Secondary organizing pneumonia (bronchiolitis obliterans with organizing pneumonia) associated with adalimumab for treatment of chronic plaque psoriasis

Organizing pneumonia is defined histopathologically by intra-alveolar buds of granulation tissue, consisting of intermixed myofibroblasts and connective tissue. The pathological pattern of organizing pneumonia may be idiopathic or related to a determined cause, termed secondary organizing pneumonia. We report a 68-year-old woman with a longstanding history of chronic plaque psoriasis, treated with the tumor necrosis factor (TNF) inhibitor, adalimumab. After 8 years of treatment, she developed a gradual-onset, non-productive cough with associated generalized fatigue and mild dyspnea. Radiological investigations demonstrated ground-glass opacities in the left lower lobe and bronchoscopy revealed a fibroinflammatory process consistent with organizing pneumonia. Her biologic treatment was ceased and corticosteroid treatment commenced, with resolution of both her symptoms and the radiological findings. Given the increasing incidence of biologic treatment in the management of dermatological conditions, clinicians should be aware of secondary organizing pneumonia as a possible side effect of TNF inhibitor therapy

Increasing Self-Regulatory Energy Using an Internet-Based Training Application Delivered by Smartphone Technology

Self-control resources can be defined in terms of “energy.” Repeated attempts to override desires and impulses can result in a state of reduced self-control energy termed “ego depletion” leading to a reduced capacity to regulate future self-control behaviors effectively. Regular practice or “training” on self-control tasks may improve an individual's capacity to overcome ego depletion effectively. The current research tested the effectiveness of training using a novel Internet-based smartphone application to improve self-control and reduce ego depletion. In two experiments, participants were randomly assigned to either an experimental group, which received a daily program of self-control training using a modified Stroop-task Internet-based application delivered via smartphone to participants over a 4-week period, or a no-training control group. Participants assigned to the experimental group performed significantly better on post-training laboratory self-control tasks relative to participants in the control group. Findings support the hypothesized training effect on self-control and highlight the effectiveness of a novel Internet-based application delivered by smartphone as a practical means to administer and monitor a self-control training program. The smartphone training application has considerable advantages over other means to train self-control adopted in previous studies in that it has increased ecological validity and enables effective monitoring of compliance with the training program

The omnivorous Tyrolean Iceman: colon contents (meat, cereals, pollen, moss and whipworm) and stable isotope analyses

The contents of the colon of the Tyrolean Iceman who lived Ga. 5300 years ago include muscle fibres, cereal remains, a diversity of pollen, and most notably that of the hop hornbeam (Ostrya carpinifolia) retaining cellular contents, as well as a moss leaf (Neckera complanata) and eggs of the parasitic whipworm (Trichuris trichiura). Based almost solely on stable isotope analyses and ignoring the work on the colon contents, two recently published papers on the Iceman's diet draw ill- founded conclusions about vegetarianism and even veganism. Neither the pollen nor the moss is likely to have been deliberately consumed as food by the Iceman. All the available evidence concerning the Iceman's broad-based diet is reviewed and the significance of the colon contents for matters other than assessment of food intake is outlined

Encouraging independent thought and learning in first year practical classes

The transition from A-level to degree-level practical classes then to a research project, hence from dependent learner to independent researcher, is a hurdle that all students face when studying for a chemistry degree. This can be daunting so any innovations that aid this transition are of great value. At the University of Reading, the first year practical course has been redesigned to facilitate this transition by embedding independent thought and experimentation across all chemistry disciplines (introductory, organic, inorganic and physical). Examples of experiments that provide opportunities for independent student investigation, along with student perceptions of the experiments of the course, are given. Using this model for practical-class delivery, student engagement, confidence, independence and ultimately preparedness for year 2 were improved

“F*ck it! Let’s get to drinking – poison our livers!”: a thematic analysis of alcohol content in contemporary YouTube music videos

Purpose: To describe the portrayal of alcohol content in popular YouTube music videos. Methods: We used inductive thematic analysis to explore the lyrics and visual imagery in 49 UK Top 40 songs and music videos previously found to contain alcohol content, and watched by many British adolescents aged between 11-18 years, and to examine if branded content contravened alcohol industry advertising codes of practice. Results: The analysis generated three themes. First, alcohol content was associated with sexualised imagery or lyrics and the objectification of women. Second, alcohol was associated with image, lifestyle and sociability. Finally, some videos showed alcohol overtly encouraging excessive drinking and drunkenness, including those containing branding, with no negative consequences to the drinker. Conclusion: Our results suggest that YouTube music videos promote positive associations with alcohol use. Further, several alcohol companies adopt marketing strategies in the video medium that are entirely inconsistent with their own or others agreed advertising codes of practice. We conclude that, as a harm reduction measure, policies should change to prevent adolescent exposure to the positive promotion of alcohol and alcohol branding in music videos

Evaluation of a nudge intervention providing simple feedback to clinicians of the consequence of radiation exposure on demand for computed tomography: a controlled study

Computerised tomography (CT) is readily available in developed countries. As one of the side-effects includes an increased risk of cancer, interventions that may encourage more judicious use of CT scans are important. Behavioural economics theory includes the use of nudges that aim to help more informed decisions to be made, although these have been rarely used in hospitals to date. We aimed to evaluate the impact of a simple educational message appended to the CT scan report on subsequent numbers of CT scans completed using a controlled interrupted time series design based in two teaching hospitals in X. The intervention was the addition of a non-directional educational message on the risk of ionising radiation to all CT scan reports. There was a statistically significant reduction in the number of CT scans requested in the intervention hospital compared to the control hospital (-4.6%, 95% confidence intervals -7.4 to -1.7, p = 0.002) in the 12 months after the intervention was implemented. We conclude that a simple, non-directional nudge intervention has the capacity to modify clinician use of CT scans. This approach is cheap, and has potential in helping support doctors make informed decisions

Is popular radio a source of exposure to alcohol references in mid to later life?:A content analysis

Background There is concern around alcohol consumption in mid to later life yet little understanding about what influences this behaviour. No previous research has explored the extent to which adults in mid to later life may be exposed to alcohol references in the media. This project aimed to determine the frequency of alcohol references on radio stations with a high proportion of listeners in mid to later life. Methods Content analysis of alcohol references on four popular UK music-based radio stations with a high proportion of listeners aged 55–64 years over three time points. Results Alcohol references occur frequently, but vary by time of year and type of radio station. When alcohol is mentioned its consumption is portrayed as the norm, without negative consequences. On three commercial stations, the majority of mentions came from advertising, whereas on BBC Radio 2 nearly all references were talk-based. All adverts for direct promotion of alcohol were by supermarkets. Alcohol was frequently associated with celebrations, socializing or something to consume for its own sake. Conclusions Adults in the age group 55–64 may be exposed to references to alcohol that could serve to reinforce norms of consumption of alcohol and promote purchases of cheap alcohol

The last forests on Antarctica: Reconstructing flora and temperature from the Neogene Sirius Group, Transantarctic Mountains

Fossil-bearing deposits in the Transantarctic Mountains, Antarctica indicate that, despite the cold nature of the continent’s climate, a tundra ecosystem grew during periods of ice sheet retreat in the mid to late Neogene (17–2.5 Ma), 480 km from the South Pole. To date, palaeotemperature reconstruction has been based only on biological ranges, thereby calling for a geochemical approach to understanding continental climate and environment. There is contradictory evidence in the fossil record as to whether this flora was mixed angiosperm-conifer vegetation, or whether by this point conifers had disappeared from the continent. In order to address these questions, we have analysed, for the first time in sediments of this age, plant and bacterial biomarkers in terrestrial sediments from the Transantarctic Mountains to reconstruct past temperature and vegetation during a period of East Antarctic Ice Sheet retreat. From tetraether lipids (MBT’/CBT palaeothermometer), we conclude that the mean continental summer temperature was ca. 5 °C, in agreement with previous reconstructions. This was warm enough to have allowed woody vegetation to survive and reproduce even during the austral winter. Biomarkers from vascular plants indicate a low diversity and spatially variable flora consisting of higher plants, moss and algal mats growing in microenvironments in a glacial outwash system. Abietane-type compounds were abundant in some samples, indicating that conifers, most likely Podocarpaceae, grew on the Antarctic continent well into the Neogene. This is supported by the palynological record, but not the macrofossil record for the continent, and has implications for the evolution of vegetation on Antarctica