High prevalence of malignancy in HIV-positive patients with mediastinal lymphadenopathy: A study in the era of antiretroviral therapy.

Mediastinal lymphadenopathy (MLN) in human immunodeficiency virus (HIV) infection has a wide spectrum of aetiologies with different prognoses and treatments. The decision to pursue a histopathological diagnosis represents a clinical challenge as patients present with non-specific symptoms. This study aimed to determine the aetiology and predictive factors of MLN in a cohort of HIV-infected patients in the combination antiretroviral therapy (cART) era

Using place-based public engagement to improve social and environmental sustainability: Lessons from partnership working in Cornwall, UK

This is the final version. Available on open access from Elsevier via the DOI in this recordPublic engagement with research and innovation is often inversely related to socio-economic status, with significant implications for realising positive solutions to pressing concerns, such as the biodiversity and climate crises. This paper reports on the use of place-based public workshops focusing on co-design of urban green spaces to understand: the extent to which public workshops can engage local people in relatively poor locations; the degree to which working with self-organised groups or newly-engaged publics impacts levels of engagement and outcomes; and how universities can play a role in developing locally relevant practical solutions to transdisciplinary issues such as the climate and biodiversity crises. We report on an action research project that involved facilitated co-design workshops in three towns in Cornwall, UK. The research methods included a survey of participants and follow up interviews with key stakeholders. We found that the workshops were successful in engaging local people, including those with less interest in the environment. Independent follow-on activities from aligned self-organised groups were greater than for newly engaged publics but this was partly dependent on the knowledge and skills of those involved. The role of the university as a neutral partner, in providing expertise and seed funding, was seen to be positive, with short-term timescales, communication and the ability to retain longer term involvement reported as hindrances to successful collaboration.UK Research and InnovationUniversity of ExeterSouth Kerrier Alliance Community Interest Company (SKACIC)Cornwall's Voluntary Sector Foru

Socio-psychological factors, beyond knowledge, predict people’s engagement with pollinator conservation (dataset)

A questionnaire about people’s perceptions, knowledge and behaviour relating to pollinators was distributed from March-June 2018, primarily via social media and email. The survey received 1,275 responses, which are provided here, in a single csv data file.The article associated with this dataset is located in ORE at: http://hdl.handle.net/10871/123383This is the dataset used for the Knapp et al. (2020) article "Socio-psychological factors, beyond knowledge, predict people’s engagement with pollinator conservation" published in People and Nature.Natural Environment Research Council (NERC)Natural Environment Research Council (NERC)Economic and Social Research Council (ESRC)Biotechnology and Biological Sciences Research Council (BBSRC)Halpin TrustEuropean Regional Development Fund (ERDF)Cornwall Area of Outstanding Natural Beauty (AONB) UnitCornwall CouncilWelsh Assembly Governmen

Effect of height and colour of bee bricks on nesting occupancy of bees and wasps in SW England

This is the final version. Available on open access from Conservation Evidence via the DOI in this recordBee bricks are a novel solitary-bee nesting habitat made from reclaimed concrete, designed to be built into walls to provide nest sites in urban areas. We tested if cavity-nesting bees and wasps used bee bricks, and if they showed any preference for nesting in bricks of different colours or at different heights. We carried out surveys of solitary bees in 15 private urban gardens and eight rural public gardens, where the bee bricks were then placed for two years (2016-2017). Bee bricks were placed on structures that were either 1 m in height with 4 bricks (red, yellow, white and wooden control) or with three platforms where white bricks were placed at 0 m, 0.6 m or 1.0 m above the ground. The number of occupied nest holes was counted at the end of each summer. Nesting holes that were capped with mud were more common than those capped with chewed or cut leaves. The average % of holes capped with either mud or chewed leaf was greatest in red bricks and lowest in wooden controls. Only one brick out of 39 placed at ground level had capped holes, although the difference in the % of holes capped between heights was not statistically significant. Cavity-nesting bees and wasps use solitary-bee bricks for nests, but population level impacts are still untested.University of Exete

Socio-psychological factors, beyond knowledge, predict people’s engagement with pollinator conservation (article)

This is the final version. Available on open access from Wiley via the DOI in this recordThe dataset associated with this article is located in ORE at: https://doi.org/10.24378/exe.2783Nature conservation often depends on the behaviour of individuals, which can be driven by socio-psychological factors such as a person’s attitude, knowledge and identity. Despite extensive ecological research about pollinator declines, there has been almost no social research assessing the drivers of people’s engagement in pollinator conservation behaviour. To address this gap, we used a large-scale, online questionnaire in the UK, broadly framed around the Theory of Planned Behaviour. We received a total of 1,275 responses from a wide range of ages, incomes and education levels, despite a selection bias towards people with a pre-existing interest in pollinators. A range of socio-psychological factors predicted people’s pollinator conservation actions and explained 45% of the variation. Respondents’ diversity of nature interactions and perceived behavioural control (feeling able to help pollinators) were consistently important predictors of people’s pollinator conservation actions, whilst the importance of other socio-psychological factors depended on the particular action. Notably, knowledge was far less important overall than people’s perceptions and other socio-psychological factors, highlighting a knowledge-action gap. Further unexplained variation in people’s behaviour can partly be explained by structural and contextual factors, particularly regarding social norms around tidiness. From a practical perspective, our findings reveal three main insights: (i) Several simple, low-cost pollinator conservation actions (reduced mowing, leaving areas unmown and creating patches of bare ground for ground-nesting bees) are currently under-utilised so should be priorities for pollinator conservation programmes. (ii) Strategies are needed to overcome reported practical barriers, for example by providing free resources (e.g. seeds of pollen- and nectar-rich plants) and communicating simple beneficial actions that can be carried out with limited time, space and money. (iii) Knowledge is just one (relatively less important) factor that predicts pollinator conservation behaviour – othersocio-psychological factors provide potential pathways for increasing uptake, and structural and contextual limitations also need to be considered. In practice, this could be achieved by engaging, inspiring and empowering the public to help pollinators and to take responsibility for their local environment, for example through environmental education and community programmes facilitating public interest and involvement in the management of greenspace.Halpin TrustNatural Environment Research Council (NERC)Cornwall Area of Outstanding Natural Beauty unitEconomic and Social Research Council (ESRC)Biotechnology and Biological Sciences Research Council (BBSRC)European Regional Development Fund (ERDF

A multi-centre qualitative study exploring the experiences of UK South Asian and White Diabetic Patients referred for renal care

Background An exploration of renal complications of diabetes from the patient perspective is important for developing quality care through the diabetic renal disease care pathway. Methods Newly referred South Asian and White diabetic renal patients over 16 years were recruited from nephrology outpatient clinics in three UK centres - Luton, West London and Leicester – and their experiences of the diabetes and renal care recorded. A semi-structured qualitative interview was conducted with 48 patients. Interview transcripts were analysed thematically and comparisons made between the White and South Asian groups. Results 23 South Asian patients and 25 White patients were interviewed. Patient experience of diabetes ranged from a few months to 35 years with a mean time since diagnosis of 12.1 years and 17.1 years for the South Asian and White patients respectively. Confusion emerged as a response to referral shared by both groups. This sense of confusion was associated with reported lack of information at the time of referral, but also before referral. Language barriers exacerbated confusion for South Asian patients. Conclusions The diabetic renal patients who have been referred for specialist renal care and found the referral process confusing have poor of awareness of kidney complications of diabetes. Healthcare providers should be more aware of the ongoing information needs of long term diabetics as well as the context of any information exchange including language barriers

The clinical effectiveness of transurethral incision of the prostate : a systematic review of randomised controlled trials

The original publication is available at www.springerlink.com.Peer reviewedPostprin

Predicting the safety and efficacy of butter therapy to raise tumour pHe: an integrative modelling study

Background: Clinical positron emission tomography imaging has demonstrated the vast majority of human cancers exhibit significantly increased glucose metabolism when compared with adjacent normal tissue, resulting in an acidic tumour microenvironment. Recent studies demonstrated reducing this acidity through systemic buffers significantly inhibits development and growth of metastases in mouse xenografts.\ud \ud Methods: We apply and extend a previously developed mathematical model of blood and tumour buffering to examine the impact of oral administration of bicarbonate buffer in mice, and the potential impact in humans. We recapitulate the experimentally observed tumour pHe effect of buffer therapy, testing a model prediction in vivo in mice. We parameterise the model to humans to determine the translational safety and efficacy, and predict patient subgroups who could have enhanced treatment response, and the most promising combination or alternative buffer therapies.\ud \ud Results: The model predicts a previously unseen potentially dangerous elevation in blood pHe resulting from bicarbonate therapy in mice, which is confirmed by our in vivo experiments. Simulations predict limited efficacy of bicarbonate, especially in humans with more aggressive cancers. We predict buffer therapy would be most effectual: in elderly patients or individuals with renal impairments; in combination with proton production inhibitors (such as dichloroacetate), renal glomular filtration rate inhibitors (such as non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitors), or with an alternative buffer reagent possessing an optimal pK of 7.1–7.2.\ud \ud Conclusion: Our mathematical model confirms bicarbonate acts as an effective agent to raise tumour pHe, but potentially induces metabolic alkalosis at the high doses necessary for tumour pHe normalisation. We predict use in elderly patients or in combination with proton production inhibitors or buffers with a pK of 7.1–7.2 is most promising

Interactions among mitochondrial proteins altered in glioblastoma

Mitochondrial dysfunction is putatively central to glioblastoma (GBM) pathophysiology but there has been no systematic analysis in GBM of the proteins which are integral to mitochondrial function. Alterations in proteins in mitochondrial enriched fractions from patients with GBM were defined with label-free liquid chromatography mass spectrometry. 256 mitochondrially-associated proteins were identified in mitochondrial enriched fractions and 117 of these mitochondrial proteins were markedly (fold-change ≥2) and significantly altered in GBM (p ≤ 0.05). Proteins associated with oxidative damage (including catalase, superoxide dismutase 2, peroxiredoxin 1 and peroxiredoxin 4) were increased in GBM. Protein–protein interaction analysis highlighted a reduction in multiple proteins coupled to energy metabolism (in particular respiratory chain proteins, including 23 complex-I proteins). Qualitative ultrastructural analysis in GBM with electron microscopy showed a notably higher prevalence of mitochondria with cristolysis in GBM. This study highlights the complex mitochondrial proteomic adjustments which occur in GBM pathophysiology

A record-linkage study of the development of hepatocellular carcinoma in persons with hepatitis C infection in Scotland

We investigated trends in first time hospital admissions and deaths attributable to hepatocellular carcinoma (HCC) in a large population based cohort of 22 073 individuals diagnosed with hepatitis C viral (HCV) infection through laboratory testing in Scotland in 1991 2006. We identified new cases of HCC through record linkage to the national inpatient hospital discharge database and deaths registry. A total of 172 persons diagnosed with HCV were admitted to hospital or died with first time mention of HCC. Hepatocellular carcinoma incidence increased between 1996 and 2006 (average annual change of 6.1, 95% confidence interval (CI):0.9 11.6%, P¼0.021). The adjusted relative risk of HCC was greater for males (hazard ratio¼2.7, 95% CI: 1.7 4.2), for those aged 60 years or older (hazard ratio ¼2.7, 95% CI: 1.9 4.1) compared with 50 59 years, and for those with a previous alcohol related hospital admission (hazard ratio¼2.5, 95% CI: 1.7 3.7). The risk of individuals diagnosed with HCV developing HCC was greatlyincreased compared with the general Scottish population (standardised incidence ratio¼127, 95% CI: 102 156). Owing to the advancing age of the Scottish HCV diagnosed population, the annual number of HCC cases is projected to increase, with a consequent increasing burden on the public healthcare system