Light and freshwater discharge drive the biogeochemistry and microbial ecology in a sub-Arctic fjord over the Polar night

The polar night has recently received increased attention as a surprisingly active biological season. Yet, polar night microbial ecology is a vastly understudied field. To identify the physical and biogeochemical parameters driving microbial activity over the dark season, we studied a sub-Arctic fjord system in northern Norway from autumn to early spring with detailed monthly sampling. We focused on the impact of mixing, terrestrial organic matter input and light on microbial ecosystem dynamics. Our study highlights strong differences in the key drivers between spring, autumn, and winter. The spring bloom started in March in a fully mixed water column, opposing the traditional critical depth hypothesis. Incident solar radiation was the key driver maximum Chlorophyll was reached in April. The onset of the autumn phytoplankton bloom was controlled by vertical mixing, causing nutrient upwelling and dilution of zooplankton grazers, which had their highest biomass during this time. According to the dilution-recoupling hypothesis grazer dilution reduced grazing stress and allowed the fall bloom formation. Mixing at that time was initiated by strong winds and reduced stratification as a consequence of freezing temperatures and lower freshwater runoff. During the light-limited polar night, the primary production was extremely low but bacteria continued growing on decaying algae, their exudates and also allochthonous organic matter. A melting event in January could have increased input of organic matter from land, supporting a mid-winter bacterial bloom. In conclusion, polar night biogeochemistry and microbial ecology was not only driven by light availability, but strongly affected by variability in reshwater discharge and allochthonous carbon input. With climate change freshwater discharge will increase in the Arctic, which will likely increase importance of the dynamics described in this study

Light and freshwater discharge drive the biogeochemistry and microbial ecology in a sub-Arctic fjord over the Polar night

The polar night has recently received increased attention as a surprisingly active biological season. Yet, polar night microbial ecology is a vastly understudied field. To identify the physical and biogeochemical parameters driving microbial activity over the dark season, we studied a sub-Arctic fjord system in northern Norway from autumn to early spring with detailed monthly sampling. We focused on the impact of mixing, terrestrial organic matter input and light on microbial ecosystem dynamics. Our study highlights strong differences in the key drivers between spring, autumn, and winter. The spring bloom started in March in a fully mixed water column, opposing the traditional critical depth hypothesis. Incident solar radiation was the key driver maximum Chlorophyll was reached in April. The onset of the autumn phytoplankton bloom was controlled by vertical mixing, causing nutrient upwelling and dilution of zooplankton grazers, which had their highest biomass during this time. According to the dilution-recoupling hypothesis grazer dilution reduced grazing stress and allowed the fall bloom formation. Mixing at that time was initiated by strong winds and reduced stratification as a consequence of freezing temperatures and lower freshwater runoff. During the light-limited polar night, the primary production was extremely low but bacteria continued growing on decaying algae, their exudates and also allochthonous organic matter. A melting event in January could have increased input of organic matter from land, supporting a mid-winter bacterial bloom. In conclusion, polar night biogeochemistry and microbial ecology was not only driven by light availability, but strongly affected by variability in reshwater discharge and allochthonous carbon input. With climate change freshwater discharge will increase in the Arctic, which will likely increase importance of the dynamics described in this study

Conversion to below-elbow cast after 3 weeks is safe for diaphyseal both-bone forearm fractures in children

Background It is unclear whether it is safe to convert above-elbow cast (AEC) to below-elbow cast (BEC) in a child who has sustained a displaced diaphyseal both-bone forearm fracture that is stable after reduction. In this multicenter study, we wanted to answer the question: does early conversion to BEC cause similar forearm rotation to that after treatment with AEC alone? Children and methods Children were randomly allocated to 6 weeks of AEC, or 3 weeks of AEC followed by 3 weeks of BEC. The primary outcome was limitation of pronation/supination after 6 months. The secondary outcomes were re-displacement of the fracture, limitation of flexion/extension of the wrist and elbow, complication rate, cast comfort, complaints in daily life, and cosmetics of the fractured arm. Results 62 children were treated with 6 weeks of AEC, and 65 children were treated with 3 weeks of AEC plus 3 weeks of BEC. The follow-up rate was 60/62 and 64/65, respectively with a mean time of 6.9 (4.7-13) months. The limitation of pronation/supination was similar in both groups (18 degrees for the AEC group and 11 degrees for the AEC/BEC group). The secondary outcomes were similar in both groups, with the exception of cast comfort, which was in favor of the AEC/BEC group. Interpretation Early conversion to BEC cast is safe and results in greater cast comfort

IEA EBC Annex 72: Assessing Life Cycle Related Environmental Impacts Caused by Buildings: Guidelines for design decision-makers:Energy in Buildings and Communities Technology Collaboration Programme

The purpose of this report is to provide support to the design decisions-makers during the design process. For each of the defined design step decision the important topics to consider were identified, the key stakeholders are declared and the purpose of LCA at the selected design step is defined. The report covers: The definition of the design steps, the definition of the tasks in each design step and an overview of the relevant milestones for performing LCA; An overview of the systematic building decomposition methods and the appropriate levels at each design step; An overview of the tools that can be used for LCA and a selection process for choosing the right LCA tool. A special emphasize is given to the topic of Building Information Modelling (BIM), how the BIM tools can facilitate the LCA assessment and what information should be implemented in the BIM model; Strategies on how to reduce the design-related uncertainties; An overview of the visualization of the LCA results and which are appropriate in the selected design steps

Recurrent candidiasis and early-onset gastric cancer in a patient with a genetically defined partial MYD88 defect

Gastric cancer is caused by both genetic and environmental factors. A woman who suffered from recurrent candidiasis throughout her life developed diffuse-type gastric cancer at the age of 23 years. Using whole-exome sequencing we identified a germline homozygous missense variant in MYD88. Immunological assays on peripheral blood mononuclear cells revealed an impaired immune response upon stimulation with Candida albicans, characterized by a defective production of the cytokine interleukin-17. Our data suggest that a genetic defect in MYD88 results in an impaired immune response and may increase gastric cancer risk

National identity predicts public health support during a global pandemic

Changing collective behaviour and supporting non-pharmaceutical interventions is an important component in mitigating virus transmission during a pandemic. In a large international collaboration (Study 1, N = 49,968 across 67 countries), we investigated self-reported factors associated with public health behaviours (e.g., spatial distancing and stricter hygiene) and endorsed public policy interventions (e.g., closing bars and restaurants) during the early stage of the COVID-19 pandemic (April-May 2020). Respondents who reported identifying more strongly with their nation consistently reported greater engagement in public health behaviours and support for public health policies. Results were similar for representative and non-representative national samples. Study 2 (N = 42 countries) conceptually replicated the central finding using aggregate indices of national identity (obtained using the World Values Survey) and a measure of actual behaviour change during the pandemic (obtained from Google mobility reports). Higher levels of national identification prior to the pandemic predicted lower mobility during the early stage of the pandemic (r = −0.40). We discuss the potential implications of links between national identity, leadership, and public health for managing COVID-19 and future pandemics.publishedVersio

SUGAR-DIP trial: Oral medication strategy versus insulin for diabetes in pregnancy, study protocol for a multicentre, open-label, non-inferiority, randomised controlled trial

Introduction In women with gestational diabetes mellitus (GDM) requiring pharmacotherapy, insulin was the established first-line treatment. More recently, oral glucose lowering drugs (OGLDs) have gained popularity as a patient-friendly, less expensive and safe alternative. Monotherapy with metformin or glibenclamide (glyburide) is incorporated in several international guidelines. In women who do not reach sufficient glucose control with OGLD monotherapy, usually insulin is added, either with or without continuation of OGLDs. No reliable data from clinical trials, however, are available on the effectiveness of a treatment strategy using all three agents, metformin, glibenclamide and insulin, in a stepwise approach, compared with insulin-only therapy for improving pregnancy outcomes. In this trial, we aim to assess the clinical effectiveness, cost-effectiveness and patient experience of a stepwise combined OGLD treatment protocol, compared with conventional insulin-based therapy for GDM. Methods The SUGAR-DIP trial is an open-label, multicentre randomised controlled non-inferiority trial. Participants are women with GDM who do not reach target glycaemic control with modification of diet, between 16 and 34 weeks of gestation. Participants will be randomised to either treatment with OGLDs, starting with metformin and supplemented as needed with glibenclamide, or randomised to treatment with insulin. In women who do not reach target glycaemic control with combined metformin and glibenclamide, glibenclamide will be substituted with insulin, while continuing metformin. The primary outcome will be the incidence of large-for-gestational-age infants (birth weight >90th percentile). Secondary outcome measures are maternal diabetes-related endpoints, obstetric complications, neonatal complications and cost-effectiveness analysis. Outcomes will be analysed according to the intention-to-treat principle. Ethics and dissemination The study protocol was approved by the Ethics Committee of the Utrecht University Medical Centre. Approval by the boards of management for all participating hospitals will be obtained. Trial results will be submitted for publication in peer-reviewed journals