Exploring a cardio-thoracic hospital ward soundscape in relation to restoration

Hospitals can provide stressful experiences for both patients and medical staff. A well-designed hospital soundscape should avoid adding to negative emotional states (e.g. stress), limit any detrimental cognitive effects (e.g. attentional fatigue), and enable restoration. Experiences of the cardio-thoracic ward soundscape, in a UK public University hospital, were explored via semi-structured interviews with 11 patients and 16 nurses. Thematic coding analysis resulted in 11 key themes including notions of restoration and emotional responses. The themes were used to develop a conceptual model to describe the processes involved in the perception and evaluation of the soundscape. The language used by patients and nurses indicated the emotional response to the soundscape was at times stressful and at others potentially restorative. Coping methods of accepting and habituating to individual sounds were noted. The impact of the patients' and nurses' ability to maintain these coping strategies are discussed in relation to restoration and the temporal variation of the soundscape. A period of 'quiet time' was in operation at the hospital and the importance of this was noted through various responses relating to emotion and restoration. The results suggest the soundscape has potentially, a beneficial role in facilitating restoration thus helping patients' recovery and medical staff's ability to remain productive. This research supports the need to study hospital soundscapes further so that design implications can be considered for the production of a more restorative environment, possibly through the masking/removal of unwanted sounds and optimising positive sounds

Tumor-reactive immune cells protect against metastatic tumor and induce immunoediting of indolent but not quiescent tumor cells

Two major barriers to cancer immunotherapy include tumor-induced immune suppression mediated by myeloid-derived suppressor cells and poor immunogenicity of the tumor-expressing self-antigens. To overcome these barriers, we reprogrammed tumor-immune cell cross-talk by combined use of decitabine and adoptive immunotherapy, containing tumor-sensitized T cells and CD25+ NKT cells. Decitabine functioned to induce the expression of highly immunogenic cancer testis antigens in the tumor, while also reducing the frequency of myeloid-derived suppressor cells and the presence of CD25+ NKT cells rendered T cells, resistant to remaining myeloid-derived suppressor cells. This combinatorial therapy significantly prolonged survival of animals bearing metastatic tumor cells. Adoptive immunotherapy also induced tumor immunoediting, resulting in tumor escape and associated disease-related mortality. To identify a tumor target that is incapable of escape from the immune response, we used dormant tumor cells. We used Adriamycin chemotherapy or radiation therapy, which simultaneously induce tumor cell death and tumor dormancy. Resultant dormant cells became refractory to additional doses of Adriamycin or radiation therapy, but they remained sensitive to tumor-reactive immune cells. Importantly, we discovered that dormant tumor cells contained indolent cells that expressed low levels of Ki67 and quiescent cells that were Ki67 negative. Whereas the former were prone to tumor immunoediting and escape, the latter did not demonstrate immunoediting. Our results suggest that immunotherapy could be highly effective against quiescent dormant tumor cells. The challenge is to develop combinatorial therapies that could establish a quiescent type of tumor dormancy, which would be the best target for immunotherapy

Sleep spindles provide indirect support to the consolidation of emotional encoding contexts

Emotional memories tend to be strengthened ahead of neutral memories during sleep-dependent consolidation. In recent work, however, we found that this is not the case when emotion pertains to the contextual features of a memory instead of its central constructs, suggesting that emotional contexts are influenced by distinct properties of sleep. We therefore examined the sleep-specific mechanisms supporting representations of emotional context and asked whether these differ to those already implicated in central emotional memory processing, such as rapid eye movement sleep (REM). Participants encoded neutral foreground images that were each associated with an emotionally negative or neutral background (context) image. Immediate and delayed tests for the emotionality of the foreground/background image association were separated by a 4-h consolidation period, which consisted of either total wakefulness or included a 2-h polysomnographically monitored nap. Although memory for negative contexts was not associated with REM, or any other parameter of sleep, sleep spindles (12–15 Hz) predicted increased forgetting and slowed response times for neutral contexts. Together with prior work linking spindles to emotional memory processing, our data may suggest that spindles provide multi-layered support to emotionally salient memories in sleep, with the nature of such effects depending on whether the emotionality of these memories pertains to their central or contextual features. Therefore, whereas spindles may mediate a direct strengthening of central emotional information, as suggested in prior work, they may also provide concurrent indirect support to emotional contexts by working to suppress non-salient neutral contexts

Sexual health clinic attendance and non-attendance in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Objectives In Britain, sexual health clinics (SHCs) are the most common location for STI diagnosis but many people with STI risk behaviours do not attend. We estimate prevalence of SHC attendance and how this varies by sociodemographic and behavioural factors (including unsafe sex) and describe hypothetical service preferences for those reporting unsafe sex.Methods Complex survey analyses of data from Britain’s third National Survey of Sexual Attitudes and Lifestyles, a probability survey of 15 162 people aged 16–74 years, undertaken 2010–2012.Results Overall, recent attendance (past year) was highest among those aged 16–24 years (16.6% men, 22.4% women), decreasing with age (<1.5% among those 45–74 years). Approximately 15% of sexually-active 16–74 year olds (n=1002 men; n=1253 women) reported ‘unsafe sex’ (condomless first sex with a new partner and/or >=2 partners and no condom use, past year); >75% of these had not attended a SHC (past year). However, of non-attenders aged 16–44 years, 18.7% of men and 39.0% of women reported chlamydia testing (past year) with testing highest in women aged <25 years. Of those aged 16–44 years reporting unsafe sex, the majority who reported previous SHC attendance would seek STI care there, whereas the majority who had not would use general practice.Conclusion While most reporting unsafe sex had not attended a SHC, many, particularly younger women, had tested for chlamydia suggesting engagement with sexual health services more broadly. Effective, diverse service provision is needed to engage those at-risk and ensure that they can attend services appropriate to their needs

Source levels of social sounds in migrating humpback whales (Megaptera novaeangliae)

The source level of an animal sound is important in communication, since it affects the distance over which the sound is audible. Several measurements of source levels of whale sounds have been reported, but the accuracy of many is limited because the distance to the source and the acoustic transmission loss were estimated rather than measured. This paper presents measurements of source levels of social sounds (surface-generated and vocal sounds) of humpback whales from a sample of 998 sounds recorded from 49 migrating humpback whale groups. Sources were localized using a wide baseline five hydrophone array and transmission loss was measured for the site. Social vocalization source levels were found to range from 123 to 183 dB re 1 mu Pa @ 1 m with a median of 158 dB re 1 mu Pa @ 1 m. Source levels of surface-generated social sounds ("breaches" and "slaps") were narrower in range (133 to 171 dB re 1 mu Pa @ 1 m) but slightly higher in level (median of 162 dB re 1 mu Pa @ 1 m) compared to vocalizations. The data suggest that group composition has an effect on group vocalization source levels in that singletons and mother-calf-singing escort groups tend to vocalize at higher levels compared to other group compositions. VC 2013 Acoustical Society of America

Falkland Island peatland development processes and the pervasive presence of fire

Acknowledgments RJP secured funding for this research from the Quaternary Research Association, University of York and the Russian Science Foundation (19-14-00102). We thank Paul Brickle and other members of the South Atlantic Environmental Research Institute for their help with logistics, David Large for valuable discussions about Falkland Islands peat and all landowners for access permission. This work is dedicated to Richard J. Payne who was tragically killed while climbing Peak 6477, a previously unclimbed subsidiary peak of Nanda Devi (Garhwal Himalayas) in May 2019. CRediT authorship contribution statement Dmitri Mauquoy: Conceptualization, Investigation, Writing - original draft, Writing - review & editing. Richard J. Payne: Conceptualization, Investigation. Kirill V. Babeshko: Investigation, Writing - original draft, Writing - review & editing. Rebecca Bartlett: Investigation, Writing - original draft, Writing - review & editing. Ian Boomer: Investigation. Hannah Bowey: Investigation. Chris D. Evans: Conceptualization, Writing - original draft, Writing - review & editing. Fin Ring-Hrubesh: Investigation. David Muirhead: Methodology, Investigation, Writing - original draft, Writing - review & editing. Matthew O’Callaghan: Investigation. Natalia Piotrowska: Investigation. Graham Rush: Investigation. Thomas Sloan: Investigation. Craig Smeaton: Methodology, Investigation, Writing - original draft. Andrey N. Tsyganov: Investigation, Writing - original draft, Writing - review & editing. Yuri A. Mazei: Investigation, Writing - original draft, Writing - review & editing.Peer reviewedPostprin

Falkland Island peatland development processes and the pervasive presence of fire

Palaeoecological analyses of Falkland Island peat profiles have largely been confined to pollen analyses. In order to improve understanding of long-term Falkland Island peat development processes, the plant macrofossil and stable isotope stratigraphy of an 11,550 year Falkland Island Cortaderia pilosa (‘whitegrass’) peat profile was investigated. The peatland developed into an acid, whitegrass peatland via a poor fen stage. Macrofossil charcoal indicate that local fires have frequently occurred throughout the development of the peatland. Raman spectroscopy analyses indicate changes in the intensity of burning which are likely to be related to changes in fuel types, abundance of fine fuels due to reduced evapotranspiration/higher rainfall (under weaker Southern Westerly Winds), peat moisture and human disturbance. Stable isotope and thermogravimetric analyses were used to identify a period of enhanced decomposition of the peat matrices dating from ∼7020 cal yr BP, which possibly reflects increasing strength of the Southern Westerly winds. The application of Raman spectroscopy and thermogravimetric analyses to the Falkland Island peat profile identified changes in fire intensity and decomposition which were not detectable using the techniques of macrofossil charcoal and plant macrofossil analyses.</p