Peacock eye disease, caused by the hemibiotrophic fungus Venturia oleaginea, is the most destructive and widespread disease of olive in Israel. In a national project to develop an environmentally friendly peacock eye disease-management protocol for the local olive industry, it was found that one or a few fungicide applications in the autumn effectively suppressed disease development in the concurrent season. Since fungicide application timing should be based on environmental criteria rather than a predefined seasonal schedule the goal of the current study was to define criteria for predicting the occurrence of infection events. It was observed that peacock eye severity and leaf abscission were significantly lower in tree canopies facing sunrise between October and December, the presumed period of autumn infection events, than in those facing other directions. Accordingly, we used the uneven distribution of the disease with varying canopy orientation as a tool to ascertain the relative importance of the respective weather variables to infection. Duration of leaf wetness caused by dew was the most salient ambient condition showing consistent, albeit short-duration (≤2 h) differences between canopy sides. In-vitro experiments were conducted to examine how this small difference leads to marked differences in disease severity and to define conditions promoting conidial germination, germ tube elongation, and sporulation. Based on these and our previous results, we defined criteria for predicting the occurrence of infection events in highly susceptible olive cultivars: a rain event of 15 mm or more (for 1 day or accumulated over several consecutive days), wetness duration of at least 6 h, and temperatures between 12 and 18oC during the wetting period. These criteria could serve to time fungicide applications.
Flower color polymorphisms are found across angiosperms and are shaped by multiple environmental factors. We investigated Anemone pavonina, which displays flower color variation from red to purple along an elevational gradient on Mount Olympus, Greece. This species serves as a model for studying how elevation-associated shifts in biotic and abiotic factors shape floral trait variation. We examined the floral biology of A. pavonina in the field (Greece) and in greenhouse experiments (Germany). We studied plant breeding system and flowering phenology; quantified pollinator dependence, pollen limitation, and pollinator contribution to seed set; and investigated pollinator distribution and color preferences, linking these patterns to elevation. Anemone pavonina is protogynous, partially self-compatible, but relies on pollinators for seed set. Both morphs experience pollen limitation, which increases with elevation in the red morph but not in the purple one. In polymorphic populations, the flowering of red morphs peaked 1-2 weeks after purple morphs. Field trapping of common flower-visitors showed that Pygopleurus beetles prefer red colors, whereas bees choose non-red colors. Beetle but not bee abundance decreased with elevation. Anemone pavonina shows clear pollinator dependence. Flower color and phenology differ among morphs, reflecting adaptation to their local environment. The purple morph is better adapted to high elevations and associated with bee pollination, whereas the red morph is tuned to beetle vision and activity patterns. These findings demonstrate how spatiotemporal pollinator dynamics drive pollinator-mediated selection, contributing to the origin and maintenance of flower color variation.
Routine echocardiography at one month after diagnosis is the current standard for screening coronary artery abnormalities (CAA), a major complication of Kawasaki disease. The study aimed to develop and validate models to predict CAA and assess whether routine echocardiography could be safely reduced in low-risk patients. Two prospective multicenter Japanese registries were utilized: PEACOCK (development/internal validation) and Post-RAISE (external validation). Variables obtained within one week of diagnosis were used to predict CAA at one month after diagnosis, defined as a maximum coronary artery Z score (Zmax) ≥ 2. The models included simple models using the previous maximum Z score only, logistic regression models, and machine learning models (LightGBM and XGBoost). Discrimination, calibration, and clinical utility were assessed. Among 4,973 PEACOCK and 2,438 Post-RAISE patients, the CAA incidence was 5.5% and 6.8%, respectively. Twenty-two models were developed using 29 variables. For external validation, a simple model using the maximum Z score at week 1 produced an area under the curve (AUC) of 0.79; adding other variables or using more complex models did not increase the AUC by more than 0.02. The models failed to efficiently reduce the number of echocardiographic examinations while minimizing missed cased of CAA.Conclusion: Until superior predictors are identified, routine echocardiography at one month after diagnosis should remain the standard practice.
Inspired by the Bouligand helicoidal architecture of the dactyl club of the peacock mantis shrimp, this study employed direct ink writing (DIW) 3D printing to construct a three-level synergistic toughening system composed of nano-SiO2, microscale flake alumina, and a macroscale helicoidal structure. The effects of nano-SiO2 content, Bouligand helix angle, and flake alumina content on the flexural strength and fracture toughness of the composite ceramics were systematically investigated. The results showed that the optimal nano-SiO2 addition was 7 wt%, yielding a fracture toughness of 1.03 MPa·m1/2, which was 13% higher than that of pure alumina. The introduced intergranular glassy phase transformed the rigid grain-boundary bonding into a moderately strong gradient interface, resulting in higher fracture toughness for all SiO2-containing samples than for pure alumina. The Bouligand structure further increased the fracture toughness to a maximum of 1.45 MPa·m1/2 at a helix angle of 10°, representing a 39% improvement over the 0° sample. When microscale flake alumina was incorporated into the optimal matrix containing 7 wt% SiO2, the best overall mechanical performance was achieved at a flake alumina content of 5 wt%, where the flakes directly dissipated fracture energy through pull-out, fracture, and bridging mechanisms. The synergistic effect of the three structural levels was most pronounced at a helix angle of 20°, at which the sample containing 5 wt% flake alumina achieved a fracture toughness of 2.07 MPa·m1/2 with almost no loss in flexural strength, corresponding to a 113% improvement over the sample without flake alumina. These results demonstrate that three-level synergy can be achieved through nanoscale interfacial optimization, microscale energy dissipation by reinforcing phases, and macroscale crack deflection induced by the helicoidal structure, thereby providing important theoretical and experimental support for the multiscale design of high-performance bioinspired ceramic materials.
Niobium polyoxometalates (Nb-POMs) form in alkaline media, which limits their use as ligands for acidic cations, particularly lanthanides and actinides. Metal-Nb-POM moieties have the potential for emergent and enhanced properties, based on strong complexation behavior and high stability of the resultant materials. Here, we probe interactions of lanthanides (Pr3+, Nd3+, Sm3+, Eu3+, Tb3+, Dy3+) and actinides (Am3+, Cm3+) with a Nb-POM [Nb6O19]8- (Nb6) in alkaline media. Nb6, the most charge-dense Nb-POM, enhances f-element luminescence emission by up to × 106, via Nb-POM-mediated sensitization. Lengthened emission lifetimes correlate with the release of the metal-cation hydration sphere, replaced by multidentate Nb-POMs. The Nb6-Ln(An) complexes resist carbonate and phosphate displacement, and Nb6-Ln(An) complexation is retained upon isolation of the solids from solution. Electrospray ionization mass spectrometry (ESI-MS) and Raman spectroscopy both indicate the formation of the unprecedented Peacock-Weakley Nb-POM ([LnIII(Nb5O18)2]19-) in addition to simple Nb6-Ln coordination complexes. Luminescence emission spectra support the presence of simple Nb6-Ln coordination complexes. Small-angle X-ray scattering (SAXS) evidence the formation of Ln-Nb-POM aggregates. This foundational investigation highlights the potential of Nb-POMs as metal-ligands at basic pH, with value-added properties including scaffolding extended materials and controlling light absorption and emission.
The aim of this study is to culturally adapt an evidence-based intervention for Latino family caregivers of persons living with dementia. Despite the availability of evidence-based interventions for family caregivers, Latino caregivers have limited access to culturally relevant interventions. Qualitative descriptive using a participatory action research approach. In 2022, an Advisory Council, comprising Latino family caregivers, was convened to partner with researchers to review and make expert recommendations about cultural adaptations to a caregiver intervention. They also guided the semi-structured interviews conducted with Latino family caregivers to learn more about culture and caregiving. Data from the interviews were analysed using content analysis. Triangulation of data from the Advisory Council and the semi-structured interviews was used to identify adaptations to the intervention that would increase its cultural relevance. Three changes to the intervention content were determined from the different sources of data. The first change was to enhance content about dementia as a medical condition and not just a function of aging. Secondly, given the strong belief among Latinos of their duty to provide care to their elders, a second change was to strengthen the content on self-care. Finally, given the lower prevalence among Latinos of utilizing palliative care resources, we enriched the information about transitional care resources and their access. Initially and successfully targeting a specific minority, this study advances the field of knowledge translation by increasing accessibility of an evidence-based intervention with content that is likely to be relevant for caregivers more widely.
 Rapid weight loss and subsequent rapid weight regain (RWR) are common practices in professional mixed martial arts (MMA), driven by weight-category regulations and competitive strategy. Although RWR is often assumed to confer a performance advantage, limited research has examined whether the magnitude of weight regained influences how bouts are won among successful fighters.  This observational study analyzed publicly available regulatory records from Ultimate Fighting Championship and Bellator MMA events sanctioned by the California State Athletic Commission between 2018 and 2024. Only winning fighters were included. Official weigh-in and fight-night body mass were recorded using commission-calibrated scales. RWR was calculated as the percentage change from official weigh-in to fight-night weight. Independent samples t-tests were used to compare RWR by organization and sex division, and one-way analysis of variance was used to examine differences by method of victory. Statistical significance was set at p≤0.05.  A total of 154 winning professional MMA fighters were included. Mean RWR was 10.17±3.66%. RWR did not differ significantly between organizations (p=0.147) or between sex divisions (p=0.354). Method of victory was not impacted by RWR, with no significant differences observed between knockout or technical knockout, submission, or decision outcomes (p=0.383).  RWR is prevalent among winning professional MMA fighters; however, the magnitude of post-weigh-in weight regain does not appear to influence the method of victory. These findings suggest that while weight regain is a common component of fight preparation, it may not be a determining factor in how competitive success is achieved.
Group B Streptococcus (GBS) remains a leading cause of neonatal sepsis and meningitis in the UK, with an incidence of around 0.9 per 1000 live births. Early-onset disease usually results from vertical transmission during delivery, while late-onset disease is also acquired through postnatal exposures. GBS disease presents as sepsis, meningitis or pneumonia and leads to death in 6% of affected infants and long-term neurodevelopmental impairment in up to a third of survivors. The current UK prevention strategy of risk-based intra-partum antibiotic prophylaxis has several limitations, including lack of impact on disease burden in infants without associated risk factors and on late-onset disease. Ongoing studies of universal antenatal GBS screening and GBS maternal immunisations, along with a new British Paediatric Surveillance Unit surveillance study to provide updated epidemiological data will help to guide policy and practice.
Nitrogen (N) foraging, the ability of plants to promote preferential root growth in N-rich patches of soil, is fundamental to the competitiveness and wellbeing of plants. A unique “split-root” system, where a heterogenous N environment stimulates root foraging, provides a powerful experimental model to study the mechanisms underlying root foraging in model (Arabidopsis) and/or crop plants. We used the split-root set up to capture early molecular events involved in systemic N-signaling after exposure to a heterogeneous N signal, through time-course transcriptomic analysis across shoots and roots of Arabidopsis. We found that a histone methyltransferase, SET DOMAIN GROUP 8 (SDG8), is necessary for root N-foraging, suggesting a previously unknown role for chromatin regulation in mediating the preferential root growth response to colonize N-rich patches. To determine if the underlying molecular mechanism is conserved in evolution, we compared the root foraging behavior from model-to-crop (Arabidopsis, tomato and maize). Our analysis showed the model and crop species shared a root N-foraging growth response, with some variation among specific genotypes. Interestingly, we observed both shared and distinct transcriptional responses to heterogenous N environments among these three species. Our study has generated insights into the molecular basis of root N-foraging, with the potential to improve nutrient use efficiency in crop plants in a heterogeneous field environment. The online version contains supplementary material available at 10.1186/s12864-026-12736-5.
Patient and public involvement and engagement (PPIE) has many benefits for the design, delivery and dissemination of health research, but this can be difficult to achieve. Systematic reporting and evaluation of PPIE in multi-year, multisite and complex clinical trials is very limited. This evaluation presents a multi-perspective description and evaluation of patient and public involvement within a large-scale, multisite, longitudinal research programme focused on developing and evaluating a vocational rehabilitation and clinical psychology intervention for individuals recovering from traumatic injury. Conducted as part of the NIHR-funded ROWTATE research programme (2019-2026), the evaluation explores the scope, impact, and lived experiences of PPIE group members across all phases of the study, from development of the intervention, feasibility study and trial design to intervention delivery, data collection, analysis and dissemination. Employing multiple methods, including open-ended surveys with PPIE group members and researchers, a 'You Said, We Did' activity log, and minute taking, the study identifies key patterns related to PPIE group members' motivations, contributions, personal impact and barriers and facilitators to engagement. Findings highlight the significant value of PPIE in enhancing study relevance, improving data collection and communication strategies, informing rehabilitation, clinical psychology and health economics components, and shaping intervention delivery. PPIE group members reported a strong sense of purpose and intellectual engagement, despite challenges including communication gaps and role clarity. Researchers valued PPIE contribution to the research, and the positive and enriching experience of working with PPIE group members. Both groups reflected on the barriers and facilitators to PPIE. The evaluation highlights the importance of inclusive, well-supported, and transparent PPIE practices and contributes novel insights into the PPIE role in under-researched domains such as clinical psychology and health economics. Traumatic injury survivors were involved in all processes of this evaluation. This includes research design, funding acquisition, data collection, data analysis and interpretation and the write-up of this manuscript. Five traumatic injury survivors are co-authors of this manuscript.
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Antimicrobial resistance (AMR), referred to as the "constant pandemic," exceeds malaria and HIV as a cause of mortality across low- and middle-income countries. As AMR has been included in the recently adopted world's first pandemic agreement, we assessed the implications going forward for addressing AMR and meeting the UN General Assembly AMR targets. A rapid literature review was conducted to synthesize policy perspectives and empirical literature using 3 databases (PubMed, Embase, and CABI-Global Health) for studies published from December 2021 to May 2025. Of the 56 included studies, only 2 were empirical research. Inductive and deductive analyses using the Organization for Economic Co-operation and Development framework with a force-field analysis were used to identify drivers and factors that may impede AMR reduction via the pandemic agreement. Challenges include inequity, inadequate governance, and financing. Factors that may impede implementation of the agreement currently outweigh driving forces. While AMR is included in the pandemic agreement, assessing the merits and risks associated with doing so is important to inform the detail and implementation strategy of the agreement itself. There is consensus that strengthening governance frameworks, fostering equity, and ensuring fair access to health resources are imperative.
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Blood-based biomarkers for traumatic brain injury (TBI) are increasingly integrated into diagnostic algorithms, but their interpretation may be confounded by age-related neurological changes. This study quantified the relative effects of age and TBI on biomarker concentrations to determine whether age-related variation approaches or exceeds that associated with injury. Serum biomarkers were analyzed from 762 adults enrolled in the HeadSMART II and HeadSMART Geriatric studies, including healthy controls (n = 88), non-head trauma controls (n = 99), and mild TBI patients (GCS 13-15, n = 575). Participants were categorized by age (18-40, 41-64, 65-74, ≥ 75 years). Six TBI-relevant biomarkers (glial fibrillary acidic protein [GFAP], brain-derived neurotrophic factor [BDNF], neurogranin [NRGN], α-synuclein [SNCA], suppression of tumorigenicity 2 [ST2], and von Willebrand factor [vWF]) were quantified using validated immunoassays (BRAINBox Solutions). Biomarker levels were compared using two-way ANOVA, and the relative effects of age and injury were estimated using Cohen's f. Age significantly influenced several biomarkers. GFAP showed strong age-related increases, with significant elevations across age strata (p < 0.001), exceeding the effect of head injury alone. vWF also increased significantly with age (p < 0.001), while ST2 did not show a main effect of age (p = 0.404), although age interacted with group (p < 0.001). SNCA demonstrated modest age effects (p = 0.001), particularly in older trauma and TBI participants. NRGN showed no significant age-related changes (p = 0.454), and BDNF exhibited age effects within interaction terms (p < 0.001). Overall, age-associated effect sizes for GFAP and vWF were comparable to, or greater than, those of head injury. Age exerts substantial influence on circulating biomarker concentrations, particularly GFAP and vWF, often rivaling or exceeding TBI-related changes. Diagnostic algorithms that fail to adjust for age may risk misclassification, especially among older adults, underscoring the need for age-normalized biomarker interpretation.
Uncontrolled hypertension disproportionately affects populations that have substantial health disparities. Data regarding the effectiveness and implementation of multifaceted, team-based strategies for hypertension control among low-income patients are lacking. We randomly assigned federally qualified health center clinics in Louisiana and Mississippi to use either a multifaceted implementation strategy (intervention group) or enhanced usual care (control group) for hypertension control. The intervention included team-based care, protocol-based intensive blood-pressure management, blood-pressure audit and feedback, health coaching on lifestyle changes and medication adherence, and home blood-pressure monitoring. Enhanced usual care involved educating physicians about clinical guidelines for hypertension. The primary effectiveness outcome was the mean change in systolic blood pressure from baseline to 18 months. The primary implementation outcome was the adherence summary score (on a scale of 0 to 4, with higher scores indicating better adherence to blood-pressure management). A total of 36 clinics underwent randomization. Among these clinics, we enrolled 1272 patients with uncontrolled hypertension who were 40 years of age or older; 642 were in the intervention group and 630 were in the control group. The mean age of the patients was 58.8 years, 56.7% were women, 63.4% were Black, 75.9% were unemployed, and 73.4% had a family income of less than $25,000 per year. At 18 months, the mean change from baseline in the systolic blood pressure was -15.5 mm Hg (95% confidence interval [CI], -17.4 to -13.6) in the intervention group and -9.1 mm Hg (95% CI, -11.0 to -7.2) in the control group (between-group difference, -6.4 mm Hg; 95% CI, -9.0 to -3.8; P<0.001). The mean adherence summary score over the 18-month follow-up period was 2.8 (95% CI, 2.7 to 2.9) in the intervention group and 2.1 (95% CI, 2.0 to 2.2) in the control group (between-group difference, 0.7 points; 95% CI, 0.6 to 0.8; P<0.001). Serious adverse events occurred in 20.9% of the patients in the intervention group and in 21.7% of those in the control group. Among low-income patients with hypertension, a multifaceted, team-based implementation strategy resulted in a significantly greater reduction in systolic blood pressure than enhanced usual care. (Funded by the National Heart, Lung, and Blood Institute and others; IMPACTS-BP ClinicalTrials.gov number, NCT03483662.).
Environmental DNA (eDNA) analysis is a non-invasive method for discovering and identifying rare and endangered species in a variety of ecosystems including aquatic environments. However, conventional eDNA analysis tends to be time consuming and labor-intensive, which limits their efficiency. In this study, a novel eDNA capture system is made from stacked layers of membranes with a binding pad of borosilicate glass paper embedded with a triple layer of high molecular weight chitosan and silica nanoparticles. The system is designed to enhance DNA capture efficiency and is part of a portable system for on-site eDNA extraction that measures approx. 22 x 70 mm using sample volumes up to 3 mL and enables DNA extraction under 10 min. The DNA recovery rate of 86% is comparable to silica bead-based laboratory methods at a significantly lower cost, and the Ct values from the nucleic acid amplification step are reached within 18 to 36 min. Real water samples were tested, yielding results comparable to those obtained with the silica bead-based laboratory methods. Thus, enables downstream applications, such as species detection through a portable system that has the potential to improve the accessibility of eDNA analysis for effective environmental monitoring and conservation practices.
Clinical trials of psychological therapies such as cognitive behavioral therapy typically show sustained posttreatment effects. However, less is known about individuals' outcomes following treatment in routine practice, and additionally, patient representatives have highlighted a need for better postdischarge support. The "Paddle" app aims to address these issues. Paddle allows patients to store their therapy materials, reflect on sessions, and monitor their well-being during and after treatment, completing outcome questionnaires and monthly reviews. Study 1 evaluated patients' use of Paddle during treatment in routine practice. Patient and therapist surveys explored feasibility, acceptability, and helpfulness. Study 2 examined the feasibility of using the app post discharge, inviting users to submit monthly questionnaires for 6 months, and seeking feedback via survey. Our findings indicate that Paddle was feasible to implement with few technical problems. Although not all patients wanted to use an app in Study 1, uptake was 66% (111/168) and users found it acceptable and helpful for organizing and remembering therapy information. Most reported using the app on a weekly or fortnightly basis. In Study 2, a total of 321 patients downloaded and used the app at least once, of whom 49% (156/321) submitted follow-up data. Of those who reliably improved during treatment, 73% (86/118) remained so throughout the 6-month follow-up period. Among all users, 20% (31/156) showed further reliable improvement at least once compared to their end-of-treatment score. We introduce the concept of "reliable relapse," which occurred for 36% (32/89) of users who had reliably recovered during treatment, highlighting that some experience fluctuations or deterioration. Feedback highlighted Paddle's value in helping people self-monitor and prioritize their well-being after treatment, with 81% (50/62) suggesting a postdischarge follow-up period longer than 6 months would be helpful. These preliminary findings suggest that Paddle shows promise in supporting patients to collate therapy resources and monitor their well-being during and after treatment. It may help to improve rates of follow-up data collection, which warrants further investigation.
To quantify inequalities in obesity-related complication (ORC) prevalence and differences in healthcare costs between the most (Q1) and least (Q5) deprived quintiles of people living with obesity. Retrospective, open cohort study of ~2.5 million people residing in North-West London using linked primary and secondary electronic health records. Individuals aged ≥18 years living with obesity (body mass index ≥30 kg/m2) between 1 January 2016 and 31 December 2019 were eligible. The population was stratified into deprivation quintiles per the Index of Multiple Deprivation (IMD). Individuals were grouped into non-mutually exclusive ORC prevalence groups covering 27 ORCs, including ORC multimorbidity. Primary outcomes were ORC prevalence and healthcare cost differences between the lowest and the highest deprivation quintiles. ORC prevalence and healthcare costs were age-standardised to the European Standard Population. Out of 362 023 people living with obesity, 64 866 were in IMD Q1 (most deprived) and 24 590 in Q5. The largest ORC prevalence differences between Q1 and Q5 were seen in conditions with highest prevalence overall: type 2 diabetes (5.1 percentage point prevalence difference; 19.5% prevalence), hypertension (3.8, 32.7%) and depression (3.4, 6.3%). The percentage point prevalence difference was larger with increasing ORC multimorbidity: 1.2 for at least one, 3.7 for at least two and 4.0 for at least three ORCs. Healthcare costs were greater in the most deprived quintile compared with the least deprived quintile for every ORC population, with the largest differences seen in peripheral arterial disease (£2801 cost difference), cancer (£2785), renal failure (£2108). Targeted interventions proportionate to these health and cost burdens could improve health equity and reduce healthcare cost, yet their causal drivers require further study.
New psychoactive stimulants and hallucinogens (NPSH) poisonings have generated considerable public health concern in recent years. We aimed to determine: 1. The characteristics, toxicology and major autopsy findings of known cases of NBZD-related poisoning in Australia, 2000-2025; and 2. Changes in characteristics of known cases from 2020 onwards compared to earlier known cases. Retrospective study of fatal NPSH-related poisonings in Australia retrieved from the National Coronial Information System. 70 cases were identified, the first occurring in 2007. In 22.9% the decedent appeared unaware they were consuming a NPHS, and in 32.9% the NPSH had been injected. The most commonly observed signs and symptoms of acute NPSH poisoning were intense agitation (22.9%), sudden collapse (22.9%) and hyperthermia (20.0%). There were 31 NPSH identified, of which 13 were first detected in the 2020 s. The most commonly detected NPSH were cathinones (48.6%), most frequently α-pyrrolidinovalerophenone and methylenedioxypyrovalerone. Phenethylamines were present in 38.6%, with paramethoxymethamphetamine and a range of the N-benzylphenethylamine series (NBOMe) the most common. Tryptamines were present in 18.6%, and three cases involved piperazines. In 18 cases (25.7%) multiple NPSH were detected in the blood. 2020 s cases were more likely to have tryptamines detected (36.7 v 5.0%), but less likely to have phenethylamines (23.3 v 50.0%). Psychoactive drugs in addition to NPSH were present in 92.9%, most commonly psychostimulants (68.6%) and hypnosedatives (40.0%). A wider range of NPHS have been detected in recent fatal poisonings, with tryptamines becoming more common in the 2020 s, and phenethylamines less common.