Reproductive ecology of the black rat (Rattus rattus) in Madagascar : the influence of density-dependent and -independent effects

Funding Information: We are grateful to the technical and research staff from the Institut Pasteur de Madagascar and Association Vahatra for fieldwork assistance during this study. K.S. was supported by the Biotechnology and Biological Sciences Research Council (BBSRC) under the EastBio DTP [grant number BB/M010996/1]. This work was also supported by the Wellcome Trust [095171/Z/10/Z]; the Medical Research Council [MR/T029862/1]; and by the National Institute for Health Research (NIHR) (using the UK's Official Development Assistance [ODA] Funding) and Wellcome [219532/Z/19/Z] under the NIHR‐Wellcome Partnership for Global Health Research. The views expressed are those of the authors and not necessarily those of Wellcome, the NIHR, or the Department of Health and Social Care. For the purpose of Open Access, the authors have applied a CC BY license to any author accepted manuscript version arising. Research Funding Biotechnology and Biological Sciences Research Council (BBSRC) under the East-Bio DTP. Grant Number: BB/M010996/1 Wellcome TrustBiotechnology. Grant Number: 095171/Z/10/Z the Medical Research Council. Grant Number: MR/T029862/1 the National Institute for Health Research (NIHR) UK’s Official Development Assistance [ODA] Wellcome. Grant Number: 219532/Z/19/ZPeer reviewedPublisher PD

Rodent control to fight plague : field assessment of methods based on rat density reduction

Research funding: Directorate General for International Relations and Strategy. Grant Number: 2018‐SB‐024‐18SSEOC049‐PMG7‐SSA5‐IPMMADAGASCAR ACKNOWLEDGMENTS: We are especially grateful to the health authorities and the population in Miantso and Ankazobe for allowing us to do this work and being so helpful. We thank the staff of the Plague Unit, Institut Pasteur de Madagascar, for helping with the field and laboratory work, especially Alain Berthin Rakotoarisoa and Andrianiaina Parfait Rakotonindrainy. This work was supported by a Directorate General for International Relations and Strategy grant (2018‐SB‐024‐18SSEOC049‐PMG7‐SSA5‐IPMMADAGASCAR) covering the project “Développement de contre‐mesures médicales à la peste à Madagascar” with scientific support of IRBA (French Armed Forces Biomedical Research Institute), within the framework of French MoD's involvement in G7 Global partnership. The French Agency for International Technical Expertise (AFETI) ensures the proper financial execution of the project and contributes to the implementation of cooperation actions under the control of the Directorate General for International Relations and Strategy. This research was also funded in part by the Wellcome Trust [095171/Z/10/Z] and the Institut Pasteur de Madagascar. For the purpose of Open Access, the authors have applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. K.S. was supported by the Biotechnology and Biological Sciences Research Council (BBSRC) under the EastBio DTP (grant number BB/M010996/1).Peer reviewedPublisher PD

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

Ten new insights in climate science 2020 – a horizon scan

Non-technical summary We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding of Earth's sensitivity to carbon dioxide, finds that permafrost thaw could release more carbon emissions than expected and that the uptake of carbon in tropical ecosystems is weakening. Adverse impacts on human society include increasing water shortages and impacts on mental health. Options for solutions emerge from rethinking economic models, rights-based litigation, strengthened governance systems and a new social contract. The disruption caused by COVID-19 could be seized as an opportunity for positive change, directing economic stimulus towards sustainable investments. Technical summary A synthesis is made of ten fields within climate science where there have been significant advances since mid-2019, through an expert elicitation process with broad disciplinary scope. Findings include: (1) a better understanding of equilibrium climate sensitivity; (2) abrupt thaw as an accelerator of carbon release from permafrost; (3) changes to global and regional land carbon sinks; (4) impacts of climate change on water crises, including equity perspectives; (5) adverse effects on mental health from climate change; (6) immediate effects on climate of the COVID-19 pandemic and requirements for recovery packages to deliver on the Paris Agreement; (7) suggested long-term changes to governance and a social contract to address climate change, learning from the current pandemic, (8) updated positive cost–benefit ratio and new perspectives on the potential for green growth in the short- and long-term perspective; (9) urban electrification as a strategy to move towards low-carbon energy systems and (10) rights-based litigation as an increasingly important method to address climate change, with recent clarifications on the legal standing and representation of future generations. Social media summary Stronger permafrost thaw, COVID-19 effects and growing mental health impacts among highlights of latest climate science

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Optimising recruitment to a lung cancer screening trial:a comparison of general practitioner and community-based recruitment

OBJECTIVES: Pre-trial focus groups of the Early detection of Cancer of the Lung Scotland (ECLS) trial indicated that those at high risk of lung cancer are more likely to engage with community-based recruitment methods. The current study aimed to understand if general practitioner (GP) and community-based recruitment might attract different groups of people, and to quantitatively explore the demographic and psychosocial differences between people responding to GP or community-based recruitment.DESIGN: Secondary data analysis of ECLS trial baseline data.METHODS: Adults (n = 11,164) aged 50 to 75 years completed a baseline questionnaire as part of their participation in the ECLS trial. The questionnaire assessed smoking behaviour, health state, health anxiety and illness perception. Alongside demographic characteristics, how participants were made aware of the study/participant recruitment method (GP recruitment/community recruitment) was also obtained via trial records.RESULTS: The likelihood of being recruited via community-based methods increased as deprivation level decreased. Those recruited via the community had higher levels of perceived personal control of developing lung cancer and were more likely to understand their own risk of developing lung cancer, compared to those who were recruited to the trial via their GP. Health state and health anxiety did not predict recruitment methods in multivariable analysis.CONCLUSIONS: Community and opportunistic screening invitations were associated with uptake in people from less-deprived backgrounds, and therefore might not be the optimal method to reach those at high risk of lung cancer and living in more deprived areas.</p

Optimising recruitment to a lung cancer screening trial: a comparison of general practitioner and community-based recruitment

No abstract available

Living with rodent pests: Unifying stakeholder interests to prioritise pest management in rural Madagascar

International audienceAbstract Rodent pests can have major social, economic, and environmental impacts. Their management, therefore, represents a complex socio-ecological problem involving a network of stakeholders from across different sectors, with diverging and sometimes competing interests. Failure to incorporate stakeholder interests can result in ineffective or unsustainable management programmes, with unintended negative consequences for people and nature. Participatory approaches to decision-making have been proposed as suitable strategies to tackle complex problems, yet, these processes are often considered too difficult, costly, or time-consuming to implement. To facilitate a participatory approach to rodent control in Madagascar, we identified and mapped key stakeholders and developed a multisector framework for guiding rodent management programmes based on current literature and expert recommendations. We then carried out interviews and focus groups with stakeholders and end-users to validate the final framework. The final framework unifies stakeholder interests around the dimensions of People, Resources, Knowledge and Power. Combined application of the stakeholder map and framework provides decision-makers with the tools to identify stakeholder interests; to explore areas of conflict, as well as areas of agreement; and to ensure that these are addressed within the design of control programmes. As an assessment tool, the framework can also be used to evaluate the responsiveness of programmes to the needs of different stakeholders and assess whether objectives are being reached. We recommend the application of the stakeholder map and framework to encourage and strengthen participatory approaches aimed at rodent pest control. Due to the inclusive and interdisciplinary nature of the framework, it can be applied to address numerous complex social, environmental, and economic issues across scales, sectors, and systems. Read the free Plain Language Summary for this article on the Journal blog