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Practitioner, patient and public views on the acceptability of mobile stroke units in England and Wales: A mixed methods study
Background Evidence for Mobile Stroke Units (MSUs) demonstrates that onset to treatment times for intravenous thrombolysis can be reduced and access to mechanical thrombectomy might be improved. Despite growing use of MSUs internationally, to date there have been no studies in NHS England and NHS Wales exploring the acceptability of MSUs to clinicians, patient and public representatives and other key stakeholders, which are important when considering potential feasibility and implementation. Methods This study used a mixed methods design with a cross-sectional survey and qualitative workshops and interviews between October 2023 to May 2024. Survey data were collected from clinicians involved in emergency stroke care. Qualitative data involved clinical and non-clinical professionals involved in stroke care alongside patient and public representatives with experience of stroke. Survey data were descriptively analysed while content analysis was used on open-ended questions. Qualitative data were thematically analysed, prior to triangulation using a convergent coding matrix. Results The study results, drawn from 25 respondents to the survey and 21 participants in qualitative workshops, found that almost all participants had positive affective attitudes to the concept of MSUs. However, several key areas of concern were identified that need to be addressed prior to implementing MSUs. These concerns included how MSUs would be staffed; whether and how telemedicine could contribute; the types of economic impacts; extent to which triage systems could accurately identify stroke patients for MSUs to attend; where the base location and geographic coverage of MSUs should be, the impact of MSUs on equitable access to stroke care, and how to improve public awareness of MSUs. Conclusion Whilst MSUs are mostly acceptable to key stakeholders, numerous areas of concern need to be addressed prior to MSU implementation. We recommend further research to address these issues prior to implementation in the NHS.
Covalent Plant Natural Product that Potentiates Antitumor Immunity
In vivo mapping of sodium homeostasis disturbances in individual ALS patients: A brain 23Na MRI study
Objective Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by significant heterogeneity among patients. 23Na MRI maps abnormal sodium homeostasis that reflects metabolic alterations and energetic failure contributing to the neurodegenerative process. In this study, we investigated disease severity at the individual level in ALS patients using brain 23Na MRI. Methods 1H and 23Na brain MRI were collected prospectively from 28 ALS patients. Individual map of abnormal total sodium concentration (TSC) was computed using voxel-based statistical mapping for each patient compared to a local database of 62 healthy controls. Clinical data included the revised ALS functional rating scale (ALSFRS-R), ALSFRS-R slope, ALSFRS-R at 6-month and survival time. Results Individual maps quantifying voxels with TSC increase evidenced a high heterogeneity between patients consistent with clinical presentation. The main areas involved were the corticospinal tracts. Half of patients showed abnormal TSC increase within more than 1% of whole brain voxels. Patients with TSC increase had worse clinical severity: higher ALSFRS-R slope (p = 0.02), lower ALSFRS-R at 6-month (p = 0.04), and shorter survival (p = 0.04). ALS patients with limited TSC increase had slower progression of disability or predominant lower motor neuron phenotype or shorter disease duration. Discussion This study mapping sodium homeostasis disturbances at the individual level in ALS patients through 23Na MRI evidenced heterogeneity of TSC increase among patients associated with clinical presentation and disease severity. These findings suggest that TSC increase detected at the individual level by 23Na MRI may be a useful marker of the clinical heterogeneity of ALS patients, a factor that is likely to greatly influence the results of therapeutic trials.
Light-Enabled Reversible Hydrogen Storage of Borohydrides Activated by Photogenerated Vacancies
AI enabled, mobile soil pH classification with colorimetric paper sensors for sustainable agriculture
For optimizing production yield while limiting negative environmental impact, sustainable agriculture benefits from real-time, on-the-spot chemical analysis of soil at low cost. Colorimetric paper sensors are ideal candidates, however, their automated readout and analysis in the field is needed. Using mobile technology for paper sensor readout could, in principle, enable the application of machine-learning models for transforming colorimetric data into threshold-based classes that represent chemical concentration. Such a classification method could provide a basis for soil management decisions where high-resolution lab analysis is not required or available. In tropical regions, where reliable soil data is difficult to acquire, this approach would be particularly useful. Here, we report a mobile chemical analysis system based on colorimetric paper sensors that operates under tropical field conditions. A standard smartphone equipped with a dedicated software application automatically classifies the paper sensor results into three classes—low, medium, or high soil pH—which provides a basis for soil correction. The classification task is performed by a machine-learning model which was trained on the colorimetric pH indicators deployed on the paper sensor. By mapping topsoil pH on a test site with an area of 9 hectares, the mobile system was benchmarked in the field against standard soil lab analysis. The mobile system has correctly classified soil pH in 97% of test cases, while reducing the analysis turnaround time from days (soil lab) to minutes (mobile). By performing on-the-spot analyses using the mobile system in the field, a 9-fold increase of spatial resolution reveals pH-variations not detectable in the standard compound mapping mode of lab analysis. We discuss how the mobile analysis can support smallholder farmers and enable sustainable agriculture practices by avoiding excessive soil correction. The system can be extended to perform multi-parameter chemical tests of soil nutrients for applications in environmental monitoring at marginal manufacturing cost.
Exploring the protective role of caffeine against Taraxacum-Induced ribotoxic stress mediated through autophagy and mitochondrial depolarization
Immobilized Saccharomyces cerevisiae viable cells for electrochemical biosensing of Cu(II)
Correction for Zhang et al., Facet-switching of rate-determining step on copper in CO <sub>2</sub> -to-ethylene electroreduction
Comparative analysis of FACT devices for optimal improvement of power quality in unbalanced distribution systems
Magnetic polymeric ionic liquid for both catalysis application and magnetic solid phase extraction approach
Exposure of insects to current use pesticide residues in soil and vegetation along spatial and temporal distribution in agricultural sites
Abstract Current use pesticides (CUPs) are recognised as the largest deliberate input of bioactive substances into terrestrial ecosystems and one of the main factors responsible for the current decline in insects in agricultural areas. To quantify seasonal insect exposure in the landscape at a regional scale (Rhineland-Palatine in Germany), we analysed the presence of multiple (93) active ingredients in CUPs across three different agricultural cultivation types (with each three fields: arable, vegetable, viticulture) and neighbouring meadows. We collected monthly soil and vegetation samples over a year. A total of 71 CUP residues in different mixtures was detected, with up to 28 CUPs in soil and 25 in vegetation in single samples. The concentrations and numbers of CUPs in vegetation fluctuated over the sampling period, peaking in the summer months in the vegetation but remaining almost constant in topsoil. We calculated in-field additive risks for earthworms, collembola, and soil-living wild bees using the measured soil concentrations of CUPs. Our results call for the need to assess CUP mixture risks at low concentrations, as multiple residues are chronically present in agricultural areas. Since this risk is not addressed in regulation, we emphasise the urgent need to implement global pesticide reduction targets.
The necroptosis-related lncRNA ENSG00000253385.1 promotes the progression of esophageal squamous cell carcinoma by targeting the miR-16-2-3p/VDAC1 axis
Quantifying glucose uptake at the single cell level with confocal microscopy reveals significant variability within and across individuals
A novel carbon emission monitoring method for power generation enterprises based on hybrid transformer model
Identifying impairments and compensatory strategies for temporal gait asymmetry in post-stroke persons
Abstract In post-stroke persons, temporal gait asymmetry (TGA) during comfortable gait involves a combination of pure impairments and compensatory strategies. In this study, we aimed to differentiate between pure impairments and compensatory strategies underlying TGA in post-stroke individuals and identify associated clinical factors. We examined 39 post-stroke individuals who participated in comfortable walking speed (CWS) and rhythmic auditory cueing (RAC). Gait evaluation included spatiotemporal parameters and trunk acceleration, while clinical evaluation comprised motor paralysis severity, sensory disturbances, spasticity, balance ability, and gait efficacy. The participants were classified by clustering based on the symmetry index during CWS and RAC. TGA during CWS or RAC gait showed no association (ρ = 0.062, p = 0.707). Clustering yielded four optimal clusters. Cluster 1 was asymmetric during CWS but symmetric during RAC condition (over-compensatory strategies); these participants had a poor score on the modified gait efficacy scale, and despite mild functional impairments, they lacked the confidence to walk safely. Cluster 2 showed impairment-driven asymmetry during CWS and RAC, with severe impairments and instability. Participants showing improved TGA under auditory cueing compared with comfortable speed demonstrate strong compensatory strategies associated with low gait efficacy. This suggests a need for targeted interventions to enhance gait self-efficacy and maximize residual function.
Author Correction: Impact of plastic waste fiber and treated construction demolition waste on the durability and sustainability of concrete
The effect of blood glucose levels on serum triglyceride clearance in patients with hyperlipidemic acute pancreatitis
Serum levels of Wnt5a in Egyptian women with obesity and their association with toll like receptor 2 Arg753Gln gene polymorphism in a pilot case control study of obesity as a state of metaflammation
Abstract Female obesity is a worldwide health issue linked to chronic metabolic low-grade inflammation (metaflammation) causing multiple obesity-related co-morbid conditions. We aimed to assess the serum levels of wingless integration site family member 5 A (Wnt5a), leptin, and tumor necrosis factor-alpha (TNF-α) as markers of obesity-associated metaflammation and investigate the association with toll-like receptors2 (TLR2) gene (Arg753Gln) single nucleotide polymorphism (SNP) among Egyptian females. The study included 60 females with obesity and 30 matched controls. Serum levels of Wnt5a, leptin, and TNF-α were assessed by ELISA, while TLR2 (Arg753Gln) genotyping was done by PCR-RFLP. Serum Wnt5a, leptin, and TNF-α showed significantly higher levels in females with obesity than controls and a significant increase with higher classes of obesity. They showed significant positive correlations with each other. Only TNF-α and leptin were associated with metabolic syndrome (MetS) among the obesity group. According to TLR2 (Arg753Gln) SNP, the homozygous GG genotype was associated with elevated levels of Wnt5a, leptin, and TNF-α compared to the AA + GA model carriers. No significant differences were found in the distribution of TLR2 Arg753Gln (rs5743708) genotypes and alleles according to obesity or MetS, and the regression analysis showed no significant risk association. Serum Wnt5a, leptin, and TNF-α levels increase in women with obesity and the A allele of TLR2 (Arg753Gln) SNP could be protective against obesity-associated metaflammation.