learners and those with greater exposure displayed more native-like processing, with shorter fixations and reduced spill-over, while familiarisation through Chinese-first reading further enhanced efficiency. Findings highlight the complementary roles of proficiency, vocabulary, and exposure in shaping L2 reading fluency, with implications for TESOL pedagogy and assessment
Intensifying Drought Patterns and Agricultural Water Stress in Erbil Governorate, Iraq:A Spatiotemporal Climate Analysis
Get PDFDrought is a prolonged lack of rainfall that causes water shortages for agricultural land by reducing soil moisture and limiting crop yields. This study assesses the impacts of drought in Erbil, Iraq, using 28 years of data from the southern, central, and northern regions. A soil‐water‐balance framework integrates precipitation with reference evapotranspiration (ETo), crop evapotranspiration (ETc), and actual evapotranspiration measures to address seasonal water deficits. According to the Standardized Precipitation Index (SPI), the area experienced basin‐wide droughts in 1998–2000, 2007–2009, a renewed event in 2020–2021, and significant negative anomalies in 2024–2025. Analyzing drought frequency shows that “near‐normal” conditions are most common (around 57%–79%), with occasional moderate to extreme events. The study reveals that winter wheat undergoes severe stress, with ETc reaching 200–250 mm month during dry years and ETa dropping to 15–30 mm/month, resulting in June deficits of nearly 277 mm. It also notes high variation in annual precipitation, with coefficients of variation (CV) ranging from 26.1% to 51.7%. ARIMA (1,0,1) models suggest weak persistence and zone‐specific accuracy, with MAPE values of 37.8% in the south, 33.9% in the central region, and 28.8% in the north. The results underscore the importance of climate‐resilient water and agricultural planning
Possible regulation of <i>Arabidopsis </i>MYB93 by both SCARECROW and MPK3
No full textThe promoter of the Arabidopsis MYB93 (MYB93) transcription factor was previously identified in a large-scale screen using the SCARECROW (SCR) transcription factor. Independent high-throughput studies also identified MYB93 as a protein-interaction partner of the MAP kinase 3 (MPK3). Here, we validate and extend those observations using RT-PCR, yeast two-hybrid assays and phenotypic analysis. MYB93 transcript levels were elevated in the scr-3 mutant and reduced upon expression of SCR-GFP, indicating regulation by SCR. In yeast, the N-terminal domain of MYB93, but not the C-terminal region, interacted with MPK3. We also observed that mpk3-1 mutants exhibited a lateral root phenotype similar to myb93-1. Together, these findings support a model in which both MYB93 gene expression and MYB93 protein function are modulated by SCR and MPK3, respectively
Modulating speech tracking through brain state-dependent changes in audio loudness
Get PDFObjective. To determine whether the perceptual intensity of speech signals—manipulated via loudness and dynamically adjusted through a brain state-dependent stimulation (BSDS) paradigm—modulates neural speech tracking and short-term memory. Approach. We implemented an EEG brain state-dependent design in which real-time variations in alpha power were used to modulate the loudness of pre-recorded digits during a task modelled on the digit span test. Speech tracking was quantified using lagged Gaussian copula mutual information (2–10 Hz), and behavioural performance was assessed through recall accuracy. Main results. Contrary to our initial hypothesis that higher loudness would enhance speech tracking and memory via bottom–up attention, digit recall accuracy was stable across loudness conditions. Speech tracking revealed an unexpected pattern: louder stimuli presented during high alpha power (low attention) elicited reduced tracking magnitudes and shorter peak latencies, whereas quieter stimuli delivered during low alpha power (high attention) produced stronger and more temporally extended tracking responses. Significance. These findings may suggest that internal attentional state, rather than external stimulus salience, plays a dominant role in shaping speech encoding. The study provides proof-of-concept evidence for BSDS in auditory paradigms, showing the importance of attentional fluctuations and stimulus loudness in determining the strength and timing of neural speech tracking, with implications for the design of adaptive speech-enhancement strategies
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