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Air pollution in the shadow of global crises:lessons from a small city in the Western Balkans
Get PDFThis study investigates how energy disruption, stemming from COVID-19 pandemic impacts, geopolitical instability, and rapid energy transitions, shaped air quality outcomes in Kičevo, a small city in the understudied pollution landscape of the Western Balkans. The research analyses a five-year dataset from 2019 to 2023, encompassing the concentration of atmospheric pollutants (CO, NO2, O3, SO2, PM10, and PM2.5) and meteorological parameters, to elucidate the complex interactions between emission sources, meteorological conditions, and anthropogenic activities. The air quality data were deweathered using a machine learning method to isolate the effects of emission sources from meteorological influences. The findings reveal significant variations in pollutant concentrations, with notable anomalies observed in 2020 and 2022. These anomalies were primarily driven by elevated activities in both near and distant power plants in the area, corresponding to shifts in energy production and consumption linked to the COVID-19 crisis. Another contributing factor was the reopening of lignite power plants in neighbouring Greece, undertaken due to instability in renewable energy supply. Greece's strategy of rapidly transitioning to renewables and natural gas proved premature given the lack of adequate storage capacity, leading to a fallback reliance on fossil fuels as a backup plan. The study highlights the impact of socio-economic factors, particularly the substantial demographic declines due to emigration, on reduced emissions from local sources such as residential heating and transportation.</p
The Impact of Climate Change on Human Health and Pharmaceuticals
No full textClimate change and air pollution affect nearly every major organ system, altering both the presentation of disease and patient responses to pharmaceutical treatments. However, existing knowledge on how patients, healthcare professionals, and governments should prepare for these challenges is fragmented. Climate change contributes to premature mortality, increased morbidity, and exacerbation of pre‑existing conditions across cardiovascular, respiratory, renal, gastrointestinal, neurological, endocrine, and dermatological systems. Additional impacts include climate‑sensitive infectious diseases, mental health disorders, pregnancy complications, adverse in vitro fertilisation (IVF) outcomes, congenital anomalies, and climate‑induced drug toxicities.Emerging evidence shows that climate variables—particularly temperature and humidity—can directly affect medication stability, bioavailability, and pharmacokinetics. For example, elevated temperatures may degrade active pharmaceutical ingredients, while humidity can accelerate disintegration of hygroscopic tablets, increasing the risk of dose dumping and adverse events. Extreme weather events may also disrupt pharmaceutical supply chains, compounding risks to patient care.This review synthesises evidence to (i) identify diseases, populations, and medications most affected by climate change, and (ii) anticipate how pharmaceutical interventions will need to adapt. The findings highlight the urgent need for integrated research exploring the interplay between climate change, therapeutic response, and drug safety to support resilient, climate‑ready healthcare systems
What role do negative self-conscious emotions play in UK medicine? A systematic review and qualitative synthesis of the evidence
No full textNegative self-conscious emotions have long been theorised to play a role in medicine and this paper outlines a systematic review of empirical research that identifies qualitative data for shame, guilt, humiliation or embarrassment in doctors, patients, and students in the UK between 1979 and 2023. PubMed, PsycInfo, CINAHL plus, Web of Sciences and Medline were searched, and a total of 160 papers were identified. Only six papers set out to identify these emotions, while 154 papers had found such experiences while investigating other topics. A Framework Approach was used to create analytical themes from the information. This review provides the most comprehensive analysis of the evidence for negative self-conscious emotions in medicine to date, showing not just how it is experienced, but also how it contributes to adverse health outcomes, and compromises the quality of patient care. We demonstrate how patients experience negative self-conscious emotions as a result of feeling flawed, which can be exacerbated by insensitive treatment or a perception of judgment. Similarly, doctors can experience negative self-conscious emotions due to perceived failures in patient care or a sense of inadequacy in their role. Rather than seeing negative self-conscious emotions as products of personal circumstance or poor practice, however, our critical analysis argues that they need to be seen as inevitable experiences of the system and practice of medicine, which changes how we should understand and address these feelings in policy and practice
A Critical Comparison of Exposure Estimators for Airborne Particulate Matter in Urban Cyclists
Get PDFUrban cyclists experience elevated traffic-related air pollutant (TRAP) exposures due to proximity to emissions and increased breathing rates during exercise. Conventional assessments rely on concentration summaries, which may misrepresent actual inhaled doses and misclassify individuals in health studies. Street-level concentrations exhibit high temporal variability, producing non-normal distributions that challenge conventional averaging approaches. This study compares concentration- and dose-based methods to characterize cyclist exposure during urban commuting. Fifty-seven healthy adults completed cycling trips on two 9-km routes (high- and low-traffic) using conventional or electrically assisted bicycles. Real-time monitoring measured black carbon, ultrafine particles, PM2.5, and PM10. Heart rate-derived breathing rates enabled individualized inhaled dose calculations using three temporal integration methods. Mean concentrations correlated strongly with time-integrated concentrations (r = 0.988–0.998). Simplified dose calculations closely approximated full temporal integration (r > 0.999), with median dose ratios of 0.99–1.01. However, correlations between mean concentrations and inhaled doses were weaker (r = 0.72–0.78). Between 29% and 50% of participants changed exposure quartiles when comparing concentration- and dose-based classifications, with the highest reclassification for ultrafine particles (46–50%). These findings demonstrate that physiological variability substantially influences exposure classification during active commuting, supporting the integration of inhaled dose metrics in cyclist exposure assessment and epidemiological studies
A decade of solar high-fidelity spectroscopy and precise radial velocities from HARPS-N
Get PDFContext. The HARPS-N solar telescope has been observing the Sun every possible day since the summer of 2015. We have recently released 10 years of these data, which are available online.Aims. The goal of this paper is to present the different optimisations made to the ESPRESSO data reduction software used to extract the published HARPS-N solar spectra, describe the data curation, and perform some analyses that demonstrate the extreme radial velocity (RV) precision of those data.Methods. By analysing all of the HARPS-N wavelength solutions over 13 years, we brought to light instrumental systematics at the 1 m s−1 level. We mitigated those systematics by curating the thorium line list used to derive the wavelength solution and applying a correction to the drift of thorium lines induced by the aging of thorium-argon hollow cathode lamps. After optimisation, we demonstrated a peak-to-peak precision on the HARPS-N wavelength solution better than 0.75 m s−1 over 13 years. We then carefully curated the decade of HARPS-N re-reduced solar observations by rejecting 30% of the data affected either by clouds, bad atmospheric conditions, or well-understood instrumental systematics. Finally, we corrected the curated data for spurious sub-meter-per-second RV effects caused by erroneous instrumental drift measurements and by changes in the spectral blaze function over time.Results. After curation and correction, a total of 109,466 HARPS-N solar spectra and respective RVs over a decade were made available. The median photon-noise precision of the RV data is 0.28 m s−1, and on daily timescales, the median RV rms is 0.49 m s−1, which is similar to the level imposed by stellar granulation signals. On 10 year timescales, the large RV rms of 2.95 m s−1 results from the RV signature of the Sun’s magnetic cycle. Through modelling of this long-term effect using the Bremen composite magnesium II activity index, we demonstrate a long-term RV precision of 0.41 m s−1. We also analysed contemporaneous HARPS-N and NEID solar RVs and found the data from both instruments to be of similar quality and precision. However, an analysis of the RV difference between these two RV datasets over the three available years gave a surprisingly large RV rms of 1.3 m s−1. This variation is dominated by an unexplained trend that could be caused by a different sensitivity to stellar activity of the two datasets. Once this trend was modelled, the overall RV rms for three years reached 0.79 m s−1, and the RV rms during the low-activity phase decreased to 0.6 m s−1, compatible with what is expected from supergranulation.Conclusions. This decade of high-cadence HARPS-N solar observations with short- and long-term precision below one m s−1 represents a crucial dataset in the pursuit of further understanding the stellar activity signals in solar-type stars and advancing other science cases requiring such extreme precision
Association Between the Prognostic Nutritional Index and Outcomes in Patients Undergoing Emergency Laparotomy
Get PDFBackground: Nutritional status is a key determinant of surgical outcomes, but its assessment in emergency settings remains challenging. The prognostic nutritional index (PNI), which is derived from the serum ALB concentration and lymphocyte count, is a rapid, objective measure of nutritional and immune status. This study evaluated the associations between the PNI and postoperative outcomes in patients undergoing emergency laparotomy. Methods: A retrospective observational study was conducted at a single district general hospital in England, including adult patients who underwent emergency laparotomy between January 2019 and December 2023. The PNI was calculated as PNI = serum albumin (g/L) + 0.005 × total lymphocyte count (cells/μL). Patients were classified as malnourished (PNI < 50) or not malnourished (PNI ≥ 50). The outcomes assessed included postoperative complications, length of hospital stay (LOS), 30-day readmission, and three-year all-cause mortality. Statistical analyses included chi-square, Mann–Whitney U, logistic regression, and Kaplan–Meier survival analyses. Preoperative albumin and lymphocyte counts were obtained on admission or within 24 h prior to surgery to calculate the PNI. Results: Among 482 patients (median age 68 years; 57% male), 66% were malnourished. Malnutrition was significantly associated with higher ASA grade (p < 0.001), frailty (p = 0.028), and comorbidity burden (p < 0.001). Malnourished patients had longer LOSs (≥12 days; p < 0.001) and higher 30-day readmissions (p = 0.026). After adjustment for key confounders, low PNI remained independently associated with stoma formation and prolonged length of stay. After adjustment for ASA grade, frailty, comorbidity burden, hypotension, and sepsis, low PNI remained independently associated with stoma formation and prolonged length of stay. Kaplan–Meier analysis revealed reduced three-year survival in malnourished patients (log-rank p < 0.01). Conclusions: Malnutrition, as defined by a low PNI, is highly prevalent and associated with adverse postoperative outcomes in emergency laparotomy. PNI is a simple, objective, and clinically useful tool that should be incorporated into preoperative assessments to guide early nutritional optimization. However, albumin and lymphocyte counts may be influenced by acute inflammation and resuscitation in emergency presentations, and nutritional interventions were not captured in this retrospective dataset
Early Results from the Coma Legacy IFU Survey (CLIFS):Ram Pressure Induced Shocks and Ionization in Jellyfish Tails
Get PDFJellyfish galaxies, which exhibit tails of gas opposite to their direction of motion, are a galaxy population showcasing the most extreme effects of ram pressure stripping (RPS). We present the emission line properties of a preliminary sample of five jellyfish galaxies in the Coma cluster, observed with the WEAVE Large-IFU as part of the Coma Legacy IFU Survey (CLIFS). When complete, CLIFS will form a sample of 29 jellyfish galaxies in Coma, selected based on the presence of one-sided tails in the radio continuum, enabling a comprehensive picture of the effects of ram pressure on galaxies in the Coma cluster. We extract emission line properties and confirm consistency between disk fluxes measured from WEAVE and MaNGA for galaxies with overlapping disk coverage between surveys. Comparing resolved radio and H-based star formation rates, we find that, in contrast to the disk, the dominant source of tail emission is not star formation. We find evidence for diffuse ionized gas excited by RPS-driven shocks in the tails, as indicated by: (1) LINER-like tail emission with the [OI]/H BPT diagnostic; (2) enhanced [OII]/H ratios in the tails relative to the disks; and (3) similarly elevated emission line velocities and velocity dispersions in the tails with respect to the disks. These results demonstrate that ram-pressure-driven shocks dominate the ionized emission in jellyfish galaxy tails
Discovery of Dimer-Dependent Aminoacrylamide Molecular Glues for 14-3-3 Protein-Protein Interactions
Get PDFMolecular glues (MGs) offer a promising strategy for stabilizing protein-protein interactions (PPIs), particularly within the 14-3-3 protein family, which regulates diverse cellular processes and is implicated in many disease pathways. This study reports on the discovery of an aminoacrylamide MG (7) for 14-3-3 PPIs. Structure-activity relationship analysis using a fluorescence polarization (FP) assay revealed that both a basic amine and acrylamide moiety are essential for activity. However, further investigation using FP, mass spectrometry, and a thermal shift assay revealed that 7 has a cysteine-independent mode of action, distinguishing it from other covalent 14-3-3 MGs. Furthermore, its activity is reliant on 14-3-3 dimerization suggesting that it targets the 14-3-3 dimer interface. Aminoacrylamide 7 differentially affected interactions with ERα, LRRK2, and AHA2, suggesting that 14-3-3 dimerization plays an important role in 14-3-3 client recognition. These findings further validate the 14-3-3 dimer interface as a novel MG target and underscore the complexities of 14-3-3 molecular recognition and small-molecule modulation. </p
Wider systems for linear logic with fixed points:proof theory and complexity
No full textWe investigate infinitary wellfounded systems for linear logic with fixed points, with transfinite branching rules indexed by some closure ordinal α for fixed points. Our main result is that provability in the system for some computable ordinal α is complete for the ω^{α^ω} level of the hyperarithmetical hierarchy. To this end we first develop proof theoretic foundations, namely cut elimination and focussing results, to control both the upper and lower bound analysis. Our arguments employ a carefully calibrated notion of formula rank, calculating a tight bound on the height of the (cut-free) proof search space
Development of a conceptual model of BKV impacts on health-related quality of life in kidney transplant recipients:a qualitative study
Get PDFBackground: BK virus (BKV) is a common latent virus that can reactivate in kidney transplant recipients due to immunosuppressive therapy, potentially leading to graft dysfunction or loss. While clinical management of BKV is well studied, little is known about its broader impact on patients’ daily lives and well-being. No conceptual model currently exists to describe the health-related quality of life (HRQoL) impacts of BKV from the patient perspective. Methods: We conducted a qualitative study using semi-structured concept elicitation interviews with 12 adult kidney transplant recipients who had experienced BKV reactivation. Participants were recruited using purposive sampling to ensure diversity in demographics and clinical experiences. Interviews were transcribed and analyzed using thematic analysis with iterative coding, saturation tracking, and structured impact prioritization to develop a conceptual model of BKV-related HRQoL impacts. Results: Participants described a range of psychosocial and practical challenges associated with BKV, despite the virus often being asymptomatic. Key themes included emotional distress, fear of graft loss, confusion about treatment, disruption to work and daily routines, and increased burden of care coordination. Many participants reported feeling unprepared and unsupported, often needing to advocate for themselves within the healthcare system. These experiences were synthesized into a conceptual model illustrating the multidimensional impact of BKV on HRQoL. Conclusions: This study presents the first patient-informed conceptual model of BKV-related HRQoL impacts in kidney transplant recipients. Findings highlight the need for improved patient education, communication, and support strategies. The model provides a foundation for future development of patient-reported outcome measures and interventions that address the unique burdens of BKV in transplant care
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