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Sex-specific division of labour and the associated use of different subsistence techniques by males (e.g. hunting) and females (e.g. gathering) has played an important role in shaping human societies. Skills needed in adulthood are practiced in play during childhood and object play has been proposed to foster tool-use skills necessary for adult subsistence techniques. Here, we investigated sex differences in the ontogeny of object play in Tsimane children in Bolivia to understand its potential role in shaping gender-specific adult roles. We used observational data (>80,000 scan samples) from nine Tsimane communities collected between 2002 and 2007. We analysed age and sex differences in general play, object play, and object types. Our results show that both general play and object play peaked in early to middle childhood (3.5–7.5 years of age), with boys spending more time playing. Moreover, boys engaged more with objects related to male-specific roles (e.g. hunting tools), while girls played more with objects related to female-specific roles (e.g. cooking tools). Our findings suggest that object play serves as an adaptive, culturally embedded pathway to develop gender-specific adult skills. Studying developmental patterns of object play across human cultures enriches our understanding of the evolutionary contexts shaping divisions of labour.
The spatio-temporal evolution of very large-scale coherent structures, also known as superstructures, is investigated in both smooth- and rough-wall boundary layers by means of direct numerical simulations up to a frictional Reynolds number of ${\textit{Re}}_\tau = 3\,150$. One smooth-wall and four rough-wall cases are considered, all developing over a region as long as $\sim$60 times the incoming boundary-layer thickness in the streamwise direction. Bio-inspired, biofouling-type topographies are employed for the rough-wall cases, following the previous work of Womack et al. (2022 J. Fluid Mech. vol. 933, p. A38) and Kaminaris et al. (2023 J. Fluid Mech. vol. 961, p. A23). We utilise three-dimensional time series, as well as multiple two-point correlation functions along the boundary layer to capture the detailed length- and time-scale evolution of the superstructures. The results suggest that the presence of roughness significantly amplifies both the strength and the streamwise growth rate of superstructures. Interestingly, however, their ratios relative to the local boundary-layer thickness, $\mathscr{L}_{\!x}/\delta$ and $\mathscr{L}_z/\delta$, remain constant and independent of the streamwise coordinate, indicating that such scaled length scales might constitute a possible flow invariant. Volumetric correlations revealed that all cases induce structures inclined with respect to the mean-flow direction, with those over the rough-wall topographies exhibiting steeper inclination angles. Finally, via proper orthogonal decomposition, pairs of counter-rotating roll modes were detected and found to flank the high- and low-speed superstructures, supporting the conjecture in the literature regarding the mechanisms responsible for the lateral momentum redistribution. The latter also suggests that the way momentum organises itself in high Reynolds number wall-bounded flows might be independent of the roughness terrain underneath.
eSource – particularly EHR-to-EDC – is an emerging paradigm in clinical research that enables automated transfer of electronic health record (EHR) data into electronic data capture (EDC) systems, with the potential to reduce site burden, improve data quality and accelerate oncology clinical trial workflows. However, widespread implementation remains limited due to technical, regulatory and operational barriers. To address these challenges, the European Institute for Innovation through Health Data (i~HD) launched the eSource Scale-Up Task Force in 2024. This multi-stakeholder initiative brings together leading oncology centres and pharmaceutical sponsors to establish a consensus-driven roadmap for eSource adoption. Central to this effort are three foundational resources: readiness criteria for early adopters, a performance indicator framework for monitoring success and an operational playbook to guide implementation. This article provides a structured overview of the Task Force’s objectives, collaborative model and outputs, with specific attention to its focus on interoperability, regulatory alignment and real-world validation. While initially developed for oncology, the Task Force’s framework is applicable across therapeutic areas characterized by data-intensive workflows.
In this work, we discuss the challenges related to the preliminary investigation of high repetition rate (HRR) experiments in the field of high energy density (HED) physics, and we present the results of preparation experiments done at the Prague Asterix Laser System (PALS) laser facility conducted with the aim of defining the needed developments in target design, real-time diagnostics and data collection needed to meet HRR requirements. Although the PALS laser facility is not an HRR facility, it has served as a valuable test bed for advancing diagnostic techniques and refining target design in preparation for HRR experimental platforms. HRR operation will result in improved statistical errors of the experimental results, in particular for experiments related to equation of state studies in extreme conditions.
Paleontology provides insights into the history of the planet, from the origins of life billions of years ago to the biotic changes of the Recent. The scope of paleontological research is as vast as it is varied, and the field is constantly evolving. In an effort to identify “Big Questions” in paleontology, experts from around the world came together to build a list of priority questions the field can address in the years ahead. The 89 questions presented herein (grouped within 11 themes) represent contributions from nearly 200 international scientists. These questions touch on common themes including biodiversity drivers and patterns, integrating data types across spatiotemporal scales, applying paleontological data to contemporary biodiversity and climate issues, and effectively utilizing innovative methods and technology for new paleontological insights. In addition to these theoretical questions, discussions touch upon structural concerns within the field, advocating for an increased valuation of specimen-based research, protection of natural heritage sites, and the importance of collections infrastructure, along with a stronger emphasis on human diversity, equity, and inclusion. These questions offer a starting point—an initial nucleus of consensus that paleontologists can expand on—for engaging in discussions, securing funding, advocating for museums, and fostering continued growth in shared research directions.
Production efficiency of pasture-based livestock production systems is primarily driven by the level of pasture utilisation, and, as such, regular monitoring of herbage mass (HM) provides essential information to assist on-farm decision making. Unfortunately, this practice is seldom carried out on commercial farms, likely due to the time commitment required across the entire grass-growing season. Recent studies have shown, however, that even moderately inaccurate HM data can improve the system-side profitability compared to enterprises with no data, warranting further investigations into the trade-off between the accuracy and cost associated with HM measurements. Using a weekly multi-paddock dataset from the North Wyke Farm Platform research site in Devon, UK, this study evaluated the technical validity and labour-saving potential of a simplified ‘pasture walk’ protocol for rising plate meters, under which only data along the diagonal transect – rather than the industry-standard W-shaped pathways – of the paddock are collected. Across 234 temporal-paddock combinations, the mean absolute difference in HM estimates between diagonal and W-transects was 106 kg DM/ha, a scale far too small to alter sward or animal management. The presented statistical analysis, together with a supplementary spatial simulation experiment, supported the generality of the findings across the full grass-growing season. With a 51.2% reduction in labour time (1.2 min/ha rather than 2.5 min/ha) across paddocks of various sizes and shapes, the proposed method is likely to facilitate uptake of evidence-based grazing management amongst farmers who currently do not quantify HM at all.
Sink flow boundary layers on smooth and rough walls were studied experimentally. In all cases a turbulent, zero-pressure-gradient boundary layer was subject to acceleration with K = 3.2 × 10–6, which suppressed the turbulence in the outer region and produced conditions similar to those in turbulent sink flow cases with lower K. In the smooth-wall case, after the momentum thickness Reynolds number had dropped to about 600, the near-wall turbulence then dropped, resulting in relaminarisation. In the rough-wall cases, the near-wall turbulence was sustained in spite of the strong favourable pressure gradient, and relaminarisation did not occur. A temporary equilibrium appears to occur that is similar to that seen with lower K, in spite of the ratio of the boundary-layer thickness to the roughness height dropping to less than 5. Mean velocity and Reynolds stress profiles, quadrant analysis and turbulence spectra are used to show the development of the boundary layer in response to the pressure gradient and the differences between the rough- and smooth-wall cases. This is believed to be the first study to consider the spatial evolution of constant-K rough-wall boundary layers with K large enough to cause relaminarisation in the smooth-wall case.
Depressive symptoms are common in mild cognitive impairment (MCI). These may be associated with poorer cognitive function and increased risks of dementia transition.
Aims
We aimed to examine the cognitive patterns associated with variations in depressive symptoms in neurodegenerative MCI without a primary mood disorder.
Method
Individuals with MCI (n = 123), including MCI due to Alzheimer’s disease (n = 54) and MCI with Lewy bodies (n = 69), underwent repeated annual assessment of cognitive function and concurrent depressive symptoms using the Addenbrooke’s Cognitive Examination-Revised and the Geriatric Depression Scale-15, respectively.
Between- and within-person differences in depressive symptoms were disaggregated and related to between- and within-person cognitive differences and modification of cognitive performance trajectories over time.
Results
There was strong evidence of a state-based association between depressive symptoms and cognitive function. Intra-individual differences in depressive symptoms were negatively associated with concurrent cognitive performance such that a 2-point increase in depressive score explained a 1-point decrease in cognitive score, on average (point estimate −0.56, 95% credibile interval (CrI) −1.05 to −0.08).
The data did not support a trait-based association between depressive symptoms and cognitive performance (point estimate 0.10, 95% CrI −0.42 to 0.59), nor any between- or within-person trajectory modification associated with depressive symptoms.
Conclusions
Within-person variations in depressive symptom severity are associated with acute cognitive performance differences. Cognitive scores derived during active depressive periods may underestimate longer-term cognitive capabilities. Treating depressive symptoms in MCI may clarify underlying cognitive performance capacity, and help maintain optimal cognitive function for longer.
There is a need for design of synthetic organs due to the high demand of organ replacements for patients and low availability of alternatives. Recent advancements in additive manufacturing are enabling the creation of biomimetic organs with biocompatible materials suitable for use in the body. Here, we consider a design, build, test approach for creating synthetic blood vessel tubules by comparing fused deposition modelling and stereolithography printing processes. Tubules were printed with vessel diameters from 10 mm to 20 mm and wall thicknesses of 1 mm to 2.5 mm. Mechanical testing results demonstrated high elongation of tubules prior to breaking. Results highlight the possibility for designers to create flexible biomimetic structures to aid biomedical applications, which opens the doors for new types of patient treatments in organ repair and transplantation.
Genetic research on nicotine dependence has utilized multiple assessments that are in weak agreement.
Methods
We conducted a genome-wide association study (GWAS) of nicotine dependence defined using the Diagnostic and Statistical Manual of Mental Disorders (DSM-NicDep) in 61,861 individuals (47,884 of European ancestry [EUR], 10,231 of African ancestry, and 3,746 of East Asian ancestry) and compared the results to other nicotine-related phenotypes.
Results
We replicated the well-known association at the CHRNA5 locus (lead single-nucleotide polymorphism [SNP]: rs147144681, p = 1.27E−11 in EUR; lead SNP = rs2036527, p = 6.49e−13 in cross-ancestry analysis). DSM-NicDep showed strong positive genetic correlations with cannabis use disorder, opioid use disorder, problematic alcohol use, lung cancer, material deprivation, and several psychiatric disorders, and negative correlations with respiratory function and educational attainment. A polygenic score of DSM-NicDep predicted DSM-5 tobacco use disorder criterion count and all 11 individual diagnostic criteria in the independent National Epidemiologic Survey on Alcohol and Related Conditions-III sample. In genomic structural equation models, DSM-NicDep loaded more strongly on a previously identified factor of general addiction liability than a “problematic tobacco use” factor (a combination of cigarettes per day and nicotine dependence defined by the Fagerström Test for Nicotine Dependence). Finally, DSM-NicDep showed a strong genetic correlation with a GWAS of tobacco use disorder as defined in electronic health records (EHRs).
Conclusions
Our results suggest that combining the wide availability of diagnostic EHR data with nuanced criterion-level analyses of DSM tobacco use disorder may produce new insights into the genetics of this disorder.
Second-generation antipsychotics (SGAs) are moderately effective treatments for psychotic disorders but are associated with significant weight gain and metabolic complications. These contribute to a nearly 20-year reduction in life expectancy for individuals with enduring psychotic illness. Weight gain can also negatively impact adherence, increase relapse risk, and worsen psychosocial outcomes.
Aims:
To highlight the mechanisms underlying antipsychotic-induced weight gain (AIWG), examine pharmacological strategies for its prevention and treatment, and argue for the early use of metformin.
Method:
This perspective article synthesises current evidence on the pathophysiology of AIWG and evaluates the role of metformin in mitigating these effects.
Conclusions:
Weight gain can occur rapidly after initiating antipsychotic treatment, particularly in young people and those prescribed antipsychotics for non-psychotic indications. Presentation and response to interventions vary. Of all pharmacological strategies, metformin has the most robust evidence for both prevention and treatment of AIWG. It is a well-tolerated, low-cost antihyperglycaemic agent with an established safety profile. Metformin should be considered early in the course of antipsychotic treatment for all individuals, regardless of diagnosis, to prevent clinically significant weight gain and reduce long-term health risks. Early intervention may improve adherence, reduce relapse, and enhance overall quality of life.
Surgical pulmonary valve replacement is commonly required to palliate patients with CHD affecting the right ventricular outflow tract; however, concerns remain about mid- and long-term durability. Post-operative short-term anticoagulation has been hypothesised to improve valve durability.
Methods:
This is a single-centre, retrospective study of paediatric patients who underwent surgical pulmonary valve replacement and received a direct oral anticoagulant in addition to aspirin post heart valve insertion. The primary objective was a composite safety score consisting of clinically relevant non-major bleeding, major bleeding, bleeding-related readmission, and medication discontinuation.
Results:
The study analysed 34 patients with a median age 14 years (Interquartile range (IQR): 11, 15) and weight 45 kg (IQR: 35, 55). Ten patients met the composite endpoint (10/34, 29%), with 4 patients experiencing major bleeding (4/34, 12%), 6 experiencing clinically relevant non-major bleeding (6/34, 18%), and 3 patients being readmitted within 90 days of surgical pulmonary valve replacement for bleeding (3/29, 8.8%) resulting in 10 patients discontinuing medication early (10/34, 29%). Lower weight was identified as a significant risk factor for adverse event development (p = 0.04).
Conclusion:
We observed a higher overall bleeding rate, driven predominately by clinically relevant non-major bleeding events, than other studies using short-term anticoagulation after surgical pulmonary valve replacement. Additional studies should be aimed at evaluating the dosing and safety of direct oral anticoagulants in children in the post-operative period.
Bipolar depression remains difficult to treat, and people often experience ongoing residual symptoms, decreased functioning and impaired quality of life. Adjunctive therapies targeting novel pathways can provide wider treatment options and improve clinical outcomes. Garcinia mangostana Linn. (mangosteen) pericarp has serotonogenic, antioxidant anti-inflammatory and neurogenic properties of relevance to the mechanisms of bipolar depression.
Aims
The current 28-week randomised, multisite, double-blind, placebo-controlled trial investigated mangosteen pericarp extract as an adjunct to treatment-as-usual for treatment of bipolar depression.
Method
This trial was prospectively registered on the Australia New Zealand Clinical Trials Registry (no. ACTRN12616000028404). Participants aged 18 years and older with a diagnosis of bipolar I or II and with at least moderate depressive symptoms were eligible for the study. A total of 1016 participants were initially approached or volunteered for the study, of whom 712 did not progress to screening, with an additional 152 screened out. Seventy participants were randomly allocated to mangosteen and 82 to a placebo control. Fifty participants in the mangosteen and 64 participants in the placebo condition completed the treatment period and were analysed.
Results
Results indicated limited support for the primary hypothesis of superior depression symptom reduction following 24 weeks of treatment. Although overall changes in depressive symptoms did not substantially differ between conditions over the course of the trial, we observed significantly greater improvements for the mangosteen condition at 24 weeks, compared with baseline, for mood symptoms, clinical impressions of bipolar severity and social functioning compared with controls. These differences were attenuated at week 28 post-discontinuation assessment.
Conclusions
Adjunctive mangosteen pericarp treatment appeared to have limited efficacy in mood and functional symptoms associated with bipolar disorder, but not with manic symptoms or quality of life, suggesting a novel therapeutic approach that should be verified by replication.
Multicenter clinical trials are essential for evaluating interventions but often face significant challenges in study design, site coordination, participant recruitment, and regulatory compliance. To address these issues, the National Institutes of Health’s National Center for Advancing Translational Sciences established the Trial Innovation Network (TIN). The TIN offers a scientific consultation process, providing access to clinical trial and disease experts who provide input and recommendations throughout the trial’s duration, at no cost to investigators. This approach aims to improve trial design, accelerate implementation, foster interdisciplinary teamwork, and spur innovations that enhance multicenter trial quality and efficiency. The TIN leverages resources of the Clinical and Translational Science Awards (CTSA) program, complementing local capabilities at the investigator’s institution. The Initial Consultation process focuses on the study’s scientific premise, design, site development, recruitment and retention strategies, funding feasibility, and other support areas. As of 6/1/2024, the TIN has provided 431 Initial Consultations to increase efficiency and accelerate trial implementation by delivering customized support and tailored recommendations. Across a range of clinical trials, the TIN has developed standardized, streamlined, and adaptable processes. We describe these processes, provide operational metrics, and include a set of lessons learned for consideration by other trial support and innovation networks.
Mild cognitive impairment with Lewy bodies (MCI-LB) may be identified prospectively based on the presence of cognitive impairment and several core clinical features (visual hallucinations, cognitive fluctuations, parkinsonism, and REM sleep behavior disorder). MCI-LB may vary in its presenting features, which may reflect differences in underlying pathological pattern, severity, or comorbidity.
We aimed to assess how clinical features of MCI-LB accumulate over time, and whether this is associated with the rate of cognitive decline.
Methods
In this cohort study, 74 individuals seen with MCI-LB prospectively underwent repeated annual cognitive and clinical assessment up to nine years. Relationships between clinical features (number of core features present and specific features present) and cognitive change on the Addenbrooke’s Cognitive Examination–Revised (ACE-R) were examined with time-varying mixed models. The accumulation of core clinical features over time was examined with a multi-state Markov model.
Results
When an individual with MCI-LB endorsed more clinical features, they typically experienced a faster cognitive decline (ACE-R Score Difference β = −1.1 [−1.7 to −0.5]), specifically when experiencing visual hallucinations (β = −2.1 [−3.5 to −0.8]) or cognitive fluctuations (β = −3.4 [−4.8 to −2.1]).
Individuals with MCI-LB typically acquired more clinical features with the passage of time (25.5% [20.0–32.0%] one-year probability), limiting the prognostic utility of baseline-only features.
Conclusions
The clinical presentation of MCI-LB may evolve over time. The accumulation of more clinical features of Lewy body disease, in particular visual hallucinations and cognitive fluctuations, may be associated with a worse prognosis in clinical settings.
The aim of this rapid scoping review was to provide a summary of the available evidence on the development and implementation of peer support work in mental health services. The specific objectives were: to undertake a comprehensive review of the literature on peer support work; and identify how such work may be best implemented.
Methods:
A rapid scoping review was identified as the most appropriate approach to reviewing the literature mainly because the objectives of this review were relatively broad and there was a short timeframe. In a rapid scoping review the data extraction and reporting are focused and limited to provide an overview of existing evidence.
Results:
From the initial database results of 7406 records, 663 were identified as meeting the inclusion criteria. The most relevant of these were then selected (n = 26) to be reported in this review with existing reviews of the research evidence (n = 7) being prioritised. The findings were organised into a number of sections: definitions, values and the role; development and implementation of peer support work; experiences of peer support workers; perceptions of others about peer support work; recruitment of peer support workers; training; supervision and support; and research on effectiveness.
Conclusions:
There are excellent sources of guidance, considerable qualitative research about experiences and some encouraging, but limited, findings about the impact of peer support work specifically on recovery-oriented outcomes. There is a need for further rigorous research on the key aspects and effectiveness of peer support work.
Lichens, renowned for their resilience in extreme environments, serve as valuable bio-indicators of environmental conditions. Despite this recognition, environmental influences on lichen ecophysiology are not well understood in urban environments. In this study, we explore the use of functional traits in analyzing the impact of the urban heat island (UHI) on epiphytic chlorolichens. Lichen material was collected from 12 sites across an UHI gradient in Amsterdam and Leiden, the Netherlands. For each lichen specimen, the specific thallus mass (STM) and water-holding capacity (WHC) were calculated. The relationship between the UHI and STM/WHC was assessed using linear mixed models and ANOVA. Our study provides functional trait values (STM and WHC) for 18 species for which no prior data were available. Furthermore, our findings reveal a significant correlation between the UHI and the STM, which suggests STM as a potential indicator for the UHI.