17 research outputs found
Collaborative Leadership Is Key for Maine’s Forest Products Industry
The forest products industry is economically, socially, culturally, and environmentally important to Maine. Thus, Maine’s future economy depends greatly on the leadership in this industry. Effective leadership grows out of understanding the changes that are taking place in the industry and finding innovative ways to address unexpected challenges and emerging opportunities. During times of change, many industry leaders settle for maintaining the status quo. The forest products industry in Maine, however, is systematically assessing the ways the landscape is changing. Rather than continuing on the same path, the industry is gathering insights that could lead to a vibrant, but perhaps different, future. What we report here is an innovative process that actively solicits insights reflecting the diverse perspectives of those who work in different subsectors of the industry. What is emerging is evidence of the importance of collective leadership that brings together different areas of knowledge. We report on the process, the emerging findings, and the implications for leadership in moving forward
Impact of the Lund Integrated Medicines Management (LIMM) model on medication appropriateness and drug-related hospital revisits
Finishing the euchromatic sequence of the human genome
The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead
Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study
Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown
Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.
BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca
Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK
Background
A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials.
Methods
This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674.
Findings
Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation.
Interpretation
ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials
Risk Perceptions of Climate Change Amongst Nature-Based Tourism Stakeholders in Western Maine
Nature-based tourism is one of Maine’s most economically important industries. Projected climate change impacts are likely to affect nature-based tourism in Maine. Especially vulnerable are areas reliant on winter nature-based tourism. Risk perceptions influence perceived vulnerability and can determine behavior, such as management decisions. Previous research has shown that risk perceptions are shaped by socio-demographic factors, cognitive factors, experiential processing, social structures, and trust in climate change communicators. Few studies have tried to understand how tourism stakeholders perceive their risk to climate change, especially using qualitative methodologies. Assessing stakeholder climate change risk perceptions is crucial for understanding motivations or barriers to engage in climate change mitigation and adaptation behaviors. Therefore, the goal of this study is to understand climate change risk perceptions and likely behavioral responses amongst nature-based tourism stakeholders in Western Maine using a qualitative approach. The Maine Lakes and Mountains Region has been selected as a study site because of its high dependence on winter outdoor recreation and the importance tourism has in supporting community resilience. We used a qualitative phenomenological approach by conducting in-depth interviews with nature-based tourism stakeholders in the region and interpretive phenomenological analysis to analyze the data. A key theme that emerged throughout the study was that of uncertainty of the causes of climate change, impacts to the region, which climate change communication sources to trust, and whether or not experienced environmental changes were related to climate change. Uncertainty hindered participants’ abilities to implement adaptation and mitigation behaviors. The research also incorporated a pile sort activity into interviews with nature-based tourism stakeholders. Few studies have used pile sorting to understand how people think about climate change, and how this view might inform adaptation and mitigation strategies. During these interviews, participants were given 34 cards listing environmental and social conditions and asked to sort them using their own criteria for organization of piles. Multidimensional scaling analysis was used in SPSS to analyze the pile sorts. Multidimensional scaling of data from unconstrained, structured pile sorts identified two dimensions: perceived behavioral control and impacts. Providing climate change information specific to the study region communicated by scientists or through the local newspaper could help empower participants to adopt more mitigation and adaptation strategies, thus bolstering the resilience of the tourism destination. Future research on tourism stakeholder demographics, visitor risk perceptions, and longitudinal changes to both is needed to maintain long-term sustainability of the region. Understanding how nature-based tourism stakeholders in the study region understand climate change could help inform interpretation of risk perceptions and behavioral responses to climate change. This knowledge will help tailor climate change communications to be more effective in building awareness, empowering stakeholders to mitigate and adapt in the face of climate change. This will ultimately lead to a more resilient socio-ecological tourism system
Effects of Sheep Grazing Systems on Water Quality with a Focus on Nitrate Leaching
This article reviews the literature on nitrate leaching under sheep grazing systems and focuses on identifying future research needs. Urinary nitrogen (N) is an important source of the nitrate leached from pastoral agriculture. Urinary N excretion can be measured or simulated using models and has been well characterised for dairy systems. It is difficult to continuously monitor the urinary N excretion of sheep under field conditions; consequently, measurements of N excretion in sheep urine are limited. Urination events by sheep vary greatly in volume (0.5 L to 6.9 L), concentration (3 to 13.7 g N/L), and frequency (8 to 23 events/day); this variation results in a corresponding variation in N loading rates in urine patches. The amount of nitrate leached under pastures grazed by sheep has typically varied between 1 and 50 kg N/ha/year, but rates as high as 300 kg N/ha/year have been reported. The quantity of nitrate leached under sheep depends on the season, climate, quantity and timing of drainage, the interaction between forage production and stocking rate, fertiliser applied, N fixation by legumes, forage type, and grazing management. The majority of studies examining nitrate leaching under sheep grazing systems are more than 20 years old; so, there is little recent information on nitrate leaching under modern pasture-based sheep production systems. Further research is required to quantify nitrate leaching levels under current sheep farming practices, to understand the impacts of this leaching on water quality, and to help identify effective strategies to reduce the transfer of N from grazed paddocks to receiving water bodies. This additional information will help provide information for decision support tools, including models and management practices, to help sheep farmers minimise their impact on the aquatic environment
Effects of Sheep Grazing Systems on Water Quality with a Focus on Nitrate Leaching
This article reviews the literature on nitrate leaching under sheep grazing systems and focuses on identifying future research needs. Urinary nitrogen (N) is an important source of the nitrate leached from pastoral agriculture. Urinary N excretion can be measured or simulated using models and has been well characterised for dairy systems. It is difficult to continuously monitor the urinary N excretion of sheep under field conditions; consequently, measurements of N excretion in sheep urine are limited. Urination events by sheep vary greatly in volume (0.5 L to 6.9 L), concentration (3 to 13.7 g N/L), and frequency (8 to 23 events/day); this variation results in a corresponding variation in N loading rates in urine patches. The amount of nitrate leached under pastures grazed by sheep has typically varied between 1 and 50 kg N/ha/year, but rates as high as 300 kg N/ha/year have been reported. The quantity of nitrate leached under sheep depends on the season, climate, quantity and timing of drainage, the interaction between forage production and stocking rate, fertiliser applied, N fixation by legumes, forage type, and grazing management. The majority of studies examining nitrate leaching under sheep grazing systems are more than 20 years old; so, there is little recent information on nitrate leaching under modern pasture-based sheep production systems. Further research is required to quantify nitrate leaching levels under current sheep farming practices, to understand the impacts of this leaching on water quality, and to help identify effective strategies to reduce the transfer of N from grazed paddocks to receiving water bodies. This additional information will help provide information for decision support tools, including models and management practices, to help sheep farmers minimise their impact on the aquatic environment
Alignment among environmental programs in higher education: What Food-Energy-Water Nexus concepts are covered in introductory courses?
Interdisciplinary environmental and sustainability (IES) programs are different from other fields because they focus on a complex integration of humanities, social, and natural sciences concepts centered on the interactions of coupled human and natural systems. The interdisciplinary nature of IES programs does not lend itself to traditional discipline-specific concept inventory frameworks for critically evaluating preconceptions and learning. We discuss the results of the first phase of a research project to develop a next generation concept inventory for evaluating interdisciplinary concepts important for introductory IES courses. Using the Food-Energy-Water (FEW) Nexus (the intersections/interdependencies of food, energy, and water sectors) as our focus, we conducted a content analysis of eight representative college-level introductory environmental course syllabi and course materials (e.g., textbooks, journal articles, print media) to identify common interdisciplinary FEW Nexus concepts taught in introductory IES courses. Results demonstrate that all IES introductory course materials reference the FEW Nexus. Food, energy, and/or water resources as individual elements of the FEW Nexus are frequently described, but connections between these resource systems are included less often. Biology, energy systems, waste and pollution in the natural environment, agriculture, earth sciences and geology, climate change, behavioral social sciences, and economics concepts are most associated with FEW concepts, hinting at commonalities across IES topics that anchor systems thinking. Despite differences in IES programs, there appears to be some alignment between core concepts being taught at the FEW Nexus in introductory courses.</p