Neal Beggs: the politics of the fall

The subject of this article is a climbable public sculpture by British artist Neal Beggs, titled Dear Prudence

Risk factors for community-acquired pneumonia among adults in Kenya: a case-control study.

BACKGROUND: Pneumonia is a leading cause of morbidity and mortality among adults worldwide; however, the risk factors for community-acquired pneumonia in Africa are not well characterized. METHODS: The authors recruited 281 cases of community-acquired pneumonia and 1202 hospital controls among patients aged ≥15 years who attended Kilifi District Hospital/Coast Provincial General Hospital in Kenya between 1994 and 6. Cases were admissions with an acute illness with ≥2 respiratory signs and evidence of consolidation on a chest radiograph. Controls were patients without signs of pneumonia, frequency matched by age, sex and hospital. Risk factors related to socio-demographic factors, drug use, clinical history, contact patterns and exposures to indoor air pollution were investigated by questionnaire, anthropometric measurements and laboratory assays. Associations were evaluated using a hierarchical logistic regression model. RESULTS: Pneumonia was associated with human immunodeficiency virus (HIV) infection (Odds Ratio [OR] 2.06, 95% CI 1.44-3.08), anemia (OR 1.91, 1.31-2.74), splenomegaly (OR 2.04, 95% CI 1.14-3.41), recent history of pneumonia (OR 4.65, 95% CI 1.66-12.5), history of pneumonia >2 years previously (OR 17.13, 95% CI 5.01-60.26), coryza in the 2 weeks preceding hospitalization (OR 2.09, 95% CI 1.44-3.03), current smoking (2.19, 95% CI 1.39-3.70), use of khat (OR 3.44, 95% CI 1.72-7.15), use of snuff (OR 2.67, 95% CI 1.35-5.49) and contact with several animal species. Presence of a Bacillus Calmette-Guerin (BCG) scar was associated with protection (OR 0.51, 95% CI 0.32-0.82). The risk factors varied significantly by sex. CONCLUSION: Pneumonia in Kenyan adults was associated with global risk factors, such as HIV and smoking, but also with specific local factors like drug use and contact with animals. Intervention strategies should account for sex-specific differences in risk factors

Ovarian serous adenocarcinoma identified during IVF: diagnostic approach, surgical management, and reproductive outcome

BACKGROUND: To present a diagnostic evaluation and treatment strategy for serous adenocarcinoma of the ovary discovered during an in vitro fertilisation (IVF) sequence, and report on reproductive outcome after tumour resection and embryo transfer. CASE PRESENTATION: Cycle monitoring in IVF identified an abnormal ovarian lesion which was subjected to ultrasound-guided needle aspiration. Cytology suggested malignancy, and unilateral oophorectomy was performed after formal staging. After surgery, the patient underwent an anonymous donor oocyte IVF cycle which established a viable twin intrauterine pregnancy. No recurrence of cancer has been detected in the >72 month follow-up interval; mother and twin daughters continue to do well. CONCLUSION: Suspicious adnexal structures noted during controlled ovarian hyperstimulation for IVF warrant assessment, and this report confirms the role of aspiration cytology in such cases. If uterine conservation is possible, successful livebirth can be achieved from IVF if donor oocyes are utilised, as described here

Carbon and nitrogen cycling during old-field succession: Constraints on plant and microbial biomass

Soil C and N dynamics were studied in a sequence of old fields of increasing age to determine how these biogeochemical cycles change during secondary succession. In addition, three different late-successional forests were studied to represent possible "steady state" conditions. Surface soil samples collected from the fields and forests were analyzed for total C, H 2 O-soluble C, total N, potential net N mineralization, potential net nitrification, and microbial biomass. Above-and belowground plant biomass was estimated within each of the old field sites.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42472/1/10533_2004_Article_BF00002062.pd

PAMELA Satellite Data as a Signal of Non-Thermal Wino LSP Dark Matter

Satellite data is accumulating that suggests and constrains dark matter physics. We argue there is a very well motivated theoretical preexisting framework consistent with dark matter annihilation being observed by the PAMELA satellite detector. The dark matter is (mainly) the neutral W boson superpartner, the wino with mass below 200 GeV. Using the program GALPROP we study the annihilation products and backgrounds together. Antimatter and gammas from annihilating winos contribute below this energy. We explain why PAMELA data does not imply no antiproton signal was observed by PAMELA or earlier experiments, and explain why the antiproton analysis was misunderstood by earlier papers. Wino annihilation does not describe the Fermi e+ + e- data (except partially below ~ 100 GeV). At higher energies we expect astrophysical mechanisms, and we simply parameterize them so the combination can describe all the data. We emphasize several predictions for satellite data to test the wino interpretation, particularly the turndown of the positron and antiproton spectra above 100 GeV. Most other interpretations require a large rise in the positron rates above 100 GeV. We focus on studying this well-motivated and long predicted wino interpretation, rather than comparisons with other interpretations. We emphasize that interpretations also depend very strongly on assumptions about the cosmological history of the universe, and on propagation of antiprotons and positrons in the galaxy. The winos PAMELA is observing arose from some non-thermal sources such as moduli decay rather than a universe that cooled in thermal equilibrium after the big bang. Then it is appropriate to normalize the wino density to the local relic density, and no "boost factors" are needed to obtain the reported PAMELA rates.Comment: Correct primary electron injection inde

Reliability of salivary cortisol and testosterone to a high-intensity cycling protocol to highlight overtraining

Athletes physically overload to improve performance. Unbalanced stress/recovery may induce overtraining, which is difficult to diagnosis as no diagnostic marker exists. Hormonal responses to a 55/80 cycle (30-min of alternating blocks of 1-min at 55% and 4-min at 80% maximum work rate) may highlight early-stage overtraining (overreaching), as blunted cortisol and testosterone responses to 55/80 follows intensified training. However, the reliability of hormonal responses to 55/80 when not overreached is unknown. Therefore, reported blunted hormonal responses could be due to inconsistent cortisol and testosterone responses to 55/80. Participants (n = 23) completed three 55/80 bouts, >7 days apart, with no exercise 24 h pre-trials. Pre-exercise urine osmolality and stress questionnaire responses were measured. Pre, post, and 30-min post-exercise saliva samples were collected for cortisol and testosterone assessment. Salivary cortisol and testosterone responses, osmolality and well-being were not different between trials. Salivary cortisol and testosterone elevated from pre- to post-exercise [by 4.2 nmol.L−1 (cortisol) and 307 pmol.L−1 (testosterone)], and 30 min post-exercise [by 160 pmol.L−1 (testosterone) only]. Intraclass correlation coefficients for pre to peak post-exercise cortisol (0.89; good) and testosterone (0.53; moderate) were calculated. This demonstrates that 55/80 induces reliable elevations of salivary cortisol and testosterone when in a healthy state

A global synthesis of managing groundwater dependent ecosystems under sustainable groundwater policy

Groundwater is a vital water supply worldwide for people and nature. However, species and ecosystems that depend on groundwater for some or all of their water needs, known as groundwater dependent ecosystems (GDEs), are increasingly becoming threatened worldwide due to growing human water demands. Over the past two decades, the protection and management of GDEs have been incorporated into several water management policy initiatives worldwide including jurisdictions within Australia, the European Union, South Africa, and the United States. Among these, Australia has implemented the most comprehensive framework to manage and protect GDEs through its water policy initiatives. Using a science-based approach, Australia has made good progress at reducing uncertainty when selecting management thresholds for GDEs in their water management plans. This has been achieved by incorporating appropriate metrics for GDEs into water monitoring programs so that information gathered over time can inform management decisions. This adaptive management approach is also accompanied by the application of the “Precautionary Principle” in cases where insufficient information on GDEs exist. Additionally, the integration of risk assessment into Australia\u27s approach has enabled water managers to prioritize the most valuable and vulnerable ecologic assets necessary to manage GDEs under Australia\u27s national sustainable water management legislation. The purpose of this paper is to: (1) compare existing global policy initiatives for the protection and management of GDEs; (2) synthesize Australia\u27s adaptive management approach of GDEs in their state water plans; and (3) highlight opportunities and challenges of applying Australia\u27s approach for managing GDEs under other water management policies worldwide

Safety and feasibility of ultrasound-triggered targeted drug delivery of doxorubicin from thermosensitive liposomes in liver tumours (TARDOX): a single-centre, open-label, phase 1 trial

BACKGROUND: Previous preclinical research has shown that extracorporeal devices can be used to enhance the delivery and distribution of systemically administered anticancer drugs, resulting in increased intratumoural concentrations. We aimed to assess the safety and feasibility of targeted release and enhanced delivery of doxorubicin to solid tumours from thermosensitive liposomes triggered by mild hyperthermia, induced non-invasively by focused ultrasound. METHODS: We did an open-label, single-centre, phase 1 trial in a single UK hospital. Adult patients (aged ≥18 years) with unresectable and non-ablatable primary or secondary liver tumours of any histological subtype were considered for the study. Patients received a single intravenous infusion (50 mg/m2) of lyso-thermosensitive liposomal doxorubicin (LTLD), followed by extracorporeal focused ultrasound exposure of a single target liver tumour. The trial had two parts: in part I, patients had a real-time thermometry device implanted intratumourally, whereas patients in part II proceeded without thermometry and we used a patient-specific model to predict optimal exposure parameters. We assessed tumour biopsies obtained before and after focused ultrasound exposure for doxorubicin concentration and distribution. The primary endpoint was at least a doubling of total intratumoural doxorubicin concentration in at least half of the patients treated, on an intention-to-treat basis. This study is registered with ClinicalTrials.gov, number NCT02181075, and is now closed to recruitment. FINDINGS: Between March 13, 2015, and March 27, 2017, ten patients were enrolled in the study (six patients in part I and four in part II), and received a dose of LTLD followed by focused ultrasound exposure. The treatment resulted in an average increase of 3·7 times in intratumoural biopsy doxorubicin concentrations, from an estimate of 2·34 μg/g (SD 0·93) immediately after drug infusion to 8·56 μg/g (5·69) after focused ultrasound. Increases of two to ten times were observed in seven (70%) of ten patients, satisfying the primary endpoint. Serious adverse events registered were expected grade 4 transient neutropenia in five patients and prolonged hospital stay due to unexpected grade 1 confusion in one patient. Grade 3-4 adverse events recorded were neutropenia (grade 3 in one patient and grade 4 in five patients), and grade 3 anaemia in one patient. No treatment-related deaths occurred. INTERPRETATION: The combined treatment of LTLD and non-invasive focused ultrasound hyperthermia in this study seemed to be clinically feasible, safe, and able to enhance intratumoural drug delivery, providing targeted chemo-ablative response in human liver tumours that were refractory to standard chemotherapy. FUNDING: Oxford Biomedical Research Centre, National Institute for Health Research