Is cross-breeding with indigenous sheep breeds an option for climate-smart agriculture?

Climate-smart agriculture aims to improve food security by increasing productivity and producer incomes, strengthening resilience to climate change, and reducing greenhouse gas (GHG) emissions. For the livestock sector, improved genetics is often identified as a climate-smart option. While there is evidence in commercial systems that improved genetics is effective, extensive livestock systems in marginal environments have received less attention. This study in Mongolia compares flocks of two indigenous breeds: flocks of pure Mongol breed and flocks of Mongol-Barga breed crosses. It finds that cross-breeding can increase productivity (measured by live weight of animals) and improve adaptation to winter cold (measured by reductions in weight loss during winter-spring), while not increasing the intensity of GHG emissions (measured as kg CO2e emitted per kg live weight marketed) (p < 0.05). The effects of cross-breeding on GHG emissions are strongly dependent on the structure of flocks and off-take. Productivity and winter adaptation are significantly improved for the cross-bred flocks compared to pure Mongol flocks (p < 0.05), but management practices also have a significant impact. Programs to promote climate-smart practices in extensive livestock systems should adopt an integrated approach combining improved animal management and marketing with breeding activities, rather than promoting single practices, such as cross-breeding with indigenous breeds

The Implementation of Video and Telephone Psychological Therapy for Adults Accessing Secondary NHS Community Mental Health Services A mixed-methods Evaluation to Understand What Works, for Whom and In What Circumstances

Background The urgent response to the COVID-19 pandemic has precipitated many changes in the delivery of health services. One such change is the introduction of telemedicine (i.e. virtual consultations) at pace and in services that had previously relied on face-to-face interaction. NHS mental health services are at the forefront of this change, with the delivery of therapeutic interventions transitioning to virtual consultations rapidly. Healthcare innovation is rarely a simple linear process; accordingly, it is crucial evaluation approaches focus on how contextual factors influence implementation success or failure. The discipline of implementation science provides this approach, defined as the scientific study of methods to promote the systematic uptake of research findings into routine practice. Aim The study used an implementation science to evaluate the implementation of virtual therapy consultations and assess impact on service user outcomes

Topological relationships between perivascular spaces and progression of white matter hyperintensities:A pilot study in a sample of the Lothian Birth Cohort 1936

Enlarged perivascular spaces (PVS) and white matter hyperintensities (WMH) are features of cerebral small vessel disease which can be seen in brain magnetic resonance imaging (MRI). Given the associations and proposed mechanistic link between PVS and WMH, they are hypothesized to also have topological proximity. However, this and the influence of their spatial proximity on WMH progression are unknown. We analyzed longitudinal MRI data from 29 out of 32 participants (mean age at baseline = 71.9 years) in a longitudinal study of cognitive aging, from three waves of data collection at 3-year intervals, alongside semi-automatic segmentation masks for PVS and WMH, to assess relationships. The majority of deep WMH clusters were found adjacent to or enclosing PVS (waves−1: 77%; 2: 76%; 3: 69%), especially in frontal, parietal, and temporal regions. Of the WMH clusters in the deep white matter that increased between waves, most increased around PVS (waves−1–2: 73%; 2–3: 72%). Formal statistical comparisons of severity of each of these two SVD markers yielded no associations between deep WMH progression and PVS proximity. These findings may suggest some deep WMH clusters may form and grow around PVS, possibly reflecting the consequences of impaired interstitial fluid drainage via PVS. The utility of these relationships as predictors of WMH progression remains unclear

A haemagglutination test for rapid detection of antibodies to SARS-CoV-2

Serological detection of antibodies to SARS-CoV-2 is essential for establishing rates of seroconversion in populations, and for seeking evidence for a level of antibody that may be protective against COVID-19 disease. Several high-performance commercial tests have been described, but these require centralised laboratory facilities that are comparatively expensive, and therefore not available universally. Red cell agglutination tests do not require special equipment, are read by eye, have short development times, low cost and can be applied at the Point of Care. Here we describe a quantitative Haemagglutination test (HAT) for the detection of antibodies to the receptor binding domain of the SARS-CoV-2 spike protein. The HAT has a sensitivity of 90% and specificity of 99% for detection of antibodies after a PCR diagnosed infection. We will supply aliquots of the test reagent sufficient for ten thousand test wells free of charge to qualified research groups anywhere in the world

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

A constructivist grounded theory study: employers' perspective of the factors that contribute towards a decision to refer an early career nurse to the nursing midwifery council’s fitness to practise committee

The Nursing Midwifery Council Fitness to Practise Committee role is to screen allegations of impaired fitness to practise to determine whether there is likely to be a cause for concern, and investigate those where there may be a case to answer. In 2018, the NMC received 5,509 new concerns, an increase of one % from 2016/17 (NMC, 2018). The total number of concerns received represent approximately 0.8 % of registered nurses and midwives; a number of referrals in England were registrants who had been registered for five years or less. This must be a concern to the profession because early career referral rates potentially reflect on standards of pre-registration education, early post registration career progression, and have implications for public protection. This qualitative research study explained the factors that preceded the referral of an early career nurse to the professional regulator from the perspective of employers. A constructivist grounded theory approach was used. Semi-structured interviews were conducted with 20 healthcare employers in different regions of England across all the fields of nursing practice. The findings highlighted four categories: alarm bells; wanted and unwanted characteristics and values in nurses; a chain of expectations; and situational stressors and health needs. A core category emerged regarding employers’ decision to refer early career nurses to the professional regulator based on a combination of factors; i) the employer’s responsibility of public safety; ii) the employers perceptions of values and expectations of the nurse; iii) the early career nurse’s risk of exposing their professional vulnerability. It is recommended that the employer and employee learn from errors in partnership, taking into consideration patterns of behaviour, work-life balance, health and well-being. Educational strategies are needed to support early career nurse’s resilience and transition into the profession and the workplace. A theoretical model and self-assessment checklist has been recommended for employers and registered professionals which may help to identify practitioners at risk of referral to the professional regulator. This requires piloting and testing in a future study

From rhetoric to reality: farmer perspectives on the economic potential of biochar in China

Biochar has garnered much attention for its potential to improve farming productivity and sustainability by amending soil, enhancing crop yields, improving fertilizer use efficiency and sequestering carbon. However, few publications consider farmer perspectives on whether biochar is attractive as an agricultural input. This paper therefore investigates the micro-economics and social suitability of biochar in four contrasting Chinese agricultural systems, using linear optimization models and qualitative contextual data. Results demonstrate that commercially produced biochar is uneconomic as an independent farming input, whilst farm-produced biochar shows promise in just one of four case-study sites. This suggests that biochar research in China should shift away from on-farm production and application of pure biochar, towards combined biochar-inorganic fertilizer products