The top 10 research priorities in cystic fibrosis developed by a partnership between people with CF and healthcare providers

There remain many treatment uncertainties in cystic fibrosis (CF). With limited resources, research should focus on questions which are most important to the CF community. We conducted a James Lind Alliance Priority Setting Partnership in CF. Research questions were elicited and then prioritised in successive surveys. A workshop agreed the final top 10. Online methods avoided cross infection and widened participation. The elicitation survey had 482 respondents (1080 questions) and prioritisation survey 677 respondents. Participants were drawn equally from the patient and clinical communities globally. We have achieved a consensus on 10 research priorities which will be attractive to funders

Once a feminist: Lynne Segal on Grace Paley’s The Little Disturbances of Man

The following contributions came in response to a request, sent to a number of key figures in feminism today, to write on a text that had been formative for their thinking as feminists. The chosen text could be a theory, a novel, an artwork, a performance, a poem: one that had stimulated, or even revolutionised, their ideas. As we hoped, this project has created a selection of texts central to our many and different experiences as feminists. I used to say that Margaret Drabble's The Garrick Year was the story of my life, in my early twenties, as if I was just a creature of time and circumstance. I read The Garrick Year sometime between October 1965, when my first child was born, and the end of 1967, before my marriage disintegrated. Like the heroine Emma Evans, I married a successful actor, had a child, and followed his career—which in the novel led Emma to Hereford for a summer season of plays

The Effect of Gamma Irradiation on the Ion Exchange Properties of Caesium-Selective Ammonium Phosphomolybdate-Polyacrylonitrile (AMP-PAN) Composites under Spent Fuel Recycling Conditions

The caesium radioisotopes 134Cs, 135Cs, and 137Cs are highly problematic medium-lived species produced during nuclear fission, due to their high radioactivity and environmental mobility. While many ion exchange materials can readily isolate Cs+ ions from neutral or basic aqueous solutions, only ammonium phosphomolybdate (AMP) functions effectively in acidic conditions, removing caesium even down to trace levels. Composites of AMP in a porous polymeric support such as polyacrylonitrile (PAN) can be used to selectively remove Cs+ ions from acidic aqueous decontamination liquors as well as other liquid wastes, and are promising for the isolation of Cs+ isotopes in spent fuel reprocessing. While both AMP and PAN have demonstrable acid stability, and PAN has known resistance to gamma radiation, AMP-PAN composites have received only a limited analysis of their physiochemical and ion exchange performance following irradiation. In this publication, we explore the effect of high levels of gamma irradiation on the ion exchange properties of AMP and AMP-PAN as a Cs+-selective adsorbent under spent fuel dissolver liquor concentrations and acidity. We demonstrate no significant reduction in performance with respect to uptake kinetics or capacity upon irradiation, abiding by the same absorption mechanism observed in the established literature

H3K9 Methyltransferases and Demethylases Control Lung Tumor-Propagating Cells and Lung Cancer Progression

Epigenetic regulators are attractive anticancer targets, but the promise of therapeutic strategies inhibiting some of these factors has not been proven in vivo or taken into account tumor cell heterogeneity. Here we show that the histone methyltransferase G9a, reported to be a therapeutic target in many cancers, is a suppressor of aggressive lung tumor-propagating cells (TPCs). Inhibition of G9a drives lung adenocarcinoma cells towards the TPC phenotype by de-repressing genes which regulate the extracellular matrix. Depletion of G9a during tumorigenesis enriches tumors in TPCs and accelerates disease progression metastasis. Depleting histone demethylases represses G9a-regulated genes and TPC phenotypes. Demethylase inhibition impairs lung adenocarcinoma progression in vivo. Therefore, inhibition of G9a is dangerous in certain cancer contexts, and targeting the histone demethylases is a more suitable approach for lung cancer treatment. Understanding cellular context and specific tumor populations is critical when targeting epigenetic regulators in cancer for future therapeutic development

Randomized placebo-controlled trial assessing the effect of 24-week fenofibrate therapy on circulating markers of abdominal aortic aneurysm: Outcomes from the FAME-2 trial

Background-There is no drug therapy for abdominal aortic aneurysm (AAA). FAME-2 (Fenofibrate in the Management of Abdominal Aortic Aneurysm 2) was a placebo-controlled randomized trial designed to assess whether administration of 145 mg of fenofibrate/d for 24 weeks favorably modified circulating markers of AAA. Methods and Results-Patients with AAAs measuring 35 to 49 mm and no contraindication were randomized to fenofibrate or identical placebo. The primary outcome measures were the differences in serum osteopontin and kallistatin concentrations between groups. Secondary analyses compared changes in the circulating concentration of AAA-associated proteins, and AAA growth, between groups using multivariable linear mixed-effects modeling. A total of 140 patients were randomized to receive fenofibrate (n=70) or placebo (n=70). By the end of the study 3 (2.1%) patients were lost to follow-up and 18 (12.9%) patients had ceased trial medication. A total of 85% of randomized patients took =80% of allocated tablets and were deemed to have complied with the medication regimen. Patients’ allocated fenofibrate had expected reductions in serum triglycerides and estimated glomerular filtration rate, and increases in serum homocysteine. No differences in serum osteopontin, kallistatin, or AAA growth were observed between groups. Conclusions-Administering 145 mg/d of fenofibrate for 24 weeks did not significantly reduce serum concentrations of osteopontin and kallistatin concentrations, or rates of AAA growth in this trial. The findings do not support the likely benefit of fenofibrate as a treatment for patients with small AAAs. Clinical Trial Registration-URL: www.anzctr.org.au. Unique identifier: ACTRN12613001039774

Learning through social spaces: migrant women and lifelong learning in post-colonial London

This article shows how migrant women engage in learning through social spaces. It argues that such spaces are little recognised, and that there are multiple ways in which migrant women construct and negotiate their informal learning through socialising with other women in different informal modes. Additionally, the article shows how learning is shaped by the socio-political, geographical and multicultural context of living in London, outlining ways in which gendered and racialised identities shape, construct and constrain participation in lifelong learning. The article shows that one way in which migrant women resist (post)colonial constructions of difference is by engaging in informal and non-formal lifelong learning, arguing that the benefits are (at least) two-fold. The women develop skills (including language skills) but also use their informal learning to develop what is referred to in this article as 'relational capital'. The article concludes that informal lifelong learning developed through social spaces can enhance a sense of belonging for migrant women

The Effect of Gamma Irradiation on the Physiochemical Properties of Caesium-Selective Ammonium Phosphomolybdate–Polyacrylonitrile (AMP–PAN) Composites

Managing certain by-products of the nuclear fuel cycle, such as the radioactive isotopes of caesium: 134Cs, 135Cs and 137Cs is challenging due to their environmental mobility and radioactivity. While a great many materials can isolate Cs+ ions from neutral or basic aqueous solutions via ion exchange, few of these, with the exception of ammonium phosphomolybdate (AMP), function effectively in acidic media. The use of AMP, and its porous composite in polyacrylonitrile (PAN) for management of Cs radioisotopes in various nuclear wastes have been known for decades and are well studied, yet the effects of radiation on the physiochemical properties of such composites have only received limited attention to date. In a previous publication, we demonstrated that a 100 kGy gamma irradiation dose has negligible effect on the ion exchange performance of AMP and AMP−PAN with respect to capacity or kinetics under the Cs+ concentrations and acidity found in spent nuclear fuel (SNF) recycling. As a continuation of this prior study, in this publication we explore the effects of gamma irradiation on the physiochemical properties of AMP and AMP−PAN using a range of characterisation methods. The effects of the same gamma dose on the oxidation state of Mo in AMP and AMP−PAN, the thermal degradation of both AMP and AMP−PAN, combined with a first study into the high-temperature degradation AMP, are reported. The implications of irradiation, its possible mechanism, the conditions present in SNF recycling, and for the end-of-life disposal or recycling of these materials are also discussed

Jarlmanns saga og Hermanns: A Translation

Agnete Lothʼs edition of the longer version of Jarlmanns saga og Hermanns included an accompanying English paraphrase (by Gillian Fellows Jensen), but there has never been a full translation into English, much less of the shorter version as edited by Hugo Rydberg. We rectify that omission here, providing a normalized text of Rydbergʼs edition with an English translation alongside in the hopes of making this entertaining saga more accessible to a wider audience

Association of serum lipoprotein (a) with the requirement for a peripheral artery operation and the incidence of major adverse cardiovascular events in people with peripheral artery disease

Background: The aim of this study was to assess the relationship between serum lipoprotein (a) (Lp[a]) concentration and the requirement for peripheral artery disease (PAD) operations or incidence of major adverse cardiovascular events. Methods and Results: A total of 1472 people with PAD presenting with intermittent claudication (n=355), abdominal aortic aneurysm (n=989) or critical limb ischemia (n=128) were prospectively recruited from 4 outpatient clinics in Australia. Lp(a) was measured in serum samples collected at recruitment using an immunoassay. Participants were followed for a median (interquartile range) of 2.4 (0.1–6.1) years to record requirement for any PAD operation, defined to include any open or endovascular PAD intervention (lower limb peripheral revascularization, abdominal aortic aneurysm repair, other aneurysm repair, or carotid artery revascularization). Myocardial infarctions, strokes, and deaths were also recorded. The association of Lp(a) with events was assessed using Cox proportional hazard analysis adjusting for traditional risk factors. Participants with Lp(a) ≥30 mg/dL had a greater requirement for any PAD operation (hazard ratio, 1.20, 95% CI, 1.02–1.41) and lower limb peripheral revascularization alone (hazard ratio 1.33, 95% CI, 1.06–1.66) but no increased risk of major adverse cardiovascular events or all‐cause mortality. Lp(a) ≥50 mg/dL and a 40 mg/dL increase in Lp(a) were also associated with an increased risk of lower limb peripheral revascularization alone but not with other outcomes. Conclusions: In participants with PAD referred for hospital management those with high Lp(a) had greater requirement for lower limb peripheral revascularization but Lp(a) was not consistently associated with other clinical events.Jonathan Golledge, Sophie Rowbotham, Ramesh Velu, Frank Quigley, Jason Jenkins ... Shivshankar Thanigaimani ... et al

Psychopolitics: Peter Sedgwick’s legacy for mental health movements

This paper re-considers the relevance of Peter Sedgwick's Psychopolitics (1982) for a politics of mental health. Psychopolitics offered an indictment of ‘anti-psychiatry’ the failure of which, Sedgwick argued, lay in its deconstruction of the category of ‘mental illness’, a gesture that resulted in a politics of nihilism. ‘The radical who is only a radical nihilist’, Sedgwick observed, ‘is for all practical purposes the most adamant of conservatives’. Sedgwick argued, rather, that the concept of ‘mental illness’ could be a truly critical concept if it was deployed ‘to make demands upon the health service facilities of the society in which we live’. The paper contextualizes Psychopolitics within the ‘crisis tendencies’ of its time, surveying the shifting welfare landscape of the subsequent 25 years alongside Sedgwick's continuing relevance. It considers the dilemma that the discourse of ‘mental illness’ – Sedgwick's critical concept – has fallen out of favour with radical mental health movements yet remains paradigmatic within psychiatry itself. Finally, the paper endorses a contemporary perspective that, while necessarily updating Psychopolitics, remains nonetheless ‘Sedgwickian’