White blood cell count and risk of incident lung cancer in the UK Biobank

Background The contribution of measurable immunological/inflammatory parameters to lung cancer development remains unclear, particularly among never-smokers. We investigated the relationship between total and differential white blood cell (WBC) counts and incident lung cancer risk overall and among subgroups defined by smoking status and sex in the United Kingdom (UK). Methods We evaluated 424,407 adults aged 37-73 years from the UK Biobank. Questionnaires, physical measurements, and blood were administered/collected at baseline in 2006-2010. Complete blood cell counts were measured using standard methods. Lung cancer diagnoses and histological classifications were obtained from cancer registries. Multivariable Cox regression models were used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) of incident lung cancer in relation to quartiles (Q) of total WBC and subtype-specific counts, with Q1 as the reference. Results There were 1,493 incident cases diagnosed over an average 7-year follow-up. Overall, the highest quartile of total WBC count was significantly associated with elevated lung cancer risk (HRQ4=1.67, 95% CI:1.41-1.98). Among women, increased risks were found in current-smokers (ncases/n=244/19,464, HRQ4=2.15, 95% CI:1.46-3.16), former-smokers (ncases/n=280/69,198, HRQ4=1.75, 95% CI:1.24-2.47), and never-smokers without environmental tobacco smoke exposure (ncases/n=108/111,294, HRQ4=1.93, 95% CI:1.11-3.35). Among men, stronger associations were identified in current-smokers (ncases/n=329/22,934, HRQ4=2.95, 95% CI:2.04-4.26) and former-smokers (ncases/n= 358/71,616, HRQ4=2.38, 95% CI:1.74-3.27) but not in never-smokers. Findings were similar for lung adenocarcinoma and squamous cell carcinoma and were driven primarily by elevated neutrophil fractions. Conclusions Elevated WBCs could potentially be one of many important markers for increased lung cancer risk, especially among never-smoking women and ever-smoking men

Computer simulation of syringomyelia in dogs

Syringomyelia is a pathological condition in which fluid-filled cavities (syringes) form and expand in the spinal cord. Syringomyelia is often linked with obstruction of the craniocervical junction and a Chiari malformation, which is similar in both humans and animals. Some brachycephalic toy breed dogs such as Cavalier King Charles Spaniels (CKCS) are particularly predisposed. The exact mechanism of the formation of syringomyelia is undetermined and consequently with the lack of clinical explanation, engineers and mathematicians have resorted to computer models to identify possible physical mechanisms that can lead to syringes. We developed a computer model of the spinal cavity of a CKCS suffering from a large syrinx. The model was excited at the cranial end to simulate the movement of the cerebrospinal fluid (CSF) and the spinal cord due to the shift of blood volume in the cranium related to the cardiac cycle. To simulate the normal condition, the movement was prescribed to the CSF. To simulate the pathological condition, the movement of CSF was blocked

Evaluating the effects of oral contraceptive use on biomarkers and body composition during a competitive season in collegiate female soccer players

High training demands throughout the competitive season in female collegiate soccer players have been shown to induce changes in biomarkers indicative of stress, inflammation, and reproduction, which may be exacerbated in athletes using oral contraceptives (OCs). Purpose: To compare biomarkers and body composition between OC-using and non-using (CON) female soccer players throughout a competitive season. Methods: Female collegiate soccer players were stratified into two groups based on their reported OC use at the start of pre-season (OC: n=6; CON: n=17). Prior to the start of pre-season and immediately post-season, athletes underwent a battery of performance tests. Blood draws and body composition assessments were performed prior to pre-season, on weeks 2, 4, 8, and 12 of the season, and post-season. Results: Area-under-the-curve ratios (OCAUC:CONAUC) indicated the OC group were exposed to substantially higher levels of sex-hormone binding globulin (AUCratio=1.4, probability=p>0.999), total cortisol (1.7; p>0.999), c-reactive protein (5.2; p>0.999), leptin (1.4; p=0.990), growth hormone (1.5; p=0.97), but substantively lower amounts ofestradiol (0.36; p<0.001),progesterone (0.48; p=0.008), free testosterone (0.58; p<0.001), follicle-stimulating hormone (0.67; p<0.001) and creatine kinase (0.33, p<0.001) compared with the CON across the season. Both groups increased fat free mass over the season, but CON experienced a greater magnitude of increase along with decreased body fat percentage. Conclusion: Although similar training loads were observed between groups over the season, the elevated exposure to stress, inflammatory, and metabolic biomarkers over the competitive season in OC users may have implications on body composition, training adaptations, and recovery in female athletes

Issues potentially affecting quality of life arising from long-term medicines use: a qualitative study

Background Polypharmacy is increasing and managing large number of medicines may create a burden for patients. Many patients have negative views of medicines and their use can adversely affect quality of life. No studies have specifically explored the impact of general long-term medicines use on quality of life. Objective To determine the issues which patients taking long-term medicines consider affect their day-to-day lives, including quality of life. Setting Four primary care general practices in North West England Methods Face-to-face interviews with adults living at home, prescribed four or more regular medicines for at least 1 year. Interviewees were identified from primary care medical records and purposively selected to ensure different types of medicines use. Interviews were recorded, transcribed and analysed thematically. Results Twenty-one interviews were conducted and analysed. Patients used an average of 7.8 medicines, 51 % were preventive, 40 % for symptom relief and 9 % treatment. Eight themes emerged: relationships with health professionals, practicalities, information, efficacy, side effects, attitudes, impact and control. Ability to discuss medicines with health professionals varied and many views were coloured by negative experiences, mainly with doctors. All interviewees had developed routines for using multiple medicines, some requiring considerable effort. Few felt able to exert control over medicines routines specified by health professionals. Over half sought additional information about medicines whereas others avoided this, trusting in doctors to guide their medicines use. Patients recognised their inability to assess efficacy for many medicines, notably those used for prophylaxis. All were concerned about possible side effects and some had poor experiences of discussing concerns with doctors. Medicines led to restrictions on social activities and personal life to the extent that, for some, life can revolve around medicines. Conclusion There is a multiplicity and complexity of issues surrounding medicines use, which impact on day-to-day lives for patients with long-term conditions. While most patients adapt to long-term medicines use, others did so at some cost to their quality of life

Enhanced Access to Climate-Smart Agriculture and Climate Information Services by Farmers in Mali

Mali is a rice basket in West Africa, providing a substantial amount of the region's rice supply, but is also highly vulnerable to climate variability and change. AICCRA-Mali aims to strengthen the technical, institutional, and human capacity required to accelerate the wide-scale adoption of climate-smart agriculture and climate information services packages by hundreds of thousands of men and women farmers in Mali. The project focuses on rice and associated speculations (legume, vegetable, tuber, fish, and tree) value chains and pursues to enhance resilience to drought and flooding in rainfed systems and cold and water scarcity in irrigated systems. In 2022, 111,064 farmers including 49% women were supported in the use of CSA and CIS interventions by AfricaRice and the national partners (Syngenta Foundation, Niger office, Mali-Meteo and IER). The focused CSA and CIS interventions were RiceAdvice, drought-tolerant rice varieties, alternate wetting and drying, mechanization services, solar-powered irrigation, GEM parboiling, direct seeding, and information about weather forecasts. The mechanisms used included service provision business models, technologies demonstration followed by farmers' exchange days, save-for-change financing mechanism, Pay-As-You-Go business model, multi-stakeholders’ platforms, and Local Groups for Meteorological Assistance. Application of RiceAdvice recommendations improved rice yield by 0.9 t/ha and farmers’ income by 320 USD/ha. The yield increase was higher in women’s fields (+1.0 t/ha) compared to men’s fields (+0.8 t/ha), which was attributed to the fact that women have culturally access to soils with lower fertility than men’s in Mali, and consequently, the soil responses to applied fertilizers were better in women’s than in men’s fields. When the benefits of the use of RiceAdvice were aggregated over the total area cultivated by the 53,045 farmers, the rice production increase was estimated to be 42966 tones and the farmers’ income increase was estimated to be 15.3 million USD. Farmers who used the solar-powered irrigation pumps increased their income by USD 5,262 per hectare, and improved their food consumption score by 3.1. The food consumption score is the frequency of consumption of different food groups consumed by a household during the 7 days before the survey. The use of solar-powered irrigation technologies enabled farmers to produce cash crops such as onion, tomato, cabbage, and potato during the dry season when fields had previously been abandoned due to water scarcity. Thanks to these additional crops, the increase in their incomes mean they are investing more in quality seeds, and fertilizers

Perinatal risk factors for neonatal encephalopathy: an unmatched case-control study

OBJECTIVE: Neonatal encephalopathy (NE) is the third leading cause of child mortality. Preclinical studies suggest infection and inflammation can sensitise or precondition the newborn brain to injury. This study examined perinatal risks factor for NE in Uganda. DESIGN: Unmatched case-control study. SETTING: Mulago National Referral Hospital, Kampala, Uganda. METHODS: 210 term infants with NE and 409 unaffected term infants as controls were recruited over 13 months. Data were collected on preconception, antepartum and intrapartum exposures. Blood culture, species-specific bacterial real-time PCR, C reactive protein and placental histology for chorioamnionitis and funisitis identified maternal and early newborn infection and inflammation. Multivariable logistic regression examined associations with NE. RESULTS: Neonatal bacteraemia (adjusted OR (aOR) 8.67 (95% CI 1.51 to 49.74), n=315) and histological funisitis (aOR 11.80 (95% CI 2.19 to 63.45), n=162) but not chorioamnionitis (aOR 3.20 (95% CI 0.66 to 15.52), n=162) were independent risk factors for NE. Among encephalopathic infants, neonatal case fatality was not significantly higher when exposed to early neonatal bacteraemia (OR 1.65 (95% CI 0.62 to 4.39), n=208). Intrapartum antibiotic use did not improve neonatal survival (p=0.826). After regression analysis, other identified perinatal risk factors (n=619) included hypertension in pregnancy (aOR 3.77), male infant (aOR 2.51), non-cephalic presentation (aOR 5.74), lack of fetal monitoring (aOR 2.75), augmentation (aOR 2.23), obstructed labour (aOR 3.8) and an acute intrapartum event (aOR 8.74). CONCLUSIONS: Perinatal infection and inflammation are independent risk factors for NE in this low-resource setting, supporting a role in the aetiological pathway of term brain injury. Intrapartum antibiotic administration did not mitigate against adverse outcomes. The importance of intrapartum risk factors in this sub-Saharan African setting is highlighted

Contrasting environmental drivers of adult and juvenile growth in a marine fish: implications for the effects of climate change

Many marine fishes have life history strategies that involve ontogenetic changes in the use of coastal habitats. Such ontogenetic shifts may place these species at particular risk from climate change, because the successive environments they inhabit can differ in the type, frequency and severity of changes related to global warming. We used a dendrochronology approach to examine the physical and biological drivers of growth of adult and juvenile mangrove jack (Lutjanus argentimaculatus) from tropical north-western Australia. Juveniles of this species inhabit estuarine environments and adults reside on coastal reefs. The Niño-4 index, a measure of the status of the El Niño-Southern Oscillation (ENSO) had the highest correlation with adult growth chronologies, with La Niña years (characterised by warmer temperatures and lower salinities) having positive impacts on growth. Atmospheric and oceanographic phenomena operating at ocean-basin scales seem to be important correlates of the processes driving growth in local coastal habitats. Conversely, terrestrial factors influencing precipitation and river runoff were positively correlated with the growth of juveniles in estuaries. Our results show that the impacts of climate change on these two life history stages are likely to be different, with implications for resilience and management of populations

ProtoDESI: First On-Sky Technology Demonstration for the Dark Energy Spectroscopic Instrument

The Dark Energy Spectroscopic Instrument (DESI) is under construction to measure the expansion history of the universe using the baryon acoustic oscillations technique. The spectra of 35 million galaxies and quasars over 14,000 square degrees will be measured during a 5-year survey. A new prime focus corrector for the Mayall telescope at Kitt Peak National Observatory will deliver light to 5,000 individually targeted fiber-fed robotic positioners. The fibers in turn feed ten broadband multi-object spectrographs. We describe the ProtoDESI experiment, that was installed and commissioned on the 4-m Mayall telescope from August 14 to September 30, 2016. ProtoDESI was an on-sky technology demonstration with the goal to reduce technical risks associated with aligning optical fibers with targets using robotic fiber positioners and maintaining the stability required to operate DESI. The ProtoDESI prime focus instrument, consisting of three fiber positioners, illuminated fiducials, and a guide camera, was installed behind the existing Mosaic corrector on the Mayall telescope. A Fiber View Camera was mounted in the Cassegrain cage of the telescope and provided feedback metrology for positioning the fibers. ProtoDESI also provided a platform for early integration of hardware with the DESI Instrument Control System that controls the subsystems, provides communication with the Telescope Control System, and collects instrument telemetry data. Lacking a spectrograph, ProtoDESI monitored the output of the fibers using a Fiber Photometry Camera mounted on the prime focus instrument. ProtoDESI was successful in acquiring targets with the robotically positioned fibers and demonstrated that the DESI guiding requirements can be met.Comment: Accepted versio

AICCRA Scaling Vision: Mali

AICCRA-Mali scaling vision is to ensure that by 2030, 1,000,000 farmers, including 35% women use the CSA and CIS interventions developed, validated, or scaled by the project to enhance the security of income, employment and food including nutrition in the face of climate change. The short-term objective is to enhance the yield income, food, and nutrition security of 250,000 farmers including 35% women in the face of climate variability and climate change by December 2023 by adopting innovative partnerships and inclusive business models to ensure sustainability

How people with dementia and their families decide about moving to a care home and support their needs: development of a decision aid, a qualitative study

yesBackground: People with dementia and their relatives find decisions about the person with dementia living in a care home difficult. Methods: We interviewed 20 people with dementia or family carers around the time of this decision in order to design a decision-aid. Results: Decision-makers balanced the competing priorities of remaining somewhere familiar, family’s wish they remain at home, reduction of risk and effects on carer’s and person with dementia’s physical health. The person with dementia frequently resented their lack of autonomy as decisions about care home moves were made after insight and judgment were impaired. Family consultation usually helped carers but sometimes exacerbated tensions. Direct professional support was appreciated where it was available. There is a need for healthcare professionals to facilitate these conversations around decision-making and to include more than signposting to other organisations. Conclusions: There is a need for a healthcare professional facilitated decision-aid. This should detail what might change for the person with dementia and their carer, possible resources and alternatives and assist in facilitating discussion with the wider family; further research will develop and test a tool to facilitate decision making about place of care needs