Routine cerebral embolic protection during transcatheter aortic-valve implantation.

This is an accepted manuscript of an article published by Massachusetts Medical Society in New England Journal of Medicine on 30/03/2025, available online: https://doi.org/10.1056/NEJMoa2415120 The accepted version of the publication may differ from the final published version.Background Transcatheter aortic-valve implantation (TAVI) is associated with procedure-related stroke. Cerebral embolic protection (CEP) devices may reduce embolization to the cerebral circulation and hence the incidence of stroke. Methods We conducted a randomized, controlled trial across 33 centers in the United Kingdom. We randomly assigned 7635 participants with aortic stenosis in a 1:1 ratio to undergo TAVI with a CEP device (CEP group) or TAVI without a CEP device (control group). The primary outcome was stroke within 72 hours after TAVI or before discharge from the hospital (if discharge occurred sooner). Results A total of 3815 participants were assigned to the CEP group and 3820 to the control group. A primary-outcome event occurred in 81 of 3795 participants (2.1%) in the CEP group and in 82 of 3799 participants (2.2%) in the control group (difference, −0.02 percentage points; 95% confidence interval, –0.68 to 0.63; P=0.94). Disabling stroke occurred in 47 participants (1.2%) in the CEP group and in 53 (1.4%) in the control group. Death occurred in 29 participants (0.8%) in the CEP group and in 26 (0.7%) in the control group. Overall access-site complications appeared to be similar in the two groups (8.1% in the CEP group and 7.7% in the control group). A total of 24 serious adverse events occurred in 22 of 3798 participants (0.6%) in the CEP group, and 13 serious adverse events occurred in 13 of 3803 participants (0.3%) in the control group. Conclusions Among participants undergoing TAVI, routine use of CEP did not decrease the incidence of stroke within 72 hours. (Funded by the British Heart Foundation and Boston Scientific; BHF PROTECT-TAVI ISRCTN Registry number, ISRCTN16665769.)BHF PROTECT-TAVI is funded by the British Heart Foundation (BHF Clinical Study no. CS/20/1/34732). Funding for the CEP devices is provided by Boston Scientific, Inc. who were not involved in the coordination, conduct or reporting of the study.Published versio

Predicting VO2max Using Lung Function and Three-Dimensional (3D) Allometry Provides New Insights into the Allometric Cascade (M0.75)

This is an author's accepted manuscript of an article published by Springer in Sports Medicine on 13/04/2025, available online: https://doi.org/10.1007/s40279-025-02208-3 The accepted manuscript may differ from the final published version. For re-use please see Springer's terms and conditions.Background Using directly measured cardiorespiratory fitness (i.e. VO2max) in epidemiological/population studies is rare due to practicality issues. As such, predicting VO2max is an attractive alternative. Most equations that predict VO2max adopt additive rather than multiplicative models despite evidence that the latter provides superior fits and more biologically interpretable models. Furthermore, incorporating some but not all confounding variables may lead to inflated mass exponents (∝ M0.75) as in the allometric cascade. Objective Hence, the purpose of the current study was to develop multiplicative, allometric models to predict VO2max incorporating most well-known, but some less well-known confounding variables (FVC, forced vital capacity; FEV1, forced expiratory volume in 1 s) that might provide a more dimensionally valid model (∝ M2/3) originally proposed by Astrand and Rodahl. Methods We adopted the following three-dimensional multiplicative allometric model for VO2max (l⋅min−1) = Mk1·HTk2·WCk3·exp(a + b·age + c·age2 + d·%fat)·ε, (M, body mass; HT, height; WC, waist circumference; %fat, percentage body fat). Model comparisons (goodness-of-fit) between the allometric and equivalent additive models was assessed using the Akaike information criterion plus residual diagnostics. Note that the intercept term ‘a’ was allowed to vary for categorical fixed factors such as sex and physical inactivity. Results Analyses revealed that significant predictors of VO2max were physical inactivity, M, WC, age2, %fat, plus FVC, FEV1. The body-mass exponent was k1 = 0.695 (M0.695), approximately∝M2/3. However, the calculated effect-sizes identified age2 and physical inactivity, not mass, as the strongest predictors of VO2max. The quality-of-fit of the allometric models were superior to equivalent additive models. Conclusions Results provide compelling evidence that multiplicative allometric models incorporating FVC and FEV1 are dimensionally and theoretically superior at predicting VO2max(l⋅min−1) compared with additive models. If FVC and FEV1 are unavailable, a satisfactory model was obtained simply by using HT as a surrogate.Published onlin

Indigenous farmer's knowledge and perception of desertification and soil erosion in Jigawa state, Nigeria

© 2025 The Authors. Published by Springer Nature. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link: https://doi.org/10.1007/s44378-025-00028-5Desertifcation and soil erosion are major agro-environmental issues in Northern Nigeria. This study assessed farmers’ knowledge and perception of these phenomena in Dutse, Jigawa State, Nigeria. Data for the study was obtained through a questionnaire survey of 500 farmers, using random sampling techniques, and in-depth key informant interviews. Of the 500 distributed questionnaires, 383 were completed, representing a response rate of 76.6%. Most (86.9%) respondents were male and within the age group 35–50 years of age. Most respondents (48.6%) had 11–15 years of farming experience, with 70.5% of respondents having a large family (6–11 members) and an annual family income of<N151,000 (USD 92.61). All interviewees were aware of desertifcation, and most (80.2%) perceived desertifcation as a problem on their farm. The majority (88.3%) perceived that soil erosion had increased desertifcation problems and identifed sand dune deposition (40.2%) and decreased crop yields (20.9%) as the main indicators of soil erosion on their farms. Most respondents identifed changes in soil color as the main indicator of a depletion in soil fertility. The main (56.4%) identifed soil color was reddish yellow. The major soil conservation practices employed by respondents were tree planting (52.0%) and crop rotation (26.6%). Many of the trees (62.1%) were planted as windbreaks. The main tree species planted were date palm (Phoenix dactylifera) (65.8%) and gum Arabic (Acacia senegal) (29.2%). Results of the regression analysis indicated that as the farmers’ level of knowledge and perception increased, the level of awareness about erosion and desertifcation also increases. However, this does not signifcantly infuence farmers’ decision to increase the level of adoption of soil conservation measures in the study area. In summary, this study provides useful information upon which local policymakers can aid and advise local farmers to control soil erosion and reduce the rate of desertifcation. In addition, it also adds to our knowledge and understanding of these issues in relation to similar data obtained in other states in Northern Nigeria and other countries within the Sahelian region of Africa

Slowing forgetting in visual working memory: proactive facilitation in the repeated-unique paradigm

©American Psychological Association, 2025. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. The final article is available, upon publication, at: https://doi.org/10.1037/xlm0001539.Proactive interference occurs when previously established memories disrupt the retention of newer memories, and some evidence from the Repeated-Unique Paradigm suggests that proactive interference reduces the capacity of visual working memory. The present project assessed whether the other major limitation of visual working memory – its brief lifetime – may also be influenced by proactive interference. In six experiments, participants encoded sets of targets and then determined whether a single probe matched any of those targets. The retention interval (Experiments 1-2, 4-6) and inter-trial interval (Experiments 3-4) were varied, as was target repetition. Lower performance was expected when targets were extensively repeated across trials, rather than when they were unique, due to proactive interference. This was hypothesized to be especially likely after longer retention intervals and shorter inter-trial intervals, yet this was not supported as temporal forgetting was typically reduced when targets were repeated rather than unique. The only exception to this was when arrangements in the memory test were inconsistent in the two conditions. Overall, stimulus repetition generally offers protection against time-dependent forgetting, challenging the notion that proactive interference is responsible for the loss of working memory over time

Policies, programs, and action plans in geriatric mental health in South Asia

This is an author's accepted manuscript of a chapter published by Springer in Kar, N., Kar, S.K., Arafat, S.M.Y. (eds) Geriatric Psychiatry in South Asia. South Asian Perspectives in Mental Health and Psychology, available online at: https://doi.org/10.1007/978-981-96-7469-5_12 The accepted manuscript may differ from the final published version. For re-use please see Springer's terms and conditions.Matching with the growing population of older adults in South Asian countries, the number of people having health-related problems, including mental illnesses, needing medical treatment, care, and support is increasing. Depression and dementia are common concerns, along with suicide. Financial problems, high cost of care, lack of support, lack of availability of appropriate professional care, and struggles associated with informal family caregiving are some of the contributing factors. The increased need for old-age mental healthcare is well reported, and countries have developed various policies, and programs to support older adults, along with different laws to protect their interests. However, the gaps in the needs and available supportive facilities are obvious and the specific support for the mental health-related concerns of older adults is minuscule in most areas. Lack of appropriate resources, manpower, and training are obvious reasons, which need to be addressed as a priority by the countries, to avoid the situation becoming a crisis.Geriatric care and research organization (GeriCaRe), India; Quality of Life Research and Development Foundation (QoLReF), India; the Institute of Insight, UK; Black Country Healthcare NHS Foundation Trust, UK

Degradation profile of biocomposite antimicrobial packaging with bacteriocins: Implications for organic recycling

© 2025 The Authors. Published by Budapest University of Technology and Economics, Faculty of Mechanical Engineering, Department of Polymer Engineering. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://www.expresspolymlett.com/article.php?a=EPL-0013287This study focused on developing compostable packaging materials possessing beneficial microbiological characteristics and evaluating their degradation process. We explore the use of nisin as a versatile antimicrobial additive in biodegradable materials. Our findings demonstrate nisin’s significant influence on the processing and degradation of composites. Nisin’s amphiphilic structure, characterized by both hydrophobic and hydrophilic components, enhances its interaction with the polymer matrix. This interaction affects smaller molar mass reduction during processing and leads to variations in degradation dynamics. The results suggest that nisin has minimal impact on the thermal stability of the matrix during processing, with less than a one-degree increase observed. Thermal stability improved for all materials during degradation, but nisin’s presence slowed this increase. Nisin’s influence on the matrix of jute fiber composites, was more pronounced, affecting the material during processing and subsequent degradation. The results indicate that samples containing nisin inhibit the growth of the gram-positive bacterium Staphylococcus aureus (S. aureus) after 24 h of incubation. The inclusion of fillers in composites elevates the microbiological activity by filler ‘antibacterial promotion’ effects in samples containing nisin. Connection with previous studies highlights the significance of polymer chain length on the composite’s antimicrobial properties.Published versio

Towards a participatory assessment of community flood resilience

© 2025 The Authors, published by Purdue University. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.7771/3067-4883.1835Existing Community Flood Resilience (CFR) frameworks often integrate a range of dimensions to measure flood resilience, but social indicators are often overlooked or neglected due to the challenges involved in gathering information and quantifying these aspects. This research presents a novel methodology towards the development of a more comprehensive CFR framework. The methodology presented combines quantitative and qualitative insights through a participatory mixed-methods approach. Initially, the Delphi process is used to co-develop resilience indicators with professional experts drawn from key stakeholders including the Environment Agency, Local Authorities and National Flood Forum, as well as a range of community representatives. This new methodology argues for initiating earlier stakeholder input and sustaining this to enhance relevance and applicability of the framework. Grounding the framework in multiple stakeholder perspectives creates an opportunity to capture local and culturally relevant resilience indicators which thus far have received scant treatment in earlier frameworks. The intention is to apply the new methodology in vulnerable UK communities, using GIS mapping and regression analysis to visualise and quantify resilience levels. This new approach can bridge the gap in traditional flood resilience measurement by providing a flexible tool for policymakers to identify specific resilience needs. It contributes to the growing field of CFR assessment, provides practical solutions for adaptive flood management and supports United Nations Sustainable Development Goals (SDGs) Goal 16 by enabling local stakeholder engagement in resilience planning

Validation of the yRAFFLE: an implementation of the RAFFLE inventory for loot box engagement in a youth cohort

© 2025 The Authors. Published by BMC (Springer Nature). This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1186/s44247-025-00160-wBackground Play is pivotal in human development, and as such the human experience. In young people, play is increasingly taking the form of video gaming—capturing a large share of the entertainment sector and potentially exposing young people to new instances of harmful behaviour. Loot boxes (purchasable items where the contents are chance based, which have structural and psychological similarities to gambling) generate significant income for the sector. They have, however, been understudied in young people. The present research validates a lightly modified version of the Reasons and Facilitators for Loot box Engagement (RAFFLE) inventory in a youth population – the youth RAFFLE (yRAFFLE). Results Five hundred six young people were recruited from urban and rural schools, including both sexes and ages 10 to 14. The psychometric properties, internal and convergent validity of yRAFFLE were assessed. Through confirmatory factor analysis, a seven-factor (Enhancement, Progression, Social Pressure, Distraction/Compulsion, Altruism, Fear of Missing Out, and ReSale) solution was established, confirming the same factor structure previously observed in an adult cohort. Inspection of standard fit measures showed the seven-factor solution to fit above benchmarks and the original RAFFLE. Cronbach’s alpha for the whole scale was 0.95 and subscales ranged from 0.73 to 0.89. yRAFFLE was highly correlated with the Video Game Addiction questionnaire. Finally, yRAFFLE showed measurement invariance to sex, location, and age. Conclusions The finalised yRAFFLE is a robust measure of 23 items for the motivations for loot box engagement in young people, that acts a parallel to its counterpart in adults. The yRAFFLE functions as a methodological tool to capture, measure, and understand young people’s engagement with loot boxes.Published onlin

Critical review on the sustainability of metal additive manufacturing: environmental and economic perspectives

© 2025. The Authors. Published by Scilight Press Pty Ltd. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://www.sciltp.com/journals/rset/articles/2507000971Manufacturing is an important pillar of socio-economic development, but it has a large carbon footprint and causes serious damage to the ecosystem. There is significant pressure on the manufacturing sector to embrace eco-friendly manufacturing technologies to reduce its environmental burden. Metal Additive Manufacturing (MAM) is a rapidly evolving field with promising prospects to balance the economic and ecological concerns. Recently, manufacturing businesses started to examine MAM as a potential route to strengthen their eco-footprint and improve sustainability performance. The shift from Conventional Manufacturing (CM) processes to MAM requires significant capital investment, staff training, and possibly changing the business model. This may lead to hesitancy among enterprises to take on such risks without guaranteeing the sustainability benefits of MAM. This paper conducts a comprehensive review and critical evaluation of the environmental and economic impacts of MAM. The paper draws guidelines on the best production contexts that enable the fulfilment of environmental goals and maintain economic viability through MAM technologies. In general, Powder Bed Fusion (PBF) techniques are considered environmentally friendly and cost-effective for small-scale production of lightweight small parts with complex shapes and relatively high resolution. In contrast, Direct Energy Deposition (DED) processes are valuable for repairing and manufacturing large-scale parts that have medium shape complexity and relatively low resolution.Published onlin

Investigating advanced practice for people with intellectual disability and autism: a mixed methods study

© 2025 The Authors. Published by Wiley. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1111/jocn.17696Introduction Little is known about the advanced practice contribution health professionals make when working with People with Intellectual Disability and Autism. This paper shares the findings from a study investigating the delivery and impact of two university-led online postgraduate certificates. These programmes specifically focused on preparing health professionals to practice at an advanced level, with people with intellectual disability and autism across the lifespan. Aims The aim was to evaluate the opportunities and challenges the programmes provided, reviewing the online delivery capacity and its usefulness for preparing this group of health professionals at an advanced level across two cohorts of learners. Methods A concurrent mixed methods approach was adopted, collating descriptive and qualitative data virtually between February 2023 and January 2024. Adults with intellectual disability and autism were involved in the panel deciding the outcome of the research tender, as steering group members and as members of a national workforce advisory panel. No computerised software was used for the data analysis. Results Observations from minimal descriptive data, virtual focus group, nine one-to-one interviews, text-based and a jam-board data revealed online pedagogical decisions through multi-professional action learning sets. This supported enhanced practice confidence, enquiry-based practice and inter-professional capability. Conclusions Policy and decision makers should invest in more advanced practice programmes in this field, as they strengthen the care contribution for people with intellectual disabilities and autism. Implications for Practice Advanced practice learning can raise both practice confidence levels and improve opportunities for evidence-based service change for a group of people with complex needs. Reporting Method Mixed Methods Reporting in Rehabilitation Health Science.This work was supported by NHS ENGLAND