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A study on the prevalence of cyathostomin and Anoplocephala perfoliata infections in Italian horses: diagnostic testing and analysis of factors affecting infection risk
Full text linkBACKGROUND: Cyathostomins and Anoplocephala perfoliata infect equids worldwide and both are of concern due to their potential to cause clinical disease. Although coprological techniques are commonly used for assessing helminth egg shedding these do not provide information about an individual's total parasite burden. Antibody-based tests provide information on infection levels within individuals. AIMS/OBJECTIVES: This study aimed to evaluate cyathostomin and Anoplocephala perfoliata occurrence in Italian horses using coprological and serum-based antibody detection methods and to analyse risk factors for infection at the individual level. METHODS: Samples from 173 horses were collected on 35 farms. Coprological examinations were performed using Mini-FLOTAC or a centrifugation/flotation technique. Parasite-specific antibody levels were assessed by ELISA using the Tapeworm Blood Test and the Small Redworm Blood Test. RESULTS: Intestinal strongyle and tapeworm eggs were detected in 140 (80.9%) and five (2.9%) faecal samples, respectively. Cyathostomin ELISA results revealed 39 horses (22.5%) below the 1,000 total worm burden threshold, with 75 (43.0%) below the 10,000. Tapeworm ELISA results indicated 136/173 horses (78.6%) were below the test's treatment threshold. Small Redworm serum score result category was associated with sex, access to pasture, strongyle FEC, no recent anti-nematode treatments and tapeworm serum score category. Tapeworm ELISA results were associated with living area, age class, sex, access to pasture, quarantine procedures, dung removal, strongyle FEC, no recent anti-nematode treatments and SR serum score category. CONCLUSION: Cyathostomin and A. perfoliata infections in Italian horses are influenced by horse signalment, specific management practices and, in the case of tapeworm, living area
Acute to Chronic Islamophobia:the impact and mitigation of counter-extremism on young Muslims in Northern Europe
Full text linkThis paper examines the evolving role of the counterterrorism state in Islamophobia across Northern Europe, exploring how new preventative counterextremism measures have reshaped Islamophobia from acute articulations of violence to chronic social exclusion and how young Muslims have sought to respond. Drawing on 114 interviews with young Muslims aged 18–25 in the UK, Netherlands, Denmark, and Norway, along with eight subsequent focus groups, the research highlights how counterterrorism policies are normalising anti-Muslim attitudes and constructing young Muslims as latent security threats in novel ways. These findings reveal significant shifts: while acute articulations of Islamophobia, marked by reports of physical acts of anti-Muslim violence, have notably declined, structural and institutional forms – understood here as chronic forms of Islamophobia have become more dominant. This shift is intricately tied to the evolution of state-led counterextremism and pre-crime programmes that perpetuate radicalisation narratives, alienating young Muslims and fostering disengagement from political and media spheres. The paper furthermore seeks to understand the agency of young Muslims, finding that they have developed new strategies for managing and mitigating chronic articulations of Islamophobia. By bringing together theories on securitisation, Islamophobia and racialisation, the authors underscore the need for critical revaluation of new and ongoing counterextremism approaches, their societal implications, and how young Muslims seek to manage and mitigate novel patterns of racialisation and social exclusion
Measurement properties of the Inflammatory Rasch-built Overall Disability Scale (I-RODS) in patients with Guillain–Barré syndrome
Full text linkGuillain–Barré syndrome (GBS) is an acute immune-mediated polyneuropathy with a high disease impact, even after good clinical recovery. The Inflammatory Rasch-built Overall Disability Scale (I-RODS) is a Patient-Reported Outcome Measure (PROM) developed for patients with immune-mediated neuropathies that measures limitations in daily activities and social participation. It consists of 24 items, scored from 0–48. The present study aimed to validate the measurement properties of the I-RODS in patients with GBS included in the prospective International GBS Outcome Study (IGOS). The current study focussed on structural validity, cross-cultural validity, internal consistency, and construct validity of I-RODS using Rasch-based methods. The study was conducted in 1226 patients diagnosed with GBS with a median I-RODS score of 28 (IQR 10–41) 4 weeks after inclusion into IGOS. Rasch analyses revealed adequate internal consistency (PSI = 0.95; α = 0.98) and sufficient construct validity, indicated by strong correlations (R = − 0.91 to − 0.77). Targeting was acceptable, although there was a skew towards the floor (10.1%) and ceiling (9.4%). However, the I-RODS showed poor unidimensionality (12.1% CI 10.7–13.5%) and poor overall fit to the Rasch model. Category thresholds were correctly ordered. Misfit was found in two items. Additionally, 15 of 276 item pairs showed local dependency. While no differential item functioning (DIF) was evident for age or sex, significant DIF by geographic region was observed, with the strongest DIF in one item. These results suggest that the current version of I-RODS could be improved or alternative PROMs for patients with GBS could be developed
Mental health and kidney disease
No full textMultiple long-term conditions, and particularly mental health conditions, are common in adults with chronic kidney disease (CKD). Some mental health conditions increase the risk of developing CKD, contribute to faster disease progression, and complicate care experiences and outcomes. Depression and anxiety are particularly prevalent and are associated with reduced quality of life, unplanned service use and poorer clinical outcomes. The manner in which depression and anxiety are detected and managed as part of routine kidney care can vary widely. Evidence for effective and acceptable treatments is mixed overall, although meta-analyses highlight the benefits of physical activity and cognitive behavioural therapy. Data on the use of antidepressants in people with CKD are also variable, limited by the lack of robust clinical trials. People with particularly complex needs, such as those with severe mental illness and CKD, have markedly shorter lifespans and higher rates of emergency hospitalizations than those without severe mental illness and are also less likely to access specialist nephrology care and to receive a transplantation. Health inequalities are amplified for those contending with wider disadvantages related to social and structural determinants of health. Reducing the burden of mental health in people with CKD is an urgent priority to alleviate personal and health system impacts. Here, we examine current evidence on mental health and CKD to inform policy and research and to support advances in prevention and management approaches
A Review of the Factors Determining Discretionary Relief from Forfeiture under the Forfeiture Act 1982
No full textThis article considers the case law which has flowed from the enactment of the Forfeiture Act 1982. In the event of unlawful killing as between joint tenant co-co-owners of land, the common law dictates that in such instance, the joint tenancy is severed, so as to prevent the unlawful killer inheriting the land exclusively and thus profiting from his/her crime. The are obviously a vast array of types of unlawful killing from outright murder to manslaughter to assisted suicide - a range of levels of moral culpability. The Forfeiture Act 1982 allows a court to give relief against the potential harshness of the forfeiture rule. The court has a discretion here, however, the Act gives no guidance on how that discretion is to be exercised. This paper reviews the case law which has arisen post the enactment of the 1982 Act and tries to formulate some guidelines on how the courts have come to exercise their discretion here
Myasthenia gravis following the initiation of statin therapy: A multinational self‐controlled case series study
Full text linkBackground: Evidence regarding the risk of new‐onset myasthenia gravis (MG) following statin therapy initiation is limited. Objectives: To investigate this potential adverse effect using multinational real‐world population‐based data. Methods: A self‐controlled case series (SCCS) study was conducted using electronic medical records and claims databases from Hong Kong, the United Kingdom (UK) and Japan. Individuals aged ≥18 years with first diagnosis of MG and initiated statins were included. Conditional Poisson regression compared the risk of MG in different risk periods (up to 2 years after initiation) with non‐exposure period, adjusted for age. Pooled results based on meta‐analysis across all study sites were reported. Results: In total, 2267 MG cases were analysed. Combined across all study sites, a significantly increased risk of incident MG was observed during the first year after statin initiation compared to non‐exposure period, with a higher risk from Days 0–179 (pooled incidence rate ratio [IRR] [95% CI]: 2.662 [1.276–5.553]) than Days 180–364 (1.407 [1.014–1.954]). No increased risk of MG was observed more than 1 year after statin initiation (1.011 [0.848–1.206]). Moreover, the magnitude of MG risk elevation within the first 180 days after statin initiation was more pronounced with higher intensity statin regimens. Conclusion: In this multinational SCCS study, statin initiation may be associated with increased risk of new‐onset MG during the first 6–12 months, with greater magnitude of risk elevation for higher intensity statin therapy. Consideration of the possibility of new‐onset MG may be advisable within first 6–12 months after initiating statins, especially for medium‐to‐high‐intensity statin therapy
Regenerative Therapeutics for Chronic Obstructive Pulmonary Disease
Full text linkChronic obstructive pulmonary disease (COPD) is one of the most common lung diseases worldwide, characterized by an accelerated loss of lung function. A key problem underlying COPD is increased tissue destruction in combination with defective lung tissue repair. As current therapies do not modify the progression of the disease, new therapies aimed at restoring lung tissue repair in COPD need to be developed. In an attempt to address this major unmet need, there has been a surge in both preclinical and clinical studies, aiming to identify key mechanisms underpinning defective lung repair and the ability to inhibit or even reverse this defect. This includes small molecules such as retinoids, as well as advanced therapy medicinal products such as cell therapies or therapies with cell-derived products such as extracellular vesicles, or secreted proteins. The results of these endeavors have been variable with failures as well as successful proof-of-concepts. In this review, we provide an overview of the current state of the field, including modes of action of the therapeutics that are or have been considered for lung regeneration, including a discussion on the reasons for failure where relevant. In addition, we discuss hurdles in the clinical development of regenerative therapeutics for COPD including clinical outcomes, route of administration and formulation as these are pivotal considerations moving forward
A Dirichlet Distribution-Based Trust-Adaptive Ensemble Approach for Pneumonia Classification from Chest X-Ray Images
No full textPneumonia diagnosis from chest radiographs is hindered by AI model variability and limited decision transparency.We present a deployment-ready, abstaining Dirichlet-evidence ensemble for paediatric CXR triage that elevates “Indeterminate”to a first-class outcome and implements dynamic, trust-adaptive weighting. Eight diverse pre-trained models each provide binary predictions, which are converted to three-way CXR supports,scaled by ongoing trust scores, and fused using a Dirichlet-evidence mechanism. Selective gates on class separation and pooled evidence allow the ensemble to defer, with auditable reasoning, when the decision is uncertain. On a 200-image paediatric hold-out, simple majority voting achieved 94.5% accuracy but dropped to 83.0%when two training models were intentionally inverted. At a fixed operating point, the proposed ensemble maintained zero errors(100% accuracy) on decided cases in both settings, abstaining on only 1–2% of studies instead of issuing incorrect labels. Unlike prior work, our system tightly integrates uncertainty, selective prediction, and per-case logging for clinical governance. This framework advances safe, interpretable automation for paediatric pneumonia assessment
Antimicrobial Resistance and Comparative Genome Analysis of High-Risk Escherichia coli Strains Isolated from Egyptian Children with Diarrhoea
Full text linkEscherichia coli is an important human pathogen that is able to cause a variety of infections, which can result in diarrhoea, urinary tract infections, sepsis, and even meningitis, depending on the pathotype of the infecting strain. Like many Gram-negative bacteria, E. coli is becoming increasingly resistant to many frontline antibiotics, including third-generation cephalosporins and carbapenems, which are often considered the antibiotics of last resort for these infections. This is particularly the case in Egypt, where multidrug-resistant (MDR) E. coli is highly prevalent. However, in spite of this, few Egyptian MDR E. coli strains have been fully characterised by genome sequencing. Here, we present the genome sequences of ten highly MDR E. coli strains, which were isolated from children who presented with diarrhoea at the Outpatients Clinic of Assiut University Children’s Hospital in Assiut, Egypt. We report that they carry multiple antimicrobial resistance genes, which includes extended spectrum β-lactamase genes, as well as blaNDM and blaOXA carbapenemase genes, likely encoded on IncX3 and IncF plasmids. Many of these strains were also found to be high-risk extra-intestinal pathogenic E. coli (ExPEC) clones belonging to sequence types ST167, ST410, and ST617. Thus, their presence in the Egyptian paediatric population is particularly worrying, and this highlights the need for increased surveillance of high-priority pathogens in this part of the world
Morpheme knowledge is shaped by information available through orthography
Full text linkA large portion of words in a language are formed by combining smaller meaningful units called morphemes (e.g., teach + -er → teacher). Understanding a language’s morphology is vital for skilled reading as it allows readers to interpret both familiar and unfamiliar words (e.g., tweeter). It is widely agreed that children rely on reading experience to acquire morpheme knowledge in English, and emerging research suggests that different aspects of this experience may impact affix learning in different ways. We contrasted three potential definitions of what constitutes readers’ affix experience using the morpheme interference paradigm with 120 adults. We found that skilled readers’ affix knowledge most closely aligns with a definition proposing that affix learning is primarily supported by experience with words in which affixes are identifiable without specialised linguistic knowledge. Due to the nature of morpheme presentation in English orthography, this excludes a significant number of genuinely complex words, while including affix-like patterns in non-meaningful contexts (e.g., -er in corner). This definition also posits that these morphological false alarms actively hinder learning. Our research represents a critical step towards a psychologically realistic theory of morpheme learning from text experience
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