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“The traditional healer said, ’I had a genie that scared me in my eyes, and that is why I fall“: an ethnographic study in Mahenge, Tanzania
Get PDFBackground: In many low-income countries, individuals with epilepsy often turn to traditional healers as their first source of treatment after the onset of seizures. However, their experiences with traditional healing practices remain poorly understood. This study examines the perceptions and experiences of people with epilepsy in relation to traditional healing in Mahenge, Tanzania.
Methods: A culturally specific ethnographic approach, centred on oral history, was employed to capture rich, contextually grounded narratives. A total of 45 oral history interviews were conducted with individuals living with epilepsy from 21 villages in Mahenge. Participants were purposively selected based on the following criteria: being at least 18 years of age, having a diagnosis of epilepsy, and the ability to recount their experiences in Swahili, the primary language spoken in the region. Data were manually analysed using thematic analysis.
Results: Traditional healers often attribute epilepsy to supernatural causes, such as curses or witchcraft, linking seizure onset to past events believed to have triggered the condition. Their treatment practices are frequently accompanied by strict behavioural restrictions, which can be challenging for individuals with epilepsy to follow and are sometimes cited as reasons for treatment failure. Moreover, some participants reported experiences of physical, emotional, and even sexual harassment during their encounters with traditional healers.
Conclusion: There is a strong reliance on traditional healing practices for epilepsy, where cultural beliefs and rituals can hinder accurate diagnosis and effective care. Raising awareness about epilepsy, its medical management, and the rights of people with epilepsy, both among traditional healers and the broader community, is essential to improve care and protect the well-being of those affected
Characterising the genetic architecture of common elastic tissue disorders using UK Biobank
No full textBackground
Elastic fibres are key extracellular matrix (ECM) components that provide elasticity to tissues throughout the body, allowing them to recover after deformation. Derangement of elastic fibres lead to cutaneous and systemic disorders that show elastic tissue pathology. To distinguish between rarer disorders of elastic tissue, and common disease, I have coined the term ‘elastopathies.’ Common elastopathies such as hiatus hernia, diverticular disease, haemorrhoids, inguinal hernia, varicose veins, female genital prolapse, umbilical hernia, aneurysmal disease, emphysema, pneumothorax, rectal prolapse, and femoral hernia, have a complex aetiology where genetic predisposition and environmental factors interplay to influence overall phenotypic expression. These elastopathies are highly prevalent and exert a significant healthcare and socioeconomic burden. However, their genetic basis remains poorly defined, with limited putative genes identified.
Method
To unravel the genetic architecture of the 12 elastopathies identified in the UK Biobank resource (hiatus hernia, diverticular disease, haemorrhoids, inguinal hernia, varicose veins, female genital prolapse, umbilical hernia, aneurysmal disease, emphysema, pneumothorax, rectal prolapse, and femoral hernia), genome-wide association study (GWAS) testing was performed across ~400,000 genotyped participants from the UK Biobank resource, with replication from ~410,000 participants from 23andMe, Inc. (California) for the varicose veins analysis. All 12 elastopathies were studied independently, and then combined in a final pan-elastopathy GWA study to identify the shared genetic architecture of common elastopathies in UK Biobank. A disparate analysis was performed combining all four types of hernia in a pan-hernia analysis to identify shared genetics. Genes and pathways were prioritised using a suite of bioinformatic approaches, and pharmacological targets identified using the Open Targets Platform. A genetic risk score was constructed to examine the genetic burden among participants with severe disease. For the pan-hernia analysis, multi-trait and multivariate meta-analysis approaches were deployed to uncover the shared genetic susceptibility to multiple hernia phenotypes. For the pan-elastopathy analysis, an individual patient data (IPD) meta-analysis was performed and the latent elastopathy phenotype was analysed using genomic structural equation modelling (SEM) to uncover shared genetic biology.
Results
Performing the largest two-stage GWAS of varicose veins in 810,625 participants, forty-nine signals at 46 susceptibility loci were discovered, including 29 previously unreported associations. Next, through (at the time) the first-ever GWA study of haemorrhoids in over 400,000 participants, 13 signals at 12 novel loci were discovered to associate with haemorrhoids. Association analysis of inguinal, femoral, umbilical, and hiatus hernia individually yielded 58 signals at 38 loci (34 new) associated with the four hernia phenotypes. When combined in a multi-trait meta-analysis, 12 biologically relevant putative loci were discovered to associate with multiple hernia phenotypes, demonstrating novel and robust evidence of shared susceptibility to hernia. Of significance, the genetic risk scoring correlated with disease severity across the varicose veins, haemorrhoids, and pan-hernia analyses, with patients undergoing surgery having a higher genetic burden than those managed non-surgically. Lastly, studying the 12 elastopathies in a pan-elastopathy IPD meta-analysis, 18 susceptibility loci were discovered to associate with the pan-elastopathy phenotype which were not discovered when the 12 elastopathies were studied individually. Moreover, employing common factor analysis to unveil the latent elastopathy phenotype, a further four loci were discovered to be integral to a shared genetic risk towards elastopathies. Collectively, over 250 independent susceptibility loci were discovered to associate with the 12 elastopathies, which were mapped to over 500 putative genes, many of which demonstrated profound evidence of a shared genetic biology, therapeutic tractability and clustered in pathways pertaining to core matrisomal components and ECM homeostasis.
Conclusion
Prioritised genes and pathways demonstrate significant biological plausibility, and represent promising candidates for further investigation of elastic tissue biology and potential pharmacological targeting. The genetic risk score correlated with disease across varicose veins, haemorrhoids and hernia disorders, representing an important proof-of-principle for the future use of genetic risk scoring in personalised medicine approaches to surgical disorders. Lastly, studying the 12 elastic tissue disorders together, a novel category of pathologically linked disorders defined by elastic tissue dysfunction were discovered— the elastopathies. To this end, this thesis advances the field of study around elastopathies and complex trait genetics
Prehospital stroke care in low- and middle-income countries: A World Stroke Organization (WSO) scientific statement
Get PDFEvidence-based prehospital stroke care is effective in reducing stroke-related mortality and morbidity. The crucial period from symptom awareness to presentation at the hospital, the first step in the World Stroke Organization Road Map to Quality Care, is under-resourced in the majority of low- and middle-income countries (LMICs). Key challenges focus on a lack of stroke action awareness as well as human resources trained in stroke care. We aimed to identify prehospital stroke practices in LMICs and identify where innovation may address service gaps. We conducted scoping reviews focused on key domains of prehospital stroke care in LMICs that include organization of services, stroke action awareness in the community, educating primary care physicians and traditional/faith healers, diagnostic tools for prehospital stroke detection, and emergency medical service (EMS) provision. We sought to determine current practices and gaps in LMICs and evidence on effective interventions to address gaps in each domain. Recommendations are provided identifying priority considerations in each domain, based on evidence, and where lacking, expert opinion. Key recommendations include the need for adequately funded national-level strategies for prehospital stroke care; stroke action awareness education for the public, primary care physicians, community health workers, EMSs, and traditional and faith healers; affordable imaging solutions; and approaches to create or improve prehospital EMS (e.g., protocols). We found that efforts, although few, have been made to address gaps in LMICs; however, they have rarely been evaluated, and it is unclear if they are sustained. The required elements necessary to improve prehospital services and stroke outcomes are known. Creativity is and perseverance are required for implementation to ensure sustainability. This scientific statement has been reviewed and approved by the World Stroke Organization Executive
A search for dark matter produced in association with a dark Higgs boson decaying into a Higgs boson pair in 3 b or 4 b final states using pp collisions at s = 13 TeV with the ATLAS detector
Get PDFA search is performed for dark matter particles produced in association with a resonant pair of Higgs bosons using 140 fb−1 of proton-proton collisions at a centre-of-mass energy of 13 TeV recorded by the ATLAS detector at the Large Hadron Collider. This signature is expected in some extensions of the Standard Model predicting the production of dark matter particles, and is interpreted in terms of a dark Higgs model containing a Z′ mediator in which the dark Higgs boson s decays into a pair of Higgs bosons. The dark Higgs boson is reconstructed through final states with at least three b-tagged jets, produced by the pair of Higgs boson decays, in events with significant missing transverse momentum consistent with the presence of dark matter. The observed data are found to be in good agreement with Standard Model predictions, constraining scenarios with dark Higgs boson masses within the range of 250 to 400 GeV and Z′ mediators up to 2.3 TeV
Taking advantage of crops’ wild relatives to bioengineer climate-resilient agriculture, achieve food security, and environmental sustainability
Get PDFShivani Malik, DPhil student in the Plant Chemetics Lab led by Professor Renier van der Hoorn, has been engaging with policymakers in her home country of India to share the importance of biological advances to the agricultural sector
Advances in population-based interventions to control falciparum malaria
Get PDFMalaria is a complex disease and transmission can be prevented in multiple ways. A range of interventions to achieve this became widely available from the year 2000, and cases continually declined, but progress has plateaued since 2015. This review aims to cover the population-level prevention strategies responsible for this and those that could continue this progress, focussing on how they can be successfully integrated. Insecticide-treated nets (ITNs) made the most substantial contribution to reducing malaria mortality, but their distribution, access and use remains suboptimal while development of insecticide resistance requires continuous adaptation. Chemoprevention provides protections to tens of millions of people, primarily children in sub-Saharan Africa, but is also threatened by the emergence and spread of drug resistance. These strategies may have reached a point of saturation for reducing morbidity and mortality, thus calling for innovative developments to build upon more basic approaches such as accurate early diagnosis, appropriate treatment and improved housing. The R21/Matrix-M vaccine is a significant improvement over the RTS,S/AS01 vaccine, with greater efficacy, lower cost and scalable mass production. Field trials of current monoclonal antibodies (mAbs) suggest that next-generation mAbs could be a promising tool for seasonal chemoprophylaxis. Furthermore, gene drives may have the potential to eradicate entire populations of malaria-transmitting mosquitoes. A multifaceted approach combining these new strategies with traditional approaches (ITNs and chemoprevention) offers a framework to reinvigorate progress towards malaria elimination
The UK Parliament, law, government policy, monarchy and the Anglican Communion
Get PDFOf the forty-two autonomous self-governing provinces in the Anglican Communion, the Church of England is the only church established by law. There are three “incidents of establishment” that are significant for this dissertation: (1) the monarch is its Supreme Governor; (2) its Second Church Estates Commissioner sits in the House of Commons and twenty-six of its diocesan bishops sit as of right in the House of Lords – “the Church of England in Parliament”; and (3) its draft Measures require the consent of Parliament. Through these incidents of establishment, the aim of this dissertation is to understand the relationship between the UK Parliament and the Anglican Communion in the modern world. The main argument of this dissertation is that though there is no juridical connection between the Anglican Communion and the UK Parliament, Parliament has recognised, in different ways, the importance of the Anglican Communion as a major global denomination of world Christianity and supports its mission as an international faith-based organisation. From this relationship, there are emerging constitutional conventions. The dissertation begins with an overview of the established status of the Church of England, the nonjuridical order of the Anglican Communion, and the December 2024 Nairobi-Cairo Proposals of the Inter-Anglican Standing Commission on Unity, Faith and Order (“IASCUFO”), which is currently (writing in April 2025) considering the future of the instruments of communion (chapter 1). The dissertation then shows the first parliamentary references to the Anglican Communion in the late nineteenth and early twentieth centuries, arguing that from its very beginnings, Parliament has understood the Communion to be independent from the British Crown (chapter 2). There are then three central chapters which examine how the Anglican Communion features during committee deliberations and parliamentary debates about ecclesiastical law (chapter 3), international development policy, UK law related to human sexuality (chapter 4), the monarchy and the Commonwealth (chapter 5). There is then a chapter that discusses Anglicanism as the established religion of England and a global denomination of world Christianity, with a focus on the office of the Lord Archbishop of Canterbury – an instrument of communion shared with the UK constitution (chapter 6). The dissertation concludes with a discussion about the election of the Labour government in July 2024, its constitutional reform agenda, and how these developments might impact the future relationship (chapter 7)
Good VIBES only
No full textHow to articulate the common ontological commitments of symmetry-related models of physical theories? This is a central (perhaps the central) question in the philosophical literature on symmetry transformations in physics; recently, Dewar (2019) has proposed a strategy for answering this question which goes by the name of ‘external sophistication’. And yet: this strategy has been accused of being hopelessly obscure by, among others, Martens and Read (2020). In this article, I demonstrate that not all cases of external sophistication are subject to this charge—for reasons which will become clear, the cases for which this is not so give us what I’ll call ‘good VIBES’. Having established this, I then go on to consider good VIBES in the context of the analysis of hidden symmetries, in dialogue with recent work on that topic by Bielinska and Jacobs (2024)
Predicting individual traits from models of brain dynamics accurately and reliably using the Fisher kernel
Get PDFPredicting an individual’s cognitive traits or clinical condition using brain signals is a central goal in modern neuroscience. This is commonly done using either structural aspects, such as structural connectivity or cortical thickness, or aggregated measures of brain activity that average over time. But these approaches are missing a central aspect of brain function: the unique ways in which an individual’s brain activity unfolds over time. One reason why these dynamic patterns are not usually considered is that they have to be described by complex, high-dimensional models; and it is unclear how best to use these models for prediction. We here propose an approach that describes dynamic functional connectivity and amplitude patterns using a Hidden Markov model (HMM) and combines it with the Fisher kernel, which can be used to predict individual traits. The Fisher kernel is constructed from the HMM in a mathematically principled manner, thereby preserving the structure of the underlying model. We show here, in fMRI data, that the HMM-Fisher kernel approach is accurate and reliable. We compare the Fisher kernel to other prediction methods, both time-varying and time-averaged functional connectivity-based models. Our approach leverages information about an individual’s time-varying amplitude and functional connectivity for prediction and has broad applications in cognitive neuroscience and personalised medicine