No substantial neurocognitive impact of COVID-19 across ages and disease severity: a multicenter biomarker study of SARS-CoV-2 positive and negative adult and pediatric patients with acute respiratory tract infections

Background Compared to intensive care unit patients with SARS-CoV-2 negative acute respiratory tract infections, patients with SARS-CoV-2 are supposed to develop more frequently and more severely neurologic sequelae. Delirium and subsequent neurocognitive deficits (NCD) have implications for patients’ morbidity and mortality. However, the extent of brain injury during acute COVID-19 and subsequent NCD still remain largely unexplored. Body-fluid biomarkers may offer valuable insights into the quantification of acute delirium, brain injury and may help to predict subsequent NCD following COVID-19. Methods In a multicenter, observational case-control study, conducted across four German University Hospitals, hospitalized adult and pediatric patients with an acute COVID-19 and SARS-CoV-2 negative controls presenting with acute respiratory tract infections were included. Study procedures comprised the assessment of pre-existing neurocognitive function, daily screening for delirium, neurological examination and blood sampling. Fourteen biomarkers indicative of neuroaxonal, glial, neurovascular injury and inflammation were analyzed. Neurocognitive functions were re-evaluated after three months. Results We enrolled 118 participants (90 adults, 28 children). The incidence of delirium [85 out of 90 patients (94.4%) were assessable for delirium) was comparable between patients with COVID-19 [16 out of 61 patients (26.2%)] and SARS-CoV-2 negative controls [8 out of 24 patients (33.3%); p > 0.05] across adults and children. No differences in outcomes as measured by the modified Rankin Scale, the Short-Blessed Test, the Informant Questionnaire on Cognitive Decline in the Elderly, and the pediatrics cerebral performance category scale were observed after three months. Levels of body-fluid biomarkers were generally elevated in both adult and pediatric cohorts, without significant differences between SARS-CoV-2 negative controls and COVID-19. In COVID-19 patients experiencing delirium, levels of GFAP and MMP-9 were significantly higher compared to those without delirium. Conclusions Delirium and subsequent NCD are not more frequent in COVID-19 as compared to SARS-CoV-2 negative patients with acute respiratory tract infections. Consistently, biomarker levels of brain injury indicated no differences between COVID-19 cases and SARS-CoV-2 negative controls. Our data suggest that delirium in COVID-19 does not distinctly trigger substantial and persistent subsequent NCD compared to patients with other acute respiratory tract infections. Trial registration ClinicalTrials.gov: NCT04359914; date of registration 24-APR 2020

Comparison of outcomes from a university counselling service before and during COVID‐19: exploring the use of remote therapy

Background Research pooling data from UK university counselling services (UCSs) has allowed UCSs to compare their outcomes and demonstrate their effectiveness in improving student mental health. During the COVID-19 pandemic, UCSs moved to remote delivery. Consequently, it was necessary to understand how this impacted students' outcomes. Aims This evaluation aimed to (1) understand how the therapeutic outcomes of a UCS compared with established norms in UK UCS literature, and (2) understand whether delivering therapy online affected student outcomes compared with UK norms from in-person therapy. Method Sessional outcome data from 627 students who attended the UCS in the 2020/2021 academic year were gathered. Descriptive analyses of students' initial clinical data (determined by the CCAPS-34) were conducted. Paired sample t-tests determined differences between the pre- and post-therapy scores. The effect size of this difference was derived. Results Students presented with high levels of academic distress, social anxiety, generalised anxiety and depression. The initial severity of mental health concerns was lower than that reported in previous literature. The largest improvements were evidenced for depression and general anxiety and 25% (n = 112) of students achieved reliable reductions in distress. Compared with existing literature, the UCS showed similar levels of improvement over therapy. It is suggested that remote therapy increased service accessibility. Conclusion The delivery of remote therapy produced results consistent with norms in the UK data, highlighting the effectiveness of online therapy for university students. Further large-scale evaluations of student outcomes from remotely delivered therapy are recommended

Advancements in immobilization of cesium and strontium radionuclides in cementitious wasteforms—a review

The safe and secure encapsulation or immobilization of nuclear waste, particularly low to intermediate-level waste (accounting for ∼97% of the total volume of nuclear waste), has been a significant concern. Consequently, numerous studies have been conducted on various materials such as ordinary Portland cement-based, bitumen, and ceramics for the purpose of waste encapsulation/immobilization. However, these studies generally offer a broad overview of materials performance without focusing on specific radioisotopes of concern. Cesium (Cs) and strontium (Sr) are important radioactive nuclides to consider for encapsulation, but the existing studies on immobilizing these elements are fragmented and lack a comprehensive understanding. This critical review article offers a thorough qualitative and quantitative analysis to uncover the primary trends/knowledge gaps within the field. It comprehensively delves into waste classifications/management and leaching assessments, followed by an exploration of the immobilization performance and durability issues of various traditional and advanced cementitious materials including low-temperature chemically bonded ceramics such as alkali-activated matrices and Mg‒K phosphates for the immobilization of Cs and Sr. Furthermore, the review article provides fresh insights and perspectives, including recommendations for improvements, novel technologies, and future trends in this domain

Unlocking planetesimal magnetic field histories: A refined, versatile model for thermal evolution and dynamo generation

The thermal and magnetic histories of planetesimals provide unique insights into the formation and evolution of Earth’s building blocks. These histories can be gleaned from meteorites by using numerical models to translate measured properties into planetesimal behaviour. In this paper, we present a new 1D planetesimal thermal evolution and dynamo generation model. This magnetic field generation model is the first of a differentiated, mantled planetesimal that includes both mantle convection and sub-eutectic core solidification. We have improved fundamental aspects of mantle heat transport by including a more detailed viscosity model and stagnant lid convection parametrisations consistent with internal heating. We have also added radiogenic heating from 60Fe in the metallic Fe-FeS core. Additionally, we implement a combined thermal and compositional buoyancy flux, as well as the latest magnetic field scaling laws to predict magnetic field strengths during the planetesimal’s thermal evolution until core solidification is complete. We illustrate the consequences of our model changes with an example run for a 500 km radius planetesimal. These effects include more rapid erosion of core thermal stratification and longer duration of mantle convection compared to previous studies. The additional buoyancy from core solidification has a marginal effect on dynamo strength, but for some initial core sulfur contents it can prevent cessation of the dynamo when mantle convection ends. Our model can be used to investigate the effects of individual parameters on dynamo generation and constrain properties of specific meteorite parent bodies. Combined, these updates mean this model can predict the most reliable and complete magnetic field history for a planetesimal to date, so is a valuable tool for deciphering planetesimal behaviour from meteorite properties

Gaps in our understanding of ice-nucleating particle sources exposed by global simulation of the UK Earth System Model

Changes in the availability of a subset of aerosol known as ice-nucleating particles (INPs) can substantially alter cloud microphysical and radiative properties. Despite very large spatial and temporal variability in INP properties, many climate models do not currently represent the link between (i) the global distribution of aerosols and INPs and (ii) primary ice production in clouds. Here we use the UK Earth System Model to simulate the global distribution of dust, marine-sourced, and black carbon INPs suitable for immersion-mode freezing of liquid cloud droplets over an annual cycle. The model captures the overall spatial and temporal distribution of measured INP concentrations, which is strongly influenced by the world's major mineral dust source regions. A negative bias in simulated versus measured INP concentrations at higher freezing temperatures points to incorrectly defined INP properties or a missing source of INPs. We find that the ability of the model to reproduce measured INP concentrations is greatly improved by representing dust as a mixture of mineralogical and organic ice-nucleating components, as present in many soils. To improve the agreement further, we define an optimized hypothetical parameterization of dust INP activity (ns(T)) as a function of temperature with a logarithmic slope of −0.175 K⁻¹, which is much shallower than existing parameterizations (e.g. −0.35 K⁻¹ for the K-feldspar data of Harrison et al., 2019). The results point to a globally important role for an organic component associated with mineral dust

A conceptual framework for human–AI collaborative genome annotation

Genome annotation is essential for understanding the functional elements within genomes. While automated methods are indispensable for processing large-scale genomic data, they often face challenges in accurately predicting gene structures and functions. Consequently, manual curation by domain experts remains crucial for validating and refining these predictions. These combined outcomes from automated tools and manual curation highlight the importance of integrating human expertise with artificial intelligence (AI) capabilities to improve both the accuracy and efficiency of genome annotation. However, the manual curation process is inherently labor-intensive and time-consuming, making it difficult to scale for large datasets. To address these challenges, we propose a conceptual framework, Human-AI Collaborative Genome Annotation (HAICoGA), that leverages the synergistic partnership between humans and AI to enhance human capabilities and accelerate the genome annotation process. Additionally, we explore the potential of integrating large language models into this framework to support and augment specific tasks. Finally, we discuss emerging challenges and outline open research questions to guide further exploration in this area

A conceptual model of factors potentially influencing prescribing decisions for chronic conditions: an overview of systematic reviews

Background Nearly half of all adults are affected by chronic conditions with long-term medications often being the primary intervention. Although models like that of Murshid and Mohaidin contribute to our understanding of prescribing behaviours, they are not specific to chronic conditions and may not reflect the full range of influencing factors relevant to long-term care. Better understanding the factors that may influence healthcare professionals’ decision-making could help inform policy and guidelines as well as identify targets for future research and interventions. Methods An overview of systematic reviews was undertaken, following the 2020 PRISMA guidelines. PubMed, Embase, Web of Science, Cochrane Library and Google Scholar were searched from 01/01/2013 to 7/11/2023. Quality assessment was undertaken using the AMSTAR 2 tool. Screening, data extraction and synthesis were conducted. Confidence in findings was assessed using the GRADE-CERQual tool. An existing generic conceptual model of prescribing was adjusted to specifically reflect chronic conditions. Results Twenty-six reviews published between 2013 and 2023 were included, synthesising 689 primary studies. Patient factors that may influence prescribers’ decisions included age, ethnicity, education and level of rurality of residence. Prescribers describe assessing individual patient characteristics when weighing the risks and benefits, with a tendency to prioritise risks—especially for patients with multiple comorbidities or complex needs. Prescribers’ approach to risk may be influenced by their clinical experience, care setting and assessment tools. High workload and competing priorities may lead to clinical inertia in terms of delaying or preventing medication initiation. Shared decision-making may not always be shared equally between patients and prescribers. Beyond direct medication costs, prescribers may also consider broader healthcare costs, such as the need for monitoring and use of support staff for monitoring. External factors such as guidelines may be helpful in navigating risks, with their effectiveness potentially enhanced when they offer specific recommendations tailored to prescribers’ population characteristics. Conclusions Prescribers may need to navigate multiple challenges when making prescribing decisions for people with chronic conditions. This overview of systematic reviews suggests possible interrelated factor categories influencing prescribing decisions. The conceptual model may be used as a framework for future research and development of interventions

The landscape and challenges of postgraduate dental basic research education: a scoping review

Background Scientific research plays an important role in the advancement of dentistry. Postgraduate Dental Basic Research Education (PDBRE) is essential for enhancing the research knowledge and skills of research-focused students. This scoping review aims to identify the landscape and challenges of PDBRE, while also proposing future directions to further strengthen and optimize its effectiveness. Methods The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and followed a descriptive approach based on Arksey and O’Malley’s framework. A systematic search was conducted across PubMed, Web of Science, Embase, and the Education Resources Information Center (ERIC) databases to identify relevant literature up to May 20, 2024. Results The review screened 660 publications and selected 10 articles based on strict inclusion and exclusion criteria. These articles focused on curriculum contents, teaching methodologies, assessments, outcomes, and challenges related to effective research education in PDBRE. Conclusions PDBRE can enhance research-focused students’ foundational scientific research abilities by diversifying the curriculum content and teaching methodologies. However, challenges such as resource constraints, faculty shortages, workload, and student engagement hinder its development. To address these issues, we suggest strengthening faculty expertise and student involvement, alongside implementing a more systematic curriculum and improved assessment tools

What patients don’t say and physicians don’t ask: a needs assessment in myasthenia gravis integrating patient and healthcare professional perspectives

Introduction: Myasthenia gravis (MG) is a rare, autoimmune neuromuscular disease characterized by unpredictable fluctuating muscle weakness. This unpredictability makes effective patient–healthcare professional (HCP) dialogue essential for optimal diagnosis and management, with communication as a key component of shared decision-making (SDM). We designed a needs assessment to understand the differences between HCP and patient communication needs and perspectives on the impact of MG. Methods: A mixed-methods approach was utilized, comprising a survey and semi-structured interviews with HCPs and patients with MG. Quantitative data from the survey were extracted and analyzed to understand trends of knowledge, skills, and attitudes toward patient–HCP dialogue and SDM in MG. Interviews were transcribed and analyzed using principles of thematic analysis to identify perspectives on the impact of MG and challenges in communication. Results: Completed survey data were collected from 47 HCPs and 122 patients. There were discrepancies and areas of alignment in the priorities each group placed on knowledge, skills, and attitudes in MG management. Patients valued HCPs’ listening skills and knowledge of treatment history, whereas HCPs prioritized knowing what matters to a patient with MG, including providing support to the patient and their family/carer. Both groups agreed on the necessity of a compassionate and informed approach to care. Interviews (10 HCPs; 10 patients) revealed key themes, including the multifaceted way in which symptoms impact patients’ lives and challenges patients face while communicating their experiences. Conclusion: This needs assessment indicated general alignment between patients and HCPs on MG symptoms; however, notable disparities were found in relation to the perceived impact of these symptoms on patients’ lives, and communication. While some HCPs expected patients to volunteer information on symptoms and MG-related challenges, patients expected their HCPs to ask. This highlights a need for improved communication strategies, which will foster SDM approaches