Rega Institute for Medical Research

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    263134 research outputs found

    Kent v Apple: The class action overturns Apple’s playbook

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    On 23 October 2025, the Competition Appeal Tribunal (CAT) issued its first judgment awarding damages in a collective action brought against a tech giant. For ten years, Apple charged developers excessive prices for services offered through its App Store. This ultimately resulted in Apple device users having to pay higher prices to use apps. Although the average user has been affected by almost negligible amounts, the total harm was estimated between 1.184-2.237 billion GBP. Cases like this are (only) suitably litigated via the collective proceeding regime available to victims of competition law infringements since 2015. The Kent judgment is of great relevance because it turns down many of Apple’s traditional arguments and marks a milestone in the development of UK class actions. This contribution focuses on three aspects of the decision: the CAT's dismissal of Apple’s line of defence, the leading role of opt-out collective proceedings in the private enforcement of UK competition law, and the regulatory developments aimed at closing the public enforcement gap.status: Publishe

    Biological causes and impacts of rugged tree landscapes in phylodynamic inference.

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    Phylodynamic analysis has been instrumental in elucidating epidemiological and evolutionary dynamics of pathogens. Bayesian phylodynamics integrates out phylogenetic uncertainty, which is typically substantial in phylodynamic datasets due to limited genetic diversity. Phylodynamic inference does not, however, scale with modern datasets, partly due to difficulties in traversing tree space. Here, we characterize tree space and landscape in phylodynamic inference and assess its impacts on analysis difficulty and key biological estimates. By running extensive Bayesian analyses of 15 classic large phylodynamic datasets and carefully analyzing the posterior samples, we find that the posterior tree landscape is diffuse yet rugged, leading to widespread tree sampling problems that usually stem from sequences in a small part of the tree. We develop clade-specific diagnostics to show that a few sequences-including putative recombinants and recurrent mutants-frequently drive the ruggedness and sampling problems, although existing data-quality tests show limited power to detect them. The sampling problems can significantly impact phylodynamic inferences or distort major biological conclusions; the impact is usually stronger on "local" estimates (e.g., introduction history) associated with particular clades than on "global" parameters (e.g., demographic trajectory) governed by general tree shape. We evaluate existing Markov chain Monte Carlo diagnostics and diagnostics developed here, and offer strategies for optimizing phylodynamic analysis settings and mitigating sampling problem impacts. Our findings highlight the need and directions to develop efficient traversal over rugged tree landscapes, ultimately advancing scalable and reliable phylodynamics.sponsorship: NIAID NIH HHS|R01 AI162611, NIAID NIH HHS|R01 AI153044, Fred Hutchinson Cancer Center (FHCRC)|S10OD028685, Fonds Wetenschappelijk Onderzoek (FWO)|G0E1420N, Fonds Wetenschappelijk Onderzoek (FWO)|G098321N, EC | ERC | HORIZON EUROPE European Research Council (ERC)|101094685status: Publishe

    Tricuspid regurgitation and pulmonary haemodynamics after pulmonary endarterectomy Reply

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    status: Publishe

    Mitigating large-scale offshore wind farm shutdowns during a severe storm using an adaptive robust optimization approach

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    sponsorship: This work has been conducted within the research project RAPIDC-Resilience aware planning of AC/DC grids funded by Reseau de Transport d'electricite. (Reseau de Transport d'electricite)status: Publishe

    Management of Cancer During Pregnancy: ASCO Guideline

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    PURPOSE: To provide guidance on the recommended management of cancer in pregnant patients. METHODS: A multidisciplinary Expert Panel convened and conducted a systematic review of the literature. RESULTS: The systematic review identified 450 eligible studies. Much of the evidence consisted of observational data, case series, and case reports. RECOMMENDATIONS: Management of cancer during pregnancy should be grounded in a values-based informed-consent process outlining maternal and fetal risks and anticipated benefits. Diagnostic evaluation should follow the as low as reasonably achievable (ALARA) principle, with timing of diagnostic studies individualized based on urgency of cancer detection, potential dangers of delay, and the balance of risks to both the pregnant patient and her embryo or fetus. Due to significant risk of harm to the developing embryo and/or fetus, systemic therapy should be deferred until the second trimester. Methotrexate, hormonal therapies, human epidermal growth factor receptor 2-targeted agents, vascular endothelial growth factor and poly (ADP-ribose) polymerase inhibitors, antibody-drug conjugates, and all cellular therapies are contraindicated during pregnancy, regardless of gestational age. For patients who wish to continue their pregnancy, delivery should be planned at or after 37 weeks, with the final chemotherapy dose scheduled 2-4 weeks before birth. Referral to psychosocial support services is essential to address emotional and practical challenges, reduce distress, and support shared decision making.Additional information is available at www.asco.org/survivorship-guidelines.status: Accepte

    Book Review: 'The beauty of falling (C. de Rham)'

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    status: Publishe

    Longitudinal Developmental Outcomes of Children With Prelingual Single-Sided Deafness With and Without a Cochlear Implant and Recommendations for Follow-Up

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    OBJECTIVES: Children with prelingual single-sided deafness (SSD) have difficulty understanding speech in noise and sound localization. They also have an increased risk of problems with their language and cognitive development. Moreover, untreated SSD can lead to cortical reorganization, that is, the aural preference syndrome. Providing these children with a cochlear implant (CI) at an early age may support improved outcomes across multiple domains. This longitudinal study aimed to identify those aspects of development that are especially at risk in children with SSD, and to determine whether early cochlear implantation affects the children's developmental outcomes. DESIGN: Over the past decade, 37 children with SSD completed regular auditory, language, cognitive, and balance assessments. Twenty of these children received a CI before the age of 2.5 yr. The same developmental outcomes were assessed in 33 children with bilateral normal hearing who served as a control group. The present study describes spatial hearing, cognitive, and postural balance development outcomes. These were assessed using standardized tests for speech perception in noise (speech reception threshold in three spatial conditions), sound localization (mean localization error in a nine-loudspeaker set-up), cognitive skills (Wechsler Preschool and Primary Scale of Intelligence), balance (Bruininks-Oseretsky Test of Motor Proficiency), and preoperative cervical vestibular evoked myogenic potentials. RESULTS: Longitudinal analysis showed that the children with SSD who did not receive a CI were at risk for poorer speech perception in noise, sound localization, and verbal intelligence quotient. On average, they had higher speech perception thresholds (1.6 to 16.8 dB, depending on the spatial condition), larger localization errors (35.4°), and lower verbal intelligence quotient scores (difference of 0.78 standard deviations). Children with SSD with a CI performed on par with the normal hearing children on the cognitive tests. In addition, they outperformed their nonimplanted peers with SSD on tests for speech perception in noise (up to 11.1 dB lower mean speech reception threshold, depending on spatial condition) and sound localization (9.5° smaller mean error). The children with SSD, with and without a CI achieved similar scores on behavioral tasks for postural balance. CONCLUSIONS: The present study shows that early cochlear implantation can improve spatial hearing outcomes and facilitate typical neurocognitive development in children with prelingual SSD. Taken together with previously published data related to children's language development, the present results confirm that children with prelingual SSD can benefit from a CI provided at an early age to support their development across multiple domains. Several guidelines are suggested regarding the clinical follow-up and rehabilitation of these children.sponsorship: Financial support was provided by Cochlear Ltd. in the form of cochlear implants and the funding of the clinical mapping. This research was supported by VLAIO, in collaboration with Cochlear Technology Center (grant number HBC.2020.2308). Early data collection was supported by the European Union (grant number FP7-607139) and the Research Foundation Flanders (grant number T002216N). The study was conducted independently and underwent peer review. Its open-access distribution was made possible through sponsorship by Cochlear Technology Center. The funding organizations had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; in the decision to submit the article for publication; or in the preparation, review, or approval of the article. (Agentschap Innoveren en Ondernemen|HBC.2020.2308, FP7 People: Marie-Curie Actions|FP7-607139, Fonds Wetenschappelijk Onderzoek|T002216N)status: Accepte

    Quantitative Imaging Advances in HPV-Positive Oropharyngeal Carcinoma

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    HPV-positive OPSCC shows a favourable prognosis, prompting evaluation of de-escalated and adaptive strategies. Quantitative imaging may provide scalable biomarkers to individualise care. Quantitative imaging can support baseline risk stratification, early on-treatment decision-making, and posttreatment surveillance in HPV-positive OPSCC. Real-world translation requires standardised reporting, calibration/harmonisation across centres, rigorous model validation, and workflow integration with radiotherapy planning. Quantitative MRI, CT, and PET, augmented by radiomics and AI, show convergent promise as noninvasive biomarkers to enable safe individualisation of therapy in HPV-positive OPSCC, contingent on methodological rigour and prospective, externally validated studies. Despite this promise, clinical translation faces substantial barriers, including limited external validation, heterogeneous methodologies, and the need for standardised, prospectively validated pipelines.status: Publishe

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