Closing the Gap

Shipping is a cornerstone of global trade and, as such, the GHG emissions created by shipping are significant and rising, accounting for almost 3% of global anthropogenic emissions (Faber et al. 2020a). Recent projections suggest that by 2050, shipping emissions will increase by between 90-130% of 2008 emissions by 2050 (ibid.). However, in April 2018, the IMO adopted the Initial GHG Strategy which set the ambition to reduce total annual GHG emissions by at least 50% by 2050, while pursuing efforts towards phasing out GHG emissions this century as a matter of urgency, consistent with the Paris Agreement temperature goal. With emissions projected to rise and international targets having been set, the question becomes, how these targets can be met by shipping? // For international shipping to align with the IMO’s Initial GHG Strategy, zero-emission fuels would need to become the dominant fuel source by the 2040s, gradually phasing out current fossil fuels. However, there exists a significant competitiveness gap between incumbent fossil fuels and alternative zero-emission options. This gap is the result of the existence of market barriers and failures, availability issues, a relative lack of information and regulation on safety, as well as the price difference in the fuels, which in turn is driven by R&D, infrastructure, and investment requirements. Projections suggest that across the 2030s and 2040s, zeroemission fuels will be approximately double the price of conventional fuel at best (Lloyd’s Register & UMAS 2020). As a result, there is an urgent need for policy to close the competitiveness gap and ensure shipping meets its decarbonisation commitments. // There is a range of potential measures to promote decarbonisation in shipping, including economic instruments or MBMs, direct regulatory approaches, information policies, voluntary initiatives, and national and regional action. This report provides an overview of different policy measures to address maritime decarbonisation and to close the competitiveness gap while enabling an equitable transition. Fairness and equity aspects are emphasised by e.g. the Initial IMO GHG Strategy. Therefore, the viability of any IMO climate policy instrument depends to a large extent on how these aspects are considered and operationalised. // This report explains which policy options could help close the competitiveness gap and enable an equitable transition

Hedgehog Signalling in Androgen Independent Prostate Cancer

Objectives: Androgen-deprivation therapy effectively shrinks hormone-naïve prostate cancer, both in the prostate and at sites of distant metastasis. However prolonged androgen deprivation generally results in relapse and androgen-independent tumour growth, which is inevitably fatal. The molecular events that enable prostate cancer cells to proliferate in reduced androgen conditions are poorly understood. Here we investigate the role of Hedgehog signalling in androgen-independent prostate cancer (AIPC). Methods: Activity of the Hedgehog signalling pathway was analysed in cultured prostate cancer cells, and circulating prostate tumour cells were isolated from blood samples of patients with AIPC. Results: AIPC cells were derived through prolonged culture in reduced androgen conditions, modelling hormone therapy in patients, and expressed increased levels of Hedgehog signalling proteins. Exposure of cultured AIPC cells to cyclopamine, which inhibits Hedgehog signalling, resulted in inhibition of cancer cell growth. The expression of the Hedgehog receptor PTCH and the highly prostate cancer-specific gene DD3PCA3 was significantly higher in circulating prostate cancer cells isolated from patients with AIPC compared with samples prepared from normal individuals. There was an association between PTCH and DD3PCA3 expression and the length of androgen-ablation therapy. Conclusions: Our data are consistent with reports implicating overactivity of Hedgehog signalling in prostate cancer and suggest that Hedgehog signalling contributes to the androgen-independent growth of prostate cancer cells. As systemic anti-Hedgehog medicines are developed, the Hedgehog pathway will become a potential new therapeutic target in advanced prostate cancer.Peer reviewedFinal Accepted Versio

Gregarious settlement by the larvae of Hydroides dianthus (Polychaeta, Serpulidae)

Also published as: Marine Ecology Progress Series 5 (1981): 69-74Larval development of the serpulid polychaete worm, Hydroides dianthus Verrill 1893 parallels that of other closely related species. The larvae prefer to settle upon surfaces already inhabited by other members of their own species rather than to colonize surfaces without such conspecific residents. However, very wide variations in the intensity of settlement are observed. These differences in the amount of settlement cannot presently be attributed to any single variable. Gregarious settlement appears to be typical for sessile species which do not have the ability to reproduce asexually after settlement.Prepared for the Office of Naval Research under Contract N00014-79-C-0071; NR 083-004 and for the National Science Foundation under Grant EAR-7926381

Managing well-being in paediatric critical care: a multiperspective qualitative study of nurses’ and allied health professionals’ experiences

Objectives: It is well evidenced that healthcare professionals working in paediatric critical care experience high levels of burn-out, compassion fatigue and moral distress. This worsened during the COVID-19 pandemic. This work examines the nature of challenges to workplace well-being and explores what well-being means to staff. This evidence will inform the development of staff interventions to improve and maintain staff well-being. Design: Qualitative study. Setting: Paediatric critical care units in the UK. Participants: 30 nurses and allied health professionals took part in online interviews and were asked about well-being and challenges to well-being. Lived experiences of well-being were analysed using interpretative phenomenological analysis. Results: Themes generated were as follows: perception of self and identity; relationships and team morale; importance of control and balance and consequences of COVID-19. They focused on the impact of poor well-being on participants’ sense of self; the significance of how or whether they feel able to relate well with their team and senior colleagues; the challenges associated with switching off, feeling unable to separate work from home life and the idealised goal of being able to do just that; and lessons learnt from working through the pandemic, in particular associated with redeployment to adult intensive care. Conclusions: Our findings align closely with the self-determination theory which stipulates autonomy, belonging and competence are required for well-being. Participants’ accounts supported existing literature demonstrating the importance of empowering individuals to become self-aware, to be skilled in self-reflection and to be proactive in managing one’s own well-being. Change at the individual and staff group level may be possible with relatively low-intensity intervention, but significant change requires systemic shifts towards the genuine prioritisation of staff well-being as a prerequisite for high-quality patient care

Substance use and self-poisoning in schizophrenia: 11-year findings from a national clinical survey of suicide in mental health patients in the UK

Suicide is the leading cause of unnatural death among people with schizophrenia. Substance use is a highly prevalent comorbid feature of schizophrenia and a modifiable risk factor for suicide. However, no studies have examined changes in the frequency of substance use or self-poisoning in those who died by suicide over time. Knowing this could support more tailored approaches to reducing specific risk factors and access to means in those with schizophrenia who are at risk of suicide. We conducted an 11-year observational study on a clinical survey of people with schizophrenia in the UK who died by suicide within 12 months of contact with mental health services between 2010 and 2020 (n = 2718). Overall, alcohol, cannabis and stimulants were the most frequently reported substances. The odds of lifetime use significantly increased over time for cannabis, stimulants, heroin, and benzodiazepines. There were differences in socio-demographic, behavioural and clinical factors between those with recent and historical alcohol and drug use before death. Deaths by hanging, jumping and self-poisoning were the most common suicide methods. Though deaths by hanging significantly increased over time, deaths by self-poisoning significantly decreased, especially by means of psychotropic medication and opioids. To improve risk management, clinical efforts should focus on identifying and treating people with schizophrenia using specific substances. Nationwide initiatives for improving safety in prescribing could be contributing to reduced risks of suicide via self-poisoning in this group

Vacuolar and plasma membrane stripping and autophagic elimination of Toxoplasma gondii in primed effector macrophages

Apicomplexan protozoan pathogens avoid destruction and establish a replicative niche within host cells by forming a nonfusogenic parasitophorous vacuole (PV). Here we present evidence for lysosome-mediated degradation of Toxoplasma gondii after invasion of macrophages activated in vivo. Pathogen elimination was dependent on the interferon γ inducible-p47 GTPase, IGTP, required PI3K activity, and was preceded by PV membrane indentation, vesiculation, disruption, and, surprisingly, stripping of the parasite plasma membrane. Denuded parasites were enveloped in autophagosome-like vacuoles, which ultimately fused with lysosomes. These observations outline a series of mechanisms used by effector cells to redirect the fate of a classically nonfusogenic intracellular pathogen toward a path of immune elimination

Qualitative study exploring the well-being experiences of paediatric critical care consultants working in the UK during the COVID-19 pandemic

Objectives: The aim of this study was to examine the well-being experiences of consultants working in paediatric critical care (PCC) settings in the UK during the COVID-19 pandemic. Design: Qualitative design using individual interviews and thematic analysis. Setting: PCC. Participants: Eleven medical consultants working in PCC in a range of PCC settings/transport teams in the UK from nine units participated. Participants ranged in years of experience as a consultant from four to 23 years. Methods: A set of open semistructured questions were used to elicit information about participants’ experiences of workplace well-being. Interviews were audiorecorded and transcribed. Findings: Thematic analysis identified six themes and data saturation was reached. These were as follows: (1) positive and negative impact of working during COVID-19, (2) job satisfaction and public scrutiny in the unique environment of PCC, (3) supporting the workforce through modified shift work, (4) perceptions of support and recognition offered from the hospital management, (5) successful coping strategies are personal and adaptive, and (6) importance of civility and good teamwork Conclusion: Findings show that consultants’ well-being is challenged in a number of ways and that the solutions to the problem of burn-out are multifaceted. Action is required from individual consultants, clinical teams, hospital management and national regulatory bodies. Our work corroborates the recent General Medical Council report highlighting doctors’ core needs for well-being: autonomy, belonging, competence. Burn-out is a long-term problem, requiring sustainable solutions. Future research needs to develop and evaluate the effectiveness of evidence-based interventions to improve consultants’ well-being. Trials of effectiveness need to present evidence that will persuade hospital management to invest in their consultants’ well-being within the economic context of reduced budgets and limited PCC workforce