Explore the vast range of titles available.

ObjectiveThis study aimed to measure the impact of COVID-19 on the quality of life (QoL) of survivors and their partners and family members.Design and settingA prospective cross-sectional global online survey using social media.ParticipantsPatients with COVID-19 and partners or family members (age ≥18 years).InterventionOnline survey from June to August 2020.Main outcome measureThe EuroQol group five dimensions three level (EQ-5D-3L) to measure the QoL of survivors of COVID-19, and the Family Reported Outcome Measure (FROM-16) to assess the impact on their partner/family member’s QoL.ResultsThe survey was completed by 735 COVID-19 survivors (mean age=48 years; females=563) at a mean of 12.8 weeks after diagnosis and by 571 partners and 164 family members (n=735; mean age=47 years; females=246) from Europe (50.6%), North America (38.5%) and rest of the world (10.9%). The EQ-5D mean score for COVID-19 survivors was 8.65 (SD=1.9, median=9; range=6–14). 81.1% (596/735) reported pain and discomfort, 79.5% (584/735) problems with usual activities, 68.7% (505/735) anxiety and depression and 56.2% (413/735) problems with mobility. Hospitalised survivors (20.1%, n=148) and survivors with existing health conditions (30.9%, n=227) reported significantly more problems with mobility and usual activities (p<0.05), with hospitalised also experiencing more impact on self-care (p≤0.001). Among 735 partners and family members, the mean FROM-16 score (maximum score=highest impact =32) was 15 (median=15, range=0-32). 93.6% (688/735) reported being worried, 81.7% (601/735) frustrated, 78.4% (676/735) sad, 83.3% (612/735) reported impact on their family activities, 68.9% (507/735) on sleep and 68.1% (500/735) on their sex life.ConclusionCOVID-19 survivors reported a major persisting impact on their physical and psychosocial health. The lives of their partners and other family members were also severely affected. There is a need for a holistic support system sensitive to the needs of COVID-19 survivors and their family members who experience a major ‘secondary burden’.

The Endangered giant pangolin Smutsia gigantea is rare and elusive across its Central African range. Because of its solitary and nocturnal nature, the species is difficult to study and so its ecology is little known. Pangolins are considered the most trafficked mammals in the world. Therefore, confirming presence accurately and monitoring trends in distribution and abundance are essential to inform and prioritize conservation efforts. Camera traps are popular tools for surveying rare and cryptic species. However, non-targeted camera-trap surveys yield low camera-trapping rates for pangolins. Here we use camera-trap data from surveys conducted within three protected areas in Uganda to test whether targeted placement of cameras improves giant pangolin detection probability in occupancy models. The results indicate that giant pangolin detection probability is highest when camera traps are targeted on burrows. The median number of days from camera deployment to first giant pangolin detection event was 12, with the majority of events captured within 32 days from deployment. The median interval between giant pangolin events at a camera-trap site was 33 days. We demonstrate that camera-trap surveys can be designed to improve the detection of giant pangolins and we outline a set of recommendations to maximize the effectiveness of efforts to survey and monitor the species.

ObjectiveTo assign clinical meanings to the Family Reported Outcome Measure (FROM-16) scores through the development of score bands using the anchor-based approach.Design and settingA cross-sectional online study recruited participants through UK-based patient support groups, research support platforms (HealthWise Wales, Autism Research Centre-Cambridge University database, Join Dementia Research) and through social service departments in Wales.ParticipantsFamily members/partners (aged ≥18 years) of patients with different health conditions.InterventionFamily members/partners of patients completed the FROM-16 questionnaire and a Global Question (GQ).Main outcome measureVarious FROM-16 band sets were devised as a result of mapping of mean, median and mode of the GQ scores to FROM-16 total score, and receiver operating characteristic-area under the curve cut-off values. The band set with the best agreement with GQ based on weighted kappa was selected.ResultsA total of 4413 family members/partners (male=1533, 34.7%; female=2858, 64.8%; Prefer not to say=16, 0.4%; other=6, 0.14%) of people with a health condition (male=1994, 45.2%; female=2400, 54.4%; Prefer not to say=12, 0.3%; other=7, 0.16%) completed the online survey: mean FROM-16 score=15.02 (range 0–32, SD=8.08), mean GQ score=2.32 (range 0–4, SD=1.08). The proposed FROM-16 score bandings are: 0–1=no effect on the quality of life of family member; 2–8=small effect on family member; 9–16=moderate effect on family member; 17–25=very large effect on family member; 26–32=extremely large effect on family member (weighted kappa=0.60).ConclusionThe FROM-16 score descriptor bands provide new information to clinicians about interpreting scores and score changes, allowing better-informed treatment decisions for patients and their families. The score banding of FROM-16, along with a short administration time, demonstrates its potential to support holistic clinical practice.

Camera traps offer enormous new opportunities in ecological studies, but current automated image analysis methods often lack the contextual richness needed to support impactful conservation outcomes. Integrating vision–language models into these workflows could address this gap by providing enhanced contextual understanding and enabling advanced queries across temporal and spatial dimensions. Here, we present an integrated approach that combines deep learning-based vision and language models to improve ecological reporting using data from camera traps. We introduce a two-stage system: YOLOv10-X to localise and classify species (mammals and birds) within images and a Phi-3.5-vision-instruct model to read YOLOv10-X bounding box labels to identify species, overcoming its limitation with hard-to-classify objects in images. Additionally, Phi-3.5 detects broader variables, such as vegetation type and time of day, providing rich ecological and environmental context to YOLO’s species detection output. When combined, this output is processed by the model’s natural language system to answer complex queries, and retrieval-augmented generation (RAG) is employed to enrich responses with external information, like species weight and IUCN status (information that cannot be obtained through direct visual analysis). Combined, this information is used to automatically generate structured reports, providing biodiversity stakeholders with deeper insights into, for example, species abundance, distribution, animal behaviour, and habitat selection. Our approach delivers contextually rich narratives that aid in wildlife management decisions. By providing contextually rich insights, our approach not only reduces manual effort but also supports timely decision making in conservation, potentially shifting efforts from reactive to proactive.

Grauer's gorilla (Gorilla beringei graueri), the World's largest primate, is confined to eastern Democratic Republic of Congo (DRC) and is threatened by civil war and insecurity. During the war, armed groups in mining camps relied on hunting bushmeat, including gorillas. Insecurity and the presence of several militia groups across Grauer's gorilla's range made it very difficult to assess their population size. Here we use a novel method that enables rigorous assessment of local community and ranger-collected data on gorilla occupancy to evaluate the impacts of civil war on Grauer's gorilla, which prior to the war was estimated to number 16,900 individuals. We show that gorilla numbers in their stronghold of Kahuzi-Biega National Park have declined by 87%. Encounter rate data of gorilla nests at 10 sites across its range indicate declines of 82-100% at six of these sites. Spatial occupancy analysis identifies three key areas as the most critical sites for the remaining populations of this ape and that the range of this taxon is around 19,700 km2. We estimate that only 3,800 Grauer's gorillas remain in the wild, a 77% decline in one generation, justifying its elevation to Critically Endangered status on the IUCN Red List of Threatened Species.

Numerous protected areas (PAs) have been created in Africa to safeguard wildlife and other natural resources. However, significant threats from anthropogenic activities and decline of wildlife populations persist, while conservation efforts in most PAs are still minimal. We assessed the impact level of the most common threats to wildlife within PAs in tropical Africa and the relationship of conservation activities with threat impact level. We collated data on 98 PAs with tropical forest cover from 15 countries across West, Central and East Africa. For this, we assembled information about local threats as well as conservation activities from published and unpublished literature, and questionnaires sent to long-term field workers. We constructed general linear models to test the significance of specific conservation activities in relation to the threat impact level. Subsistence and commercial hunting were identified as the most common direct threats to wildlife and found to be most prevalent in West and Central Africa. Agriculture and logging represented the most common indirect threats, and were most prevalent in West Africa. We found that the long-term presence of conservation activities (such as law enforcement, research and tourism) was associated with lower threat impact levels. Our results highlight deficiencies in the management effectiveness of several PAs across tropical Africa, and conclude that PA management should invest more into conservation activities with long-term duration.

Pangolins are some of the most overexploited but least studied mammals. The giant pangolin Smutsia gigantea is the largest of the eight pangolin species, measuring up to 180 cm in length and weighing up to 40 kg. It is a nocturnal, solitary species that occurs at low densities and little is known regarding its biology and ecology. It is distributed widely across the rainforests and forest savannah mosaics of equatorial Africa but its exact range extent is unknown. Apart from a single record in Kenya predating 1971, the eastern limit of its range was thought only to extend to central Uganda and western Tanzania. Here we present three spatially separate records confirming the presence of this species in Kenyan Afromontane forests. The three records are c. 120 km apart and c. 500 km east of the nearest confirmed giant pangolin population in Uganda. These records represent a significant range extension for the species and highlight the biodiversity and conservation importance of the Afromontane forests of western Kenya.

IntroductionThere remains a high unmet need for disease-modifying therapies that can impact disability progression in secondary progressive multiple sclerosis (SPMS). Following positive results of the phase 2 MS-STAT study, the MS-STAT2 phase 3 trial will evaluate the efficacy and cost-effectiveness of repurposed high-dose simvastatin in slowing the progression of disability in SPMS.Methods and analysisMS-STAT2 will be a multicentre, randomised, placebo-controlled, double-blind trial of participants aged between 25 and 65 (inclusive) who have SPMS with an Expanded Disability Status Scale (EDSS) score of 4.0–6.5 (inclusive). Steady progression rather than relapse must be the major cause of increasing disability in the preceding 2 years.Participants will be allocated to simvastatin or placebo in a 1:1 ratio. The active treatment will be 80 mg daily, after 1 month at 40 mg daily. 31 hospitals across the UK will participate.The primary outcome is (confirmed) disability progression at 6 monthly intervals, measured as change from EDSS baseline score. Recruitment of 1050 participants will be required to achieve a total of 330 progression events, giving 90% power to demonstrate a 30% relative reduction in disability progression versus placebo. The follow-up period is 36 months, extendable by up to 18 months for patients without confirmed progression.Clinician-reported measures include Timed 25 Foot Walk; 9 Hole Peg Test; Single Digit Modalities Test; Sloan Low Contrast Visual Acuity; Relapse assessment; modified Rankin Scale and Brief International Cognitive Assessment For Multiple Sclerosis. Patient-reported outcomes include MS-specific walking, fatigue and impact scales. A health economic analysis will occur.Ethics and disseminationThe protocol was approved by the London-Westminster REC (17/LO/1509). This manuscript is based on protocol version 8.0, 26 February 2024. Trial findings will be disseminated through peer-reviewed publications and conference presentations.Trial registration numbersNCT03387670; ISRCTN82598726.

Background Multiple sclerosis (MS) may have a major impact on the physical, social and psychological wellbeing of people with multiple sclerosis (pwMS) and their family members/partners. Aim To measure the impact of a person's MS on the quality of life of their family members/partner, and the associates of impact among family members, using a validated generic family-specific quality of life instrument, the Family Reported Outcome Measure (FROM-16). Methods An online cross-sectional study was conducted to recruit family members/partners of pwMS through UK patient support groups. Results A total of 219 family members/partners (mean age = 49.3 years, SD = 13.7; females = 55.3%) of pwMS (mean age = 50.1, SD = 12.5; females = 56.6%) completed the FROM-16. The FROM-16 mean total score was 16.9 (SD = 7.8), indicating ‘a very large effect’ on family members’ quality of life. The increasing age of pwMS, being a male person with MS, and being a female carer were significant predictors of family impact. 50.7% of family members had FROM-16 scores ≥17. Spouses/partners (170/219) of pwMS reported a significant impact on their sex life compared to other relationships (p < 0.001). Conclusion MS substantially impacts the quality of life of family members/partners of pwMS, indicating a need to assess this impact routinely. The FROM-16 could be used to measure the MS family impact in routine practice to support family members appropriately and to include this impact in health economic appraisal and therapeutic clinical trials.