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Maternal perspectives on the RSV vaccine (Abrysvo): a thematic analysis of survey findings from the first season of implementation in England and Scotland
Get PDFBACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of infant hospitalisation due to lower respiratory tract infections. Until 2022, prevention was limited to the costly monoclonal antibody palivizumab. In August 2024, the UK introduced the RSVpreF (Abrysvo, Pfizer) maternal vaccine into its national immunisation schedule. The success of this programme depends not only on vaccine effectiveness, but also on maternal access, acceptance and uptake. OBJECTIVE: To explore maternal perspectives on the RSVpreF vaccine and identify barriers and facilitators to vaccine uptake, to inform antenatal education and public health strategies. METHODS: This qualitative analysis is based on free-text survey responses from 388 vaccine-eligible mothers of infants hospitalised with bronchiolitis, lower respiratory tract infection or acute wheeze, collected between September 2024 and March 2025 across 30 sites, as part of the BronchStop study. RESULTS: Four key themes were identified: (1) access-related barriers to vaccination, (2) insufficient RSV awareness and information to support informed decision-making, (3) vaccine safety concerns and hesitancy and (4) perception of the maternal RSV vaccine as beneficial and protective. These themes were consistent across sociodemographic groups. CONCLUSIONS: Uptake of the maternal vaccine was influenced by barriers to access, informational gaps and perceived safety concerns. Improved vaccine delivery, enhanced awareness and personalised antenatal counselling are essential to increase vaccine uptake. There is an urgent need to address structural inaccessibility and provide tailored antenatal education to address informational gaps. Ongoing qualitative research is crucial to guide targeted public health interventions ahead of future RSV seasons
The genome sequence of the cryptorhynchine weevil, <i>Kyklioacalles roboris</i> (Stüben, 2003) (Coleoptera: Curculionidae)
Get PDFWe present a genome assembly from an individual male Kyklioacalles roboris (cryptorhynchine weevil; Arthropoda; Insecta; Coleoptera; Curculionidae). The assembly contains two haplotypes with total lengths of 698.93 megabases and 609.02 megabases. Most of haplotype 1 (87.44%) is scaffolded into 20 chromosomal pseudomolecules, including the X and Y sex chromosomes. Haplotype 2 was assembled to scaffold level. The mitochondrial genome has also been assembled, with a length of 20.21 kilobases. This assembly was generated as part of the Darwin Tree of Life project, which produces reference genomes for eukaryotic species found in Britain and Ireland
COVID's origins: what we do and don't know
No full textResearchers summarize key insights from the world’s first comprehensive investigation into how a pandemic started
Ro-to-go! Robust reactive control with signal temporal logic
Get PDFSignal Temporal Logic robustness is a common objective for optimal robot control, but its dependence on history limits the robot’s decision-making capabilities when used in model predictive control approaches. In this work, we introduce Signal Temporal Logic robustness-to-go, a new quantitative semantics for the logic that isolates the contributions of suffix trajectories. We prove its relationship to formula progression for Metric Temporal Logic, and show that the robustness-to-go depends only on the suffix trajectory and progressed formula. We implement robustness-to-go as the objective in a model predictive control algorithm and use formula progression to efficiently evaluate it online. We test the algorithm in simulation and compare it to model predictive control using other robustness measures. Our experiments show that using robustness-to-go improves performance compared to using traditional robustness
Efficient quantification of time-series prediction error: optimal selection conformal prediction
Get PDFUncertainty is almost ubiquitous in safety-critical autonomous systems due to dynamic environments and the integration of learning-based components. Quantifying this uncertainty–particularly for time-series predictions in multistage optimization–is essential for safe control and verification tasks. Conformal Prediction (CP) is a distribution-free uncertainty quantification tool with rigorous finite-sample guarantees, but its performance relies on the design of the nonconformity measure, which remains challenging for timeseries data. Existing methods either overfit on small datasets, or are computationally intensive on long-time-horizon problems and/or large datasets. To overcome these issues, we propose a new parameterization of the score functions and formulate an optimization program to compute the associated parameters. The optimal parameters directly lead to norm-ball regions that constitute minimal-average-radius conformal sets. We then provide a reformulation of the underlying optimization program to enable faster computation. We provide theoretical proofs on both the validity and efficiency of predictors constructed based on the proposed approach. Numerical results on various case studies demonstrate that our method outperforms stateof-the-art methods in terms of efficiency, with much lower computational requirements
Hypoxic and Fe‐Responses are Regulated by the ERFVII Factors and the PCO Branch of the N‐Degron Pathway According to Iron Availability
Get PDFIn plants, iron homeostasis and oxygen metabolism are strictly related, indeed several Fe‐requiring enzymes catalyze reactions that also involve O2 as a reagent, product, entry or end point of the pathway. Oxygen sensing itself relies on the Fe‐dependent enzymes Plant cysteine oxidases. However, the impact of iron deficiencies on the response to hypoxic stresses has not been investigated so far. PCOs channel the ERFVII ethylene‐responsive factors into a proteasomal N‐degron pathway that connects hypoxia‐inducible responses to the stabilization of the ERFVII transcription factors, which act as master regulators of plant hypoxic transcription. Here, we investigated the interplay between low oxygen and Fe‐deficiency stresses in A. thaliana. PCO activity in vivo was inferred from the expression of hypoxia marker genes and from the activity of a genetically encoded reporter of ERFVII protein stability. Our results highlight that Fe deprivation can elicit hypoxia‐like responses depending on its severity. Moreover, evidence from the pentuple erfVII mutant indicate that the ERFVIIs take part to the responses to chronic Fe‐deficiency and fine‐tune nutrient content to the shoot of submerged plants growing on moderately Fe‐deficient substrates. This work expands the known functions of the ERFVII factors and provides new information to understand plant responses to combined environmental stresses
Development of AWaRe-Based Quality Indicators to Assess the Appropriateness of Antibiotic Prescribing in Primary Healthcare in South Africa
Get PDFBackground/Objectives: The overuse and misuse of antibiotics contribute to antimicrobial resistance (AMR) globally. The appropriateness of antibiotic prescribing at the primary healthcare (PHC) level must be urgently addressed to reduce high levels of inappropriate antibiotic prescribing and associated AMR. This study aimed to develop quality indicators, based on the World Health Organization (WHO)’s Access, Watch, Reserve (AWaRe) guidance, to assess the appropriateness and quality regarding antibiotic prescribing in public PHC settings in South Africa. Methods: Potential indicators were identified from indicators developed by City St George’s, University of London (SGUL); a review of AWaRe-based indicators; and the results from point prevalence surveys at PHC clinics in South Africa. The indicators were developed using the RAND/UCLA Appropriateness Method. In Round 1, 12 experts individually rated 78 indicators for clarity and appropriateness. In Round 2, 10 experts rated 89 indicators for appropriateness and feasibility during an interactive online meeting. Results: The final set had 61/89 indicators (68.5%) that were rated both appropriate and feasible with agreement. Dental infections (9/9; 100%) alongside skin and soft tissue infections (11/13; 84.6%) had the highest percentage of indicators that were rated appropriate and feasible with agreement. Lower urinary tract infections (6/11; 54.5%) and general (4/8; 50%) categories had the lowest percentage of indicators rated appropriate and feasible with agreement. Conclusions: The process proved valuable in developing potential indicators for use in future antimicrobial stewardship programmes to improve antibiotic prescribing in public sector PHC facilities in South Africa and beyond
Introducing the Universal Periprosthetic Femur Fracture (UPFF) Classification: All Fractures Femur
Get PDFPeri-Prosthetic Femur Fractures (PPFFs) are occurring with increasing frequency as the incidence of hip and knee arthroplasty is rising globally. PPFFs are presenting with more complex patterns commensurate with the increasing sophistication of implant technology and surgical technique. Moreover, with patients undergoing arthroplasty procedures at a younger mean age, it is not uncommon to see both ipsilateral implants (hip and knee) being affected by the fracture. Previous classifications have separated PPFFs into the hip or knee regions, and most do not include fracture patterns about revision-style implants. Prior schemes are antiquated and are not applicable to all current fracture patterns. We present a codified anthropometric, rule-based staging system that incorporates PPFFs across the entire femur. This system is designed to standardize communication and capture variables relevant to treatment planning and future research analysis. Formal reliability and clinical validation studies are ongoing
Early Radiation Therapy Response Assessment Using Multi‐Scale Photoacoustic Imaging
Get PDFThere is a critical unmet clinical need to identify biomarkers that predict and detect radiation therapy (RT) response in cancer. Using the unique capabilities of multi‐scale photoacoustic imaging (PAI) to depict tumor oxygenation and vasculature in vivo, we identified surrogate biomarkers of RT response in two human breast cancer xenograft models (MCF7 and MDA‐MB‐231), comparing hypofractionated delivery with an ablative single‐dose scheme. Mesoscopic and multispectral tomographic PAI were performed 24h pre‐RT, 24h post‐RT and at endpoint and were supported by ex vivo immunohistochemistry. MCF7 xenografts, which exhibited a denser and more mature vasculature, showed improved response to both RT schemes than MDA‐MB‐231, in terms of oxygenation, volume control and proliferation. Higher pre‐RT oxygenation and oxygen‐diffusion capacity were associated with improved outcome, consistent with the oxygen‐enhancement effect. PAI further revealed regimen‐specific vascular effects: ablative RT produced early pruning of looping vessels and superficial blood volume, while only hypofractionated RT led to a rise in intratumoral oxygenation at the endpoint in radiosensitive MCF7, indicative of reduced oxygen consumption in damaged tumor cells. We showed that PAI could capture early RT response and inform on radioresistance, thus demonstrating PAI as a promising tool to monitor the tumor vascular response to RT
Hormone Replacement Therapy for Menopausal Symptoms and the Risk of Cardiometabolic Disease: Current Evidence and Future Directions
Get PDFBackground: The transition through menopause is accompanied by a series of adverse metabolic changes which are associated with an increased risk of cardiometabolic disease, a major cause of mortality in women after midlife. Whilst the indication for menopausal hormone replacement therapy (HRT) is the control of menopausal symptoms, understanding and discussing the cardiometabolic impacts of HRT are necessary to facilitate informed decision‐making at treatment initiation and continuation, and to select appropriate regimens. Methodology: A narrative review. Results: Existing evidence suggests that HRT is likely to impact the development of metabolic risk factors including visceral fat accumulation, adverse changes in lipid profile, blood pressure and glycaemic control. Findings from randomised controlled trials have refined our understanding of the impact of HRT on cardiometabolic outcomes including coronary heart disease and stroke. Furthermore, recent research has highlighted the impact of the menopause on the development and severity of metabolic dysfunction‐associated steatotic liver disease (MASLD) that has been poorly studied in the context of HRT. The route of oestrogen administration, timing of initiation and type of progestogen are all likely to affect the impact of HRT on many of these outcomes. There has recently been extensive media interest in HRT in some countries resulting in increased prescription rates. Understanding the impact of HRT on cardiometabolic risk is therefore particularly important. In this narrative review, we discuss the existing evidence and clinical guidelines on the effect of HRT on cardiometabolic risk factors and the risk of coronary heart disease, stroke and MASLD, highlighting areas of uncertainty and priorities for further research