Unexpected changes in community size structure in a natural warming experiment

Natural ecosystems typically consist of many small and few large organisms. The scaling of this negative relationship between body mass and abundance has important implications for resource partitioning and energy usage. Global warming over the next century is predicted to favour smaller organisms, producing steeper mass-abundance scaling and a less efficient transfer of biomass through the food web. Here, we show that the opposite effect occurs in a natural warming experiment involving 13 whole-stream ecosystems within the same catchment, which span a temperature gradient of 5-25 °C. We introduce a mechanistic model that shows how the temperature dependence of basal resource carrying capacity can account for these previously unexpected results. If nutrient supply increases with temperature to offset the rising metabolic demand of primary producers, there will be sufficient resources to sustain larger consumers at higher trophic levels. These new data and the model that explains them highlight important exceptions to some commonly assumed 'rules' about responses to warming in natural ecosystems

COVID-19: Rapid antigen detection for SARS-CoV-2 by lateral flow assay: A national systematic evaluation of sensitivity and specificity for mass-testing

Background Lateral flow device (LFD) viral antigen immunoassays have been developed around the world as diagnostic tests for SARS-CoV-2 infection. They have been proposed to deliver an infrastructure-light, cost-economical solution giving results within half an hour. Methods LFDs were initially reviewed by a Department of Health and Social Care team, part of the UK government, from which 64 were selected for further evaluation from 1st August to 15th December 2020. Standardised laboratory evaluations, and for those that met the published criteria, field testing in the Falcon-C19 research study and UK pilots were performed (UK COVID-19 testing centres, hospital, schools, armed forces). Findings 4/64 LFDs so far have desirable performance characteristics (orient Gene, Deepblue, Abbott and Innova SARS-CoV-2 Antigen Rapid Qualitative Test). All these LFDs have a viral antigen detection of >90% at 100,000 RNA copies/ml. 8951 Innova LFD tests were performed with a kit failure rate of 5.6% (502/8951, 95% CI: 5.1–6.1), false positive rate of 0.32% (22/6954, 95% CI: 0.20–0.48). Viral antigen detection/sensitivity across the sampling cohort when performed by laboratory scientists was 78.8% (156/198, 95% CI 72.4–84.3). Interpretation Our results suggest LFDs have promising performance characteristics for mass population testing and can be used to identify infectious positive individuals. The Innova LFD shows good viral antigen detection/sensitivity with excellent specificity, although kit failure rates and the impact of training are potential issues. These results support the expanded evaluation of LFDs, and assessment of greater access to testing on COVID-19 transmission. Funding Department of Health and Social Care. University of Oxford. Public Health England Porton Down, Manchester University NHS Foundation Trust, National Institute of Health Research

The unique challenges of building permanent supportive housing for female veterans : a comparative case study

Thesis: M.C.P., Massachusetts Institute of Technology, Department of Urban Studies and Planning, 2017.Thesis: S.M. in Real Estate Development, Massachusetts Institute of Technology, Program in Real Estate Development in conjunction with the Center for Real Estate, 2017.Cataloged from PDF version of thesis.Includes bibliographical references (pages 52-54).In 2009, President Barack Obama and mayors around the country pledged to end veteran homelessness by 2015. Although their collaborative efforts led to a dramatic decrease in the rate of homelessness among veterans, the number of homeless female veterans peaked during the same period. The federal and state governments have increased the amount of permanent supportive housing units to address this rising homeless population, but experts have cited several reasons for stagnant rates of homelessness among female veterans. Many female veterans are unaware of housing opportunities, confused about identifying as a veteran, and/or perceive veteran housing as incompatible. Reasons for the perceived incompatibility of veteran housing by female veterans include the impression that it is an unsafe living environment, inaccessibility to supportive services such as childcare, and a lack of privacy. This thesis is a comparative case study of three veteran housing developments in Boston: Patriot Homes, New England Center and Home for Veterans (NECHV), and Brighton Marine. These cases explore how developers in Boston navigated the development process to provide housing for female veterans. This thesis examines such obstacles to building veteran housing as general development barriers, permitting issues, design requirements, and funding needs. Several recommendations for ending female veterans' homelessness are offered and focused on improving the development process using design, data, and policy.by Ronette C. Seeney.M.C.P.S.M. in Real Estate Developmen

6.4 Transfusion management and haemostatic changes in major obstetric haemorrhage in the UK.

UNLABELLED: : Blood transfusion is fundamental to improving outcomes during major obstetric haemorrhage (MOH). Current guidelines recommend that fresh frozen plasma (FFP), cryoprecipitate and platelets are transfused when PT/APTT is >1.5 × baseline, fibrinogen 1.5x baseline, fibrinogen <1.0 g/dL and platelet <50 × 10(9)/L respectively. FFP, cryoprecipitate and platelets were transfused in 99%, 61% and 77% of women. The median (IQR) RBC, FFP and cryoprecipitate transfused were: 10 (8-1), 6 (4-8), and 2 units (2-4), with the first FFP and cryoprecipitate transfused after a median of 4 (3-6) and 7 RBC units (6-9) respectively. 45% of women underwent hysterectomy, 2 died, 82% were admitted to ITU/HDU, and 28% developed additional major morbidity. CONCLUSION: Guideline criteria for plasma/platelet transfusion were fulfilled in only 25% of these severe cases, indicating that further research is needed to define transfusion triggers in MOH

6.4 Transfusion management and haemostatic changes in major obstetric haemorrhage in the UK.

UNLABELLED: : Blood transfusion is fundamental to improving outcomes during major obstetric haemorrhage (MOH). Current guidelines recommend that fresh frozen plasma (FFP), cryoprecipitate and platelets are transfused when PT/APTT is &gt;1.5 × baseline, fibrinogen &lt;1 g/dL and platelet count &lt;50 × 10(9)/L, respectively. However, these recommendations are not evidence-based. AIMS: to describe coagulation abnormalities and transfusion requirements during MOH (defined as transfusion of ≥8 units of RBC within 24 hrs of delivery). METHODS: Cases were identified using the UK Obstetric Surveillance System, between July 2012 and June 2013. RESULTS: We identified 181 cases; 68% delivered by caesarean. The median estimated blood loss was 6000 mL (IQR: 4500-8000). The main causes for MOH were uterine atony (40%) and placenta accreta/increta/percreta (16%). The median (IQR) platelet count, APTT-ratio and fibrinogen (worst values) were 68 x 10(9)/L (50-95), 1.3 (1.0-1.9) and 1.4 (0.8-2.2) respectively. In 33%, 27% and 25% of cases APTT-ratio was &gt;1.5x baseline, fibrinogen &lt;1.0 g/dL and platelet &lt;50 × 10(9)/L respectively. FFP, cryoprecipitate and platelets were transfused in 99%, 61% and 77% of women. The median (IQR) RBC, FFP and cryoprecipitate transfused were: 10 (8-1), 6 (4-8), and 2 units (2-4), with the first FFP and cryoprecipitate transfused after a median of 4 (3-6) and 7 RBC units (6-9) respectively. 45% of women underwent hysterectomy, 2 died, 82% were admitted to ITU/HDU, and 28% developed additional major morbidity. CONCLUSION: Guideline criteria for plasma/platelet transfusion were fulfilled in only 25% of these severe cases, indicating that further research is needed to define transfusion triggers in MOH

Authors' reply re: The epidemiology and outcomes of women with postpartum haemorrhage requiring massive transfusion with eight or more units of red cells: a national cross-sectional study

We thank Dr Killicoat and colleagues for their interest in our paper. We agree that it is important that both trainee and consultant obstetricians and mid- wives are skilled in recognising and managing obstetric haemorrhage

Re: The epidemiology and outcomes of women with postpartum haemorrhage requiring massive transfusion with eight or more units of red cells: a national cross-sectional study Reply

We thank Dr Killicoat and colleagues for their interest in our paper. We agree that it is important that both trainee and consultant obstetricians and mid- wives are skilled in recognising and managing obstetric haemorrhage