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Abstract Background Healthcare professionals (HCPs) can play an important role in encouraging patients and their caregivers to be vaccinated. The objective of this qualitative study was to investigate HCPs’ perspectives on challenges in vaccine communication and unmet training needs in this domain. Methods Semi-structured interviews were conducted with 41 HCPs (mainly nurses and physicians) with vaccination roles (23 in England; 18 in France), gathering information on: (1) HCPs’ approach to vaccine conversations with patients; (2) Challenges of communicating about vaccines; (3) Vaccine-related training and learning resources available to HCPs, and; (4) HCPs’ training needs around vaccine communication. Results HCPs described a range of communication experiences that indicated insufficient time, information, and skills to confidently navigate difficult conversations with vaccine-hesitant patients. Communication skills were especially important to avoid conflict that could potentially damage the patient-provider relationship. Some HCPs interviewed had received communication training, but for most, this training was not specific to vaccination. Although general communication skills were transferable to vaccine conversations, most HCPs welcomed specific training and informational resources to support countering patients’ misconceptions or misinformation about vaccines. Conclusions HCPs would benefit from training tailored to address vaccine communication with patients, and this should be part of a systemic approach that also provides time and space to have effective vaccine conversations.

Short-term electric load forecasting is critical for power system planning and operations due to demand fluctuations driven by variable energy resources. While deep learning-based forecasting models have shown strong performance, time-sensitive applications require improvements in both accuracy and convergence speed. To address this, we propose a hybrid model that combines long short-term memory (LSTM) with a modified particle swarm optimisation (mPSO) algorithm. Although LSTM is effective for nonlinear time-series predictions, its computational complexity increases with parameter variations. To overcome this, mPSO is used for parameter tuning, ensuring accurate forecasting while avoiding local optima. Additionally, XGBoost and decision tree filtering algorithms are incorporated to reduce dimensionality and prevent overfitting. Unlike existing models that focus mainly on accuracy, our framework optimises accuracy, stability, and convergence rate simultaneously. The model was tested on real hourly load data from New South Wales and Victoria, significantly outperforming benchmark models such as ENN, LSTM, GA-LSTM, and PSO-LSTM. For NSW, the proposed model reduced MSE by 91.91%, RMSE by 94.89%, and MAPE by 74.29%. In VIC, MSE decreased by 91.33%, RMSE by 95.73%, and MAPE by 72.06%, showcasing superior performance across all metrics.

Introduction Minimally symptomatic large vessel occlusion (LVO) is an area of prognostic and management uncertainty. Current guidelines recommend thrombectomy only for patients with NIHSS of 6 or greater when additional timeline and imaging criteria are met. However, patients with initial mild or rapidly improving symptoms with LVO can eventually deteriorate, raising the question of whether all patient with acute LVO should be offered thrombectomy. Methods We present a case of minimally symptomatic M1 occlusion due to ipsilateral carotid web managed without thrombectomy. Results A 42‐year‐old woman with Systemic Lupus Erythematosus (SLE) and hypertension presented to an outside hospital with sudden transient left monocular vision loss, aphasia, right‐side weakness, and dizziness. At the time of presentation (1h from LKW) exam revealed only mild aphasia (NIHSS 1) with normal blood pressure. CTA demonstrated left M1 occlusion with reconstitution of flow at the M2 bifurcation. She was given IV Alteplase and transferred to our center. On 7 h from LKW repeat imaging demonstrated persistence of the left M1 occlusion with an ipsilateral near‐occlusion suspicious for carotid web at the ICA origin, but exam was without deficit. She was monitored closely for neurological deterioration, but remained without significant symptoms. MRA taken the next day demonstrated complete recanalization of the left M1. She was taken to the angiography suite on an outpatient basis for stenting of the carotid web at the origin of the internal carotid artery. Initial diagnostic angiogram revealed near occlusion of the ICA at the origin with post‐stenotic dilation, which was treated with angioplasty and stenting with distal embolic protection. She has remained stable to 8‐month follow‐up with no recurrent stroke. Conclusions Minimally symptomatic LVO presents significant endovascular management uncertainty. While clinical trials support the use of mechanical thrombectomy for significantly symptomatic patients, there is no consensus to guide treatment decisions for patients with minimal symptoms. This uncertainty is driven at least in part by an inability to reliably distinguish between patients who are likely to progress and would benefit from intervention before their collateral circulation fails, and those who will recanalize or develop a compensated chronic occlusion. In this case, our patient received tPA and saw symptom improvement, but this did not remove her M1 occlusion. Angiographic investigation was limited as the patient was asymptomatic, however non‐invasive imaging revealed robust collateralization including reconstitution of MCA flow and left ICA injection failed to opacify the ipsilateral ACA despite patency in recent CT angiography, indicating a right to left flow dominance in circle of Willis collaterals. We opted for close monitoring with follow‐up imaging and outpatient correction of the carotid web, which resulted in a positive outcome. More work is needed to establish criteria to predict which patients with minimally symptomatic LVO are likely to progress.

Large vessel occlusions account for ≈30% of acute ischemic stroke. Mechanical thrombectomy is a highly beneficial treatment for large vessel occlusion strokes in appropriately selected patients. However, there is significant geographic variability in regional access to this important therapy, and broadening coverage by using non‐neuroscience specialties places patients at risk for suboptimal cerebrovascular care. An alternative solution is to train more neurologists to perform this procedure and consolidate expertise in vascular neurology. However, neurology residents have minimal exposure to the angiography suite and are disadvantaged in this regard when it comes to preparedness for fellowship training. We detail a novel training pathway incorporating neuroendovascular training into the adult neurology residency and an option to continue hybridized stroke–neurointervention training in a vascular neurology fellowship. Here, we present the development of the training curriculum, early trainee experience, and challenges to widespread implementation. The stroke–neurointervention training pathway was created with the intention of improving access to this important therapy by enfolding early training into neurology residency.

We report a survey (August 2017 to March 2018) and risk factor analysis of faecal carriage of antibacterial-resistant (ABR) Escherichia coli in 223 16-week-old dogs in the United Kingdom. Raw feeding was associated with the presence of fluoroquinolone-resistant (FQ-R) E. coli and those resistant to tetracycline, amoxicillin, and streptomycin, but not to cefalexin. Whole genome sequencing of 36 FQ-R E. coli isolates showed a wide range of sequence types (STs), with almost exclusively mutational FQ-R dominated by ST744 and ST162. Comparisons between E. coli isolates from puppies known to be located within a 50 × 50 km region with those isolated from human urinary tract infections (isolated in parallel in the same region) identified an ST744 FQ-R lineage that was carried by one puppy and caused one urinary tract infection. Accordingly, we conclude that raw feeding is associated with carriage of ABR E. coli in dogs even at 16 weeks of age and that bacteria carried by puppies are shared with humans. We therefore suggest that those who feed their dogs raw meat seriously consider the potential ABR-transmission threat their pet may become as a result and deploy appropriate hygiene practices in mitigation.

Objectives: Antibacterial resistance (ABR) is a major global health security threat, with a disproportionate burden on lower-and middle-income countries (LMICs). It is not understood how ‘One Health’, where human health is co-dependent on animal health and the environment, might impact the burden of ABR in LMICs. Thailand's 2017 “National Strategic Plan on Antimicrobial Resistance” (NSP-AMR) aims to reduce AMR morbidity by 50% through 20% reductions in human and 30% in animal antibacterial use (ABU). There is a need to understand the implications of such a plan within a One Health perspective. Methods: A model of ABU, gut colonisation with extended-spectrum beta-lactamase (ESBL)-producing bacteria and transmission was calibrated using estimates of the prevalence of ESBL-producing bacteria in Thailand. This model was used to project the reduction in human ABR over 20 years (2020–2040) for each One Health driver, including individual transmission rates between humans, animals and the environment, and to estimate the long-term impact of the NSP-AMR intervention. Results: The model predicts that human ABU was the most important factor in reducing the colonisation of humans with resistant bacteria (maximum 65.7–99.7% reduction). The NSP-AMR is projected to reduce human colonisation by 6.0–18.8%, with more ambitious targets (30% reductions in human ABU) increasing this to 8.5–24.9%. Conclusions: Our model provides a simple framework to explain the mechanisms underpinning ABR, suggesting that future interventions targeting the simultaneous reduction of transmission and ABU would help to control ABR more effectively in Thailand.

Abstract We have investigated current-current correlations in a cross-shaped conductor made of graphene. The mean free path of charge carriers is on the order of the ribbon width which leads to a hybrid conductor where there is diffusive transport in the device arms while the central connection region displays near ballistic transport. Our data on auto and cross correlations deviate from the predictions of Landauer-Büttiker theory, and agreement can be obtained only by taking into account contributions from non-thermal electron distributions at the inlets to the semiballistic center, in which the partition noise becomes strongly modified. The experimental results display distinct Hanbury – Brown and Twiss (HBT) exchange correlations, the strength of which is boosted by the non-equilibrium occupation-number fluctuations internal to this hybrid conductor. Our work demonstrates that variation in electron coherence along atomically-thin, two-dimensional conductors has significant implications on their noise and cross correlation properties.

The self-assembly of block copolymers to form micelles has been used in applications such as drug delivery and composite reinforcement. Here the authors explore the use of fibre-like micelles of controlled length in the active layer of field-effect transistor devices.

Anisotropic nanoparticles made from block copolymers are important building blocks for synthetic hierarchical materials. Here, the authors report a reversible coordination-driven self-assembly strategy for the preparation of micron-scale fibres and macroscopic films based on monodisperse cylindrical micelles.

A material weakly linking two superconductors may itself exhibit superconductivity whilst its material properties strongly influence the nature of the supercurrent. Here, the authors identify a supercurrent with p-wave symmetry in such a Josephson junction made of topologically non-trivial material.

Here, we report the investigation of the anomalous Hall effect in the magnetically doped topological insulator (V,Bi,Sb)_{2}Te_{3}. We find it contains two contributions of opposite sign. Both components are found to depend differently on carrier density, leading to a sign inversion of the total anomalous Hall effect as a function of applied gate voltage. The two contributions are found to have different magnetization reversal fields, which in combination with a temperature dependent study points towards the coexistence of two ferromagnetic orders in the system. Moreover, we find that the sign of total anomalous Hall response of the system depends on the thickness and magnetic doping density of the magnetic layer. The thickness dependence suggests that the two ferromagnetic components originate from the surface and bulk of the magnetic topological insulator film. We believe that our observations provide insight into the magnetic behavior, and thus will contribute to an eventual understanding of the origin of magnetism in this material class. In addition, our data bear a striking resemblance to anomalous Hall signals often associated with skyrmion contributions. Our analysis provides a straightforward explanation for both the magnetic field dependence of the Hall signal and the observed change in sign without needing to invoke skyrmions, and thus suggest that caution is needed when making claims of effects from skyrmion phases.

Heterogeneity in the structural brain abnormalities associated with schizophrenia has made identification of reliable neuroanatomical markers of the disease difficult. The use of more homogenous clinical phenotypes may improve the accuracy of predicting psychotic disorder/s on the basis of observable brain disturbances. Here we investigate the utility of cognitive subtypes of schizophrenia – ‘cognitive deficit’ and ‘cognitively spared’ – in determining whether multivariate patterns of volumetric brain differences can accurately discriminate these clinical subtypes from healthy controls, and from each other. We applied support vector machine classification to grey- and white-matter volume data from 126 schizophrenia patients previously allocated to the cognitive spared subtype, 74 cognitive deficit schizophrenia patients, and 134 healthy controls. Using this method, cognitive subtypes were distinguished from healthy controls with up to 72% accuracy. Cross-validation analyses between subtypes achieved an accuracy of 71%, suggesting that some common neuroanatomical patterns distinguish both subtypes from healthy controls. Notably, cognitive subtypes were best distinguished from one another when the sample was stratified by sex prior to classification analysis: cognitive subtype classification accuracy was relatively low (

Traducción de Juan Antonio Fernández Manzano y Octavio Barriuso VarelEl siguiente texto corresponde al capítulo 15 de Gould, Carol C., Interactive Democracy. The Social Roots of Global Justice, Cambridge, Cambridge University Press, 2014. La autora persigue un doble objetivo: profundizar en la democracia y aumentar la protección de los derechos humanos como modo de encarar problemas de justicia global como la cada vez mayor desigualdad económica y la pobreza. Su reto es hallar la forma de abordar ambos frentes desde el plano local, regional y global. El presente trabajo arroja nueva luz sobre cómo el desarrollo de formas regionales de democracia, limitadas por acuerdos regionales de derechos humanos, constituye una importante, y a menudo olvidada área de interés para la teoría normativa.Palabras clave: Democracia, Derechos Humanos, justicia global, regionalismoAbstract:The following text corresponds to chapter 15 of Gould, Carol C., Interactive Democracy. The Social Roots of Global Justice, Cambridge, Cambridge University Press, 2014. The author pursues a dual objective: to deepen democracy and increase the protection of Human Rights as a way of dealing with problems of global justice such as the increasing economic inequality and poverty. Her challenge is to find ways to address both fronts from local, regional and global levels. This paper sheds new light on how the development of regional forms of democracy bounded by regional human rights agreements constitutes an important, and often forgotten focus for normative theory.Keywords: Democracy , Human Rights, Global Justice , regionalism

The effects of acute exposure to high glucose levels as experienced by glomerular mesangial cells in postprandial conditions and states such as in prediabetes were investigated using proteomic methods. Two-dimensional gel electrophoresis and matrix assisted laser desorption ionization time of flight mass spectrometry methods were used to identify protein expression patterns in immortalized rat mesangial cells altered by 2 h high glucose (HG) growth conditions as compared to isoosmotic/normal glucose control (NG⁎) conditions. Unique protein expression changes at 2 h HG treatment were measured for 51 protein spots. These proteins could be broadly grouped into two categories: (1) proteins involved in cell survival/cell signaling and (2) proteins involved in stress response. Immunoblot experiments for a protein belonging to both categories, prohibitin (PHB), supported a trend for increased total expression as well as significant increases in an acidic PHB isoform. Additional studies confirmed the regulation of proteasomal subunit alpha-type 2 and the endoplasmic reticulum chaperone and oxidoreductase PDI (protein disulfide isomerase), suggesting altered ER protein folding capacity and proteasomal function in response to acute HG. We conclude that short term high glucose induces subtle changes in protein abundances suggesting posttranslational modifications and regulation of pathways involved in proteostasis.

Nature Communications 8 Article number: 15909 (2017); Published 26 June 2017; Updated 27 Jul 2017. An incorrect version of the Supplementary Information was inadvertently published with this Article where the wrong file was included. The Article has been updated to include the correct version of theSupplementary Information.

BACKGROUND: Erinaceidae is a family of small mammals that include the spiny hedgehogs (Erinaceinae) and the silky-furred moonrats and gymnures (Galericinae). These animals are widely distributed across Eurasia and Africa, from the tundra to the tropics and the deserts to damp forests. The importance of these animals lies in the fact that they are the oldest known living placental mammals, which are well represented in the fossil record, a rarity fact given their size and vulnerability to destruction during fossilization. Although the Family has been well studied, their phylogenetic relationships remain controversial. To test previous phylogenetic hypotheses, we combined molecular and morphological data sets, including representatives of all the genera. METHODOLOGY AND PRINCIPAL FINDINGS: We included in the analyses 3,218 bp mitochondrial genes, one hundred and thirty-five morphological characters, twenty-two extant erinaceid taxa, and five outgroup taxa. Phylogenetic relationships were reconstructed using both partitioned and combined data sets. As in previous analyses, our results strongly support the monophyly of both subfamilies (Galericinae and Erinaceinae), the Hylomys group (to include Neotetracus and Neohylomys), and a sister-relationship of Atelerix and Erinaceus. As well, we verified that the extremely long branch lengths within the Galericinae are consistent with their fossil records. Not surprisingly, we found significant incongruence between the phylogenetic signals of the genes and the morphological characters, specifically in the case of Hylomys parvus, Mesechinus, and relationships between Hemiechinus and Paraechinus. CONCLUSIONS: Although we discovered new clues to understanding the evolutionary relationships within the Erinaceidae, our results nonetheless, strongly suggest that more robust analyses employing more complete taxon sampling (to include fossils) and multiple unlinked genes would greatly enhance our understanding of the Erinaceidae. Until then, we have left the nomenclature of the taxa unchanged; hence it does not yet precisely reflect their phylogenetic relationships or the depth of their genetic diversity.

The measurement of the slip of an induction motor is a common industrial and educational measurement. Traditional methods of slip measurement, of which some of the most common are outlined, tend to be either inaccurate or cumbersome. A recently developed instrument which may be used for both transient and steady-state measurements, is described, which is easy to use and accurate results are quickly obtained. It is not necessary to make any connections to the supply or to fit a transducer to the shaft of the machine.