Newcastle College

Despite the availability of various anti-vascular endothelial growth factor (anti-VEGF) therapies for diabetic macular edema (DME), high treatment burden remains a significant issue in many European countries, including Italy. This burden impacts healthcare costs, clinic capacities, and patient adherence. Aflibercept 8mg was developed to reduce treatment burden by requiring only three monthly injections before allowing extended dosing intervals up to 6months, without compromising efficacy and safety. This analysis aimed to evaluate the efficacy, safety, and treatment burden of aflibercept 8mg regimens compared to other anti-VEGF options (aflibercept 2mg, ranibizumab 0.5mg, faricimab 6mg, brolucizumab 6mg, and bevacizumab 1.25mg) in Italy. A systematic literature review identified randomised controlled trials of anti-VEGF therapies for DME with a 2-year follow-up. This informed a Bayesian network meta-analysis (NMA) assessing efficacy, safety, and treatment burden. A cost-minimisation analysis (CMA) was conducted from the perspective of the Italian National Health System over a 2-year horizon. The NMA, involving nine studies, showed no significant differences in best-corrected visual acuity, anatomical outcomes, and safety between aflibercept 8mg and the other anti-VEGF agents. Aflibercept 8mg required fewer injections than the comparators, with a mean of 9.3 injections over 2years for T&E (Q12) and 8.4 for T&E (Q16) regimens. Economically, aflibercept 8mg was the least costly licensed and reimbursed anti-VEGF in Italy. Aflibercept 8mg may be the most advantageous anti-VEGF option for reducing treatment burden in Italian patients with DME, benefiting healthcare providers, clinics, and the healthcare system. Aflibercept 8mg offers comparable efficacy and safety to other anti-VEGF therapies, with fewer injections and potentially lower overall costs.

Circular economy business models have the potential to reduce the environmental impacts of production, consumption and disposal, however their uptake is hindered by negative perceptions of ‘material change’, which encompasses ageing, wear and contamination. The framework presented in this paper provides researchers and practitioners with a greater understanding of the factors which influence how materials change through time and use, and how people’s responses to material change impacts upon the movement of products through circular economy business models, highlighting the challenges and opportunities for design.

Flash droughts are characterised by rapid soil-moisture depletion driven by elevated atmospheric evaporative demand from higher air temperatures, low humidity, stronger solar radiation and wind, especially when precipitation is limited. This heightened atmospheric evaporative demand enhances evapotranspiration, accelerates moisture depletion in the root zone and intensifies vegetation water stress. As plants dry and weaken, their flammability rises, creating a feedback loop that elevates wildfire risk during prolonged heat and drought conditions.This study investigates the relationship between flash drought and wildfire dynamics using two commonly used methods of flash drought detection across diverse land-cover types in the continental United States. We show that the frequency and spatial patterns of flash drought and its relationship with wildfire is significantly influenced by the method used for flash drought detection. Flash drought events identified by the Standardized Evapotranspiration Stress Ratio (SESR) capture atmospheric evaporative stress, while Root Zone Soil Moisture (RZSM) reflects sustained soil drying that directly increases fuel flammability. Approximately 53% of fires occurred after flash droughts identified using SESR definition, whereas RZSM classified about 10%, with each producing different spatial footprints.To quantify how flash drought alters fire evolution, we applied Kaplan–Meier survival analysis to time-to-burn, estimating the probability that pixels remain unburned as a function of time since ignition under flash drought and non-flash drought conditions, and used Cox proportional-hazards models to derive hazard ratios (HR), which measure the relative instantaneous burning rate under FD (HR > 1 indicating faster spread). Grasslands and croplands show the highest vulnerability to flash drought–related fires due to their fine, continuous fuels that rapidly dry and ignite, with stronger acceleration and earlier spread under RZSM identified flash droughts (HR ≈ 1.45 in grasslands, 1.33 in croplands, 1.84 in open shrublands; woody savannas ≈ 1.17), while SESR effects are small or near zero in several covers (HR ≈ 1.05 in croplands and grasslands; ≈ 0.99 in woody savannas).We therefore recommend incorporating rapid soil-moisture drying dynamics into wildfire risk models and enhancing real-time monitoring to strengthen early warnings and fire management, especially in ecosystems prone to swift drying and ignition.

Reinforcement sensitivity theory outlines three systems which guide our decision-making and risk-taking. The behavioral activation system (BAS) increases sensitivity to rewarding stimuli (i.e., approach motivation), while the flight-fright-freeze system (FFFS) increases sensitivity to threatening stimuli (i.e., avoidance motivation) and revised behavioral inhibition system (r-BIS) mediates competition between BAS and FFFS. Alcohol is established to diminish neural indices associated with FFFS and r-BIS; however, whether intoxication also influences neural correlates of BAS is unclear. The current experiment (N = 71) used electroencephalography (EEG) to assess frontal-cortical asymmetry associated with BAS versus r-BIS during the balloon analogue risk task (BART). Participants consumed alcoholic versus non-alcoholic (placebo) drinks. Intoxicated participants exhibited greater risk-taking compared to placebos. Yet, placebos exhibited greater relative left frontal-cortical asymmetry during the first half of BART trials (i.e., associated with approach motivation) followed by a shift toward relative right frontal-cortical asymmetry in the second half of trials (i.e., associated with inhibition). Relative left frontal-cortical asymmetry observed among placebos predicted poorer BART performance. Intoxicated participants did not exhibit these shifts in frontal asymmetry, likely indicating impaired or delayed engagement of inhibitory control. Despite greater risk-taking, intoxicated participants responded more conservatively during the second set of BART trials. However, unlike placebos, these shifts in performance were unrelated to frontal asymmetry, suggesting alternative mechanisms underlying their behavioral adjustments. Findings provide novel insights into neural correlates of approach motivation following actual versus perceived consumption of alcohol, supporting links between frontal-cortical asymmetry and risk-taking, in addition to suggesting unique pathways which promote impulsiveness.

Composite membranes between polymeric membranes and inorganic substrates have been widely investigated for gas separation applications. Soft polymeric coatings on hard substrates are favourable due to the high mechanical strength imparted by the hard substrates and the high separation capacity conferred by the thin polymeric selective layer. To achieve these desirable properties whilst ensuring that the membrane manufacturing process is scalable and reproducible, this study systematically investigated the design of a vacuum-assisted, dip-coating process for gutter-free, tubular membranes as a function of vacuum pressure and drying temperature to produce a thin film polyetherimide (PEI) selective layer on an alumina substrate for gas molecular-sieving applications. Well-defined PEI alumina membranes were discovered for specific sets of synthesis conditions pertaining to a low vacuum (> −1 bar) dip-coating and drying (110 °C) film consolidation. The composite PEI membrane demonstrated interlayer confinement effect within the selective layer upon second deposition further improving the CO 2 /N 2 permselectivity from 1 to 21.9 ± 0.9 and CO 2 /CH 4 permselectivity from 1 to 20.5 ± 1.4 with a pore aperture of 4.6 ± 0.1 Å allowing He, H 2 , and CO 2 passage. The findings of this study demonstrated important correlations between the vacuum-assisted dip-coating, drying parameter and gas separation performance in controlling the membrane sieving property for He, H 2 , and CO 2 in N 2 and CH 4 permeations. • Vacuum-assisted, dip-coating process resulted well-defined PEI membrane structure. • Membrane pore aperture of 4.6 ± 0.1 Å allowing He, H 2 , and CO 2 passage. • Best membranes achieved He/CH 4 permselectivity of 79.5, H 2 /N 2 of 76.4, and CO 2 /CH 4 of 20.5. • Excellent gas permeation consistency demonstrating membrane reproducibility and scalability.

This work presents SuSEF, a full content aware paper recommendation system. SuSEF embeds summaries of a paper's abstract, background, methodology, and results sections which are then fused into a paper embedding via a global Gated-scalar fusion. SuSEF is trained on a citation graph of academic papers. Each paper's full content is included. Findings demonstrate that section summaries generated through gpt-4.1-nano properly encapsulate key details found in larger paper sections, which results in section embedding that far outperform abstract-only baselines. SuSEF outperforms leading paper recommendation methods trained on the same dataset and matches leading abstract-only baselines with just approximately 33% of the training data. Suggesting that incorporating full document text provides more discriminative embeddings over abstract-only methods.

BackgroundIn many low- and middle-income countries (LMICs), domestic investments to strengthen surgical services compete with services delivered by international missions. While addressing the high burden of unmet surgical need is a priority, there remains limited evidence on the comparative economic value of different delivery options to guide investment decisions.MethodsFour databases and grey literature were searched for publications in any language from January 2013 to January 2023. Eligible studies evaluated the cost-effectiveness, cost-utility, or cost-benefit of international missions and domestic initiatives used for scale up of surgical care. Average cost-effectiveness ratios were computed for each intervention and then converted to 2022 international dollars (I$). Findings were synthesized narratively.ResultsA total of 32 studies were identified (17 studies evaluated domestic surgical system strengthening programmes, 14 studies assessed international missions, and 1 study directly compared a domestic surgical development initiative against international missions). Financial protection schemes, investments in physical infrastructure, surgical residency training, and local missions were cost-effective, as were most of the international missions, compared with status quo or no intervention. However, when compared head-to-head, the unit costs per disability-adjusted life-year averted of domestic initiatives were significantly lower relative to the international missions—mean (standard deviation) I$27 051 (I$65 360) and median (interquartile range) I$498 (I$602) versus mean (standard deviation) I$515 500 (I$1 528 716) and median (interquartile range) I$5068 (I$31 618). The difference was statistically significant (Wilcoxon rank-sum test: z = 2.412; P = 0.016).ConclusionInvestments in domestic surgical system strengthening efforts provide better value for money than international missions and should be prioritized over international missions.