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Ten Years On: A “Montgomery Blue-print” for Healthcare Professionals in the United Kingdom and Beyond
No full textExperiences of youth and caregivers waiting for mental health services in the UK: a qualitative study to inform policy and practice
Full text linkAbstract Long waitlists are the most commonly reported barrier to accessing mental health services in the UK and across Europe. Yet, we have almost no understanding of the lived experiences of waiting among youth and their caregivers. In this qualitative study, we conducted semi-structured interviews with a purposive sample of 20 youth (aged 11–17) and 15 caregivers from ten child and adolescent mental health services (CAMHS) sites geographically spread across England. We used reflexive thematic analysis to analyse the data. We generated four themes that characterised participants’ experiences of waiting: (1) decline in mental and physical health, (2) strain on family dynamics and wider relationships, (3) unclear processes and communication, and (4) perceived mismatch between need and support. We also generated four themes illustrating participants’ coping strategies while waiting: (1) using self-help and parenting resources, (2) engaging in hobbies, (3) relying on social support, and (4) seeking alternative services. There is an urgent need to shorten CAMHS wait times as our findings show the adverse impact of waiting on youth and their families, with mental health worsening not just due to time passing but as a direct result of being put on a waitlist. While youth on CAMHS waitlists make active efforts to manage their symptoms, limitations to these coping strategies suggest that improved information sharing and tailored interim support is needed to mitigate against mental health deterioration while waiting.</jats:p
Ultrafast High-Temperature Synthesis of Battery-Grade Graphite Through Energy-Effective Joule Heating: A Combined Experimental and Simulation Study
Full text linkEpoxy-oxylipins direct monocyte fate in inflammatory resolution in humans.
Full text linkThe role of cytochrome P450-derived epoxy-oxylipins and their metabolites in human inflammation and resolution is unknown. We report that epoxy-oxylipins are present in blood of healthy, male volunteers at baseline and following intradermal injection of UV-killed Escherichia coli, an experimental model of acute resolving inflammation. At the site of inflammation, cytochrome P450s and epoxide hydrolase (EH) isoforms, which catabolise oxylipins to corresponding diols, are differentially upregulated throughout the inflammatory response, as is the biosynthesis of epoxy-oxylipins. GSK2256294, a selective sEH inhibitor specifically elevates 12,13-EpOME and 14,15-EET. While inhibition of sEH hastens pain resolution, it has no effect on tissue heat, redness and swelling. GSK2256294, however, significantly reduces numbers of circulating intermediate monocytes that expand during inflammation. We find that 12,13-EpOME blocks the transition of classical to intermediate monocytes in a p38 MAPK-dependent manner, results that are recapitulated when blocking p38 MAPK in vitro and when administering the p38 MAPK inhibitor losmapimod in vivo to healthy volunteers. Furthermore, fewer intermediate monocytes are observed at the site of inflammation, accompanied by reduced tissue CD4 T cells. Hence, we have mapped the expression, activity and function of epoxy-oxylipins in human inflammation revealing new mechanisms of monocyte differentiation and resolution biology
Cardiac magnetic resonance characteristics and prognostic associations of hypertension-mediated left ventricular hypertrophy.
Full text linkAIMS: Hypertension-mediated left ventricular hypertrophy (LVH) phenotypes: normal left ventricle (LV), LV remodelling, eccentric and concentric LVH have been reported using cardiac magnetic resonance (CMR). Although previous smaller studies have explored associations of these phenotypes with select CMR metrics, large population-based longitudinal data comparing their clinical trajectories are lacking. This study aimed to evaluate CMR characteristics across hypertension-mediated LVH phenotypes and their associations with incident cardiovascular outcomes. METHODS AND RESULTS: In the UK Biobank imaging cohort, 24 463 hypertensives were categorized into LVH phenotypes using CMR. Logistic regression models explored the relationship between phenotypes, setting normal LV as the reference, and CMR parameters as exposures. Cox proportional hazard models evaluated associations with incident major adverse cardiovascular events (MACE) and separately heart failure over a median follow-up of 4.9 years. Among the participants, 23 206 had normal LV, 889 LV remodelling, 253 eccentric and 115 concentric LVH. Hypertensives with eccentric LVH had the most impaired LV function using ejection fraction and strain, and those with concentric LVH had the highest T1 values and maximal wall thickness. Hypertensives with eccentric LVH were associated with a 2.5 times higher rate of MACE (HR 2.5, CI: 1.7-3.8) and 9 times higher heart failure event rates (HR 9.0, CI: 5.7-14.2). Hypertensives with concentric LVH had 4.1 times higher heart failure events rates (HR 4.1, CI: 1.8-9.3), and no association with MACE. CONCLUSION: In this large population study, we found distinct differences in CMR characteristics between hypertension-mediated LVH phenotypes with eccentric and concentric LVH exhibiting the worst prognosis
The Difficulty of Thinking Perpetually of Oneself: Iris Murdoch’s Existentialism in French Exit
No full textESDR627 - Dissection of the molecular and cellular heterogeneity of dermal fibroblasts in skin fibrosis
No full textSpatiotemporal Interaction Analysis of Urban Human Mobility and Environmental Factors Based on Geospatial Big Data
No full textUnderstanding how active travel behaviour interacts with environmental conditions is critical for promoting healthy and equitable urban mobility. This thesis aims to investigate the spatiotemporal patterns of short-distance active travel, the dynamic levels and inequality of greenspace exposure (GE), and the behavioural response mechanisms to air pollution and meteorological conditions, using Beijing, China, as a case study. To achieve this, the research integrates dockless bike-sharing origin–destination data, environmental monitoring data and urban spatial datasets within a multi-method analytical framework combining spatiotemporal statistics, network analysis, panel regression and explainable machine learning. First, spatiotemporal and network analyses identify daily travel rhythms, spatial mobility structures and the role of bike-sharing in last-mile connectivity. Second, multi-scale panel regression models are employed to estimate the effects of air pollution and weather conditions on active travel behaviour at both city and community levels, revealing heterogeneous and activity-specific responses. Third, a dynamic, population-weighted GE model is applied to capture real-time exposure during travel, moving beyond static, residence-based assessments and enabling the quantification of exposure inequality using the Gini index. Finally, explainable machine learning methods (SHAP and partial dependence plots) are applied to uncover nonlinear and interaction effects between environmental factors, travel behaviour and GE. The results demonstrate that environmental factors, particularly ozone pollution and meteorological conditions, play a critical moderating role by reshaping travel behaviour and exposure patterns. The key contribution of this thesis lies in linking dynamic human mobility, environmental conditions and GE within a unified, interpretable framework, providing new empirical evidence for health-oriented urban planning and equitable greenspace provision
