The Effects of Combined Ocean Acidification and Nanoplastic Exposures on the Embryonic Development of Antarctic Krill

In aquatic environments, plastic pollution occurs concomitantly with anthropogenic climate stressors such as ocean acidification. Within the Southern Ocean, Antarctic krill (Euphausia Superba) support many marine predators and play a key role in the biogeochemical cycle. Ocean acidification and plastic pollution have been acknowledged to hinder Antarctic krill development and physiology in singularity, however potential multi-stressor effects of plastic particulates coupled with ocean acidification are unexplored. Furthermore, Antarctic krill may be especially vulnerable to plastic pollution due to their close association with sea-ice, a known plastic sink. Here, we investigate the behaviour of nanoplastic [spherical, aminated (NH2), and yellow-green fluorescent polystyrene nanoparticles] in Antarctic seawater and explore the single and combined effects of nanoplastic (160 nm radius, at a concentration of 2.5 µg ml−1) and ocean acidification (pCO2 ∼900, pHT 7.7) on the embryonic development of Antarctic krill. Gravid female krill were collected in the Atlantic sector of the Southern Ocean (North Scotia Sea). Produced eggs were incubated at 0.5 ◦C in four treatments (control, nanoplastic, ocean acidification and the multi-stressor scenario of nanoplastic presence, and ocean acidification) and their embryonic development after 6 days, at the incubation endpoint, was determined. We observed that negatively charged nanoplastic particles suspended in seawater from the Scotia Sea aggregated to sizes exceeding the nanoscale after 24 h (1054.13 ± 53.49 nm). Further, we found that the proportion of embryos developing through the early stages to reach at least the limb bud stage was highest in the control treatment (21.84%) and lowest in the multi-stressor treatment (13.17%). Since the biological thresholds to any stressors can be altered by the presence of additional stressors, we propose that future nanoplastic ecotoxicology studies should consider the changing global ocean under future climate scenarios for assessments of their impact and highlight that determining the behaviour of nanoplastic particles used in incubation studies is critical to determining their toxicity

Detailed systematic analysis of recruitment strategies in randomised controlled trials in patients with an unscheduled admission to hospital

ObjectivesTo examine the design and findings of recruitment studies in randomised controlled trials (RCTs) involving patients with an unscheduled hospital admission (UHA), to consider how to optimise recruitment in future RCTs of this nature.DesignStudies within the ORRCA database (Online Resource for Recruitment Research in Clinical TriAls;www.orrca.org.uk) that reported on recruitment to RCTs involving UHAs in patients &gt;18 years were included. Extracted data included trial clinical details, and the rationale and main findings of the recruitment study.ResultsOf 3114 articles populating ORRCA, 39 recruitment studies were eligible, focusing on 68 real and 13 hypothetical host RCTs. Four studies were prospectively planned investigations of recruitment interventions, one of which was a nested RCT. Most recruitment papers were reports of recruitment experiences from one or more ‘real’ RCTs (n=24) or studies using hypothetical RCTs (n=11). Rationales for conducting recruitment studies included limited time for informed consent (IC) and patients being too unwell to provide IC. Methods to optimise recruitment included providing patients with trial information in the prehospital setting, technology to allow recruiters to cover multiple sites, screening logs to uncover recruitment barriers, and verbal rather than written information and consent.ConclusionThere is a paucity of high-quality research into recruitment in RCTs involving UHAs with only one nested randomised study evaluating a recruitment intervention. Among the remaining studies, methods to optimise recruitment focused on how to improve information provision in the prehospital setting and use of screening logs. Future research in this setting should focus on the prospective evaluation of the well-developed interventions to optimise recruitment.</jats:sec

Surgical ward rounds in England: a trainee-led multi-centre study of current practice

BACKGROUND: Recent guidance advocates daily consultant-led ward rounds, conducted in the morning with the presence of senior nursing staff and minimising patients on outlying wards. These recommendations aim to improve patient management through timely investigations, treatment and discharge. This study sought to evaluate the current surgical ward round practices in England. METHODS: Information regarding timing and staffing levels of surgical ward rounds was collected prospectively over a one-week period. The location of each patient was also documented. Two surgical trainee research collaboratives coordinated data collection from 19 hospitals and 13 surgical subspecialties. RESULTS: Data from 471 ward rounds involving 5622 patient encounters was obtained. 367 (77.9%) ward rounds commenced before 9am. Of 422 weekday rounds, 190 (45%) were consultant-led compared with 33 of the 49 (67%) weekend rounds. 2474 (44%) patients were seen with a nurse present. 1518 patients (27%) were classified as outliers, with 361 ward rounds (67%) reporting at least one outlying patient. CONCLUSION: Recommendations for daily consultant-led multi disciplinary ward rounds are poorly implemented in surgical practice, and patients continue to be managed on outlying wards. Although strategies may be employed to improve nursing attendance on ward rounds, substantial changes to workforce planning would be required to deliver daily consultant-led care. An increasing political focus on patient outcomes at weekends may prompt changes in these areas

Perceptions of the New Role of the Research Champion in Developing a New ITE Partnership: Challenges and Opportunities for Schools and Universities

After a process of competitive tendering for the provision of initial teacher education in Wales, there is an opportunity to re-examine the relationship between schools and universities. With the growing importance of research for both student and serving teachers, the Cardiff Partnership developed a model where a school-based 'Research Champion' (RC) would be an integral part of the support for capacity building and developing excellence. Although this model has previously been used in different forms at Oxford and Manchester Universities, the role was new to schools in the Cardiff Partnership. Semi-structured one-to-one interviews were conducted with a representative sample of RCs in primary and secondary schools and university staff to reflect on the challenges and opportunities in the early stages in developing this unique role in the context of an evolving education context in Wales. This study uses data from these interviews to establish key ideas around the emerging role of the RC, the shift in working relationships between schools and universities and what is needed to bridge the gap between research and practice. Interviews were transcribed and, after open-ended thematic analysis, opportunities and challenges are reported. These themes include: bridging the gap between educational research and classroom practitioners; types of knowledge drawn upon by teachers; changes in role and identity. Suggestions for further research monitoring the ongoing development of the role are suggested

Development of an online resource for recruitment research in clinical trials to organise and map current literature

Medical Research Council (MRC) Network of Hubs for Trials Methodology Research (MR/L004933/1– B2).Peer reviewedPublisher PD

Genomic investigations of unexplained acute hepatitis in children

Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children