Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

Peer reviewe

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

State of Knowledge on UK Agricultural Peatlands for Food Production and the Net Zero Transition

Peer reviewed: TrueAcknowledgements: The authors wish to thank the AgriFood4NetZero Network+ for providing funds for the organization of the workshop. Further thanks to R.M.F. and H.D. for organizing in-person hubs at Newcastle University and the University of Cambridge, respectively, and to C.D.E., L.E.F., J.K., P.N. and S.E.P. for giving plenary lectures at the workshop.Publication status: PublishedFunder: Centre for Landscape RegenerationAgricultural peatlands are the most productive soils in the UK for the cultivation of many food crops. Historical drainage of peat for agriculture (i.e., cropland and managed grassland), without consideration of other associated environmental and climatic impacts, has resulted in a significant emission of greenhouse gases (GHGs). There is a need to reduce GHG emissions without compromising the rural economy and jeopardizing food security in the UK to a greater extent than is currently being experienced. In March 2023, in a bid to identify alternative land management systems for agricultural peatlands to support the UK’s commitment to achieving net zero GHG emissions by 2050, a group of forty investigators met at a workshop convened by the AgriFood4NetZero Network+. The workshop reviewed the state of knowledge surrounding the Fens of Eastern England and their importance for food provision, the economy, cultural identity, and climate change mitigation. A broad consensus emerged for research into how GHG emissions from agricultural peatlands could be reduced, whether alternative farming methods, such as seasonal farming or paludiculture, would offer a solution, and how a localized approach for the Fens could be defined. The development of a holistic, inclusive, and plausible land use scenario that considers all aspects of ecosystem services provided by the Fens is urgently needed

Pathogenic Leptospira are widespread in the urban wildlife of southern California

Abstract: Leptospirosis, the most widespread zoonotic disease in the world, is broadly understudied in multi-host wildlife systems. Knowledge gaps regarding Leptospira circulation in wildlife, particularly in densely populated areas, contribute to frequent misdiagnoses in humans and domestic animals. We assessed Leptospira prevalence levels and risk factors in five target wildlife species across the greater Los Angeles region: striped skunks (Mephitis mephitis), raccoons (Procyon lotor), coyotes (Canis latrans), Virginia opossums (Didelphis virginiana), and fox squirrels (Sciurus niger). We sampled more than 960 individual animals, including over 700 from target species in the greater Los Angeles region, and an additional 266 sampled opportunistically from other California regions and species. In the five target species seroprevalences ranged from 5 to 60%, and infection prevalences ranged from 0.8 to 15.2% in all except fox squirrels (0%). Leptospira phylogenomics and patterns of serologic reactivity suggest that mainland terrestrial wildlife, particularly mesocarnivores, could be the source of repeated observed introductions of Leptospira into local marine and island ecosystems. Overall, we found evidence of widespread Leptospira exposure in wildlife across Los Angeles and surrounding regions. This indicates exposure risk for humans and domestic animals and highlights that this pathogen can circulate endemically in many wildlife species even in densely populated urban areas

Pathogenic Leptospira are widespread in the urban wildlife of southern California

Abstract Leptospirosis, the most widespread zoonotic disease in the world, is broadly understudied in multi-host wildlife systems. Knowledge gaps regarding Leptospira circulation in wildlife, particularly in densely populated areas, contribute to frequent misdiagnoses in humans and domestic animals. We assessed Leptospira prevalence levels and risk factors in five target wildlife species across the greater Los Angeles region: striped skunks (Mephitis mephitis), raccoons (Procyon lotor), coyotes (Canis latrans), Virginia opossums (Didelphis virginiana), and fox squirrels (Sciurus niger). We sampled more than 960 individual animals, including over 700 from target species in the greater Los Angeles region, and an additional 266 sampled opportunistically from other California regions and species. In the five target species seroprevalences ranged from 5 to 60%, and infection prevalences ranged from 0.8 to 15.2% in all except fox squirrels (0%). Leptospira phylogenomics and patterns of serologic reactivity suggest that mainland terrestrial wildlife, particularly mesocarnivores, could be the source of repeated observed introductions of Leptospira into local marine and island ecosystems. Overall, we found evidence of widespread Leptospira exposure in wildlife across Los Angeles and surrounding regions. This indicates exposure risk for humans and domestic animals and highlights that this pathogen can circulate endemically in many wildlife species even in densely populated urban areas

State of Knowledge on UK Agricultural Peatlands for Food Production and the Net Zero Transition

Agricultural peatlands are the most productive soils in the UK for the cultivation of many food crops. Historical drainage of peat for agriculture (i.e., cropland and managed grassland), without consideration of other associated environmental and climatic impacts, has resulted in a significant emission of greenhouse gases (GHGs). There is a need to reduce GHG emissions without compromising the rural economy and jeopardizing food security in the UK to a greater extent than is currently being experienced. In March 2023, in a bid to identify alternative land management systems for agricultural peatlands to support the UK’s commitment to achieving net zero GHG emissions by 2050, a group of forty investigators met at a workshop convened by the AgriFood4NetZero Network+. The workshop reviewed the state of knowledge surrounding the Fens of Eastern England and their importance for food provision, the economy, cultural identity, and climate change mitigation. A broad consensus emerged for research into how GHG emissions from agricultural peatlands could be reduced, whether alternative farming methods, such as seasonal farming or paludiculture, would offer a solution, and how a localized approach for the Fens could be defined. The development of a holistic, inclusive, and plausible land use scenario that considers all aspects of ecosystem services provided by the Fens is urgently needed

Delaying surgery for patients with a previous SARS-CoV-2 infection

Not availabl