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Discordant real-world glycaemic outcomes with Omnipod™ 5 and MiniMed™ 780G in adults with type 1 diabetes:Why validated measures matter
Get PDFAutomated and continuous estimation of FAPAR from distributed wireless PAR sensor networks
Get PDFAccurate estimation of the fraction of absorbed photosynthetically active radiation (FAPAR) is crucial for understanding plant productivity and ecosystem dynamics. A number of indirect measurement techniques are used for estimating FAPAR with hand-held instruments, but researchers have identified discrepancies among different techniques when using them to validate satellite land products. Many researchers have also utilised photosynthetically active radiation (PAR) sensors to obtain quantitative measurements of PAR, but these lack robust measurement frameworks and protocols. Only very limited research has started on automated wireless PAR network systems to measure at finer temporal scales as well as to reduce human error and logistical costs. This study evaluates the performance of two flux (2f) and four flux (4f) FAPAR measurement systems and digital hemispherical photography (DHP) across multiple vegetation types (e.g., vineyard, broadleaf deciduous forest, savanna woodland) and different temporal scales (instantaneous and daily integrated). Results reveal strong agreement (R2 > 0.99, RMSE ≤ 0.04) between 2f- and 4f-FAPAR for all three study sites, with minimal overestimation (bias ≤ 0.04) by the 2f systems, suggesting that it can substitute, over similar environments, the more complex and costly 4f setup without substantially compromising accuracy. Daily integrated FAPAR exhibited greater stability and lower uncertainty compared to instantaneous FAPAR, underscoring its importance for long-term ecosystem monitoring. However, instantaneous FAPAR remains essential for satellite product validation due to its alignment with satellite overpass times. Additionally, 2f-FAPAR showed a good relationship with DHP-derived FAPAR. The findings highlight the potential of the 2f wireless PAR network as an automated, cost-effective, and reliable tool for canopy light absorption studies, offering substantial advantages for both ground-based ecosystem monitoring and remote sensing applications.</p
Immunophenotyping TCF1-expressing TILs:spatial profiling and prognostic value in operable non-small cell lung cancer
Get PDFBACKGROUND: The spatial distribution and functional heterogeneity of tumor-infiltrating lymphocytes (TILs) significantly impact patient outcomes in non-small cell lung cancer (NSCLC). While T cell factor 1 (TCF1) expressing TILs have emerged as key players in sustaining anti-tumor immunity, their subset characterization, localization, and clinical significance within the tumor microenvironment remain poorly defined.METHOD: We performed multiplex immunohistochemistry and immunofluorescence to characterize TCF1 + immune cell subsets, in 102 NSCLC tumors, separately analyzing the tumor center (TC) and invasive front (IF). We integrated this data with publicly available single-cell RNA-sequencing datasets and clinical outcome analyses. RESULTS: CD4 + T cells and CD79α + B cells, dominate the TCF1 + landscape, while CD8 + T cells constitute a minority of TCF1 + immune cells, particularly in the TC. We demonstrated the presence of tumor-infiltrating IgG +/IgA + plasma cells co-expressing TCF1. PD1 +TCF1 - cells were more frequent than PD1 +TCF1 + cells both in the TC and IF, reflecting that terminally differentiated exhausted TILs predominate within the tumor microenvironment. Survival analyses revealed significantly different prognostic impact of TILs including TCF1-expressing cells based on topography. Multivariate analysis showed that increased CD8 +TCF1 + cells (HR: 2.5; p=0.039) and increased TCF1 expression by cancer cells (HR: 2,7; p=0.041) in the TC and CD4 +TCF1 + cells (HR: 0.4; p=0.043) in the IF emerged as negative and positive independent prognostic markers for Disease-free survival (DFS), respectively. Integrating PD-L1 expression with TILs, PD-L1 immunopositivity was correlated with increased CD8 + and PD1 +TCF1 - cell infiltration and was associated with favorable DFS especially in the TC. CONCLUSIONS: Our findings support a more refined framework for TCF1 + TIL assessment and TCF1 expression across cellular populations in the tumor microenvironment, with implications for prognostication in operable NSCLC. </p
SpArking change for patients with psoriatic arthritis and axial spondyloarthritis in the UK:results from a UK Delphi consensus study
Get PDFOBJECTIVES: To establish a UK-specific consensus on improving standards of care for patients with PsA and axial SpA through patient empowerment, education, access and optimal treatment approaches.METHODS: A modified Delphi methodology was employed. A steering group of UK rheumatologists and pharmacists developed 56 consensus statements across four domains: patient empowerment, patient and healthcare professional (HCP) knowledge, access to healthcare and treatment principles. These statements were tested with a panel of 100 UK rheumatologists using a 4-point Likert scale. Consensus was predefined as ≥75% agreement.RESULTS: Consensus was achieved for 98% (55/56) of statements; 93% (52/56) reached strong consensus (≥90%). Statements supported embedding patient empowerment tools (e.g. patient-reported outcome measures, patient activation measures), implementing patient-initiated follow-up and ensuring shared decision-making. Respondents strongly endorsed multidisciplinary care, tailored educational resources, psychological support and timely access to physiotherapy and biologics. Treatment decisions should prioritise clinical need and patient goals rather than cost alone.CONCLUSION: This UK Delphi consensus highlights expert agreement that best practice care for PsA and axial SpA should centre on patient empowerment, supported by multidisciplinary teams, education and equitable access to treatments. Implementing personalised, holistic care models has the potential to improve patient outcomes and reduce healthcare burden. Further research should validate these recommendations with patients and explore strategies for their integration into National Health Service practice.</p
Hallucinogen persisting perception disorder in adolescence: a complex case of lysergic acid diethylamide-induced visual disturbances with trauma-associated exacerbation
No full textHallucinogen Persisting Perception Disorder (HPPD) is a condition affecting 1-5% of psychedelic users, with higher prevalence observed among recurrentLSD consumers and synthetic cannabinoid users [1]. The disorder is characterised by persistent visual disturbances including palinopsia and visual snow, along with dissociative symptoms, which have been neurobiologically linked to 5-HT2A receptor dysfunction and visual cortex hyperactivation [2];[3]. Approximately 20% of cases progress to chronic forms, often associated with early onset and polysubstance use history, necessitating comprehensive therapeutic approaches [1]. We present the case of a 16 year-old with an acute presentation compatible with HPPD after recreational use of lysergic acid diethylamide (LSD). All identifiable data has been removed. A is a 16 year-old young person who presented to an outpatient mental health service with perceptual abnormalities after using LSD for the second time. A’s symptoms had been present for 3 months prior to the assessment, and consisted of visual snow, micropsia and changes in the image definition of objects, with the outlines of objects abruptly becoming much neater. A reported that the symptoms were episodic and sudden.Since the beginning of the symptoms, A had unfortunately been through an extremely traumatic event, the nature of which will not be disclosed in order to protect A’s privacy. A found that situations linked to the trauma trigger episodes of HPPD symptoms and this caused significant distress, including significant suicidal ideation due to how overwhelming these symptoms were. A did not present with flashbacks of the traumatic event. A's functionality had been significantly impaired, with A spending most of the time at home, not going out due to fear of these symptoms reappearing. A did not present with other perceptual abnormalities, delusional beliefs or first-rank symptoms pointing towards a diagnosis of psychosis. A’s mood was low as are result of these symptoms, but denied presenting with depressive symptoms or other mood symptoms prior to the onset of HPPD. A was initially prescribed Levetiracetam up to 750mg twice a day, with initial good response and functional recovery. However, after a few weeks A’s symptoms worsened again, which led to a switch to Lamotrigine up to 50mg with no response. A eventually acknowledged believing that the symptom worsening after initial stability was due to a relapse in substance misuse (cannabis use), and requested to try Levetiracetam again with the intention to avoid drugs this time. Lamotrigine was discontinued and Levetiracetam was introduced gradually up to a dose of 750mg twice a day, with good response. A’s symptoms improved to the point where A could go back to his usual academic and social activities without being impaired by them. Although the visual snow persisted in an attenuated manner, A did not want to increase the dose of Levetiracetam or change to a different medication, and was happy with the prescription. A went on to his previous routine and also engaged in ongoing psychological support for the presenting symptoms
Self-blame-selective social conceptual overgeneralisation and vulnerability to depression
Get PDFBeck observed overgeneralised thinking as a key vulnerability factor for excessive self-blame/-criticism in major depressive disorder (MDD). Whilst the contribution of reduced access to specific autobiographical memory episodes has often been considered, the role of more abstract semantic memory systems remains elusive. Here, we investigated the individual ability to differentiate between the meaning of abstract social concepts when interpreting behaviour (e.g. “critical” vs. “fault-finding”) and its contribution to vulnerability to self-blaming biases and MDD using a previously developed cognitive task in 96 participants (n=60 medication-free remitted MDD and n=36 controls). Of those, 75 participants also completed an fMRI paradigm in which they viewed self- and other-blame emotion-evoking statements. A priori right anterior temporal lobe (ATL) seed and bilateral anterior subgenual cingulate and dorsolateral prefrontal cortex regions-of-interest were defined. As expected, the MDD group exhibited greater self-blame-selective conceptual overgeneralisation and stronger interdependency of conceptual overgeneralisation with negative emotional valence relative to the control group. Individuals with this interdependency showed higher self-blame-selective right anterior subgenual cingulate and primary motor cortex activations across groups, potentially corresponding to stronger self-blame and self-agency attributions, respectively, when conceptually overgeneralising the interpretation of their negative actions. Individuals with higher self-blame-selective conceptual overgeneralisation displayed lower right ATL activation for self- vs. other-blame, suggesting reduced access to differentiated conceptual representations. Future studies are needed to confirm the hypothesis that self-blame-selective conceptual overgeneralisation characterises a distinct neurocognitive subtype of primary MDD vulnerability which may be modulated by depressive state and thus serve as a personalised treatment target
Impact of adverse life experiences on pain, depression, anxiety, and comorbidities:a youth longitudinal sample
Get PDFAbstract – Introduction: – Exposure to adverse life experiences (ALEs) renders individuals vulnerable to the emergence of pain, depression, and anxiety. It remains unclear to what extent these symptom categories share common ALEs, especially in cases of comorbidity, and how these relationships manifest in developmental trajectories and neural pathways.Objectives: – In this study, we investigated the impact of ALEs, considering their timing, quality, and quantity, as well as structural brain changes, on pain, depression, and anxiety symptoms, and their comorbidity from adolescence to young adulthood.Methods: – We used prospective and retrospective questionnaires and magnetic resonance imaging data from a large European longitudinal cohort (N = 1700) spanning from 14 to 25 years. We conducted Latent-Class-Growth-Analysis for symptom levels of pain, depression, and anxiety, subsequent logistic regressions to explore prediction of ALEs on symptom classes, and mediation analysis to examine the role of insula in this association.Results: – Physical illness unrelated to pain, bullying, and abuse-maltreatment were associated with pain; sexual abuse, bullying, parental violence, and deprivation with depression; bullying and deprivation with anxiety; substance abuse in the household and abuse-maltreatment with pain–depression comorbidity; deprivation with pain–anxiety comorbidity. Smaller insula volume in late adolescence was a significant mediator for the association between deprivation-related ALEs and the pain–anxiety, but not the pain–depression comorbidity.Conclusion: – Together, although various and mainly different types of ALEs strongly impact pain, depression, and anxiety symptoms and their comorbidity, insula volume impacts are specific for pain–anxiety comorbidity. These findings may inform early screening and prevention for individuals affected by ALEs.</p
Turning pain into purpose:a qualitative investigation into the psycho-social impacts associated with ectopic pregnancy loss among women in the United Kingdom
Get PDFDespite the profound effects ectopic pregnancy has been demonstrated to have on women’s mental health, this type of pregnancy loss has received little attention compared to other forms. Ectopic pregnancies are the leading cause of maternal death in early pregnancy and often require urgent medical intervention, which overshadows the psycho-social impacts associated with pregnancy loss. We aimed to undertake a detailed investigation into women’s experiences and associated psychosocial impacts of ectopic pregnancy. Using a qualitative research design, semi-structured interviews (N = 20) were conducted with women who suffered an ectopic pregnancy. The interviews were subject to a Grounded Theory Analysis. Four interconnected themes emerged: ‘Waiting for the Inevitable’, ‘End of the Agony’, ‘Fighting through Perceived Loneliness’, and ‘Restorative Empowerment’. Together, these themes form the theory ‘Turning Pain into Purpose’. This theory suggests, although ectopic pregnancy loss is deeply painful, the challenges encountered can foster personal growth, transforming suffering into a source of empowerment and, ultimately, purpose. Whilst ectopic pregnancies represent a life-threatening condition with profound mental health impacts, this research emphasizses the potential for resilience and healing. It underscores the need for compassionate, tailored care and mental health support, along with increased societal awareness. By listening to women’s voices and understanding their complex experiences, healthcare systems can improve care and support, fostering better outcomes and effecting lasting positive change. When women reach out and form networks of support, they can end the psycho-emotional agony whilst also recovering from the physical agony of the ectopic pregnancy
Divergent paths of political trust in Southern Europe:the roles of economic performance, corruption, congruence, and polarisation
Get PDFThis study examines long-term patterns of political trust in Southern Europe through a comparison of Greece, Portugal, and Spain— countries that led the third wave of democratisation. Drawing on data from 45 Eurobarometer surveys (1997–2022), it tests four explanations of political trust: macroeconomic performance, corruption, ideological congruence, and party-system polarisation. The analysis highlights the varying importance of these factors across countries. Economic performance and political polarisation consistently influence trust, while corruption is a significant factor in Greece and Spain. Ideological congruence shows no substantial effect, except in Portugal. The study demonstrates that countries exposed to a common systemic shock may nonetheless develop divergent trajectories of political trust, shaped by the interaction of economic and political conditions.<br/
The Struggle for the City—Urban Recovery and Dispossession in Mosul and Damascus
No full textwalk through the old city of Mosul, Iraq, reveals an urban landscape still scarred by the violence of war and transfigured by ongoing reconstruction. Rubble-lined narrow streets give way to half-rebuilt homes and scaffolded storefronts, as merchants return and daily life resumes amid the heavy hum of generators and construction.The destructive reign of the Islamic State in Iraq and Syria (ISIS) from 2014 to 2017 and the city’s bloody liberation by Iraqi and allied forces left around 1 million inhabitants displaced and 130,000 homes damaged and destroyed. Mosul’s rebuilding process has been slow and imbalanced, imperiled by corruption scandals, militia control, property ownership forgery and a recovery focused on elite-driven commercial projects and internationally funded cultural heritage projects.[1] Many displaced Moslawis still remain uncertain about returning to rebuild homes, reclaim land or resurrect former lives