Genome-wide meta-analysis implicates mediators of hair follicle development and morphogenesis in risk for severe acne

Acne vulgaris is a highly heritable common, chronic inflammatory disease of the skin for which five genetic risk loci have so far been identified. Here, we perform a genome-wide association study of 3823 cases and 16,144 controls followed by meta-analysis with summary statistics from a previous study, with a total sample size of 26,722. We identify 20 independent association signals at 15 risk loci, 12 of which have not been previously implicated in the disease. Likely causal variants disrupt the coding region of WNT10A and a P63 transcription factor binding site in SEMA4B. Risk alleles at the 1q25 locus are associated with increased expression of LAMC2, in which biallelic loss-of-function mutations cause the blistering skin disease epidermolysis bullosa. These findings indicate that variation affecting the structure and maintenance of the skin, in particular the pilosebaceous unit, is a critical aspect of the genetic predisposition to severe acne

The Role of Published Materials in Curriculum Development and Implementation for Secondary School Design and Technology in England and Wales

This is a postprint of an article whose final and definitive form has been published in the International Journal of Technology and Design Education. The original publication is available at www.springerlink.com.This paper discusses the ways in which teachers exploited a set of curriculum materials published as a vehicle for curriculum innovation, and the relationship between chosen modes of exploitation and teachers’ own perceptions of how the materials had ’added value’ to their teaching. The materials in question were developed by the Nuffield Design and Technology Project (’the Project’) to offer a pedagogy appropriate to the statutory curriculum for secondary school design and technology education in England and Wales (DFE/WO 1995). The Project had sought both to inform the statutory curriculum, and respond to its requirements. An earlier case study (Givens 1997) laid the foundations for the survey that is reported here. This paper focuses on the teaching of pupils aged 11–14. It finds that while most teachers made at least some use of all the various components of the publications, they were selective. While the Study Guide, which carries out a meta-cognitive dialogue with pupils, was generally underused, those teachers who did use it perceived greater value added by the materials as a whole to the quality of pupils’ work, their effectiveness in design and technology and their autonomy

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Managing Urban Deer

Conflicts are emerging between humans and wildlife populations adaptable to the high density of humans found in urban and suburban areas. In response to these threats, animal control programs are typically designed with the objective of establishing and maintaining a stable population. This article challenges this view by studying the management of urban deer in Irondequoit, NY. Pulsing controls can be more efficient than steady-state regimes under a wide range of conditions in both deterministic and stochastic environments, but potential gains can be dissipated by management constraints. The effect of citizen opposition to lethal control methods is also investigated. Copyright 2003, Oxford University Press.