11237 research outputs found
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Obstetric management for pregnant women with Klippel–Trenaunay syndrome: a UK case report and review of the literature
No full textKlippel–Trenaunay Syndrome (KTS) is a rare congenital vascular disorder characterized by extensive capillary and venous malformations that pose unique challenges during pregnancy. This case report discusses the successful management of a 34‐year‐old pregnant woman with KTS who had two caesarean sections, resulting in the birth of two healthy babies. Despite the lack of evidence‐based guidelines for obstetrical management in KTS, a multidisciplinary team collaborated to devise a high‐risk thrombosis management plan, involving the use of compression stocking and low molecular weight heparin prophylaxis. The patient's elevated risk of thrombosis, exacerbated during pregnancy, informed the decision of caesarean sections, aligning with finding that in most KTS pregnancies, this method of delivery based on obstetric indications and arteriovenous malformations is chosen. This case highlights the importance of systematic and patient‐centered care, advocating for comprehensive obstetric management guidelines to address the unique challenges posed by KTS during pregnancy. Further research is warranted to enhance our understanding and refine guidelines for individuals with vascular abnormalities linked to KTS.</p
Exploring motivators for trust in the dichotomy of human—AI trust dynamics
No full textThis study analyses the dimensions of trust in artificial intelligence (AI), focusing on why a significant portion of the UK population demonstrates a higher level of trust in AI compared to humans. Conducted through a mixed-methods approach, this study gathered 894 responses, with 451 meeting the criteria for analysis. It utilised a combination of a six-step Likert-scale survey and open-ended questions to explore the psychological, sociocultural, and technological facets of trust. The analysis was underpinned by structural equation modelling (SEM) and correlation techniques. The results unveil a strong predilection for trusting AI, mainly due to its perceived impartiality and accuracy, which participants likened to conventional computing systems. This preference starkly contrasts with the scepticism towards human reliability, which is influenced by the perception of inherent self-interest and dishonesty in humans, further exacerbated by a general distrust in media narratives. Additionally, this study highlights a significant correlation between distrust in AI and an unwavering confidence in human judgment, illustrating a dichotomy in trust orientations. This investigation illuminates the complex dynamics of trust in the era of digital technology, making a significant contribution to the ongoing discourse on AI’s societal integration and underscoring vital considerations for future AI development and policymaking
Unravelling the complexities of biotic homogenization and heterogenization in the British avifauna
No full textBiotic homogenization is a process whereby species assemblages become more similar through time. The standard way of identifying the process of biotic homogenization is to look for decreases in spatial beta–diversity. However, using a single assemblage‐level metric to assess homogenization can mask important changes in the occupancy patterns of individual species. Here, we analysed changes in the spatial beta–diversity patterns (i.e. biotic heterogenization or homogenization) of British bird assemblages within 30 km × 30 km regions between two periods (1988–1991 and 2008–2011). We partitioned the change in spatial beta–diversity into extirpation and colonization‐resultant change (i.e. change in spatial beta–diversity within each region resulting from both extirpation and colonization). We used measures of abiotic change in combination with Bayesian modelling to disentangle the drivers of biotic heterogenization and homogenization. We detected both heterogenization and homogenization across the two time periods and three measures of diversity (taxonomic, phylogenetic, and functional). In addition, both extirpation and colonization contributed to the observed changes, with heterogenization mainly driven by extirpation and homogenization by colonization. These assemblage‐level changes were primarily due to shifting occupancy patterns of generalist species. Compared to habitat generalists, habitat specialists had significantly (i) higher average contributions to colonization‐resultant change (indicating heterogenization within a region due to colonization) and (ii) lower average contributions to extirpation‐resultant change (indicating homogenization from extirpation). Generalists showed the opposite pattern. Increased extirpation‐resultant homogenization within regions was associated with increased urban land cover and decreased habitat diversity, precipitation, and temperature. Changes in extirpation‐resultant heterogenization and colonization‐resultant heterogenization were associated with differences in elevation between regions and changes in temperature and land cover. Many of the ‘winners’ (i.e. species that increased in occupancy) were species that had benefitted from conservation action (e.g. buzzard (Buteo buteo)). The ‘losers’ (i.e. those that decreased in occupancy) consisted primarily of previously common species, such as cuckoo (Cuculus canorus). Our results show that focusing purely on changes in spatial beta–diversity over time may obscure important information about how changes in the occupancy patterns of individual species contribute to homogenization and heterogenization.</p
Si-P-Cu internally bonded anode: An innovative strategy for low-cost and high-performance pseudocapacitive Li-ion storage
No full textMaintaining the structural integrity of silicon and phosphorus anodes during the Li+ insertion and extraction cycles poses a significant challenge. Inspired by the natural process of plant roots anchoring into soil, we present a simple yet effective method for integrating a Sisingle bondP anode into the copper current collector. This approach involves subjecting readily available and cost-effective micrometre-sized silicon particles (50–150 μm) and red phosphorus to mechanochemical treatment. Subsequently, the resulting Si/P composite is coated onto copper foil and subjected to annealing treatment, resulting in the formation of an integrated structure, incorporating Cu3Si, Cu3P, and P-doped Si, firmly established within the copper current collector. The electrode obtained (BM-Si@P/Cu-350), promoted by a crosslinked (polyimide) PI binder, outperforms not only the ball-milled Si and red P but also the same electrode in which the annealing process is absent (BM-Si@P/Cu-100). During the mechanochemical treatment, red P acts as both the doping agent and a lubricant, facilitating the grinding of the Si particles into P-doped Si particles in the range of predominantly 200–300 nm; while during the thermal treatment, Si plays a key role in preventing excessive interaction between the P and the Cu current collector. Instead, a tailored rooting of the active material into the current collector is achieved through the formation of Cu3P and Cu3Si phases, not only increasing the mechanical stability of the electrode to endure volume changes during cycling and limit developing cracks, but also enhancing the electrical conductivity of the system. This article suggests a simple and potentially low-cost strategy for the utilization of highly available micrometre-sized silicon and red-P for Li-ion storage applications.</p
Social capital and the care and support of older people in Ghana: understanding perceptions and attitudes
No full textGhana, like many sub-Saharan African countries, struggles with population ageing, but this is often under-reported, thereby marginalising the concerns of older people in major social, national, and economic debates. Traditionally, older people's care has been primarily entrusted to the extended family, reflecting and fostering collectivism and communalism. However, trends suggest that the traditional extended family system is declining and is no longer capable of sustaining older people’s care due to multiple interrelated and complex socio-economic and cultural factors, including structural social and economic changes, modernisation, urbanisation, individualism, and growing adherence among youth to a nuclear family system.The study employed social capital as a lens to investigate the perception and attitudes of household members towards older people's care in Cape Coast, Ghana, using mixed methods. The study was guided by a pragmatist philosophical paradigm. Quantitative data was collected by a household survey using the Integrated Questionnaire for Measuring Social Capital (SC-IQ), and qualitatively through focus group discussion. The SC-IQ data on six proxy social capital variables were analysed through categorical principal component analysis (CATPCA). The focus group data was analysed thematically. The results were integrated for interpretation.The study revealed that while social capital remains high at the household level, it has evolved from traditional extended family systems to membership in groups and networks, such as welfare associations and religious groups. Despite the high level of social capital, this has not translated into improved care for older people. The study also found a mixed picture in terms of attitudes to the traditional care of older people. The results indicate a mismatch between what people say and do in practice. They also show Ghana poised at a juncture, in which the old system of care has broken down but an adequate new one, reflective of the continued influence of communal attitudes, has not yet emerged.</p
Reducing the gender digital divide amongst immigrant entrepreneurs
No full textInformation and communication technology (ICT) can boost existing socio-economic inequalities if the former is socially exclusive. Longstanding barriers prevent minoritized populations from accessing ICT, thus leading to a vicious circle between digital divide and poor development. The digital divide can be most important when assessing United Nations (UN) sustainable development goals No. 4 (lifelong learning opportunities), No. 5 (empowerment), No. 8 (growth), and No. 10 (reduced inequalities). The current study presents the outcomes of a business apps training intervention, targeting immigrant entrepreneurs running small firms in Greece, Cyprus and the UK. Multifaceted gender digital divides were unravelled, and training was found to improve entrepreneurs’ internet/digital skills and firms’ digital competencies, whilst also boosting empowerment and reducing gender digital disparities. Given the positive contribution of immigrant firms to countries’ growth, ways to facilitate sustainable performances through digital skills training merit consideration. Further, improving immigrant female entrepreneurs’ digital skills requires intersectional approaches that address a vector of socio-economic and cultural barriers, ensuring that ICT-driven sustainable development is much more inclusive.</p
The Amphibian Genomics Consortium: advancing genomic and genetic resources for amphibian research and conservation
No full textAmphibians represent a diverse group of tetrapods, marked by deep divergence times between their three systematic orders and families. Studying amphibian biology through the genomics lens increases our understanding of the features of this animal class and that of other terrestrial vertebrates. The need for amphibian genomic resources is more urgent than ever due to the increasing threats to this group. Amphibians are one of the most imperiled taxonomic groups, with approximately 41% of species threatened with extinction due to habitat loss, changes in land use patterns, disease, climate change, and their synergistic effects. Amphibian genomic resources have provided a better understanding of ontogenetic diversity, tissue regeneration, diverse life history and reproductive modes, anti-predator strategies, and resilience and adaptive responses. They also serve as essential models for studying broad genomic traits, such as evolutionary genome expansions and contractions, as they exhibit the widest range
of genome sizes among all animal taxa and possess multiple mechanisms of genetic sex determination. Despite these features, genome sequencing of amphibians has significantly lagged behind that of other vertebrates, primarily due to the challenges of assembling their large, repeat-rich genomes and the relative lack of societal support. The emergence of long-read sequencing technologies, combined with advanced molecular and computational techniques that improve scaffolding and reduce computational workloads, is now making it possible to address some of these challenges. To promote and accelerate the production and use of amphibian genomics research through international coordination and collaboration, we launched the Amphibian Genomics Consortium (AGC, https:// mvs. unimelb. edu. au/ amphi bian-genom ics-conso rtium) in early 2023. This burgeoning community already has more than 282 members from 41 countries. The AGC aims to leverage the diverse capabilities of its members to advance genomic resources for amphibians and bridge the implementation gap between biologists, bioinformaticians, and conservation practitioners. Here we evaluate the state of the field of amphibian genomics, highlight previous studies, present
challenges to overcome, and call on the research and conservation communities to unite as part of the AGC to enable amphibian genomics research to “leap” to the next level
Extreme genetic depletion upon postglacial colonization hampers determining the provenance of introduced palmate newt populations
No full textAbstract
MtDNA barcoding is regularly applied to determine the provenance of invasive species. Variation in spatial genetic structuring across a species’ range, typically high within glacial refugia and low in postglacially colonized areas, influences the precision of this approach. The palmate newt (Lissotriton helveticus) has been introduced north of its native range inside the Netherlands. We conduct mtDNA barcoding to try and retrace the origin of the introduced localities. A large increase in sample size, particularly focusing on temperate Europe, emphasizes that the palmate newt shows practically no genetic variation outside the Iberian Peninsula glacial refugium. While we find a haplotype previously only known from the Iberian Peninsula inside the native range in Belgium, the haplotype present in the introduced Dutch populations occurs widely throughout the native range north of the Iberian Peninsula. Although mtDNA barcoding can be a powerful tool in invasion biology, the palmate newt case exposes its limitations.</p
Botensilimab plus balstilimab in relapsed/refractory microsatellite stable metastatic colorectal cancer: a phase 1 trial
No full textMicrosatellite stable metastatic colorectal cancer (MSS mCRC; mismatch repair proficient) has previously responded poorly to immune checkpoint blockade. Botensilimab (BOT) is an Fc-enhanced multifunctional anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) antibody designed to expand therapy to cold/poorly immunogenic solid tumors, such as MSS mCRC. BOT with or without balstilimab (BAL; anti-PD-1 antibody) is being evaluated in an ongoing expanded phase 1 study. The primary endpoint is safety and tolerability, which was evaluated separately in the dose-escalation portion of the study and in patients with MSS mCRC (using combined dose-escalation/dose-expansion data). Secondary endpoints include investigator-assessed RECIST version 1.1–confirmed objective response rate (ORR), disease control rate (DCR), duration of response (DOR) and progression-free survival (PFS). Here we present outcomes in 148 heavily pre-treated patients with MSS mCRC (six from the dose-escalation cohort; 142 from the dose-expansion cohort) treated with BOT and BAL, 101 of whom were considered response evaluable with at least 6 months of follow-up. Treatment-related adverse events (TRAEs) occurred in 89% of patients with MSS mCRC (131/148), most commonly fatigue (35%, 52/148), diarrhea (32%, 47/148) and pyrexia (24%, 36/148), with no grade 5 TRAEs reported and a 12% discontinuation rate due to a TRAE (18/148; data fully mature). In the response-evaluable population (n = 101), ORR was 17% (17/101; 95% confidence interval (CI), 10–26%), and DCR was 61% (62/101; 95% CI, 51–71%). Median DOR was not reached (NR; 95% CI, 5.7 months–NR), and median PFS was 3.5 months (95% CI, 2.7–4.1 months), at a median follow-up of 10.3 months (range, 0.5–42.6 months; data continuing to mature). The combination of BOT plus BAL demonstrated a manageable safety profile with no new immune-mediated safety signals and encouraging clinical activity with durable responses. ClinicalTrials.gov identifier: NCT03860272.</p
Serial Postoperative Circulating Tumor DNA Assessment Has Strong Prognostic Value During Long-Term Follow-Up in Patients With Breast Cancer
No full textPURPOSE Here, we report the sensitivity of a personalized, tumor-informed circulating tumor DNA (ctDNA) assay (Signatera) for detection of molecular relapse during long-term follow-up of patients with breast cancer. METHODS A total of 156 patients with primary breast cancer were monitored clinically for up to 12 years after surgery and adjuvant chemotherapy. Semiannual blood samples were prospectively collected, and analyzed retrospectively to detect residual disease by ultradeep sequencing using ctDNA assays, developed from primary tumor whole-exome sequencing data. RESULTS Personalized Signatera assays detected ctDNA ahead of clinical or radiologic relapse in 30 of the 34 patients who relapsed (patient-level sensitivity of 88.2%). Relapse was predicted with a lead interval of up to 38 months (median, 10.5 months; range, 0-38 months), and ctDNA positivity was associated with shorter relapse-free survival ( P < .0001) and overall survival ( P < .0001). All relapsing triple-negative patients (n = 7/23) had a ctDNA-positive test within a median of 8 months (range, 0-19 months), while the 16 nonrelapsed patients with triple-negative breast cancer remained ctDNA-negative during a median follow-up of 58 months (range, 8-99 months). The four patients who had negative tests before relapse all had hormone receptor–positive (HR+) disease and conversely, five of the 122 nonrelapsed patients (all HR+) had an occasional positive test. CONCLUSION Serial postoperative ctDNA assessment has strong prognostic value, provides a potential window for earlier therapeutic intervention, and may enable more effective monitoring than current clinical tests such as cancer antigen 15-3. Our study provides evidence that those with serially negative ctDNA tests have superior clinical outcomes, providing reassurance to patients with breast cancer. For select cases with HR+ disease, decisions about treatment management might require serial monitoring despite the ctDNA-positive result.</p
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