Combined immune checkpoint inhibitor therapy with nivolumab and ipilimumab causing acute-onset type 1 diabetes mellitus following a single administration: two case reports.

The use of immune checkpoint inhibitor (ICI) therapy is becoming a standard of care for several cancers. Monoclonal antibodies targeting cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1) or its ligand (PD-L1) cause a broad spectrum of autoimmune adverse events. ICI-induced type 1 diabetes mellitus (T1DM) is extremely rare (< 1%) but potentially life-threatening. It appears to be more common with PD-1 blockade (or combination immunotherapy) than with anti-CTLA-4 therapy, often during the first three to six months of therapy. We report an acute onset T1DM with severe inaugural diabetic ketoacidosis (DKA) and remarkably elevated Glutamic Acid Decarboxylase antibody (GADA) titres following a single administration of combined ICI therapy with nivolumab (anti-PD-1) and ipilimumab (anti-CTLA-4) in two adult patients with advanced metastatic melanoma. In these cases, the time to diabetes onset was remarkably short (two and five weeks), and one presented with fulminous T1DM in a previous long-standing type 2 diabetes mellitus. Oncological patients treated with combination therapy of anti-PD-1 and anti-CTLA-4 can develop a particular pattern of T1DM, with very rapid onset within a few weeks after starting ICI therapy, even in the presence of an existing type 2 diabetes. ICI-induced T1DM is a medical emergency in presence of severe inaugural DKA and requires a collaboration between specialists and primary care physicians, as well as patient education, for early diagnosis and supportive care

Performance of spanish white Macael marble exposed to narrow- and medium-range temperature cycling

Se aplican ciclos de estrés térmico de medio (100/-20 ºC y 75/-20 ºC) y bajo (50/-20 ºC) rango sobre probetas de mármol blanco de Macael (Almería, España), y se evalúa ciclo a ciclo su incidencia mediante ultrasonidos. Los resultados indican un considerable descenso de velocidad de los ultrasonidos en las muestras sometidas a estrés de 100/-20 ºC, más moderado en el caso de 75/-20 ºC, poco significativo en el caso de 50/-20 ºC. Las variaciones de velocidad tienen lugar durante los primeros 5-7 ciclos, permaneciendo los valores constantes en ciclos posteriores. Los resultados proporcionados por medidas de dureza de Schmidt, y de rotura por compresión uniaxial son coincidentes con los proporcionados por los ultrasonidos. Las imágenes de microscopía petrográfica y electrónica (SEM) manifiestan una cierta descohesión granular en zonas muy superficiales de las probetas sometidas a 40 ciclos de 100/-20 ºC. La coincidencia entre los datos por las técnicas de rotura por compresión, medidas de dureza superficial y ultrasonidos indican la validez de estas dos últimas —técnicas no destructivas, NDT— en el control de la incidencia de ciclos de stress térmico sobre las características mecánicas de materiales pétreos.White marble specimens from Macael in the Spanish province of Almeria were exposed to narrow- (50/ -20 ºC) and medium- (100/-20 ºC and 75/-20 ºC) range thermal stress cycles. The effects were monitored with ultrasound techniques. Ultrasound velocity declined considerably in samples subjected to 100/-20 ºC cycles, more moderately when the range was 75/-20 ºC and insignificantly when it was narrowed to 50/-20 ºC. All variations were recorded in the first five to seven cycles, with values flattening thereafter. The Schmidt hardness and compression test results concurred with the ultrasound findings. Petrographic and scanning electron microscope (SEM) imaging revealed some very superficial granular decohesion in the specimens subjected to forty 100/-20 ºC cycles. The concurrent results from compression testing on the one hand and surface hardness and ultrasound measurements on the other confirmed the validity of the latter two nondestructive techniques (NDT) for determining the effects of thermal stress cycling on stone mechanical strength.La investigación presentada en este artículo es parte del Proyecto MAT 2004-06804-CO2-0 del Plan Nacional de Investigación científica, Desarrollo e Innovación Tecnológica (Ministerio de Ciencia y Tecnología) y llevado a cabo en el Grupo de Investigación RNM 0179 de la Junta de Andalucía

Estimating food production in an urban landscape

There is increasing interest in urban food production for reasons of food security, environmental sustainability, social and health benefits. In developed nations urban food growing is largely informal and localised, in gardens, allotments and public spaces, but we know little about the magnitude of this production. Here we couple own-grown crop yield data with garden and allotment areal surveys and urban fruit tree occurrence to provide one of the first estimates for current and potential food production in a UK urban setting. Current production is estimated to be sufficient to supply the urban population with fruit and vegetables for about 30 days per year, while the most optimistic model results suggest that existing land cultivated for food could supply over half of the annual demand. Our findings provide a baseline for current production whilst highlighting the potential for change under the scaling up of cultivation on existing land

Predicting youth participation in urban agriculture in Malaysia: insights from the theory of planned behavior and the functional approach to volunteer motivation

This study examines factors associated with the decision of Malaysian youth to participate in a voluntary urban agriculture program. Urban agriculture has generated significant interest in developing countries to address concerns over food security, growing urbanization and employment. While an abundance of data shows attracting the participation of young people in traditional agriculture has become a challenge for many countries, few empirical studies have been conducted on youth motivation to participate in urban agriculture programs, particularly in non-Western settings. Drawing on the theories of planned behavior and the functional approach to volunteer motivation, we surveyed 890 students from a public university in Malaysia about their intention to join a new urban agriculture program. Hierarchical regression findings indicated that the strongest predictor of participation was students’ attitude toward urban agriculture, followed by subjective norms, career motives and perceived barriers to participation. The findings from this study may provide useful information to the university program planners in Malaysia in identifying mechanisms for future students’ involvement in the program

Cross-Location Analysis of the Impact of Household Socioeconomic Status on Participation in Urban and Peri-Urban Agriculture in West Africa

This study explores the relation between household socioeconomic status (SES) and participation in urban and periurban agriculture (UPA) in three West African cities. We used a structured questionnaire to survey 700 randomly selected households: 250 in Kano, Nigeria, 250 in Bobo Dioulasso, Burkina Faso, and 200 in Sikasso, Mali. Multiple correspondence analysis was applied on household asset variables to create an index of assets which was used as a proxy for household SES. The results showed no significant differences in households’ rate of participation in UPA across socioeconomic groups. Participation in UPA was rather significantly (P < 0.001) and positively related to household size. Interestingly, the analysis revealed that field crop cultivation and gardening were more common among households in the low and medium SES groups while those in the high SES group were more likely to keep livestock