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The condition of planetary crisis widely referred to as the Anthropocene is ubiquitous, but it is often unmarked or unseen. This article examines why through a study of Oman’s ‘Grand Canyon of Arabia’, where the absence of birds provides a lens for two sociolinguistic approaches to planetary crisis: (i) a planetary perspective on semiotic landscapes indicates that allegedly ‘natural’ landscapes are produced by human and more-than-human semiotic interventions, and (ii) the perception of space is shaped by attention, as the power of orientation around a discourse structures semiotic ideologies. An analysis of ethnographic fieldwork and digital data subsequently describes how orientation around Nature/culture dualism produces the Grand Canyon of Arabia as a ‘natural’ landscape, which is disturbed by disorienting Anthropocenic signs. Rather than resisting such disturbances, it is suggested that disorientation presents a way forward into planetary crisis, as attunement to more-than-human signs and entanglements yields relational landscapes. (Nature, tourism, posthumanism, semiotic landscapes, attunement, environment, Oman, Gulf, Anthropocene)
The Anthropocene concept has been widely embraced, with scholars and practitioners demonstrating its potential to challenge the most tenacious frameworks of modernity even as the Holocene remains the officially designated geological epoch. This special issue takes up the Anthropocene’s conceptual provocations as a heuristic for the study of space and semiosis, laying groundwork for new theoretical and methodological frameworks through which sociolinguistics can address planetary crisis. After locating the sociolinguistic study of space within the field of linguistic and semiotic landscapes, this introduction critically reviews the colonial origins of the Anthropocene. Three directions for the study of space and semiosis are then proposed: (i) entangled and expanded space, (ii) attunement as method and praxis, and (iii) political economy as planetary actor. Six contributing articles are summarized, followed by a discussion that charts a path forward for sociolinguistics in planetary crisis. (Linguistic/semiotic landscape, environment, nature, posthumanism, climate change, space, attunement, political economy, coloniality)
Acute rhinosinusitis is one of the most common conditions seen in primary care. One in seven adults are diagnosed with ARS annually, resulting in one in five of all antibiotic prescriptions. Yet there has been limited research comparing the effectiveness of widely used treatments such as antibiotics and nasal steroids. Conducting such a trial in the context of decades of established practice poses unique challenges.
Methods:
A feasibility phase was conducted with continuing feedback to provide refinement and guidance regarding the design of a large-scale, pragmatic randomized controlled trial. The pilot trial assessed the ability to enroll, retain, and evaluate adherence to the intervention and assessment protocols.
Results:
The feasibility phase allowed us to seek input from patients and experts. This resulted in changes pre and post pilot that will impact the full study. A priori enrollment targets for the pilot were achieved, and with high adherence rates. In total, 373 patients were pre-screened and 140 patients were enrolled participants. Adherence to data collection via the daily diary was 93% throughout the study, with 95% completing their diary on the day of the primary outcome, 3 post-randomization.
Conclusion:
Expert panels and a patient advisory committee recommended critical changes to our study design. Stakeholder engagement is a key component of this funding source and was widely used throughout the 18-months. An achieved primary goal of the feasibility phase was to evaluate recruitment and study methods prior to implementing a large clinical trial that requires significant resources.
Cardiovascular disease (CVD) and dementia are leading causes of death in women, with dementia disproportionately affecting females. Both share risk factors such as type 2 and gestational diabetes. While diabetes and CVD risk factors are well studied, gaps remain in understanding dementia’s lifespan influences, sex-specific effects, and social determinants. This report advocates a convergence science approach, integrating basic, behavioral, and implementation sciences, to address these gaps. We propose a novel framework to examine shared cardiometabolic risks across the lifespan, enabling targeted early interventions to reduce dementia burden and improve heart-brain health outcomes in women.
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.
Describe the hemodynamic implications of anaesthetic choice among children with heart disease undergoing cardiac catheterisation.
Methods:
Study 1 was a secondary analysis of data obtained during catheterisation-based hemodynamic assessment of infants with hypoplastic left heart syndrome following Stage 1 palliation, randomised in the Single Ventricle Reconstruction trial. Measured and calculated hemodynamics including pulmonary and systemic vascular resistance indexed to body surface area (PVRi and SVRi respectively) and pulmonary/systemic blood flow (Qp/Qs) were analysed with respect to anaesthetic employed during catheterisation, classified as moderate sedation or general anaesthesia. Study 2 consisted of a single centre, prospective analysis of patients requiring percutaneous closure of a patent ductus arteriosus or endomyocardial biopsy after orthotopic heart transplant. Participants underwent hemodynamic assessment first using inhaled volatile anaesthesia (IA), and then transitioned to total intravenous anaesthesia, comparing hemodynamic measures with respect to anaesthetic approach.
Results:
In Study 1, independent of shunt type, PVRi, and patient size, moderate sedation was associated with a greater than two-fold odds of a Qp/Qs >1 (OR 2.12, 95%CI 1.18–3.87, p = 0.013). In Study 2, while PVRi was similar, SVRi was significantly higher using total intravenous anaesthesia. Among the patent ductus arteriosus subgroup, Qp/Qs increased significantly with a total intravenous anaesthesia relative to IA (p = 0.003); additionally, among the orthotopic heart transplant subgroup, left ventricular end diastolic pressure increased following a transition to total intravenous anaesthesia (p = 0.002).
Conclusions:
Analyses of hemodynamics during catheterisation support a significant impact of anaesthetic type on hemodynamic values including SVRi, left ventricular end diastolic pressure, and Qp/Qs. Anaesthesia choice and intraprocedural management of SVRi are important considerations when making clinical decisions based on hemodynamic data.
Since the early 1950s, national statisticians have regarded unpaid work as non-economic, excluding it from GDP. Feminist scholars argue this exclusion reflects a gender-biased view of progress that renders women’s non-market productivity invisible. As what gets measured drives policy priorities and resource allocation, breastfeeding highlights the need to account for women’s unpaid care work in economic statistics. This paper advances the Beyond GDP agenda by demonstrating how market-derived prices can improve the measurement and recognition of women’s lactation labour. We first trace the historical displacement of breastfeeding by commercial formula and identify key economic drivers. Next, we review critiques of GDP and debates over including non-market household services in the UN’s System of National Accounts. We then present novel estimates of breast milk’s economic value in selected countries. Our analysis shows that existing market prices can robustly proxy for breastfeeding work, correcting GDP’s gender bias and realigning policy priorities. Including human milk production in core economic indicators not only reflects its true contribution but also promotes women’s and children’s rights and supports sustainable development through comprehensive true-cost accounting.
The mental health status and capacity to govern of democratically-elected politicians have become significant topics of interest, which have attracted speculation in the media and beyond. In fulfilling demanding and high-stress positions, politicians could encounter distinctive risk factors that may harm their mental wellbeing, yet existing research literature about this topic remains underexplored.
Objectives
This scoping review aimed to systematically examine the breadth of available evidence on mental health issues and risk factors affecting democratically-elected politicians and to identify future research needs.
Methods
Using pre-defined eligibility criteria based on JBI guidelines, a systematic keyword search was conducted in May 2024 of MEDLINE, Scopus, and APA PsycNet, supplemented by snowballing techniques. Only studies reporting primary, empirical evidence on mental ill-health or risk factors with adverse psychological correlates from serving politicians in “Full” or “Flawed” democracies (per the Democracy Index) were included from 1999-2024. Titles and abstracts were screened and the full-text of potentially eligible literature was assessed before data extraction and synthesis.
Results
Eighteen sources met the eligibility criteria, cumulatively encompassing ~3,500 politicians across seven democracies, namely: Australia, Canada, the Netherlands, Norway, New Zealand, the United Kingdom, and the United States. Four sources (22.2%) explored general psychopathology trends, revealing varying but sizeable rates of mental ill-health and high-risk alcohol consumption. The other fourteen studies (77.8%) provided evidence on risk factors; twelve underlined the psychological toll of violence and two investigations highlighted the injurious effects of specific occupational conditions. Notably, exposure to violence often precipitated detrimental mental health outcomes, with certain data indicating a disproportionate impact on female officeholders.
Conclusions
Existing research literature suggests that democratically-elected politicians face considerable mental health challenges, especially from the effects of violence. However, there are notable research gaps with a paucity of reliable prevalence estimates, intervention studies, and work on national leaders. Equally, the underrepresentation of numerous democratic countries accentuates the need for a more diverse evidence-base to better support the mental wellbeing of politicians worldwide.
Individuals who develop an Imposter Syndrome do not attribute objective successes to their own abilities and competences, but rather believe that they are not intelligent enough, and are sometimes convinced that they have deceived others. It is known that the Imposter Syndromehas various effects on health. In particular, it affects the mental health of the individuals affected. Although it is known that the manifestation of the Imposter Syndrome is higher in marginalized groups in academic fields. Whether the intersectionality of the relevant diversity domains and personal resources such as social support and belonging have an influence on the extent of the imposter phenomenon has not yet been investigated.
Objectives
The aim of the study was to determine the association between imposter syndrome to the psychological well-being of supervisors and doctoral students in the doctoral process considering the mediating influence of experiences of discrimination, social support and belonging.
Methods
A six-month program was developed to accompany the promotion process. A total of seven groups were conducted from April 2024 to May 2025. At the beginning of the programme, baseline data was collected using The WHO-5 Well Being Questionnaire, the Sense of Belonging Questionnaire, the F-Sozu-6 Questionnaire, the Diversity minimal item set and the Clance Imposter Phenomenon Scale.
Results
Preliminary data show that the Imposter syndrome is widespread among supervisors and doctoral students. Individuals who perceive themselves as belonging to multiple diversity domains tend to exhibit diminished psychological well-being, particularly when considering the intersectionality of these domains.
Conclusions
The findings of this study indicate that the Imposter syndrome should be addressed in an accompanying doctoral program with a focus on gender- and diversity aspects. Diversity domains, social support and sense of belonging should be considered more frequently in the development of academic career interventions.
Understanding how different symptoms co-occur and are correlated may provide insights into the pathophysiology of disease. The lack of group-to-individual generalizability of co-occurrence of symptoms was recently demonstrated by comparing intra-individual and inter-individual correlations in several psychological studies. Here, we investigate this phenomenon for lower urinary tract symptoms (LUTS).
Methods:
We analyzed data collected in the Symptoms of Lower Urinary Tract Dysfunction Research Network Recall Study. Participants responded to questions about their urinary symptoms for 25 consecutive days. These questions queried urologic symptoms including storage (urinary urgency, frequency, nocturia, and urinary incontinence), voiding (slow/weak stream), and post-micturition (incomplete emptying and post-micturition dribble) symptoms. We calculated Pearson correlation coefficients and cosine similarity measures and compared distributions of intra-individual and inter-individual (cohort) metrics.
Results:
Among 234 participants, distributions of intra-individual measures were 10-fold wider than those of inter-individual correlations. There are pairs of questions with distributions of correlations and cosine similarities containing individuals with extreme positive (>0.8) and extreme negative values (<–0.8). There are groups of participants with strong positive and negative correlations of urinary frequency and nocturia, urinary incontinence and weak flow, as well as strong negative and positive correlations of urinary frequency and dribbling. Information on these extreme groups is averaged out and lost in the inter-individual correlations.
Conclusions:
Lack of group-to-individual generalizability previously shown for psychological symptoms is confirmed for LUTS. Wealth of information on the co-occurrence and co-evolution of LUTS in the intra-individual correlations and cosine similarities corroborates heterogeneity of LUTS and can be useful for deep phenotyping and for identifying personalized treatments of LUTS.
Dietary protein provides amino acids, nine of which are indispensable (IAAs) as they are not synthesised within the body. Adoption of a vegan diet has shown an increased trend in several Western countries.(1) Past assessments of total protein intake of vegan populations were found to be low but not necessarily below daily requirements.(2) However, plant-sourced proteins generally have lower quantities of digestible IAAs as compared to animal-sourced proteins.(3) Simply accounting for protein intake without considering amino acid profile and digestibility could overestimate protein adequacy among vegans. This study aims to quantify protein intake and protein quality (digestible IAAs) among a cohort of NZ vegans as compared to individual requirements. Dietary intake data was obtained through a four-day recall from 193 individuals participating in a cross-sectional study of adult vegans (above 18 years) residing in New Zealand who have followed a vegan diet for at least two years. Ethical approval was granted (HDEC 2022 EXP 12312). Anthropometric data was collected at Massey University, Auckland. Protein and IAA composition of all foods were derived by comparing dietary data to food composition data from New Zealand FoodFiles and the US Department of Agriculture. Mean values for protein and IAA were adjusted for true ileal digestibility and body weight (kg).(4,5) Mean protein intakes for males and females were 0.99 and 0.81 g/kg of body weight/day, respectively. Overall, 78.8% of males and 74.5% of females met the Estimated Average Requirement (EAR) for daily protein. Plant-sourced proteins in the vegan diet provided 52.9 mg of leucine/g of protein and 35.7 mg of lysine/g of protein, which were below the reference scoring patterns (leucine: 59mg/g, lysine: 45mg/g).(5) When adjusted to individual body weight, average IAA intakes were above daily requirements, but lysine just met requirements at 31.2 mg/kg of body weight/day (reference: 30 mg/kg/d). The importance of adjusting for digestibility is noted as the percentage of vegans meeting adequacy for protein and IAAs decreased as compared to using only IAA compositions without this adjustment. In contrast to grains and pasta, legumes and pulses were the foods that contributed most to overall protein and lysine intake while providing lower energy intake. Lysine followed by leucine were the two most limiting IAAs in the diet of this NZ vegan cohort. Increased proportion of legumes and pulses, and decreased proportion of grains and pasta within the diet can potentially increase leucine and lysine intake but must be considered in the context of the whole diet.
Background: While efgartigimod usage is expected to reduce immunoglobulin (IG) utilization, evidence in clinical practice is limited. Methods: In this retrospective cohort study, patients with gMG treated with efgartigimod for ≥1-year were identified from US medical/pharmacy claims data (April 2016-January 2024) and data from the My VYVGART Path patient support program (PSP). The number of IG courses during 1-year before and after efgartigimod initiation (index date) were evaluated. Patients with ≥6 annual IG courses were considered chronic IG users. Myasthenia Gravis Activities of Daily Living (MG-ADL) scores before and after index were obtained from the PSP where available. Descriptive statistics were used without adjustment for covariates. Results: 167 patients with ≥1 IG claim before index were included. Prior to efgartigimod initiation, the majority of patients (62%) received IG chronically. During the 1-year after index, the number of IG courses fell by 95% (pre: 1531, post: 75). 89% (n=149/167) of patients fully discontinued IG usage. Mean (SD) best-follow up MG-ADL scores were significantly reduced after index (8.0 [4.1] to 2.8 [2.1], P<0.05, n=73/167, 44%). Conclusions: Based on US claims, IG utilization was substantially reduced among patients who continued efgartigimod for ≥1-year, with patients demonstrating a favorable MG-ADL response.
We present the Evolutionary Map of the Universe (EMU) survey conducted with the Australian Square Kilometre Array Pathfinder (ASKAP). EMU aims to deliver the touchstone radio atlas of the southern hemisphere. We introduce EMU and review its science drivers and key science goals, updated and tailored to the current ASKAP five-year survey plan. The development of the survey strategy and planned sky coverage is presented, along with the operational aspects of the survey and associated data analysis, together with a selection of diagnostics demonstrating the imaging quality and data characteristics. We give a general description of the value-added data pipeline and data products before concluding with a discussion of links to other surveys and projects and an outline of EMU’s legacy value.
Posttraumatic stress disorder (PTSD) has been associated with advanced epigenetic age cross-sectionally, but the association between these variables over time is unclear. This study conducted meta-analyses to test whether new-onset PTSD diagnosis and changes in PTSD symptom severity over time were associated with changes in two metrics of epigenetic aging over two time points.
Methods
We conducted meta-analyses of the association between change in PTSD diagnosis and symptom severity and change in epigenetic age acceleration/deceleration (age-adjusted DNA methylation age residuals as per the Horvath and GrimAge metrics) using data from 7 military and civilian cohorts participating in the Psychiatric Genomics Consortium PTSD Epigenetics Workgroup (total N = 1,367).
Results
Meta-analysis revealed that the interaction between Time 1 (T1) Horvath age residuals and new-onset PTSD over time was significantly associated with Horvath age residuals at T2 (meta β = 0.16, meta p = 0.02, p-adj = 0.03). The interaction between T1 Horvath age residuals and changes in PTSD symptom severity over time was significantly related to Horvath age residuals at T2 (meta β = 0.24, meta p = 0.05). No associations were observed for GrimAge residuals.
Conclusions
Results indicated that individuals who developed new-onset PTSD or showed increased PTSD symptom severity over time evidenced greater epigenetic age acceleration at follow-up than would be expected based on baseline age acceleration. This suggests that PTSD may accelerate biological aging over time and highlights the need for intervention studies to determine if PTSD treatment has a beneficial effect on the aging methylome.
The Hippoboscidae are ectoparasites of birds and mammals, which, as a group, are known to vector multiple diseases. Avipoxvirus (APV) is mechanically vectored by various arthropods and causes seasonal disease in wild birds in the United Kingdom (UK). Signs of APV and the presence of louse flies (Hippoboscidae) on Dunnocks Prunella modularis were recorded over a 16·5-year period in a rural garden in Somerset, UK. Louse flies collected from this site and other sites in England were tested for the presence of APV DNA and RNA sequences. Louse flies on Dunnocks were seen to peak seasonally three weeks prior to the peak of APV lesions, an interval consistent with the previously estimated incubation period of APV in Dunnocks. APV DNA was detected on 13/25 louse flies, Ornithomya avicularia and Ornithomya fringillina, taken from Dunnocks, both with and without lesions consistent with APV, at multiple sites in England. Collectively these data support the premise that louse flies may vector APV. The detection of APV in louse flies, from apparently healthy birds, and from sites where disease has not been observed in any host species, suggests that the Hippoboscidae could provide a non-invasive and relatively cheap method of monitoring avian diseases. This could provide advanced warnings of disease, including zoonoses, before they become clinically apparent.