Search

CONTEXT Digital innovations can enhance the participation of often-marginalized social groups – including women and resource-poor farmers in low- and middle-income countries – in sustainable, profitable food systems. But digital interventions can also reinforce existing inequities by further increasing the competitive advantage of user groups privileged with literacy, access to smartphones, or high investment capacity. To ensure that the digital transformation in the Global South leaves no one behind, therefore, deliberate efforts are needed to promote the inclusivity of emerging digital innovations. To date, however, there is a lack of practical guidelines and tools to critically assess, demonstrate, and enhance the inclusivity of digital food systems interventions. Too often, inclusivity remains a blurry concept and distant objective. In result, digital development researchers and practitioners have limited incentives for investing time and effort into safeguarding inclusivity.

Worldwide hundreds of millions of people suffer from water, food and energy insecurity in transboundary river basins, such as the Zambezi River Basin. The interconnected nature of nexus is often not recognized in investment planning and many regional policymakers lack adequate tools to tackle it. Future growing demands and climate change add an additional challenge. In this study, we combine policy relevant co-developed stakeholder scenarios and integrated nexus modeling tools to identify key solutions to achieve sustainable development in the Zambezi. Results show that siloed development without coordination achieves the least economic and social benefits in the long term. Prioritizing economic benefits by maximizing the use of available natural resources results in the expansion of irrigated areas by more than a million hectares and increase in hydropower production by 22,000 GWh/year in the coming decades, bringing significant economic benefits, up to $12.4 billion per year, but causes local water scarcity and negative impacts on the environment. Combining environmental protection policies with sustainable investments of $7.2 billion per year (e.g. groundwater pumping and wastewater treatment and reuse, irrigation efficiency improvements, and farmer support aimed to improve food security and productivity) results in significantly higher social benefits with economic benefits that still reach $11.3 billion per year.

Worldwide hundreds of millions of people suffer from water, food and energy insecurity in transboundary river basins, such as the Zambezi River Basin. The interconnected nature of nexus is often not recognized in investment planning and many regional policymakers lack adequate tools to tackle it. Future growing demands and climate change add an additional challenge. In this study, we combine policy relevant co-developed stakeholder scenarios and integrated nexus modeling tools to identify key solutions to achieve sustainable development in the Zambezi. Results show that siloed development without coordination achieves the least economic and social benefits in the long term. Prioritizing economic benefits by maximizing the use of available natural resources results in the expansion of irrigated areas by more than a million hectares and increase in hydropower production by 22,000 GWh/year in the coming decades, bringing significant economic benefits, up to $12.7 billion per year, but causes local water scarcity and negative impacts on the environment. Combining environmental protection policies with sustainable investments of $7.2 billion per year (e.g. groundwater pumping and wastewater treatment and reuse, irrigation efficiency improvements, and farmer support aimed to improve food security and productivity) results in significantly higher social benefits with economic benefits that still reach $11.7 billion per year.

Worldwide hundreds of millions of people suffer from water, food and energy insecurity in transboundary river basins, such as the Zambezi River Basin. The interconnected nature of nexus is often not recognized in investment planning and many regional policymakers lack adequate tools to tackle it. Future growing demands and climate change add an additional challenge. In this study, we combine policy relevant co-developed stakeholder scenarios and integrated nexus modeling tools to identify key solutions to achieve sustainable development in the Zambezi. Results show that siloed development without coordination achieves the least economic and social benefits in the long term. Prioritizing economic benefits by maximizing the use of available natural resources results in the expansion of irrigated areas by more than a million hectares and increase in hydropower production by 22,000 GWh/year in the coming decades, bringing significant economic benefits, up to $12.4 billion per year, but causes local water scarcity and negative impacts on the environment. Combining environmental protection policies with sustainable investments of $7.2 billion per year (e.g. groundwater pumping and wastewater treatment and reuse, irrigation efficiency improvements, and farmer support aimed to improve food security and productivity) results in significantly higher social benefits with economic benefits that still reach $11.3 billion per year.

The continuous rising of atmospheric carbon dioxide (CO2) concentration is undoubtedly affecting the resilience of tropical forests worldwide. However, the magnitude of such effects is poorly known, limiting our capacity to assess the vulnerability of tropical forests and to improve their representation by models. Functional diversity (FD) is an important component of biodiversity enhancing ecosystem resilience, as high FD can provide higher response diversity and capacity to buffer against climate change. How FD is represented by different Dynamic Global Vegetation Models (DGVMs) may affect how such models predict the impacts of environmental changes on hyperdiverse ecosystems. We compared simulations of five trait-based DGVMs (i.e., with flexible, variable traits) constrained with data from the Amazon rainforest in the scope of the AmazonFACE project. Simulations were conducted considering initial high or low diversity scenarios under ambient and elevated CO2 (400 ppm and 600 ppm, respectively). We searched for correspondence between the functional identity of simulated plant strategies and their ecophysiological performances under elevated CO2. As models take different approaches to simulating functional trait distributions and they differ in their structure and in the trade-offs implemented, we found important intermodel differences in simulated results. Nevertheless, we took advantage of these differences in order to assess the most likely scenarios in terms of functional composition under elevated CO2, as well as to give feedback for better harmonization of model inputs and outputs and future model improvements. In the face of the pessimistic scenarios that project a continuous increase in CO2 levels, resolving the divergent responses among model predictions is critical, given the global importance of the Amazon rainforest's biodiversity and climate regulation, as well as the approximately 30 million people that directly or indirectly depend on the forest for

Relative energy deficiency in sport (REDs) is a widely adopted model, originally proposed by an International Olympic Committee (IOC) expert panel in 2014 and recently updated in an IOC 2023 consensus statement. The model describes how low energy availability (LEA) causes a wide range of deleterious health and performance outcomes in athletes. With increasing frequency, sports practitioners are diagnosing athletes with “REDs,” or “REDs syndrome,” based largely upon symptom presentation. The purpose of this review is not to “debunk” REDs but to challenge dogmas and encourage rigorous scientific processes. We critically discuss the REDs concept and existing empirical evidence available to support the model. The consensus (IOC 2023) is that energy availability, which is at the core of REDs syndrome, is impossible to measure accurately enough in the field, and therefore, the only way to diagnose an athlete with REDs appears to be by studying symptom presentation and risk factors. However, the symptoms are rather generic, and the causes likely multifactorial. Here we discuss that (1) it is very difficult to isolate the effects of LEA from other potential causes of the same symptoms (in the laboratory but even more so in the field); (2) the model is grounded in the idea that one factor causes symptoms rather than a combination of factors adding up to the etiology. For example, the model does not allow for high allostatic load (psychophysiological “wear and tear”) to explain the symptoms; (3) the REDs diagnosis is by definition biased because one is trying to prove that the correct diagnosis is REDs, by excluding other potential causes (referred to as differential diagnosis, although a differential diagnosis is supposed to find the cause, not demonstrate that it is a pre-determined cause); (4) observational/cross-sectional studies have typically been short duration (< 7 days) and do not address the long term “problematic LEA,” as described in the IOC 2023 consensus stateme

This study explores dissatisfaction and neutrality metrics from 12 years of a national-level undergraduate student survey. The notion of dissatisfaction is much less prevalent in the narratives surrounding student survey outcomes, and the underpinning metrics are seldom considered. This is despite an increasingly vociferous debate about ‘value for money’ of higher education and the positioning of students as consumers in a marketised sector. We used machine learning methods to explore over 2.7 million national survey outcomes from 154 institutions to describe year-on-year stability in the survey items that best predicted dissatisfaction and neutrality, together with their similarity to known metric predictors of satisfaction. The widely publicised annual increases in student ‘satisfaction’ are shown to be the result of complex reductions in the proportions of disagreement and neutrality across different survey dimensions. Due to the widespread use of survey metrics in university league tables, we create an anonymised, illustrative table to demonstrate how UK institutional rankings would have differed if dissatisfaction metrics had been the preferred focus for reporting. We conclude by debating the tensions of balancing the provision of valuable information about dissatisfaction, with perpetuating negative impacts that derive from this important subset of the survey population.

The aim of the present study was to simultaneously audit hormonal contraceptive (HC) use, menstrual cycle characteristics and training/nutrition related profiles in pre-menopausal women from varying athletic and exercise backgrounds. Elite (n = 51), sub-elite (n = 118) and amateur (n = 392) female athletes and exercisers were examined via an anonymous quantitative/qualitative survey tool. All analyses for ratio data were conducted utilising one- and two-way ANOVA/ANCOVA and odds ratio models, with ordinal data analysed via Pearson's Chi-squared tests. HC use was similar across elite, sub-elite and amateurs (34–44%). Menstrual cycle length was not different (P = 0.08) between competitive levels (28 ± 13 days), but 66% of respondents reported cycle variability (10 ± 11 days). Training profiles were not different based on contraceptive status (P > 0.05) yet were across competitive groups (P < 0.05). Daily meal/snack intakes were not different between contraceptive status (P > 0.05), though elite and sub-elite groups reported a higher daily meal consumption compared to amateurs (P < 0.01). Forty percent of all respondents skipped meals, attributed to lack of time, schedule and alterations in appetite, with reported changes in taste preferences during pre-menses (14–35%) and menses (15–25%) towards sweet foods (60%), with cravings for chocolate and other confectionary (25%). Prevalence of dietary supplement use was not influenced by contraceptive status (P = 0.31), though elites (76%) reported higher use (P = 0.04) than amateurs (63%). Data demonstrates that in female athletes and exercisers, competitive level appears to affect simple markers of training and nutrition practice, yet contraceptive status does not.

Absorption line spectroscopy using background quasars can provide strong constraints on galactic outflows. In this paper, we investigate possible scaling relations between outflow properties, namely outflow velocity \Vout, the mass ejection rate $\dot M_{\rm out}$, and the mass loading factor $\eta$ and the host galaxy properties, such as star formation rate (SFR), SFR surface density, redshift, and stellar mass using galactic outflows probed by background quasars from MEGAFLOW and other surveys. We find that $V_{\rm out}$ ($\eta$) is (anti-)correlated with SFR and SFR surface density. We extend the formalism of momentum-driven outflows of Heckman et al. to show that it applies not only to down the barrel studies but also to winds probed by background quasars, suggesting a possible universal wind formalism. Under this formalism, we find a clear distinction between ``strong'' and ``weak'' outflows where ``strong'' outflows seem to have tighter correlations with galaxy properties (SFR or galaxy stellar mass) than ``weak'' outflows., Comment: 13 pages, 9 figures, accepted for publication in A&A

Galaxy morphology is shaped by stellar activity, feedback, gas and dust properties, and interactions with surroundings, and can therefore provide insight into these processes. In this paper, we study the spatial offsets between stellar and interstellar medium emission in a sample of 54 main-sequence star-forming galaxies at $z\sim4-6$ observed with the Atacama Large Millimeter/submillimeter Array (ALMA) and drawn from the ALMA Large Program to INvestigate C$^+$ at Early times (ALPINE). We find no significant spatial offset for the majority ($\sim$ 70 percent) of galaxies in the sample among any combination of [C II], far-infrared continuum, optical, and ultraviolet emission. However, a fraction of the sample ($\sim$ 30 percent) shows offsets larger than the median by more than 3$\sigma$ significance (compared to the uncertainty on the offsets), especially between [C II] and ultraviolet emission. We find that these significant offsets are of the order of $\sim$0.5-0.7 arcsec, corresponding to $\sim$3.5-4.5 kiloparsecs. The offsets could be caused by a complex dust geometry, strong feedback from stars and active galactic nuclei, large-scale gas inflow and outflow, or a combination of these phenomena. However, our current analysis does not definitively constrain the origin. Future, higher resolution ALMA and JWST observations may help resolve the ambiguity. Regardless, since there exist at least some galaxies that display such large offsets, galaxy models and spectral energy distribution fitting codes cannot assume co-spatial emission in all main-sequence galaxies, and must take into account that the observed emission across wavelengths may be spatially segregated., Comment: 20 pages, 8 figures. Submitted to MNRAS; second revision

Faint, star-forming galaxies likely play a dominant role in cosmic reionisation. Strides have been made in recent years to characterise these populations at high redshifts ($z>3$). Now for the first time, with JWST photometry beyond 1$\,\mu m$ in the rest frame, we can derive accurate stellar masses and position these galaxies on the galaxy main sequence. We seek to assess the place of 96 individual Lyman-alpha emitters (LAEs) selected behind the A2744 lensing cluster with MUSE spectroscopy on the galaxy main sequence. We also compare derived stellar masses to Lyman-alpha luminosities and equivalent widths to better quantify the relationship between the Lyman-alpha emission and the host galaxy. These 96 LAEs lie in the redshift range $2.9

Antibiotics have revolutionised medicine in the last century and enabled the prevention of bacterial infections that were previously deemed untreatable. However, in parallel, bacteria have increasingly developed resistance to antibiotics through various mechanisms. When resistant bacteria find their way into terrestrial and aquatic environments, animal and human exposures increase, e.g., via polluted soil, food, and water, and health risks multiply. Understanding the fate and transport of antibiotic resistant bacteria (ARB) and the transfer mechanisms of antibiotic resistance genes (ARGs) in aquatic environments is critical for evaluating and mitigating the risks of resistant-induced infections. The conceptual understanding of sources and pathways of antibiotics, ARB, and ARGs from society to the water environments is essential for setting the scene and developing an appropriate framework for modelling. Various factors and processes associated with hydrology, ecology, and climate change can significantly affect the fate and transport of ARB and ARGs in natural environments. This article reviews current knowledge, research gaps, and priorities for developing water quality models to assess the fate and transport of ARB and ARGs. The paper also provides inputs on future research needs, especially the need for new predictive models to guide risk assessment on AR transmission and spread in aquatic environments.

Antibiotics have revolutionised medicine in the last century and enabled the prevention of bacterial infections that were previously deemed untreatable. However, in parallel, bacteria have increasingly developed resistance to antibiotics through various mechanisms. When resistant bacteria find their way into terrestrial and aquatic environments, animal and human exposures increase, e.g., via polluted soil, food, and water, and health risks multiply. Understanding the fate and transport of antibiotic resistant bacteria (ARB) and the transfer mechanisms of antibiotic resistance genes (ARGs) in aquatic environments is critical for evaluating and mitigating the risks of resistant-induced infections. The conceptual understanding of sources and pathways of antibiotics, ARB, and ARGs from society to the water environments is essential for setting the scene and developing an appropriate framework for modelling. Various factors and processes associated with hydrology, ecology, and climate change can significantly affect the fate and transport of ARB and ARGs in natural environments. This article reviews current knowledge, research gaps, and priorities for developing water quality models to assess the fate and transport of ARB and ARGs. The paper also provides inputs on future research needs, especially the need for new predictive models to guide risk assessment on AR transmission and spread in aquatic environments.

Galactic outflows are believed to play a critical role in the evolution of galaxies by regulating their mass build-up and star formation1. Theoretical models assume bipolar shapes for the outflows that extend well into the circumgalactic medium (CGM), up to tens of kiloparsecs (kpc) perpendicular to the galaxies. They have been directly observed in the local Universe in several individual galaxies, for example, around the Milky Way and M82 (refs. 2,3). At higher redshifts, cosmological simulations of galaxy formation predict an increase in the frequency and efficiency of galactic outflows owing to the increasing star-formation activity4. Galactic outflows are usually of low gas density and low surface brightness and therefore difficult to observe in emission towards high redshifts. Here we present an ultra-deep Multi-Unit Spectroscopic Explorer (MUSE) image of the mean Mg II emission surrounding a sample of galaxies at z ≈ 1 that strongly suggests the presence of outflowing gas on physical scales of more than 10 kpc. We find a strong dependence of the detected signal on the inclination of the central galaxy, with edge-on galaxies clearly showing enhanced Mg II emission along the minor axis, whereas face-on galaxies show much weaker and more isotropic emission. We interpret these findings as supporting the idea that outflows typically have a bipolar cone geometry perpendicular to the galactic disk. We demonstrate that this CGM-scale outflow is prevalent among galaxies with stellar mass M * ≳ 109.5 M ⊙.

PROBLEM: Ambiguity in communication of key study parameters limits the utility of real-world evidence (RWE) studies in healthcare decision-making. Clear communication about data provenance, design, analysis, and implementation is needed. This would facilitate reproducibility, replication in independent data, and assessment of potential sources of bias.WHAT WE DID: The International Society for Pharmacoepidemiology (ISPE) and ISPOR-The Professional Society for Health Economics and Outcomes Research (ISPOR) convened a joint task force, including representation from key international stakeholders, to create a harmonized protocol template for RWE studies that evaluate a treatment effect and are intended to inform decision-making. The template builds on existing efforts to improve transparency and incorporates recent insights regarding the level of detail needed to enable RWE study reproducibility. The overarching principle was to reach for sufficient clarity regarding data, design, analysis, and implementation to achieve 3 main goals. One, to help investigators thoroughly consider, then document their choices and rationale for key study parameters that define the causal question (e.g., target estimand), two, to facilitate decision-making by enabling reviewers to readily assess potential for biases related to these choices, and three, to facilitate reproducibility.STRATEGIES TO DISSEMINATE AND FACILITATE USE: Recognizing that the impact of this harmonized template relies on uptake, we have outlined a plan to introduce and pilot the template with key international stakeholders over the next 2 years.CONCLUSION: The HARmonized Protocol Template to Enhance Reproducibility (HARPER) helps to create a shared understanding of intended scientific decisions through a common text, tabular and visual structure. The template provides a set of core recommendations for clear and reproducible RWE study protocols and is intended to be used as a backbone throughout

Elizabeth I Adesanya,1 Alasdair D Henderson,1 Julian Matthewman,1 Ketaki Bhate,1 Joseph F Hayes,2 Amy Mulick,1 Rohini Mathur,1 Catherine Smith,3 Helena Carreira,1 Sujit D Rathod,4 Sinéad M Langan,1 Kathryn E Mansfield1 1Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; 2Division of Psychiatry, University College London, London, UK; 3St John’s Institute of Dermatology, Guys and St Thomas’ Foundation Trust and King’s College London, London, UK; 4Department of Population Health, London School of Hygiene & Tropical Medicine, London, UKCorrespondence: Elizabeth I Adesanya, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK, Email elizabeth.adesanya@lshtm.ac.ukBackground: Existing research exploring associations between atopic eczema (AE) or psoriasis, and severe mental illness (SMI – ie, schizophrenia, bipolar disorder, other psychoses) is limited, with longitudinal evidence particularly scarce. Therefore, temporal directions of associations are unclear. We aimed to investigate associations between AE or psoriasis and incident SMI among adults.Methods: We conducted matched cohort studies using primary care electronic health records (January 1997 to January 2020) from the UK Clinical Practice Research Datalink GOLD. We identified two cohorts: 1) adults (≥ 18 years) with and without AE and 2) adults with and without psoriasis. We matched (on age, sex, general practice) adults with AE or psoriasis with up to five adults without. We used Cox regression, stratified by matched set, to estimate hazard ratios (HRs) comparing incident SMI among adults with and without AE or psoriasis.Results: We identified 1,023,232 adults with AE and 4,908,059 without, and 363,210 with psoriasis and 1,801,875 without. After adjusting for matching variables (age, sex, general practice) and potential confounders (deprivation, calendar period) both AE and psoriasis were associated with a

Eczema is a common chronic disease that affects both children and adults, and may have an adverse impact on school performance, as it is characteristically pruri-tic, and hence may lead to poor concentration and ina-dequate sleep. The aim of this study was to elucidate the relationship between eczema and self-reported difficulties keeping up with school education. The study was based on cross-sectional questionnaire data collec-ted in schools among all 9th graders (15–16 years old) within a Swedish county. Logistic regression analyses were used to assess the association between having eczema and self-reported difficulties keeping up with school education. A total of 2,620 pupils participated (50.1% female). An increased odds ratio (OR) of self-reported difficulties keeping up with school education was found in adolescents with eczema compared with those without eczema after adjustment for sex and family residence (OR 2.13, 95% confidence interval (95% CI) 1.32–3.44), and with additional adjustment for sleeping problems, attention-deficit hyperactivity disorder, allergy, rhinitis, asthma, and alcohol con-sumption (adjusted OR 1.78, CI 1.05–3.00). Eczema may be a relevant risk factor for difficulty keeping up with school education in adolescents. However, studies that can assess temporality, based in different settings with objective reports of both eczema and self-reported difficulties at school, are needed to con-firm these findings.

Eczema is a common chronic disease that affects both children and adults, and may have an adverse impact on school performance, as it is characteristically pruri-tic, and hence may lead to poor concentration and ina-dequate sleep. The aim of this study was to elucidate the relationship between eczema and self-reported difficulties keeping up with school education. The study was based on cross-sectional questionnaire data collec-ted in schools among all 9th graders (15–16 years old) within a Swedish county. Logistic regression analyses were used to assess the association between having eczema and self-reported difficulties keeping up with school education. A total of 2,620 pupils participated (50.1% female). An increased odds ratio (OR) of self-reported difficulties keeping up with school education was found in adolescents with eczema compared with those without eczema after adjustment for sex and family residence (OR 2.13, 95% confidence interval (95% CI) 1.32–3.44), and with additional adjustment for sleeping problems, attention-deficit hyperactivity disorder, allergy, rhinitis, asthma, and alcohol con-sumption (adjusted OR 1.78, CI 1.05–3.00). Eczema may be a relevant risk factor for difficulty keeping up with school education in adolescents. However, studies that can assess temporality, based in different settings with objective reports of both eczema and self-reported difficulties at school, are needed to con-firm these findings.

Julian Matthewman,1 Kathryn E Mansfield,1 Joseph F Hayes,2 Elizabeth I Adesanya,1 Catherine H Smith,3 Amanda Roberts,1 Sinéad M Langan,1 Alasdair D Henderson1 1Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; 2Division of Psychiatry, University College London, London, UK; 3St John’s Institute of Dermatology, Kings College London, London, UKCorrespondence: Julian Matthewman, Email julian.matthewman1@lshtm.ac.ukIntroduction: Previous research has shown associations between eczema and psoriasis and anxiety and depression. We investigated whether associations are consistent across different settings of ascertainment for depression and anxiety, including interview and survey responses from UK Biobank (a large longitudinal cohort recruiting individuals aged 40– 69 years between 2006– 2010), and linked primary care data, with the aim of drawing more reliable conclusions through triangulation.Methods: In cross-sectional studies, we estimated associations between eczema or psoriasis and anxiety or depression, defining anxiety or depression as 1) self-reported previous diagnosis at UK Biobank recruitment interview; 2) PHQ-9/GAD-7 score indicating depression or anxiety from a UK Biobank mental health follow-up survey in 2016; and 3) diagnosis in linked primary care electronic health record data.Results: We analysed 230,047 people with linked Biobank and primary care data. We found poor agreement between the data sources for eczema, psoriasis, anxiety, and depression. Eg, 9474 had a previous eczema diagnosis in primary care data, 4069 self-reported previous eczema diagnosis at the UK biobank interview, and 1536 had eczema in both data sources (for depression 40,455; 13,320; and 9588 respectively). Having eczema or psoriasis (recorded in primary care or baseline interview) was associated with higher odds of anxiety and depression. Eg, the adjusted odds ratio for depression comparing those with eczema to those

The warm-water species, striped searobin (Prionotus evolans), has colonized Narragansett Bay (Rhode Island, USA) in recent decades. To clarify the high variability of past investigations, the aim of this study was to characterize the diet of striped searobins. Stomach contents from searobins collected throughout Narragansett Bay in 2019 were identified and analyzed. Diet varied ontogenetically, seasonally, and regionally. The ontogenetic changes in diet reflected an expansion of searobin niche breadth: all searobins ate a diet with sand shrimp; however, smaller searobins ate primarily sand shrimp, while larger searobins also consumed crustaceans and finfish. Searobin diet varied by month, but diet composition did not exhibit a singular trend. Regional variation was illustrated by a dominance of mysid shrimp in Upper-Bay searobin samples, while the Mid- and Lower-Bay samples contained larger proportions of other crustacea and sand shrimp. Their flexible diet provides strong evidence that striped searobins are adaptable generalist feeders. Searobin stomachs included nine prey species of economic importance; such predation could become more common as continued increase of habitat use of searobins in Narragansett Bay may result in greater overlap with the occurrence of vulnerable juvenile stages of economically valuable species (e.g., winter flounder). The results of this work contribute to our understanding of the evolving role of the striped searobin in food webs, particularly those in Southern New England (USA).

As the impacts of climate change become more severe throughout the global oceans, fisheries managers will be increasingly challenged to rebuild stocks exhibiting declining productivity. In such cases, detailed knowledge of species life history will be necessary to both restrict harvest and manage other environmental conditions, where possible, that impact survivorship. A current example of these challenges, the Southern New England/Mid-Atlantic Bight winter flounder stock remains in a persistently depleted state due to a combination of past harvest and the effects of climate change mediated through increased predation. To explore the recovery capacity of a subpopulation of this stock, a life-cycle model was fit to 29 year classes of stage-specific winter flounder data from surveys conducted in Narragansett Bay, Rhode Island and used to project future subpopulation abundance. Supporting a prevailing hypothesis, the results indicated that environmental factors influencing juvenile mortality were largely responsible for inhibiting recovery. Furthermore, recovery of the subpopulation to past levels of abundance was determined to be unlikely even under optimistic future conditions resulting from aggressive management interventions. Taken together, the findings of this work pose important questions regarding the realism of assessing climate-challenged populations against biological reference points set under past environmental regimes and the degree to which harvest restrictions to promote recovery of such stocks should be allowed to limit warm-water fisheries thriving in a warming ocean.

Uncertainty in how the land carbon (C) sink will change over time contributes to uncertainty in Earth system model (ESM) projections of climate change. Much of the land sink is thought to reside in old-growth tropical forests, but recent analyses suggest a diminishing C sink in these forests due to rising temperatures and drought. Thus, there is an urgent need to better understand tropical forest responses to drought and to incorporate this understanding into ESMs. Previous work with vegetation demographic models (VDMs) – which represent the dynamics of individuals or cohorts, along with hydrology and biogeochemistry − suggest that functional diversity can enhance tropical forest resilience to climate change. However, there is little understanding of how different approaches to representing trait diversity and demography affect model outcomes. To explore the potential for trait diversity to moderate tropical forest responses to drought, we explored the behavior of nine VDMs, ranging from models with detailed site-level parameterizations to more generalized land models designed as ESM components. The behavior of each model was studied using soil and meteorological data collected at each of two tropical forest sites: Paracou Research Station, French Guiana, and Tapajos National Forest, Brazil. Low and high trait-diversity scenarios were simulated for each model using historical meteorology, as well as reduced rainfall scenarios. Few models showed strong effects of trait diversity on drought resistance (short-term response of forest biomass to rainfall reduction), but most models showed positive effects of diversity on resilience (long-term recovery of forest biomass following the initial biomass loss due to rainfall reduction). Long-term recovery was always associated with shifts in community composition towards greater drought-tolerance. However, there were large differences among models in the degree and time-scale of recovery. These differences were unrelated to th

Uncertainty in how the land carbon (C) sink will change over time contributes to uncertainty in Earth system model (ESM) projections of climate change. Much of the land sink is thought to reside in old-growth tropical forests, but recent analyses suggest a diminishing C sink in these forests due to rising temperatures and drought. Thus, there is an urgent need to better understand tropical forest responses to drought and to incorporate this understanding into ESMs. Previous work with vegetation demographic models (VDMs) – which represent the dynamics of individuals or cohorts, along with hydrology and biogeochemistry − suggest that functional diversity can enhance tropical forest resilience to climate change. However, there is little understanding of how different approaches to representing trait diversity and demography affect model outcomes. To explore the potential for trait diversity to moderate tropical forest responses to drought, we explored the behavior of nine VDMs, ranging from models with detailed site-level parameterizations to more generalized land models designed as ESM components. The behavior of each model was studied using soil and meteorological data collected at each of two tropical forest sites: Paracou Research Station, French Guiana, and Tapajos National Forest, Brazil. Low and high trait-diversity scenarios were simulated for each model using historical meteorology, as well as reduced rainfall scenarios. Few models showed strong effects of trait diversity on drought resistance (short-term response of forest biomass to rainfall reduction), but most models showed positive effects of diversity on resilience (long-term recovery of forest biomass following the initial biomass loss due to rainfall reduction). Long-term recovery was always associated with shifts in community composition towards greater drought-tolerance. However, there were large differences among models in the degree and time-scale of recovery. These differences were unrelated to th

Uncertainty in how the land carbon (C) sink will change over time contributes to uncertainty in Earth system model (ESM) projections of climate change. Much of the land sink is thought to reside in old-growth tropical forests, but recent analyses suggest a diminishing C sink in these forests due to rising temperatures and drought. Thus, there is an urgent need to better understand tropical forest responses to drought and to incorporate this understanding into ESMs. Previous work with vegetation demographic models (VDMs) – which represent the dynamics of individuals or cohorts, along with hydrology and biogeochemistry − suggest that functional diversity can enhance tropical forest resilience to climate change. However, there is little understanding of how different approaches to representing trait diversity and demography affect model outcomes. To explore the potential for trait diversity to moderate tropical forest responses to drought, we explored the behavior of nine VDMs, ranging from models with detailed site-level parameterizations to more generalized land models designed as ESM components. The behavior of each model was studied using soil and meteorological data collected at each of two tropical forest sites: Paracou Research Station, French Guiana, and Tapajos National Forest, Brazil. Low and high trait-diversity scenarios were simulated for each model using historical meteorology, as well as reduced rainfall scenarios. Few models showed strong effects of trait diversity on drought resistance (short-term response of forest biomass to rainfall reduction), but most models showed positive effects of diversity on resilience (long-term recovery of forest biomass following the initial biomass loss due to rainfall reduction). Long-term recovery was always associated with shifts in community composition towards greater drought-tolerance. However, there were large differences among models in the degree and time-scale of recovery. These differences were unrelated to th

Antibiotics have revolutionised medicine in the last century and enabled the prevention of bacterial infections that were previously deemed untreatable. However, in parallel, bacteria have increasingly developed resistance to antibiotics through various mechanisms. When resistant bacteria find their way into terrestrial and aquatic environments, animal and human exposures increase, e.g., via polluted soil, food, and water, and health risks multiply. Understanding the fate and transport of antibiotic resistant bacteria (ARB) and the transfer mechanisms of antibiotic resistance genes (ARGs) in aquatic environments is critical for evaluating and mitigating the risks of resistant-induced infections. The conceptual understanding of sources and pathways of antibiotics, ARB, and ARGs from society to the water environments is essential for setting the scene and developing an appropriate framework for modelling. Various factors and processes associated with hydrology, ecology, and climate change can significantly affect the fate and transport of ARB and ARGs in natural environments. This article reviews current knowledge, research gaps, and priorities for developing water quality models to assess the fate and transport of ARB and ARGs. The paper also provides inputs on future research needs, especially the need for new predictive models to guide risk assessment on AR transmission and spread in aquatic environments.

Background: Lymphocyte skin homing in atopic eczema (AE) may induce lymphopenia. Objective: To determine if AE is associated with lymphopenia. Methods: We used UK primary care electronic health records (Clinical Practice Research Datalink GOLD) for a matched cohort study in adults (18 years+) (1997–2015) with at least one recorded lymphocyte count. We matched people with AE to up to five people without. We used multivariable logistic regression to estimate the association between AE and lymphopenia (two low lymphocyte counts within 3 months) and linear mixed effects regression to estimate the association with absolute lymphocyte counts using all available counts. Cox proportional hazard models were used to investigate the effect of lymphopenia on common infections. We replicated the study using US survey data (National Health and Nutrition Examination Survey [NHANES]). Results: Among 71,731 adults with AE and 126,349 adults without AE, we found an adjusted odds ratio (OR) for lymphopenia of 1.16 (95% CI: 1.09–1.23); the strength of association increased with increasing eczema severity. When comparing all recorded lymphocyte counts from adults with AE (n = 1,497,306) to those of people without AE (n = 4,035,870) we saw a lower mean lymphocyte (adjusted mean difference −0.047 × 109/L [95% CI: −0.051 to −0.043]) in those with AE. The difference was larger for men, with increasing age, and with increasing AE severity and was present among people with AE not treated with immunosuppressive drugs. In NHANES (n = 22,624), the adjusted OR for lymphopenia in adults with AE was 1.30 (95% CI: 0.80–2.11), and the adjusted mean lymphocyte count difference was −0.03 × 109/L (95% CI: −0.07 to 0.02). Despite having a lower lymphocyte count, adjusting for time with lymphopenia, did not alter risk estimates of infections. Conclusion: Atopic eczema, including increasing AE severity, is associated with a decreased lymphocyte count, regardless of immunosuppressiv

Eczema is a common chronic disease that affects both children and adults, and may have an adverse impact on school performance, as it is characteristically pruri-tic, and hence may lead to poor concentration and ina-dequate sleep. The aim of this study was to elucidate the relationship between eczema and self-reported difficulties keeping up with school education. The study was based on cross-sectional questionnaire data collec-ted in schools among all 9th graders (15–16 years old) within a Swedish county. Logistic regression analyses were used to assess the association between having eczema and self-reported difficulties keeping up with school education. A total of 2,620 pupils participated (50.1% female). An increased odds ratio (OR) of self-reported difficulties keeping up with school education was found in adolescents with eczema compared with those without eczema after adjustment for sex and family residence (OR 2.13, 95% confidence interval (95% CI) 1.32–3.44), and with additional adjustment for sleeping problems, attention-deficit hyperactivity disorder, allergy, rhinitis, asthma, and alcohol con-sumption (adjusted OR 1.78, CI 1.05–3.00). Eczema may be a relevant risk factor for difficulty keeping up with school education in adolescents. However, studies that can assess temporality, based in different settings with objective reports of both eczema and self-reported difficulties at school, are needed to con-firm these findings.

We study the link between gas flow events and key galaxy scaling relations: the relations between star formation rate (SFR) and stellar mass (the main sequence, MS), gas metallicity and stellar mass (the mass-metallicity relation, MZR) and gas metallicity, stellar mass and SFR (the fundamental metallicity relation, FMR). Using all star-forming galaxies (SFGs) in the 22 MUSE fields of the MusE GAs FLOw and Wind (MEGAFLOW) survey, we derive the MS, MZR and FMR scaling relations for 385 SFGs with $M = 10^8 - 10^{11.5}$ $M_\odot$ at redshifts 0.35 < z < 0.85. Using the MUSE data and complementary X-Shooter spectra at 0.85 < z < 1.4, we determine the locations of 21 SFGs associated with inflowing or outflowing circumgalactic gas (i.e. with strong MgII absorption in background quasar spectra) relative to these scaling relations. Compared to a control sample of galaxies without gas flows (i.e., without MgII absorption within 70 kpc of the quasar), SFGs with inflow events (i.e., MgII absorption along the major axis) are preferentially located above the MS, while SFGs with ouflow events (i.e., MgII absorption along the minor axis) are preferentially more metal rich. Our observations support the scenario in which gas accretion increases the SFR while diluting the metal content and where circumgalactic outflows are found in more metal-rich galaxies., Comment: 13 pages, 8 figures

Eczema is a common chronic disease that affects both children and adults, and may have an adverse impact on school performance, as it is characteristically pruri-tic, and hence may lead to poor concentration and ina-dequate sleep. The aim of this study was to elucidate the relationship between eczema and self-reported difficulties keeping up with school education. The study was based on cross-sectional questionnaire data collec-ted in schools among all 9th graders (15–16 years old) within a Swedish county. Logistic regression analyses were used to assess the association between having eczema and self-reported difficulties keeping up with school education. A total of 2,620 pupils participated (50.1% female). An increased odds ratio (OR) of self-reported difficulties keeping up with school education was found in adolescents with eczema compared with those without eczema after adjustment for sex and family residence (OR 2.13, 95% confidence interval (95% CI) 1.32–3.44), and with additional adjustment for sleeping problems, attention-deficit hyperactivity disorder, allergy, rhinitis, asthma, and alcohol con-sumption (adjusted OR 1.78, CI 1.05–3.00). Eczema may be a relevant risk factor for difficulty keeping up with school education in adolescents. However, studies that can assess temporality, based in different settings with objective reports of both eczema and self-reported difficulties at school, are needed to con-firm these findings.

Eczema is a common chronic disease that affects both children and adults, and may have an adverse impact on school performance, as it is characteristically pruri-tic, and hence may lead to poor concentration and ina-dequate sleep. The aim of this study was to elucidate the relationship between eczema and self-reported difficulties keeping up with school education. The study was based on cross-sectional questionnaire data collec-ted in schools among all 9th graders (15–16 years old) within a Swedish county. Logistic regression analyses were used to assess the association between having eczema and self-reported difficulties keeping up with school education. A total of 2,620 pupils participated (50.1% female). An increased odds ratio (OR) of self-reported difficulties keeping up with school education was found in adolescents with eczema compared with those without eczema after adjustment for sex and family residence (OR 2.13, 95% confidence interval (95% CI) 1.32–3.44), and with additional adjustment for sleeping problems, attention-deficit hyperactivity disorder, allergy, rhinitis, asthma, and alcohol con-sumption (adjusted OR 1.78, CI 1.05–3.00). Eczema may be a relevant risk factor for difficulty keeping up with school education in adolescents. However, studies that can assess temporality, based in different settings with objective reports of both eczema and self-reported difficulties at school, are needed to con-firm these findings.

Eczema is a common chronic disease that affects both children and adults, and may have an adverse impact on school performance, as it is characteristically pruritic, and hence may lead to poor concentration and inadequate sleep. The aim of this study was to elucidate the relationship between eczema and self-reported difficulties keeping up with school education. The study was based on cross-sectional questionnaire data collected in schools among all 9th graders (15-16 years old) within a Swedish county. Logistic regression analyses were used to assess the association between having eczema and self-reported difficulties keeping up with school education. A total of 2,620 pupils participated (50.1% female). An increased odds ratio (OR) of selfreported difficulties keeping up with school education was found in adolescents with eczema compared with those without eczema after adjustment for sex and family residence (OR 2.13, 95% confidence interval (95% CI) 1.32-3.44), and with additional adjustment for sleeping problems, attention-deficit hyperactivity disorder, allergy, rhinitis, asthma, and alcohol consumption (adjusted OR 1.78, CI 1.05-3.00). Eczema may be a relevant risk factor for difficulty keeping up with school education in adolescents. However, studies that can assess temporality, based in different settings with objective reports of both eczema and self-reported difficulties at school, are needed to confirm these findings., Funding agencies:Health Data Research UK LOND1UK Research & Innovation (UKRI)Medical Research Council UK (MRC)Engineering & Physical Sciences Research Council (EPSRC)Economic & Social Research Council (ESRC)National Institutes of Health Research (NIHR)Chief Scientist Office of the Scottish Government Health and Social Care DirectoratesHealth and Social Care Research and Development Division (Welsh Government)Public Health Agency (Northern Ireland)British Heart Foundation

The volume of scientific output is creating an urgent need for automated tools to help scientists keep up with developments in their field. Semantic Scholar (S2) is an open data platform and website aimed at accelerating science by helping scholars discover and understand scientific literature. We combine public and proprietary data sources using state-of-the-art techniques for scholarly PDF content extraction and automatic knowledge graph construction to build the Semantic Scholar Academic Graph, the largest open scientific literature graph to-date, with 200M+ papers, 80M+ authors, 550M+ paper-authorship edges, and 2.4B+ citation edges. The graph includes advanced semantic features such as structurally parsed text, natural language summaries, and vector embeddings. In this paper, we describe the components of the S2 data processing pipeline and the associated APIs offered by the platform. We will update this living document to reflect changes as we add new data offerings and improve existing services., Comment: 8 pages, 6 figures

Small uninhabited aerial vehicles (SUAVs) are in high demand to cover applications that are undesirable, dangerous or even impossible to humans due to their low cost, portability and flexibility in infrastructure. These vehicles are also characterised by low wing-loading which makes them better suited for most of these applications at low altitudes and low airspeeds. However, two major challenges affecting SUAV operations are their limited on-board energy capacity and their susceptibility to turbulent and gusty conditions. These are due to limitations in scaling of electronic components, payload limitations in relation to their size, reduced cruise speed relative to wind speed and increasing angular acceleration as the size of the vehicle decreases. Innovative solutions to these challenges can be taken from the natural world. In order to reduce energy consumption during flight natural fliers make use of the environment at low altitudes with the aid of distributed sensing to react to the airflow and load distributions affecting them. The deployment and evaluation of these techniques in SUAVs constitutes the scope of this thesis. This work begins by investigating the control effort required to exploit orographic lift within urban environments. The study linked the control effort of an SUAV in simulation to gull flight observations for the same mean wind conditions. Maximum performance improvements were seen close to buildings, but came with an increased risk of collision. Distributed pressure and strain sensors around the wing of an SUAV were investigated to help reduce this risk and to further improve performance. An initial study into the application of these sensors for end-to-end airspeed control by means of artificial neural networks (ANNs) was described. Results suggested that the combination of novel and conventional sensors produced the best results overall, even when tested with different Dryden disturbance levels not included in the training set. This st

Context. Determining when the first galaxies formed remains an outstanding goal of modern observational astronomy. Theory and current stellar population models imply that the first galaxies formed at least at z = 14 15. But to date, only one galaxy at z > 13 (GS-z13-0) has been spectroscopically confirmed.Aims. The galaxy `HD1' was recently proposed to be a z similar to 13:27 galaxy based on its potential Lyman break and tentative [O iii] 88 mu m detection with ALMA. We hereby aim to test this scenario with new ALMA Band 4 observations of what would be the [C II] 158 mu m emission if HD1 is at z similar to 13:27.Methods. We carefully analyse the new ALMA Band 4 observations and re-analyse the existing ALMA Band 6 data on the source to determine the proposed redshift.Results. We find a tentative 4 sigma feature in the Band 4 data that is spatially o ffset by 1:'' 7 and spectrally o ffset by 190 km s(-1) from the previously reported 3.8 sigma `[O III] 88 mu m' feature. Through various statistical tests, we demonstrate that these tentative features are fully consistent with both being random noise features.Conclusions. We conclude that we are more likely to be recovering noise features than both [O III] 88 mu m and [C II] 158 mu m emission from a source at z similar to 13 :27. Although we find no credible evidence of a z similar to 13 :27 galaxy, we cannot entirely rule out this scenario. Non-detections are also possible for a z similar to 13 source with a low interstellar gas-phase metallicity or ionisation parameter and/or high gas density. Moreover, the new continuum and line upper limits provide no strong evidence for or against a lower-redshift scenario. Determining where and exactly what type of galaxy HD1 is, will now likely require JWST /NIRSpec spectroscopy.

Context. Determining when the first galaxies formed remains an outstanding goal of modern observational astronomy. Theory and current stellar population models imply that the first galaxies formed at least at z = 14 15. But to date, only one galaxy at z > 13 (GS-z13-0) has been spectroscopically confirmed.Aims. The galaxy `HD1' was recently proposed to be a z similar to 13:27 galaxy based on its potential Lyman break and tentative [O iii] 88 mu m detection with ALMA. We hereby aim to test this scenario with new ALMA Band 4 observations of what would be the [C II] 158 mu m emission if HD1 is at z similar to 13:27.Methods. We carefully analyse the new ALMA Band 4 observations and re-analyse the existing ALMA Band 6 data on the source to determine the proposed redshift.Results. We find a tentative 4 sigma feature in the Band 4 data that is spatially o ffset by 1:'' 7 and spectrally o ffset by 190 km s(-1) from the previously reported 3.8 sigma `[O III] 88 mu m' feature. Through various statistical tests, we demonstrate that these tentative features are fully consistent with both being random noise features.Conclusions. We conclude that we are more likely to be recovering noise features than both [O III] 88 mu m and [C II] 158 mu m emission from a source at z similar to 13 :27. Although we find no credible evidence of a z similar to 13 :27 galaxy, we cannot entirely rule out this scenario. Non-detections are also possible for a z similar to 13 source with a low interstellar gas-phase metallicity or ionisation parameter and/or high gas density. Moreover, the new continuum and line upper limits provide no strong evidence for or against a lower-redshift scenario. Determining where and exactly what type of galaxy HD1 is, will now likely require JWST /NIRSpec spectroscopy.

Scholarly publications are key to the transfer of knowledge from scholars to others. However, research papers are information-dense, and as the volume of the scientific literature grows, the need for new technology to support the reading process grows. In contrast to the process of finding papers, which has been transformed by Internet technology, the experience of reading research papers has changed little in decades. The PDF format for sharing research papers is widely used due to its portability, but it has significant downsides including: static content, poor accessibility for low-vision readers, and difficulty reading on mobile devices. This paper explores the question "Can recent advances in AI and HCI power intelligent, interactive, and accessible reading interfaces -- even for legacy PDFs?" We describe the Semantic Reader Project, a collaborative effort across multiple institutions to explore automatic creation of dynamic reading interfaces for research papers. Through this project, we've developed ten research prototype interfaces and conducted usability studies with more than 300 participants and real-world users showing improved reading experiences for scholars. We've also released a production reading interface for research papers that will incorporate the best features as they mature. We structure this paper around challenges scholars and the public face when reading research papers -- Discovery, Efficiency, Comprehension, Synthesis, and Accessibility -- and present an overview of our progress and remaining open challenges.

El vasto cuerpo de historias de detectives ofrece un modelo de cómo integrar dos formas complementarias de pensamiento: el pensamiento lógico y el pensamiento narrativo. Este artículo ofrece una hipótesis, elaborada por Chesterton, en la que el padre Brown es un paradigma de la relación entre estas dos formas. Dado que se ha afirmado la existencia de herramientas de pensamiento lógico desde hace más de dos mil años, este artículo se centra en la existencia de herramientas de pensamiento narrativo específicamente en el personaje del padre Brown. Demostrar la existencia de estas herramientas de pensamiento narrativo es un primer paso importante para lograr una integración con la lógica. Este artículo representa, por tanto, un avance de los estudios que se están realizando como parte de la tesis doctoral: cómo la existencia del pensamiento narrativo en el detective de Chesterton, el padre Brown, lo equipó para conocer la realidad. Este artículo propone que hay espacio para estudios adicionales para codificar realmente estas herramientas de pensamiento narrativo; tal como había hecho Aristóteles con la lógica. También apunta a la posibilidad de un modelo detectivesco de pensamiento; especialmente porque las historias de detectives continúan siendo tan populares.

Galactic outflows are believed to play a critical role in the evolution of galaxies by regulating their mass build-up and star formation. Theoretical models assumes bipolar shapes for the outflows that extends well into the circumgalctic medium (CGM), up to tens of kpc perpendicular to the galaxies. They have been directly observed in the local Universe in several individual galaxies, e.g., around the Milky Way and M82. At higher redshifts, cosmological simulations of galaxy formation predict an increase in the frequency and efficiency of galactic outflows due to the increasing star formation activity. Outflows are responsible for removing potential fuel for star formation from the galaxy, while at the same enriching the CGM and the intergalactic medium. These feedback processes, although incorporated as key elements of cosmological simulations, are still poorly constrained on CGM scales. Here we present an ultra-deep MUSE image of the mean MgII emission surrounding a sample of galaxies at z~1 that strongly suggests the presence of outflowing gas on physical scales of more than 10kpc. We find a strong dependence of the detected signal on the inclination of the central galaxy, with edge-on galaxies clearly showing enhanced MgII emission along the minor axis, while face-on galaxies display much weaker and more isotropic emission. We interpret these findings as supporting the idea that outflows typically have a bipolar cone geometry perpendicular to the galactic disk. We demonstrate that the signal is not dominated by a few outliers. After dividing the galaxy sample in subsamples by mass, the bipolar emission is only detected in galaxies with stellar mass $\mathrm{M_* \gtrsim 10^{9.5} M_\odot}$., Comment: published in Nature. 25 pages, 10 figures

We present a study of the cool gas ($\approx 10^4$ K) traced by MgII absorptions around groups of galaxies in the MEGAFLOW survey. Using a combination of two algorithms we blindly identify 32 groups of more than 5 galaxies at $0.3 < z < 1.5$ with $10.7 < \log_{10}(M/\rm M_{\odot}) < 13.7$. Among them 26 can be used to study potential counterpart MgII absorptions. We report that 21 out of the total 120 MgII absorption systems present in MEGAFLOW are associated with groups. We observe that the MgII rest-frame equivalent width ($W^{2796}_r$) drops at an impact parameter of $\approx 150$ projected kpc from the closest galaxy and $\approx$ one virial radius from the identified group center indicating that MgII halos scale with the mass of the groups.The impact parameter where the covering fraction exceeds $50\%$ is $\log_{10}(b/\rm kpc) = 2.17 \pm 0.47$ $(2 \sigma)$ and $(b/R_{\rm vir}) = 1.67 \pm 0.98$, which is $\approx 3$ times larger than for field galaxies ($\log_{10}(b/\rm kpc)=1.67\pm0.15$). Finally, we estimate the cool gas column density profile in groups (from the $W^{2796}_r$) and show that its shape follows closely the typical dark matter column density profile for halos at similar redshift and masses.

Background: The multimorbid burden and use of systemic immunosuppressants in people with psoriasis may confer greater risk of adverse outcomes of coronavirus disease 2019 (COVID-19), but the data are limited. Objective: Our aim was to characterize the course of COVID-19 in patients with psoriasis and identify factors associated with hospitalization. Methods: Clinicians reported patients with psoriasis with confirmed/suspected COVID-19 via an international registry, Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 Infection. Multiple logistic regression was used to assess the association between clinical and/or demographic characteristics and hospitalization. A separate patient-facing registry characterized risk-mitigating behaviors. Results: Of 374 clinician-reported patients from 25 countries, 71% were receiving a biologic, 18% were receiving a nonbiologic, and 10% were not receiving any systemic treatment for psoriasis. In all, 348 patients (93%) were fully recovered from COVID-19, 77 (21%) were hospitalized, and 9 (2%) died. Increased hospitalization risk was associated with older age (multivariable-adjusted odds ratio [OR] = 1.59 per 10 years; 95% CI = 1.19-2.13), male sex (OR = 2.51; 95% CI = 1.23-5.12), nonwhite ethnicity (OR = 3.15; 95% CI = 1.24-8.03), and comorbid chronic lung disease (OR = 3.87; 95% CI = 1.52-9.83). Hospitalization was more frequent in patients using nonbiologic systemic therapy than in those using biologics (OR = 2.84; 95% CI = 1.31-6.18). No significant differences were found between classes of biologics. Independent patient-reported data (n = 1626 across 48 countries) suggested lower levels of social isolation in individuals receiving nonbiologic systemic therapy than in those receiving biologics (OR = 0.68; 95% CI = 0.50-0.94). Conclusion: In this international case series of patients with moderate-to-severe psoriasis, biologic use was associated with lower risk of COVID-19–related hospitalization than with

Objectives: Ambiguity in communication of key study parameters limits the utility of real-world evidence (RWE) studies in healthcare decision-making. Clear communication about data provenance, design, analysis, and implementation is needed. This would facilitate reproducibility, replication in independent data, and assessment of potential sources of bias. Methods: The International Society for Pharmacoepidemiology (ISPE) and ISPOR–The Professional Society for Health Economics and Outcomes Research (ISPOR) convened a joint task force, including representation from key international stakeholders, to create a harmonized protocol template for RWE studies that evaluate a treatment effect and are intended to inform decision-making. The template builds on existing efforts to improve transparency and incorporates recent insights regarding the level of detail needed to enable RWE study reproducibility. The over-arching principle was to reach for sufficient clarity regarding data, design, analysis, and implementation to achieve 3 main goals. One, to help investigators thoroughly consider, then document their choices and rationale for key study parameters that define the causal question (e.g., target estimand), two, to facilitate decision-making by enabling reviewers to readily assess potential for biases related to these choices, and three, to facilitate reproducibility. Strategies to Disseminate and Facilitate Use: Recognizing that the impact of this harmonized template relies on uptake, we have outlined a plan to introduce and pilot the template with key international stakeholders over the next 2 years. Conclusion: The HARmonized Protocol Template to Enhance Reproducibility (HARPER) helps to create a shared understanding of intended scientific decisions through a common text, tabular and visual structure. The template provides a set of core recommendations for clear and reproducible RWE study protocols and is intended to be used as a backbone throughout the research proc

Item does not contain fulltext, Objective: We evaluated reporting completeness and transparency in randomised controlled trials (RCTs) conducted using administrative data based on 2021 CONSORT Extension for Trials Conducted Using Cohorts and Routinely Collected Data (CONSORT-ROUTINE) criteria. Study Design and Setting: MEDLINE and the Cochrane Methodology Register were searched (2011 and 2018). Eligible RCTs used administrative databases for identifying eligible participants or collecting outcomes. We evaluated reporting based on CONSORT-ROUTINE, which modified eight items from CONSORT 2010 and added five new items. Results: Of 33 included trials (76% used administrative databases for outcomes, 3% for identifying participants, 21% both), most were conducted in the United States (55%), Canada (18%), or the United Kingdom (12%). Of eight items modified in the extension; six were adequately reported in a majority (>50%) of trials. For the CONSORT-ROUTINE modification portion of those items, three items were reported adequately in >50% of trials, two in <50%, two only applied to some trials, and one only had wording modifications and was not evaluated. For five new items, four that address use of routine data in trials were reported inadequately in most trials. Conclusion: How administrative data are used in trials is often sub-optimally reported. CONSORT-ROUTINE uptake may improve reporting.

Item does not contain fulltext, Objective: Registries are important data sources for randomised controlled trials (RCTs), but reporting of how they are used may be inadequate. The objective was to describe the current adequacy of reporting of RCTs using registries. Study Design and Setting: We used a database of trials using registries from a scoping review supporting the development of the 2021 CONSORT extension for Trials Conducted Using Cohorts and Routinely Collected Data (CONSORT-ROUTINE). Reporting completeness of 13 CONSORT-ROUTINE items was assessed. Results: We assessed reports of 47 RCTs that used a registry, published between 2011 and 2018. Of the 13 CONSORT-ROUTINE items, 6 were adequately reported in at least half of reports (2 in at least 80%). The 7 other items were related to routinely collected data source eligibility (32% adequate), data linkage (8% adequate), validation and completeness of data used for outcome assessment (8% adequate), validation and completeness of data used for participant recruitment (0% adequate), participant flow (9% adequate), registry funding (6% adequate) and interpretation of results in consideration of registry use (25% adequate). Conclusion: Reporting of trials using registries was often poor, particularly details on data linkage and quality. Better reporting is needed for appropriate interpretation of the results of these trials.

Item does not contain fulltext, Objective: To describe characteristics of randomised controlled trials (RCTs) conducted using electronic health records (EHRs), including completeness and transparency of reporting assessed against the 2021 CONSORT Extension for RCTs Conducted Using Cohorts and Routinely Collected Data (CONSORT-ROUTINE) criteria. Study design: MEDLINE and Cochrane Methodology Register were searched for a sample of RCTs published from 2011–2018. Completeness of reporting was assessed in a random sample using a pre-defined coding form. Results 183 RCT publications were identified; 122 (67%) used EHRs to identify eligible participants, 139 (76%) used the EHR as part of the intervention and 137 (75%) to ascertain outcomes. When 60 publications were evaluated against the CONSORT 2010 item and the corresponding extension for the 8 modified items, four items were 'adequately reported' for the majority of trials. Five new reporting items were identified for the CONSORT-ROUTINE extension; when evaluated, one was 'adequately reported', three were reported 'inadequately or not at all', the other 'partially'. There were, however, some encouraging signs with adequate and partial reporting of many important items, including descriptions of trial design, the consent process, outcome ascertainment and interpretation. Conclusion: Aspects of RCTs using EHRs are sub-optimally reported. Uptake of the CONSORT-ROUTINE Extension may improve reporting.

BackgroundLower socioeconomic position usually portends worse health outcomes, but multiple studies have found that atopic dermatitis is associated with higher socioeconomic position. The nature of this relationship remains unclear.ObjectiveTo systematically review the literature on socioeconomic position and atopic dermatitis and determine whether the association varies by patient or study characteristics.MethodsA literature search was conducted in the PubMed and Embase databases. Individual-level studies addressing the association between all measures of socioeconomic position and the prevalence or incidence of atopic dermatitis were eligible for inclusion. Two independent reviewers screened all texts and extracted all data for qualitative synthesis.ResultsEighty-eight studies met the inclusion criteria. Of the 88 studies, 42% (37) found a positive association between atopic dermatitis and socioeconomic position, 15% (13) found a negative association, and 43% (38) found a null or inconsistent association. Studies conducted in Europe, among children, and based on self-report of eczema were more likely to find a positive association with socioeconomic position.LimitationsStudies varied both in terms of the measurement of socioeconomic position and the definition of atopic dermatitis, limiting quantitative synthesis.ConclusionThe evidence of a positive association between atopic dermatitis and socioeconomic position is not consistent.

OBJECTIVE: We evaluated reporting completeness and transparency in randomised controlled trials (RCTs) conducted using administrative data based on 2021 CONSORT Extension for Trials Conducted Using Cohorts and Routinely Collected Data (CONSORT-ROUTINE) criteria. STUDY DESIGN AND SETTING: MEDLINE and the Cochrane Methodology Register were searched (2011 and 2018). Eligible RCTs used administrative databases for identifying eligible participants or collecting outcomes. We evaluated reporting based on CONSORT-ROUTINE, which modified eight items from CONSORT 2010 and added five new items. RESULTS: Of 33 included trials (76% used administrative databases for outcomes, 3% for identifying participants, 21% both), most were conducted in the United States (55%), Canada (18%), or the United Kingdom (12%). Of eight items modified in the extension; six were adequately reported in a majority (>50%) of trials. For the CONSORT-ROUTINE modification portion of those items, three items were reported adequately in >50% of trials, two in <50%, two only applied to some trials, and one only had wording modifications and was not evaluated. For five new items, four that address use of routine data in trials were reported inadequately in most trials. CONCLUSION: How administrative data are used in trials is often sub-optimally reported. CONSORT-ROUTINE uptake may improve reporting.