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Despite significant advances in knowledge and the development of guidelines, the management of hypoplastic left heart syndrome (HLHS) remains highly variable. A structured questionnaire was circulated across European Association of Paediatric & Congenital Cardiology (AEPC) affiliated centres. The aims were to evaluate standards in pre-operative assessment, types of surgery, follow-up and medic

Background: There is limited data on the organisation of paediatric echocardiography laboratories in Europe. Methods: A structured and approved questionnaire was circulated across all 95 Association for European Paediatric and Congenital Cardiology affiliated centres. The aims were to evaluate: (1) facilities in paediatric echocardiography laboratories across Europe, (2) accredited laboratories, (

Limited data exist on the implementation of current fetal cardiology training and practice guidelines, how trainees are assessed, and how trained fetal cardiologists maintain their skills among countries affiliated with the Association of European Paediatric and Congenital Cardiology (AEPC). A structured questionnaire was sent to fetal cardiologists or national delegates from 44 centers in 33 Euro

AIMS: The COVID-19 pandemic had substantial impacts on mortality and morbidity, even after the rollout of vaccinations. These impacts however, varied considerably across regions. We examined regional disparities in COVID-19 mortality and hospitalizations among older people in Sweden from January 2021 to August 2023 and assessed the role of vaccination coverage in shaping these disparities.METHODS:

The congenital heart disease (CHD) population has seen substantial growth due to advancements in paediatric cardiac care, cardiothoracic surgery, anaesthesia, and intensive care. Although improved surgical interventions have enhanced survival rates for even the most severe defects, such as hypoplastic left heart syndrome, most CHD patients remain palliated rather than cured, requiring lifelong exp

Background Trauma is the leading cause of quality-related mortality in low- and middle-income countries, with an estimated two million preventable deaths each year. Although trauma quality improvement programmes have been utilised in high-income countries for more than three decades, there is no high-level evidence of their effect on patient outcomes. We aimed to assess whether implementing a cont

Background:Trauma patients present with heterogeneous injury patterns that are challenging to represent in statistical models. Traditional approaches either use high-dimensional one-hot encoding, resulting in sparse features, or aggregate injuries into summary scores that lose patient-specific detail.Objective:This study developed data-driven ICD-10 embeddings for trauma injuries and evaluated the

The effects of quality improvement interventions in healthcare are mixed, and the mechanisms through which they mediate their effect remain poorly understood. Quality improvement methods often rest on implicit assumptions of predictability, linear causality, and standardisation. Health systems are increasingly recognised as complex adaptive systems, where outcomes emerge through adaptation, self-o

octurnal lepidopteran pollinators face pesticide exposure risks in agricultural landscapes, yet lack adequate risk assessment frameworks compared to diurnal species. We present a formal model description for Noctua pronuba within the Animal Landscape and Man Simulation System (ALMaSS), providing the first comprehensive agent-based framework for assessing the impacts of pesticides on nocturnal mothNocturnal lepidopteran pollinators face pesticide exposure risks in agricultural landscapes, yet lack adequate risk assessment frameworks compared to diurnal species. We present a formal model description for Noctua pronuba within the Animal Landscape and Man Simulation System (ALMaSS), providing the first comprehensive agent-based framework for assessing the impacts of pesticides on nocturnal mot

Horizontal gene transfer by conjugative plasmids plays a critical role in the evolution of antibiotic resistance. Interactions between bacteria and other organisms can affect the persistence and spread of conjugative plasmids. Here we show that protozoan predation increased the persistence and spread of the antibiotic resistance plasmid RP4 in populations of the opportunist bacterial pathogen Serr

Mobile genetic elements such as conjugative plasmids are responsible for antibiotic resistance phenotypes in many bacterial pathogens. The ability to conjugate, the presence of antibiotics, and ecological interactions all have a notable role in the persistence of plasmids in bacterial populations. Here, we set out to investigate the contribution of these factors when the conjugation network was di

The increasing prevalence of antimicrobial-resistant bacterial infections has ushered in a major global public health crisis. Judicious or restricted antimicrobial use in animal agriculture, aiming to confine the use for the treatment of infections, is the most commonly proposed solution to reduce selection pressure for resistant bacterial strains and resistance genes. However, a multifaceted solu

Experimental microbial ecology and evolution have yielded foundational insights into ecological and evolutionary processes using simple microcosm setups and phenotypic assays with one- or two-species model systems. The fields are now increasingly incorporating more complex systems and exploration of the molecular basis of observations. For this purpose, simplified, manageable and well-defined mult

Low concentrations of antibiotics have numerous effects on bacteria. However, it is unknown whether ecological factors such as trophic interactions and spatial structuring influence the effects of low concentrations of antibiotics on multispecies microbial communities. Here, we address this question by investigating the effects of low antibiotic concentration on community composition and horizonta

Recognizing when and how rapid evolution drives ecological change is fundamental for our understanding of almost all ecological and evolutionary processes such as community assembly, genetic diversification and the stability of communities and ecosystems. Generally, rapid evolutionary change is driven through selection on genetic variation and is affected by evolutionary constraints, such as trade

A tumour grows when the total division (birth) rate of its cells exceeds their total mortality (death) rate. The capability for uncontrolled growth within the host tissue is acquired via the accumulation of driver mutations which enable the tumour to progress through various hallmarks of cancer. We present a mathematical model of the penultimate stage in such a progression. We assume the tumour ha

Increasing body of experimental evidence suggests that anticancer and antimicrobial therapies may themselves promote the acquisition of drug resistance by increasing mutability. The successful control of evolving populations requires that such biological costs of control are identified, quantified and included to the evolutionarily informed treatment protocol. Here we identify, characterise and ex

Mutation supply can influence evolutionary and thereby ecological dynamics in important ways which have received little attention. Mutation supply influences features of population genetics, such as the pool of adaptive mutations, evolutionary pathways and importance of processes, such as clonal interference. The resultant trait evolutionary dynamics, in turn, can alter population size and species

A popular idea in ecology is that trait variation among individuals from the same species may promote the coexistence of competing species. However, theoretical and empirical tests of this idea have yielded inconsistent findings. We manipulated intraspecific trait diversity in a ciliate competing with a nematode for bacterial prey in experimental microcosms. We found that intraspecific trait varia

ABSTRACT Aim To examine how butterfly population trends respond to climate change and urbanisation at a continental scale, and whether responses differ between urban and rural environments. Location 869 sites across 12 European countries, spanning six bioclimatic zones. Time Period 1976?2021. Major Taxa Studied Butterflies (Lepidoptera). Methods We analysed long-term monitoring data from >?8400 po