Idiopathic Regression in Down Syndrome

Aims: Idiopathic Regression in Down Syndrome (IRDS) is reported to be present in 16% of people with Down syndrome however the clinical presentation is heterogeneous with no universal diagnostic criteria. It often presents in adolescence or early adulthood and there are often no known triggers. Common symptoms include language regression, mood symptoms, psychotic phenomena, motor symptoms and loss of previously acquired cognitive skills. We present a case series of two patients who presented to the West Norfolk Community Intellectual Disability Service with symptoms suggesting IRDS. Methods: AB (F; 34 years) has the diagnoses of Mild Learning Disability, Down syndrome, Bipolar Affective Disorder following a manic episode at the age of 18 and obsessive-compulsive disorder with predominantly compulsive acts. She was described by parents as a very sociable, active, and high achieving before she developed acute regression. Around the age of 12 years following an episode of profoundly serious pneumonia, she became catatonic, anorexic, and doubly incontinent. Clearly described episodes of depression and mania, obsessional behaviours and speech deterioration were also noted. The diagnosis of IRDS was raised by parents in 2023 and AB is currently being assessed for immunotherapy. XY (M; 46 years). Following a gastrointestinal infection aged 18 years, the family noticed he became more housebound, obsessional about symmetry, and depressed. No specialist investigations were done but he was managed for depression with several antidepressants with no improvement. He was also diagnosed with dementia and started on donepezil but nothing changed. He is currently psychotropics-free and following a retrospective diagnosis of IRDS and discussion with family, they were relieved that the correct diagnosis of XY’s condition has been found. Results: A physical illness appears to have triggered the regression in both cases. Personality and mood changes especially a manic presentation which is uncommon in people with Down syndrome were also reported. Psychotropic medications were not beneficial in at least the second case. In both cases, the diagnosis of Idiopathic Regression in Down Syndrome was an acceptable explanatory model for the family. Conclusion: We hope clinicians will make the diagnosis more promptly thus facilitating quick access to adequate treatment

The survey of planetary nebulae in Andromeda (M31) VII. Predictions of a major merger simulation model compared with chemodynamical data of the disc and inner halo substructures

Context. The nearest giant spiral, the Andromeda galaxy (M31), exhibits a kinematically hot stellar disc, a global star formation episode ∼2-4 Gyr ago, and conspicuous substructures in its stellar halo that are suggestive of a recent accretion event. Aims. Recent chemodynamical measurements in the M31 disc and inner halo can be used as additional constraints for N-body hydrodynamical simulations that successfully reproduce the disc age-velocity dispersion relation and star formation history as well as the morphology of the inner halo substructures. Methods. We combined an available N-body hydrodynamical simulation of a major merger (mass ratio 1:4) with a well-motivated chemical model to predict abundance distributions and gradients in the merger remnant at z=0. We computed the projected phase space and the [M/H] distributions for the substructures in the M31 inner halo, namely, the Giant Stellar Stream (GSS) and the North-East (NE) and Western (W) shelves. We compared the chemodynamical properties of the simulated M31 remnant with recent measurements for the M31 stars in the inner halo substructures. Results. This major merger model predicts (i) multiple distinct components within each of the substructures; (ii) a high mean metallicity and large spread in the GSS and NE and W shelves, which explain various photometric and spectroscopic metallicity measurements; (iii) simulated phase space diagrams that qualitatively reproduce various features identified in the projected phase space of the substructures in published data from the Dark Energy Spectroscopic Instrument (DESI); (iv) a large distance spread in the GSS, as suggested by previous tip of the red giant branch measurements; and (v) phase space ridges caused by several wraps of the secondary as well as up-scattered main M31 disc stars that also have plausible counterparts in the observed phase spaces. Conclusions. These results provide further strong and independent arguments for a major satellite merger in M31 ∼3 Gyr ago and a coherent explanation for many of the observational results that make M31 appear so different from the Milky Way

The Surprising Long-Term Evolution of the ULXP NGC 7793 P13

The ultra-luminous x-ray pulsar (ULXP) NGC 7793 P13 has been regularly monitored with XMM-Newton, NuSTAR, and Swift for the last 8 years. Here, we present the latest results of this monitoring campaign with respect to the pulse period evolution and spectral variability. We find that since the source recovered from an x-ray low state in 2020–2022 the spin-up rate has increased significantly compared with before the off-state, even though the x-ray luminosity has not shown an equivalent increase. We find that the x-ray and optical/UV flux are anti-correlated, and speculate that this variability might be driven by a large accretion disk, precessing at a super-orbital period of 7–8 years. We study the spectral behavior in the XMM-Newton and NuSTAR data, and find very little changes in the spectral shape, despite the large flux variability. This spectral consistency provides further indication that the observed flux variability is a geometric effect and not due to intrinsic changes of the accretion rate

Two-stepping: sol–gel–gel transitions in a mixed thermoresponsive polymer system †

Conventional thermoreversible gels exhibit a sol–gel transition upon modulation of temperature. These systems are typically comprised of block copolymers in which one block exhibits a lower critical solution temperature (LCST), triggering a solvophilic to relatively solvophobic switch of that moiety when heated. The systems, which include poly(ethylene oxide)(PEO)-b-poly(propylene oxide)(PPO)-b-PEO (“poloxamers”) and poly(N-isopropylacrylamide) (PNIPAM)-based block copolymers, thus exhibit a single step in their rheological profile upon heating, switching from a predominantly dissipative response to an elastic one. It has been found that a mixed tertiary system of PNIPAM–PEO–PNIPAM and poloxamer 407 displays an unconventional sol–gel–gel transition. The rheological behaviours of this system have been studied to demonstrate the rheological profiles of the sol, “Gel I” and “Gel II” phases, as well as the reversibility of the gelation. A mechanism is proposed for this process, learning from small-angle neutron-scattering experiments in dilute and concentrated regimes

Visiting and Exploring Digital Transformation Management: A Bibliometric Analysis and Review Study

Purpose: This study aims to explore and understand the literature on digital transformation (DT) research that will lead to developing a conceptual and thematic structure of DT management. Design/methodology/approach: The research approach employed a hybrid approach of bibliometric analysis and a structured review of DT management research studies from 2017 to 2023. Although systematic reviews and bibliometric analysis are distinct methods, they complement one another in research by enabling the synthesis and analysis of existing literature. Scopus and Web of Science (WoS) were selected as the bibliographic databases for this study since they are generally accepted as the most comprehensive data sources for various purposes. Findings: Findings revealed 186 publications during these periods, with the top three publications being the Journal of Business Research, Business Horizons and California Business Review. Top-ranking researchers hailed from Germany, Japan and Spain. Keywords that appeared were innovation, digital transformation, artificial intelligence and DT. In the management area, there are fewer studies conceptualising DT management that led to this study forming a conceptual framework using a qualitative, interpretative and thematic analysis approach. Originality/value: These findings are relevant for understanding the phenomenon of DT and DT management. The study contributes to the emerging body of knowledge in management and DT

Renewable energy market in Africa: Opportunities, progress, challenges, and future prospects

The transition to renewable energy is crucial for addressing Africa's rising energy demand while fostering sustainable development. With abundant renewable resources such as solar, wind, hydropower, and biomass, Africa is uniquely positioned to play a key role in the global low carbon energy transition. This study investigates the role of renewable energy in supporting Africa's Nationally Determined Contributions (NDCs) and its alignment with the Paris Agreement's climate goals. Using a combination of empirical methodologies, including market analysis and cost-benefit evaluations, we assess the potential of renewable energy to reduce greenhouse gas emissions, alleviate energy poverty, and promote economic growth. Our findings show that harnessing just 25 % of Africa's renewable energy potential could significantly reduce energy poverty, contributing to a sustainable, low-carbon future. Furthermore, we highlights the declining costs of renewable energy technologies, driven by innovation, economies of scale, and market dynamics, making renewable energy increasingly competitive with traditional energy sources. This has led to lower consumer energy prices, improved market attractiveness, and enhanced profitability for renewable energy investments. By examining the socio-economic impacts of renewable energy adoption, the study provides key insights into the market dynamics, investment potential, and policy implications for accelerating Africa's renewable energy transition. Our findings suggest that targeted investments in renewable energy could drive a just transition, improve energy access, and foster long-term socio-economic development across the continent

Understanding food insecurity in England: a systems-based approach

Food insecurity is a significant public health issue in England. National and local policies have not been able to adequately address its complex drivers, in part due to unintended consequences that arise from the way these policies interact with the system. Through an integrative review and group model building workshops with 17 subject matter experts, we developed four causal loop diagrams (CLDs) to map the interactions between food insecurity drivers and major policies such as Universal Credit, Healthy Start, and School Meal programs. The CLDs reveal that while these policies and interventions are intended to reduce food insecurity, specific implementation issues can unintentionally perpetuate food insecurity. These unintended consequences result in a shift in responsibility between governments and communities, with a subsequent erosion of public trust in governments and policies. This study highlights the need for redistributing responsibility back to governments, rebuilding trust and mitigating unintended consequences of current policies. By addressing the feedback mechanisms driving food insecurity, this research provides actionable insights and policy recommendations for creating equitable and effective policies

Clinical Management of Synthetic-Cannabinoid-Induced Psychosis: A Systematic Review of Treatment Strategies and Outcomes

Background: Synthetic cannabinoid receptor agonists (SCRAs, commercially known as “Spice”) have become a leading cause of substance-induced psychosis worldwide. These compounds show strong associations not only with acute psychotic episodes but also, in a subset of patients, with persistent or relapsing psychotic disorders, patterns that raise concern about progression to schizophrenia. Yet clinicians still lack clear, evidence-based guidance, and the optimal management of SCRA-induced psychosis remains inadequately defined. Methods: We carried out a systematic search of PubMed, Scopus, and Web of Science on 2 April 2025, identifying 35 primary studies that together describe roughly 4600 clinical presentations (≈77% male; mean age: 24.7 years). Results: Across diverse settings a convergent three-step pharmacological strategy emerged. First, rapid tranquillization with parenteral benzodiazepines consistently controlled severe agitation and autonomic instability. Second, when florid psychosis persisted beyond 30–60 min, clinicians introduced a second-generation antipsychotic—most commonly olanzapine, risperidone, or aripiprazole—often at doses exceeding those used for primary psychoses. Third, for the minority of refractory or relapse-prone cases, escalation to long-acting injectable formulations or low-dose clozapine achieved symptom control, even at plasma levels below those required in treatment-resistant schizophrenia. Although the evidence base consists largely of uncontrolled clinical descriptions, across studies, a recurrent clinical pattern was observed: initial benzodiazepines for agitation, followed by antipsychotics when psychosis persisted and escalation to clozapine or long-acting injectables in refractory cases. This approach appears to be associated with symptom improvement, although the certainty of the evidence is low to very low. Conclusions. Prospective, comparative studies are urgently needed to refine dosing, directly compare antipsychotic classes, and evaluate emerging cannabinoid-modulating interventions

Principles in practice? A policy review of the IOC’s environmental sustainability agenda.

This paper is a policy review focused on the environmental sustainability (ES) agenda of the International Olympic Committee (IOC). This incorporates exploration of IOC documents such as policies, strategies, guidelines, reports, codes, and conference outputs. The IOC's ES agenda is interpreted as both strategy around ES, as a plan of action to achieve desired outcomes, and policies around ES, as matters of practice and principle to be enacted. This review encompasses each of the IOC's three spheres of activity (as an organisation, as owner of the Olympic Games, and as leader of the Olympic Movement). The documentary analysis incorporates inductive thematic analysis and Critical Policy Discourse Analysis (CPDA). This allows for consideration of the role of the IOC as a driver of ES with the power and reach to influence pro-environmental behaviours on a global scale, as well as analysis of the extent to which documentary discourse demonstrates committed leadership in this sphere. Key themes arising from the data are networks and knowledge transfer, leadership and influence, governance and accountability, and opportunities and obstacles. Power relationships between stakeholders are important in terms of facilitating or inhibiting ES, and there are missed opportunities for the IOC both to better demonstrate positive ES outcomes from existing practices and to utilise its power in leveraging ES commitments from stakeholders across the Olympic Movement (OM). The application of CPDA highlights varying levels of commitment across these themes as well as a tendency toward ambiguity and contradiction that engenders the likelihood of unintended consequences including greenwashing. The IOC ES agenda needs to encompass clear and unambiguous policy and strategy with more explicit commitment and accountability across its three spheres of activity

Experimental study on improving thermal management of fan-wall data center by setting baffles in cold aisle

To maintain a stable thermal environment in the data center, the air conditioning system operates at high energy consumption levels annually. The airflow organization within the data center significantly impacts the cooling effectiveness of the air conditioning system. To achieve uniform airflow distribution, this study explores the effects of vertical and horizontal baffles placed between the air supply outlet and rack, both individually and in combination. This study explores the applicability of baffles in fan-wall data centers, analyzing and obtaining the optimal baffle angle, spacing, distance, and their corresponding thermal environment. This research aims to provide an optimized solution for enhancing thermal conditions within server rooms. The results indicate that: (1) Both vertical and horizontal baffles can improve the cold air trajectory from the air supply outlet to the rack, effectively improving the thermal environment of the rack. (2) Implementing a single vertical baffle at a distance of 0 cm and an angle of 75° effectively eliminates heat accumulation and achieves uniform temperature distribution. (3) When vertical or horizontal baffles are arranged individually, distance has a significant impact on airflow organization, however, when both vertical and horizontal baffles are combined, the influence of distance is minimal