Solid fuel users' perceptions of household solid fuel use in low- and middle-income countries: a scoping review

Almost half of the global population is exposed to household air pollution (HAP) from the burning of biomass fuels primarily for cooking, and this has been linked with considerable mortality and morbidity. While alternative cooking technologies exist, sustained adoption of these is piecemeal, indicating that there is insufficient knowledge of understandings of HAP within target communities. To identify potential gaps in the literature, a scoping review was conducted focused on solid fuel users' perceptions of HAP and solid fuel use in low- and middle-income countries. From the initial 14,877 search returns, 56 were included for final analysis. An international multi-disciplinary workshop was convened to develop the research question; six key domains: health; family and community life; home, space, place and roles; cooking and cultural practices, environment; and policy and practice development, were also identified using a Social Ecological Model framework. The review showed a series of disconnects across the domains which highlighted the limited research on perceptions of HAP in the literature. Reviewed studies showed that participants emphasized short-term health impacts of HAP as opposed to longer-term health benefits of interventions and prioritized household security over improved ventilation. There was also a socio-demographic gendered disconnect as although women and children generally have most exposure to HAP, their decision-making power about use of solid fuels is often limited. In the domain of policy and practice, the review identified the importance of community norms and cultural traditions (including taste). Research in this domain, and within the environment domain is however limited and merits further attention. We suggest that interventions need to be locally situated and community-led and a deeper understanding of perceptions of HAP could be obtained using participatory and innovative research methods. Bridging the disconnects and gaps identified in this review is essential if the global disease burden associated with HAP is to be reduced

Formation of Long-Lived Color Centers for Broadband Visible Light Emission in Low-Dimensional Layered Perovskites.

We investigate the origin of the broadband visible emission in layered hybrid lead-halide perovskites and its connection with structural and photophysical properties. We study ⟨001⟩ oriented thin films of hexylammonium (HA) lead iodide, (C6H16N)2PbI4, and dodecylammonium (DA) lead iodide, (C12H28N)2PbI4, by combining first-principles simulations with time-resolved photoluminescence, steady-state absorption and X-ray diffraction measurements on cooling from 300 to 4 K. Ultrafast transient absorption and photoluminescence measurements are used to track the formation and recombination of emissive states. In addition to the excitonic photoluminescence near the absorption edge, we find a red-shifted, broadband (full-width at half-maximum of about 0.4 eV), emission band below 200 K, similar to emission from ⟨110⟩ oriented bromide 2D perovskites at room temperature. The lifetime of this sub-band-gap emission exceeds that of the excitonic transition by orders of magnitude. We use X-ray diffraction measurements to study the changes in crystal lattice with temperature. We report changes in the octahedral tilt and lattice spacing in both materials, together with a phase change around 200 K in DA2PbI4. DFT simulations of the HA2PbI4 crystal structure indicate that the low-energy emission is due to interstitial iodide and related Frenkel defects. Our results demonstrate that white-light emission is not limited to ⟨110⟩ oriented bromide 2D perovskites but a general property of this class of system, and highlight the importance of defect control for the formation of low-energy emissive sites, which can provide a pathway to design tailored white-light emitters

Can a GP be a generalist and a specialist? Stakeholders views on a respiratory General Practitioner with a special interest service in the UK

Peer reviewedPublisher PD

Can asthma control be improved by understanding the patient's perspective?

Clinical trials show that asthma can be controlled in the majority of patients, but poorly controlled asthma still imposes a considerable burden. The level of asthma control achieved reflects the behaviour of both healthcare professionals and patients. A key challenge for healthcare professionals is to help patients to engage in self-management behaviours with optimal adherence to appropriate treatment. These issues are particularly relevant in primary care, where most asthma is managed. An international panel of experts invited by the International Primary Care Respiratory Group considered the evidence and discussed the implications for primary care practice

Basic science232. Certolizumab pegol prevents pro-inflammatory alterations in endothelial cell function

Background: Cardiovascular disease is a major comorbidity of rheumatoid arthritis (RA) and a leading cause of death. Chronic systemic inflammation involving tumour necrosis factor alpha (TNF) could contribute to endothelial activation and atherogenesis. A number of anti-TNF therapies are in current use for the treatment of RA, including certolizumab pegol (CZP), (Cimzia ®; UCB, Belgium). Anti-TNF therapy has been associated with reduced clinical cardiovascular disease risk and ameliorated vascular function in RA patients. However, the specific effects of TNF inhibitors on endothelial cell function are largely unknown. Our aim was to investigate the mechanisms underpinning CZP effects on TNF-activated human endothelial cells. Methods: Human aortic endothelial cells (HAoECs) were cultured in vitro and exposed to a) TNF alone, b) TNF plus CZP, or c) neither agent. Microarray analysis was used to examine the transcriptional profile of cells treated for 6 hrs and quantitative polymerase chain reaction (qPCR) analysed gene expression at 1, 3, 6 and 24 hrs. NF-κB localization and IκB degradation were investigated using immunocytochemistry, high content analysis and western blotting. Flow cytometry was conducted to detect microparticle release from HAoECs. Results: Transcriptional profiling revealed that while TNF alone had strong effects on endothelial gene expression, TNF and CZP in combination produced a global gene expression pattern similar to untreated control. The two most highly up-regulated genes in response to TNF treatment were adhesion molecules E-selectin and VCAM-1 (q 0.2 compared to control; p > 0.05 compared to TNF alone). The NF-κB pathway was confirmed as a downstream target of TNF-induced HAoEC activation, via nuclear translocation of NF-κB and degradation of IκB, effects which were abolished by treatment with CZP. In addition, flow cytometry detected an increased production of endothelial microparticles in TNF-activated HAoECs, which was prevented by treatment with CZP. Conclusions: We have found at a cellular level that a clinically available TNF inhibitor, CZP reduces the expression of adhesion molecule expression, and prevents TNF-induced activation of the NF-κB pathway. Furthermore, CZP prevents the production of microparticles by activated endothelial cells. This could be central to the prevention of inflammatory environments underlying these conditions and measurement of microparticles has potential as a novel prognostic marker for future cardiovascular events in this patient group. Disclosure statement: Y.A. received a research grant from UCB. I.B. received a research grant from UCB. S.H. received a research grant from UCB. All other authors have declared no conflicts of interes

Multiple sclerosis and the genes and proteins of central nervous system myelin

A prevalence study of MS in the Channel Islands was undertaken. This showed the prevalence rates to be similar to other south British studies, with a slightly lower (but not statistically significant) rate for women in the Bailiwick of Guernsey.The finding that receptors for known neurotransmitters and proteins involved in signal transduction such as the heterotrimeric G proteins and low molecular weight GTPases are present in myelin shows that little is known about active processes occurring in the myelin membrane. The rho group of proteins are of particular interest as they have a clear role in complex membrane structures such as ruffles, lamellipodia and filopodia as well as actin stress fibre formation. They are good candidates for a role in a complex membrane such as myelin.This led to an attempt to enumerate the number of low molecular weight GTPases in myelin and to identify some of these proteins so as to suggest functional roles for them. A large number of low molecular weight GTP binding proteins were shown to be in both rabbit and in human myelin, using two-dimensional protein electrophoresis, electroblotting, binding to GTPγS and autoradiography. Members of the rho family were then identified as being present in myelin using both Western blotting and the highly specific ADP ribosylation of rho proteins in the presence of Clostridium botulinum C3 and Limosum toxins. Attempts to isolate the rho protein for sequence analysis proved difficult, as quantities in myelin are small. Some of the rho group of GTPases are found in the cytoskeletal fraction of CNS myelin, which is believed to be rich in the radial element. The association appears inhibited by ADP ribosylation (inactivation).Further study of both the proteins and genes of CNS myelin is indicated if understanding of the processes of de- and remyelination are to be understood in the healthy state and in diseases such as multiple sclerosis.</p

An equitable redistribution of unburnable carbon

The allocation of remaining fossil fuel production has stimulated a discussion around issues of equitable allocation but the implications of different options are unclear. Here the authors show that shifting production to low-medium human development regions has limited economic benefits under strong climate policy