Evaluating the effects, implementation experience and political economy of primary healthcare facility autonomy reforms within counties in Kenya: a mixed methods study protocol.

Introduction: There is a growing emphasis on improving primary health care services and granting frontline service providers more decision-making autonomy. In October 2023, Kenya enacted legislation mandating nationwide facility autonomy. There is limited understanding of the effects of health facility autonomy on primary health care (PHC) facilities performance.

SGLT2 Inhibitor Use in Chronic Kidney Disease: Supporting Cardiovascular, Kidney, and Metabolic Health.

Originally developed for use in type 2 diabetes mellitus (T2DM), sodium-glucose co-transporter-2 (SGLT2) inhibitors demonstrated diverse cardiovascular- and kidney-protective effects in large outcome trials. Their subsequent approval as a treatment for chronic kidney disease (CKD) marked a pivotal shift in the landscape of CKD management. Further to this, the approval of dapagliflozin and empagliflozin for use in patients with CKD with and without T2DM afforded new treatment opportunities for this population.

Has COVID-19 affected the publication productivity of neurosurgeons in UK and Republic of Ireland? A bibliometric analysis.

Background: Our aim was to determine the impact of the COVID-19 pandemic on the publication productivity of neurosurgeons in the United Kingdom and Republic of Ireland.

Methods: Using bibliometric data we quantified and analysed the academic output of neurosurgeons in England, Scotland, Northern Ireland, Wales, and the Republic of Ireland, between two time periods i.e.

NET Models Meeting 2024 white paper: the current state of neuroendocrine tumour research models and our future aspirations.

Current models for the study of neuroendocrine tumours (NETs) are severely limited. While (e.g.

Commodity risk assessment of Alnus cordata, Alnus glutinosa and Alnus incana plants from the UK.

The European Commission requested the EFSA Panel on Plant Health to prepare and deliver risk assessments for commodities listed in Commission Implementing Regulation (EU) 2018/2019 as 'high-risk plants, plant products and other objects'. Taking into account the available scientific information, including the technical information provided by the applicant country, this Scientific Opinion covers the plant health risks posed by the following commodities: , and graftwood, bare-root plants and rooted plants in pots up to 7 years old imported into the EU from the UK. A list of pests potentially associated with the commodities was compiled.

Genomic Insights Into Red Squirrels in Scotland Reveal Loss of Heterozygosity Associated With Extreme Founder Effects.

Remnant populations of endangered species often have complex demographic histories associated with human impact. This can present challenges for conservation as populations modified by human activity may require bespoke management. The Eurasian red squirrel, (L.

Patient and public involvement in the design and protocol development for a platform randomised trial to evaluate diagnostic tests to optimise antimicrobial therapy (PROTECT).

Background: Our patient and public involvement activities were part of a project aiming to develop a master protocol and National Institute for Health and Care research application for the PROTECT trial aiming to assess the effectiveness, implementation, and efficiency of antimicrobial stewardship interventions, to safely reduce unnecessary antibiotic usage by excluding severe bacterial infection in acutely unwell patients.

Methods: Three public involvement sessions were held with representation from young people and parents, people from diverse backgrounds and people with experience of presenting to the emergency department with undifferentiated illness. The teleconference meetings lasted between 60-90 minutes, were recorded, notes were subsequently taken, and findings summarised.

The genome sequence of the Poplar Grey moth, (Denis & Schiffermüller, 1775).

We present a genome assembly from an individual male (Poplar Grey moth; Arthropoda; Insecta; Lepidoptera; Noctuidae). The genome sequence has a total length of 424.20 megabases.

Diabetic Ketoacidosis in Pregnancy: A Systematic Review of the Reported Cases.

Background: Diabetic ketoacidosis (DKA) is a rare but serious complication that can develop during pregnancy, with up to 30% of patients presenting with euglycemia, making prompt recognition challenging. It is associated with increased perinatal mortality rates, although the exact risk of maternal mortality remains unclear. The purpose of this systematic review was to examine the available literature and provide an overview of reported cases of DKA during pregnancy.

Disease characteristics and outcomes of acute myeloid leukemia in germline deficiency (Familial Platelet Disorder with associated Myeloid Malignancy).

Familial Platelet Disorder with associated Myeloid Malignancy (FPDMM, FPD/AML, -FPD), caused by monoallelic deleterious germline variants, is characterized by bleeding diathesis and predisposition for hematologic malignancies, particularly myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Clinical data on FPDMM-associated AML (FPDMM-AML) are limited, complicating evidence-based clinical decision-making. Here, we present retrospective genetic and clinical data of the largest cohort of FPDMM patients reported to date.

Novel efficient reservoir computing methodologies for regular and irregular time series classification.

Time series is a data structure prevalent in a wide range of fields such as healthcare, finance and meteorology. It goes without saying that analyzing time series data holds the key to gaining insight into our day-to-day observations. Among the vast spectrum of time series analysis, time series classification offers the unique opportunity to classify the sequences into their respective categories for the sake of automated detection.

Rapid rise in atmospheric CO marked the end of the Late Palaeozoic Ice Age.

Atmospheric CO is thought to play a fundamental role in Earth's climate regulation. Yet, for much of Earth's geological past, atmospheric CO has been poorly constrained, hindering our understanding of transitions between cool and warm climates. Beginning ~370 million years ago in the Late Devonian and ending ~260 million years ago in the Permian, the Late Palaeozoic Ice Age was the last major glaciation preceding the current Late Cenozoic Ice Age and possibly the most intense glaciation witnessed by complex lifeforms.

Preservation of organic carbon in marine sediments sustained by sorption and transformation processes.

Controls on organic carbon preservation in marine sediments remain controversial but crucial for understanding past and future climate dynamics. Here we develop a conceptual-mathematical model to determine the key processes for the preservation of organic carbon. The model considers the major processes involved in the breakdown of organic carbon, including dissolved organic carbon hydrolysis, mixing, remineralization, mineral sorption and molecular transformation.

Inefficient transfer of diatoms through the subpolar Southern Ocean twilight zone.

The Southern Ocean, a region highly vulnerable to climate change, plays a vital role in regulating global nutrient cycles and atmospheric CO via the biological carbon pump. Diatoms, photosynthetically active plankton with dense opal skeletons, are key to this process as their exoskeletons are thought to enhance the transfer of particulate organic carbon to depth, positioning them as major vectors of carbon storage. Yet conflicting observations obscure the mechanistic link between diatoms, opal and particulate organic carbon fluxes, especially in the twilight zone where greatest flux losses occur.

Association between choroidal microvasculature in the eye and Alzheimer's disease risk in cognitively healthy mid-life adults: A pilot study.

Introduction: We explored associations between measurements of the ocular choroid microvasculature and Alzheimer's disease (AD) risk.

Methods: We measured the choroidal vasculature appearing in optical coherence tomography (OCT) scans of 69 healthy, mid-life individuals in the PREVENT Dementia cohort. The cohort was prospectively split into low-, medium-, and high-risk groups based on the presence of known risk factors (apolipoprotein E [] ε4 genotype and family history of dementia [FH]).

Plasma biomarkers of amyloid, tau, astrogliosis, and axonal injury in a mixed memory clinic cohort.

Introduction: Studies have shown that blood biomarkers can differentiate dementia disorders. However, the diagnosis of dementia still relies primarily on cerebrospinal fluid and imaging modalities. The new disease-modifying treatments call for more widely applicable biomarkers.

The relationship between smoking and recurrent aphthous stomatitis: A Mendelian randomization study.

Introduction: Existing research suggests an association between smoking and the incidence of recurrent aphthous stomatitis (RAS); however, the causal relationship remains ambiguous. We employed Mendelian randomization (MR) to clarify the potential causal association between smoking and the risk of developing RAS.

Methods: We utilized genome-wide association study (GWAS) sequencing data related to smoking from the Finnish database as instrumental variables (IVs) and GWAS data for RAS from the UK Biobank (UKB) as the outcome to perform a two-sample MR analysis.

Overview of Effects of Motor Learning Strategies in Neurologic and Geriatric Populations: A Systematic Mapping Review.

Objective: To provide a broad overview of the current state of research regarding the effects of 7 commonly used motor learning strategies to improve functional tasks within older neurologic and geriatric populations.

Data Sources: PubMed, CINAHL, and Embase were searched.

Study Selection: A systematic mapping review of randomized controlled trials was conducted regarding the effectiveness of 7 motor learning strategies-errorless learning, analogy learning, observational learning, trial-and-error learning, dual-task learning, discovery learning, and movement imagery-within the geriatric and neurologic population.

Terminal Alkyne Activation by an Al(I)-Centered Anion: Impact on the Mechanism of Alkali Metal Identity.

The group 1 alumanyls, [{SiN}AlM] (M = K, Rb, Cs; SiN = {CHSiMeNDipp}), display a variable kinetic facility (K < Rb < Cs) toward oxidative addition of the acidic C-H bond of terminal alkynes to provide the corresponding alkali metal hydrido(alkynyl)aluminate derivatives. Theoretical analysis of the formation of these compounds through density functional theory (DFT) calculations implies that the experimentally observed changes in reaction rate are a consequence of the variable stability of the [{SiN}AlM] dimers, the integrity of which reflects the ability of M to maintain the polyhapto group 1-arene interactions necessary for dimer propagation. These observations highlight that such "on-dimer" reactivity takes place sequentially and also that the ability of each constituent Al(I) center to effect the activation of the organic substrate is kinetically differentiated.

Oxidised Apolipoprotein Peptidome Characterises Metabolic Dysfunction-Associated Steatotic Liver Disease.

Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) encompasses a spectrum of histological conditions ranging from simple steatosis to fibrosing steatohepatitis, and is a risk factor for cardiovascular diseases (CVD). While oxidised apolipoproteins A and B have been linked to obesity and CVD, the association between other oxidised apolipoproteins and MASLD is yet to be established. To fill this gap, we characterised the circulating serum peptidome of patients with MASLD.

Development of a Perioperative Risk Mortality Calculator for Humanitarian Surgical Care.

Background: Risk models to predict perioperative mortality rates (POMR) are critical to surgical quality improvement yet are not widely adapted for use in humanitarian and low-resource settings (LRS). We developed a POMR and corresponding nomogram and calculator for use in humanitarian surgical care.

Methods: Electronic health record data from a high-income academic medical center from 2015 to 2019 were retrospectively extracted, selecting variables and operations specific to LRS.