Moulting season corticosterone correlates with winter season bodyweight in an Arctic migrant bird

In vertebrates, the endocrine system translates environmental changes into physiological responses on which natural selection can act to regulate individual fitness and, ultimately, population dynamics. Corticosterone (CORT) and dehydroepiandrosterone (DHEA) are important regulators of the avian endocrine system but relatively few studies have investigated their downstream effects on key morphological fitness‐related traits in free‐living populations. This study quantified endocrine–morphology relationships in free‐living Greenland Barnacle Geese Branta leucopsis that breed in the high Arctic. CORT and DHEA were extracted from feather and blood samples and tested for relationships with three morphological traits associated with survival and reproduction: bodyweight, body size and facial plumage coloration. We expected CORT concentration to be higher in birds with less favourable morphological traits (i.e. lighter, smaller and less attractive) and DHEA to be higher in birds with more favourable traits (i.e. heavier, bigger and more attractive). As expected, individuals with higher CORT during the post‐breeding moult (July/August) had significantly lower bodyweight during the following winter (November–April). In contrast, we found no robust DHEA–morphology relationships and no statistically significant relationship between CORT and body size or facial plumage. Overall, this study provides evidence of a negative relationship between CORT and bodyweight extending across different seasons of the annual cycle in a long‐distance migrant. This is of particular interest because bodyweight fluctuates rapidly in response to environmental resources and is closely linked to both survival and reproductive success in this species. Understanding the relationship between CORT and key morphological traits is important because endocrine‐disrupting contaminants in the Arctic increasingly interfere with CORT function in birds, including Barnacle Geese, and based on the results of this study may have consequences for bodyweight regulation

Therapy with mycophenolate mofetil for refractory acute and chronic GVHD.

We evaluated the pharmacokinetics and efficacy of oral mycophenolate mofetil (MMF) for treatment of refractory GVHD. In a prospective study of acute GVHD, 9 of 19 patients (47%) had a response and 10 (53%) had no improvement. Survival at 6 and 12 months after the start of MMF was 37 and 16%, respectively. In a retrospective study of acute GVHD, 14 of 29 patients (48%) had a response and 15 (52%) had no improvement. Survival at 6 and 12 months was 55 and 52%, respectively. In a prospective study of chronic GVHD, the cumulative incidence of disease resolution and withdrawal of all systemic immunosuppressive treatment was 9, 17 and 26% at 12, 24 and 36 months, respectively, after starting MMF. Thirteen patients (59%) required additional systemic immunosuppressive treatment for chronic GVHD. Nine of the 42 patients (21%) in the prospective studies discontinued MMF treatment because of toxicity. The area under the curve plasma concentrations of mycophenolic acid seemed to be suboptimal among patients with acute GVHD but not among those with chronic GVHD. MMF can be used effectively for treatment of GVHD.Bone Marrow Transplantation advance online publication, 20 April 2009; doi:10.1038/bmt.2009.76

INSPIRE (INvestigating Social and PractIcal suppoRts at the End of life): Pilot randomised trial of a community social and practical support intervention for adults with life-limiting illness

YesBACKGROUND: For most people, home is the preferred place of care and death. Despite the development of specialist palliative care and primary care models of community based service delivery, people who are dying, and their families/carers, can experience isolation, feel excluded from social circles and distanced from their communities. Loneliness and social isolation can have a detrimental impact on both health and quality of life. Internationally, models of social and practical support at the end of life are gaining momentum as a result of the Compassionate Communities movement. These models have not yet been subjected to rigorous evaluation. The aims of the study described in this protocol are: (1) to evaluate the feasibility, acceptability and potential effectiveness of The Good Neighbour Partnership (GNP), a new volunteer-led model of social and practical care/support for community dwelling adults in Ireland who are living with advanced life-limiting illness; and (2) to pilot the method for a Phase III Randomised Controlled Trial (RCT). DESIGN: The INSPIRE study will be conducted within the Medical Research Council (MRC) Framework for the Evaluation of Complex Interventions (Phases 0-2) and includes an exploratory two-arm delayed intervention randomised controlled trial. Eighty patients and/or their carers will be randomly allocated to one of two groups: (I) Intervention: GNP in addition to standard care or (II) Control: Standard Care. Recipients of the GNP will be asked for their views on participating in both the study and the intervention. Quantitative and qualitative data will be gathered from both groups over eight weeks through face-to-face interviews which will be conducted before, during and after the intervention. The primary outcome is the effect of the intervention on social and practical need. Secondary outcomes are quality of life, loneliness, social support, social capital, unscheduled health service utilisation, caregiver burden, adverse impacts, and satisfaction with intervention. Volunteers engaged in the GNP will also be assessed in terms of their death anxiety, death self efficacy, self-reported knowledge and confidence with eleven skills considered necessary to be effective GNP volunteers. DISCUSSION: The INSPIRE study addresses an important knowledge gap, providing evidence on the efficacy, utility and acceptability of a unique model of social and practical support for people living at home, with advanced life-limiting illness. The findings will be important in informing the development (and evaluation) of similar service models and policy elsewhere both nationally and internationally. TRIAL REGISTRATION: ISRCTN18400594 18(th) February 2015

Counting Carbon: Calculative Activism and Slippery Infrastructure

The environmental movement in the global North is in a state of impasse. It appears that despite the renewed international focus on climate change, and the actions of innumerable social movements, a “solution” to the problem appears as one, without a viable solution. It is the contention of this paper that climate change has no clearly viable solution as it is a seemingly impossible problem. This paper investigates how the problem of climate change is constructed as a global object of political action and how it functions to render politics into a matter of calculative action, one that seeks—but fails—to take hold of a slippery carbon infrastructure. It concludes by suggesting one possible solution to this dilemma is to turn away from the global scalar logic of climate change and towards a situated focus on questions of infrastructure, or what Dimitris Papadopoulos calls “thick justice”

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2–4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2,3,4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

A Comparison of Youth Policy in England and Wales under New Labour

Although there has been a divergence in the development of youth policy across the UK, no country comparisons have been undertaken and a gap exists in the literature. This article focuses on the emergence of youth policy in England and Wales under New Labour (1997–2010), providing a cross-national comparison of policy developments in both countries. It critically explores the impact of the context for policy development and the policy content of both countries' key youth policies. The research found significant differences between the two, despite their common goals, with implications for future policy makers. This article identifies these differences, and the key similarities, providing a theoretical understanding of them and indicating lessons to inform future youth policy

Effect of changing match format from halves to quarters on the performance characteristics of male university field hockey players

The study examined whether the performance characteristics of male university field hockey players differed when the match format was 2 × 35 min halves compared to 2 × 2 × 17.5 min quarters. Thirty-five male university field hockey players (age 21.2 ± 3.0 years, height 1.81 ± 0.07 m, body mass 75.1 ± 8.9 kg), competing at national level in the UK, were monitored over 52 matches played across the 2018–2019 (2 × 35 min halves) and 2019–2020 (2 × 2 × 17.5 min quarters) seasons using 15 Hz Global Positioning System units and heart rate monitors. Total distance, high-speed running distance (≥15.5 km·h−1), accelerations (≥2 m·s−1), decelerations (≤−2 m·s−1), average heart rate and percentage of time spent at >85% of maximum heart rate were recorded during both match formats. Two-level random intercept hierarchal models (Match—level 1, Player—level 2) suggested that the change in format from 2 × 35 min halves (2018–2019 season) to 2 × 2 × 17.5 min quarters (2019–2020 season) resulted in a reduction in total distance and high-speed running distance completed during a match (by 221 m and 120 m, respectively, both p < 0.001). As no significant cross-level interactions were observed (between season and half), the change from 35 min halves to 17.5 min quarters did not attenuate the reduced physical performance evident during the second half of matches (total distance: −235 m less in second half; high-speed running distance: −70 m less in second half; both p < 0.001). Overall, the findings suggest that the change in match format did alter the performance characteristics of male university field hockey players, but the quarter format actually reduced the total distance and high-speed running distance completed during matches, and did not attenuate the reduction in performance seen during the second half of matches