The effectiveness and cost-effectiveness of resuscitative endovascular balloon occlusion of the aorta (REBOA) for trauma patients with uncontrolled torso haemorrhage : study protocol for a randomised clinical trial (the UK-REBOA trial)

Acknowledgements The UK-REBOA trial grantholders include Jan O. Jansen, University of Aberdeen, UK, and University of Alabama at Birmingham, USA; Marion K. Campbell, University of Aberdeen, UK; Chris Moran, Nottingham University Hospital Trust, UK; Karim Brohi, Queen Mary University of London, UK; Fiona Lecky, University of Sheffield, UK; Robbie Lendrum, Bart’s Health NHS Trust, UK; Graeme MacLennan, University of Aberdeen, UK; Jonathan J. Morrison, University of Maryland, USA; Nigel Tai, Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, UK; Tim Harris, Bart’s Health NHS Trust, UK; John Norrie, University of Edinburgh, UK; Dwayne Boyers, University of Aberdeen, UK; Alan Paterson, University of Strathclyde, UK; and Nick Welch. Funding {4} This study/project is funded by the National Institute for Health Research (NIHR) HTA Programme (reference 14/199/09). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funder has/had no role in the design of the study; the collection, analysis, and interpretation of data; or writing the manuscript. The Health Services Research Unit, Institute of Applied Health Sciences (University of Aberdeen), is core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.Peer reviewedPublisher PD

Ethnicity questions and antenatal screening for sickle cell/thalassaemia (EQUANS) in England : Observation and interview study.

Objectives To describe understandings that mothers and midwives have of ethnicity. To explore barriers to the successful implementation of ethnicity screening questions for sickle cell/thalassaemia. Design Observation of 121 first antenatal interviews between midwife and mother in four contrasting areas of sickle cell prevalence in England. Taped interviews with 111 mothers and 115 taped interviews with 61 different midwives. Fieldwork data from 76 preparatory workshops and liaison meetings. Results 'Ethnicity' and 'family' are terms liable to variable interpretation. Both midwives and mothers implied belief in distinct 'racial' groups, disrupting scientifically accurate understandings of the relation between risk of sickle cell/thalassaemia and ethnic/family origins. Bookings were characterised by time pressures and a lack of explanation of sickle cell/thalassaemia. The mother was not permitted to self-assign ethnicity in 13 of 115 observed encounters. Conclusions Antenatal screening for sickle cell/thalassaemia based on an ethnicity screening question is weakened by a range of factors. Some midwives use intuition to select/exclude clients from the screening questions rather than implement formal policy. The screening term 'ethnic/family origins' is vulnerable to varied interpretations by clients. The persistence of erroneous beliefs in 'racial' groups displaces correct understandings of the relation between ethnicity and risk of carrying genes associated with sickle cell/thalassaemia. Midwives require support in both in ethnicity awareness and knowledge of sickle cell and thalassaemia, and more time at antenatal bookings to administer the ethnicity screening question. A challenge to the continued prevalence of scientific racism in popular discourse is required.The NHS Sickle Cell and Thalassaemia Screening Programme, Department of Health and the Unit for the Social Study of Thalassaemia and Sickle Cel

Narratives from the road to social justice in PETE: teacher educator perspectives

Developing teacher education programmes founded upon principles of critical pedagogy and social justice has become increasingly difficult in the current neoliberal climate of higher education. In this article, we adopt a narrative approach to illuminate some of the dilemmas which advocates of education for social justice face and to reflect upon how pedagogy for inclusion in the field of physical education (PE) teacher education (PETE) is defined and practiced. As a professional group, teacher educators seem largely hesitant to expose themselves to the researcher's gaze, which is problematic if we expect preservice teachers to engage in messy, biographical reflexivity with regard to their own teaching practice. By engaging in self- and collective biographical story sharing about ‘our’ teacher educator struggles in England and Norway, we hope that the reader can identify ‘her/his’ struggles in the narratives about power and domination, and the spaces of opportunity in between

Global Spatial Risk Assessment of Sharks Under the Footprint of Fisheries

Effective ocean management and conservation of highly migratory species depends on resolving overlap between animal movements and distributions and fishing effort. Yet, this information is lacking at a global scale. Here we show, using a big-data approach combining satellite-tracked movements of pelagic sharks and global fishing fleets, that 24% of the mean monthly space used by sharks falls under the footprint of pelagic longline fisheries. Space use hotspots of commercially valuable sharks and of internationally protected species had the highest overlap with longlines (up to 76% and 64%, respectively) and were also associated with significant increases in fishing effort. We conclude that pelagic sharks have limited spatial refuge from current levels of high-seas fishing effort. Results demonstrate an urgent need for conservation and management measures at high-seas shark hotspots and highlight the potential of simultaneous satellite surveillance of megafauna and fishers as a tool for near-real time, dynamic management

Rethinking Social Justice in Education: An Epistemological Approach

There are many different notions of social justice in education. For example, some argue that social justice in education means giving individuals the opportunity to succeed; for others, it means seeking equality of outcome so that everyone does succeed. So great is the diversity of views that it has been suggested the term has become meaningless, or that it can mean anything people want it to mean. This has led some to argue that trying to define social justice in education is a hopeless task. This chapter argues that an approach informed by the later philosophy of Wittgenstein can be helpful in dealing with such issues. In particular, attention is focussed on Wittgenstein’s epistemology and theory of meaning in the Philosophical Investigations. It is argued that these are helpful in understanding the multiplicity of meanings of the term social justice in education. This multiplicity however, it is argued, does not lead to a situation where the term can mean anything its users want it to mean. Nor does it lead to a situation where all attempts to define the term are ruled out, or where only one definition is acceptable, presumably to be imposed on all users of the term. Instead, the significance of contextual understanding and meaning in different language-games is highlighted. Wittgenstein’s theory of meaning is then allied to Gallie’s notion of an essentially contested concept to advance the idea of engagement between those with different views, and of the need to recontextualize rather than decontextualize the notion of social justice in education

Genome-wide CRISPR screen identifies protein pathways modulating tau protein levels in neurons

Aggregates of hyperphosphorylated tau protein are a pathological hallmark of more than 20 distinct neurodegenerative diseases, including Alzheimer's disease, progressive supranuclear palsy, and frontotemporal dementia. While the exact mechanism of tau aggregation is unknown, the accumulation of aggregates correlates with disease progression. Here we report a genome-wide CRISPR screen to identify modulators of endogenous tau protein for the first time. Primary screens performed in SH-SY5Y cells, identified positive and negative regulators of tau protein levels. Hit validation of the top 43 candidate genes was performed using Ngn2-induced human cortical excitatory neurons. Using this approach, genes and pathways involved in modulation of endogenous tau levels were identified, including chromatin modifying enzymes, neddylation and ubiquitin pathway members, and components of the mTOR pathway. TSC1, a critical component of the mTOR pathway, was further validated in vivo, demonstrating the relevance of this screening strategy. These findings may have implications for treating neurodegenerative diseases in the future

Genome-wide CRISPR screen identifies protein pathways modulating tau protein levels in neurons

Using an unbiased genome-wide CRISPR screen approach, Sanchez et al. identified modulators of endogenous tau protein. This study suggests that chromatin modifiers, neddylation, ubiquitination, and the mTOR pathways regulate overall levels of tau protein in neurons, which could help in future identification of therapeutics for neurodegenerative diseases