AID INSTRUMENTS IN FRAGILE STATES

International Development,

Adrenal vein sampling for ACTH-producing pheochromocytomas

Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma can cause a variety of clinical manifestations of excess catecholamine and corticosteroid. Anatomic localization of this source of ectopic ACTH is critical to facilitate unilateral adrenalectomy and prevent adrenal insufficiency due to bilateral adrenalectomy. Although nuclear scintigraphy remains the diagnostic gold standard, recent radiotracer supply shortages have necessitated alternative diagnostic paradigms to localize adrenal pheochromocytomas. We present a case where adrenal vein sampling (AVS) was utilized to lateralize an adrenal pheochromocytoma and discuss the approach and nuance as it differs from routine AVS for hyperaldosteronism or hypercortisolism

Diverse response of shallow lake water levels to decadal weather patterns in a heterogeneous glacial Boreal Plains landscape

To examine the relative controls of landscape and climate on spatial variability, we measured water level dynamics of shallow lakes over two decades that represent both the heterogeneity of surficial geology classifications, and thus the potential range in surface and groundwater connectivity, and the long‐term weather patterns of the Boreal Plain hydrogeoclimatic setting. Large ranges in shallow lakes water levels (between 0.25 and 2 m) were observed corresponding to extremes in precipitation relative to the long‐term mean precipitation over the study period. We found low concurrence in water level dynamics among four detailed study lakes that received the same meteorological weather signal, but were located in different surficial geology texture classifications that incorporated important landscape parameters associated with lake water balance and storage. Surficial geology classification alone did not, however, distinguish between different ranges in lake water level measured in a broader synoptic survey of 26 lakes across the region. Thus, simple surficial geology classifications cannot alone be applied to classify Boreal Plain lake water level dynamics and other controls, notably landscape position, must also be considered. We further show that inter‐annual variability in lake water levels was significantly greater than seasonal variability in this hydrogeoclimatic setting. This emphasizes the need for studies of sufficient length to capture weather extremes that include periods of wetting and drying, and demonstrates how observed magnitudes of water level variability, and lake function, can be an artefact of study length and initiation date. These findings provide a foundation to test and calibrate conceptual understanding of the wider controls of lake water levels to form holistic frameworks to mitigate ecological and societal impacts due to hydrological changes under climate and anthropogenic disturbance within and between hydrogeoclimatic settings

Birmingham Bog outdoor laboratory::potentials and possibilities for embedding field-based teaching within the undergraduate classroom

Providing cost-effective, hands-on field-based experiences to large cohorts of undergraduate students provides a core challenge for effective teaching and learning. This grand challenge is tackled through the construction of an exemplar outdoor learning environment within the Environmental Change Outdoor Laboratory (ECOLAB): Birmingham Bog (BB). Adjacent to the Geography building, the facility aims to produce a seamless, interconnected learning environment (in both space and time) that brings inaccessible fieldwork activities direct to the classroom at the time and frequency appropriate to the learning objectives. With the integration of this facility within a 3rd year undergraduate module, we explore through group interviews the ways in which BB adapted and influenced students’ engagement with lecture material, and the extent to which the approach can complement or replace current field based teaching activities. The group interviews identified how BB was considered an example of “effective learning” within the context of the wider degree programme. However, if confirmed, the value placed on residential field courses cannot be met by such campus experiences. Despite this, BB represents an increasingly fertile space for deeper stimulation and innovative ways of learning; diversifying pedagogical techniques and enabling students to re-engage with lecture content

Enhanced Hydrologic Connectivity and Solute Dynamics Following Wildfire and Drought in a Contaminated Temperate Peatland Catchment

Intact peatlands provide hydrological ecosystem services, such as regulating water regimes and immobilizing pollutants within catchments. Climate change impacts including drought and wildfire may impair their functioning, potentially impacting ecosystem service delivery. Here we investigate stream water quality changes following the combined impacts of a summer drought and wildfire in a peat‐dominated catchment in the UK during 2018. The study catchment stores legacy pollutants (i.e., metals) due to past industrial activity, thus making it particularly susceptible to pollutant release during wildfires. We quantified changes in water chemistry during five storm events over a 9‐month period following the wildfire. Concentration‐discharge (C‐Q) relationships for nine solutes were analyzed to explore changes in activation and connectivity of solute source zones. Hysteresis and flushing indices of C‐Q responses further described solute dynamics during storm events. We found that most nutrient and base cation concentrations in the stream discharge were highest in the immediate post‐fire storm events and decreased during subsequent autumn and spring storms. Metal concentrations increased during autumn and spring storms, indicating delayed mobilization from within‐peat or distal headwater sources. Our findings suggest that seasonal re‐wetting and hydrologic connectivity following disturbance influenced solute source zone activation and transport in the study catchment. Water quality responses associated with wildfire and drought were primarily observed in the months following the wildfire, suggesting mobilization of pollutants peaks shortly after fire. Our results contribute to a critical understanding of the future of water quality risks in temperate peatland catchments subject to disturbances exacerbated by climate change

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

A first update on mapping the human genetic architecture of COVID-19

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