With or without you? Why the European Union’s climate targets will be harder to meet post-Brexit

The UK has played an important role in shaping and advancing European action on climate change. Without it, other Member States will find themselves picking up the slack or the EU will miss its greenhouse gas target for 2030, write Maria Carvalho and Sam Fankhauser

Climate change and migration in developing countries: evidence and implications for PRISE countries

Headline issue: This paper informs the development community about the effects of climate change on migration patterns within and out of developing countries. It concentrates on the economic aspects of migration and on information that is relevant for the six semi-arid countries that are the focus of the PRISE (Pathways to Resilience in Semi-Arid Economies) project: Burkina Faso, Senegal, Kenya, Tanzania, Pakistan and Tajikistan. Policy intervention is required to reduce potential negative impacts in both the sending and receiving region. Badly managed migration is associated with high economic, social and psychological costs. Key findings: To ensure effective migration choices and a good management of the wider socio-economic effects, policy-makers should: Provide sufficient information about the costs and benefits of migrating, including psychological and social, along with more clarity about alternative adaptation options. Release credit constraints, present in all PRISE countries and in particular in Senegal and Tajikistan, to offset the up-front costs incurred by potential migrants, particularly high in areas with poor transportation infrastructure. Improve institutional quality to ensure the incentives to migrate are not reduced, in particular in the context of land tenure security when people are not able to sell their land or are not confident of reclaiming it upon return. Define the legal status of environmental migrants, for example, through a process led by the UN or UNHCR, in order to give people certainty about their legal situation. Put in place safeguards against distress migration, for example in the event of conflict, which can force people to choose sub-optimal migration strategies, leading to maladaptation. Support the areas affected by outward migration by promoting links between migrants and their region of origin; “managed retreat” from severely affected regions may be a last resort if they become inhospitable. Support the absorptive capacity of the receiving jurisdictions, in particular urban labour markets and public services, to manage the socio-economic implications of the arrival of migrants in a new destination. Direct migrants away from environmentally vulnerable areas where they move to for different reasons, as is the case in Senegal where more than 40 per cent of new migrant populations are located in high risk flood zones

Preparation and certification of 243Am spike reference material: IRMM-0243 : Certified reference material for the amount content of 243Am and n(241Am)7n(243Am) isotope amount ratio

This report describes the preparation and certification of IRMM-0243, a 243Am spike reference material. It is certified for the amount content of 243Am and the isotope amount ratios of n(241Am)/n(243Am) and n(242mAm)/n(243Am). Furthermore, the material is certified for the amount contents of 241Am and total Am, the mass fractions of 243Am, 241Am and total Am, the isotope amount and mass fractions (e.g. isotopic composition) and the molar mass of Am. The material was produced in compliance with ISO/IEC 17034:2016 and certified in accordance with ISO Guide 35:2006. The material was prepared by dilution of an americium starting solution in nitric acid and dispensing of the solution into glass ampoules. In total 587 units were produced. Between-unit homogeneity was quantified and stability during dispatch and storage were assessed in accordance with ISO Guide 35:2006. The characterisation of the amount content of 243Am was performed by Isotope Dilution Mass Spectrometry (IDMS) using a 241Am spike, produced from highly enriched 241Pu material. The isotope amount ratios of n(241Am)/n(243Am) and n(242mAm)/n(243Am) were measured by Thermal Ionisation Mass Spectrometry (TIMS). The certified values were verified by alpha particle spectrometry, alpha particle counting at a defined solid angle (DSA) and high-resolution gamma-ray spectrometry as independent verification methods. The uncertainties of the certified values were estimated in compliance with the Guide to the Expression of Uncertainty in Measurement (GUM) [ ] and include uncertainties related to possible inhomogeneity, instability and characterisation. The main purpose of this material is for use as a spike isotopic reference material for the quantification of americium by IDMS in unknown samples. A unit of IRMM-0243 consists of a glass ampoule with a screw cap containing about 3.5 mL nitric acid solution (c = 1 mol/L) with an americium mass fraction of about 1.5 μg/g solution. The material is a true solution; therefore there is no recommended minimum sample intake to be taken into account.JRC.G.2-Standards for Nuclear Safety, Security and Safeguard

LSE’s experts explain what awaits Britain and Europe ahead of Brexit

On Thursday 8 December, LSE hosted a day of EU- and UK-focused expert panel events and networking activities about Brexit. Below is the full programme, along with audio recordings of each session

Norovirus gastroenteritis general outbreak associated with raw shellfish consumption in South Italy

BACKGROUND: Despite Noroviruses (NV, previously "Norwalk-like viruses") being a leading cause of acute gastroenteritis outbreaks, the impact of NV infection is at present unknown and little information is available about strains circulating in Italy. In April 2002 an outbreak of gastroenteritis occurred in the province of Bari (South-east Italy), involving several households. METHODS: A retrospective cohort study was performed in order to assess risk factors associated with illness. All households where a case occurred were included in the study. Faecal specimens were collected from ill individuals. NV-specific RT-PCR was performed. Eleven samples of mussels were collected from fish-markets involved in the outbreak. A nested PCR was used for mussel samples. RESULTS: One hundred and three cases, detected by means of active surveillance, met the case definition. Raw shellfish eating was the principal risk factor for the disease, as indicated by the analytic issues (Risk Ratio: 1.50; IC 95%: 1.18 – 1.89; p < 0.001). NVs were found by means of RT-PCR of all the stool specimens from the 24 patients tested. Eleven samples of shellfish from local markets were tested for the presence or NVs; six were positive by nested PCR and genotypes were related to that found in patients' stools. CONCLUSION: This is the first community outbreak caused by NVs related to sea-food consumption described in Italy. The study confirms that the present standards for human faecal contamination do not seem to be a reliable indicator of viral contaminants in mussels

Outcomes of relapsed clinical stage I versus de novo metastatic testicular cancer patients: an analysis of the IGCCCG Update database.

BACKGROUND Active surveillance after orchiectomy is the preferred management in clinical stage I (CSI) germ-cell tumours (GCT) associated with a 15 to 30% relapse rate. PATIENTS AND METHODS In the IGCCCG Update database, we compared the outcomes of gonadal disseminated GCT relapsing from initial CSI to outcomes of patients with de novo metastatic GCT. RESULTS A total of 1014 seminoma (Sem) [298 (29.4%) relapsed from CSI, 716 (70.6%) de novo] and 3103 non-seminoma (NSem) [626 (20.2%) relapsed from CSI, 2477 (79.8%) de novo] were identified. Among Sem, no statistically significant differences in PFS and OS were found between patients relapsing from CSI and de novo metastatic disease [5-year progression-free survival (5y-PFS) 87.6% versus 88.5%; 5-year overall survival (5y-OS) 93.2% versus 96.1%). Among NSem, PFS and OS were higher overall in relapsing CSI patients (5y-PFS 84.6% versus 80.0%; 5y-OS 93.3% versus 88.7%), but there were no differences within the same IGCCCG prognostic groups (HR = 0.89; 95% CI: 0.70-1.12). Relapses in the intermediate or poor prognostic groups occurred in 11/298 (4%) Sem and 112/626 (18%) NSem. CONCLUSION Relapsing CSI GCT patients expect similar survival compared to de novo metastatic patients of the same ICCCCG prognostic group. Intermediate and poor prognosis relapses from initial CSI expose patients to unnecessary toxicity from more intensive treatments

Epidemiological and virological investigation of a Norovirus outbreak in a resort in Puglia, Italy

<p>Abstract</p> <p>Background</p> <p>This paper describes the third large outbreak of Norovirus (NoV) gastroenteritis reported in the Southern Italy region of Puglia.</p> <p>Methods</p> <p>A matched case control study was conducted, on 19 July 2005, for investigating risk factors, using a structured questionnaire on food consumption. A multivariate analysis was conducted to estimate the adjusted Odds Ratios. Laboratory and environmental investigation were also performed.</p> <p>Results</p> <p>On the day of the study 41 cases were identified and 41 controls were enrolled. Controls were matched for age and gender. The mean age of the cases was 26 years old, and 58% were female. The clinical pattern of the disease was characterised by the presence of diarrhoea (95%), vomiting (70%), abdominal pain (51%) and fever (32%). Of the 41 cases included in the study, the majority (65%) were residents of Northern Italian regions. No food samples were available for testing. The matched univariate analysis revealed that cases were more likely to have consumed raw mussels, eggs or ice cubes made of tap water than controls. In the multivariate conditional logistic regression analysis, having eaten raw mussels or ice became more strongly associated with illness.</p> <p>All of the 20 faecal samples collected were tested for NoVs. Eighteen stools (90% of total examined) were positive by RT-PCR, and sequence analysis performed onto 3 samples confirmed the presence of a GGII NoV. No test specific for NoV was performed on water or food samples.</p> <p>Conclusion</p> <p>The most likely hypothesis supported by the findings of the epidemiological investigation was that illness was associated with raw mussels and ice, made with tap water. These hypothesis could not be confirmed by specific microbiologic testing for NoV in food or ice. The lack of clear knowledge of NoV as a major causative agent of epidemic outbreaks of gastroenteritis in Italy is due to the absence of timely reporting of the cases to the local public health offices and the uncommon practice of saving clinical samples for virological analysis after bacteriological testing.</p

Unilateral Pelvic Lymph Node Dissection in Prostate Cancer Patients Diagnosed in the Era of Magnetic Resonance Imaging-targeted Biopsy: A Study That Challenges the Dogma

PURPOSE Bilateral extended pelvic lymph node dissection at the time of radical prostatectomy is the current standard of care if pelvic lymph node dissection is indicated; often, however, pelvic lymph node dissection is performed in pN0 disease. With the more accurate staging achieved with magnetic resonance imaging-targeted biopsies for prostate cancer diagnosis, the indication for bilateral extended pelvic lymph node dissection may be revised. We aimed to assess the feasibility of unilateral extended pelvic lymph node dissection in the era of modern prostate cancer imaging. MATERIALS AND METHODS We analyzed a multi-institutional data set of men with cN0 disease diagnosed by magnetic resonance imaging-targeted biopsy who underwent prostatectomy and bilateral extended pelvic lymph node dissection. The outcome of the study was lymph node invasion contralateral to the prostatic lobe with worse disease features, ie, dominant lobe. Logistic regression to predict lymph node invasion contralateral to the dominant lobe was generated and internally validated. RESULTS Overall, data from 2,253 patients were considered. Lymph node invasion was documented in 302 (13%) patients; 83 (4%) patients had lymph node invasion contralateral to the dominant prostatic lobe. A model including prostate-specific antigen, maximum diameter of the index lesion, seminal vesicle invasion on magnetic resonance imaging, International Society of Urological Pathology grade in the nondominant side, and percentage of positive cores in the nondominant side achieved an area under the curve of 84% after internal validation. With a cutoff of contralateral lymph node invasion of 1%, 602 (27%) contralateral pelvic lymph node dissections would be omitted with only 1 (1.2%) lymph node invasion missed. CONCLUSIONS Pelvic lymph node dissection could be omitted contralateral to the prostate lobe with worse disease features in selected patients. We propose a model that can help avoid contralateral pelvic lymph node dissection in almost one-third of cases

Detection of the pandemic norovirus variant GII.4 Sydney 2012 in Rio Branco, state of Acre, northern Brazil

Noroviruses (NoVs) are important cause of gastroenteritis in humans worldwide. Genotype GII.4 is responsible for the majority of outbreaks reported to date. This study describes, for the first time in Brazil, the circulation of NoV GII.4 variant Sydney 2012 in faecal samples collected from children aged less than or equal to eight years in Rio Branco, state of Acre, northern Brazil, during July-September 2012

Unilateral Pelvic Lymph Node Dissection in Prostate Cancer Patients Diagnosed in the Era of Magnetic Resonance Imaging-targeted Biopsy: A Study That Challenges the Dogma

PURPOSE: Bilateral extended pelvic lymph node dissection at the time of radical prostatectomy is the current standard of care if pelvic lymph node dissection is indicated; often, however, pelvic lymph node dissection is performed in pN0 disease. With the more accurate staging achieved with magnetic resonance imaging-targeted biopsies for prostate cancer diagnosis, the indication for bilateral extended pelvic lymph node dissection may be revised. We aimed to assess the feasibility of unilateral extended pelvic lymph node dissection in the era of modern prostate cancer imaging. MATERIALS AND METHODS: We analyzed a multi-institutional data set of men with cN0 disease diagnosed by magnetic resonance imaging-targeted biopsy who underwent prostatectomy and bilateral extended pelvic lymph node dissection. The outcome of the study was lymph node invasion contralateral to the prostatic lobe with worse disease features, ie, dominant lobe. Logistic regression to predict lymph node invasion contralateral to the dominant lobe was generated and internally validated. RESULTS: Overall, data from 2,253 patients were considered. Lymph node invasion was documented in 302 (13%) patients; 83 (4%) patients had lymph node invasion contralateral to the dominant prostatic lobe. A model including prostate-specific antigen, maximum diameter of the index lesion, seminal vesicle invasion on magnetic resonance imaging, International Society of Urological Pathology grade in the nondominant side, and percentage of positive cores in the nondominant side achieved an area under the curve of 84% after internal validation. With a cutoff of contralateral lymph node invasion of 1%, 602 (27%) contralateral pelvic lymph node dissections would be omitted with only 1 (1.2%) lymph node invasion missed. CONCLUSIONS: Pelvic lymph node dissection could be omitted contralateral to the prostate lobe with worse disease features in selected patients. We propose a model that can help avoid contralateral pelvic lymph node dissection in almost one-third of cases