Thyroxine treatment in patients with symptoms of hypothyroidism but thyroid function tests within the reference range: randomised double blind placebo controlled crossover trial

OBJECTIVES: To determine whether thyroxine treatment is effective in patients with symptoms of hypothyroidism but with thyroid function tests within the reference range, and to investigate the effect of thyroxine treatment on psychological and physical wellbeing in healthy participants. DESIGN: Randomised double blind placebo controlled crossover trial. SETTING: Outpatient clinic in a general hospital. Participants: 25 patients with symptoms of hypothyroidism who had thyroid function tests within the reference range, and 19 controls. Methods: Participants were given thyroxine 100 microgram or placebo to take once a day for 12 weeks. Washout period was six weeks. They were then given the other to take once a day for 12 weeks. All participants were assessed physiologically and psychologically at baseline and on completion of each phase. MAIN OUTCOME MEASURES: Thyroid function tests, measures of cognitive function and of psychological and physical wellbeing. RESULTS: 22 patients and 19 healthy controls completed the study. At baseline, patients' scores on 9 out of 15 psychological measures were impaired when compared with controls. Patients showed a significantly greater response to placebo than controls in 3 out of 15 psychological measures. Healthy participants had significantly lower scores for vitality when taking thyroxine compared to placebo (mean (SD) 60 (17) v 73 (16), P<0.01). However, patients' scores from psychological tests when taking thyroxine were no different from those when taking placebo except for a poorer performance on one visual reproduction test when taking thyroxine. Serum concentrations of free thyroxine increased and those of thyroid stimulating hormone decreased in patients and controls while they were taking thyroxine, confirming compliance with treatment. Although serum concentrations of free triiodothyronine increased in patients and controls taking thyroxine, the difference between the response to placebo and to thyroxine was significant only in the controls. CONCLUSIONS: Thyroxine was no more effective than placebo in improving cognitive function and psychological wellbeing in patients with symptoms of hypothyroidism but thyroid function tests within the reference range. Thyroxine did not improve cognitive function and psychological wellbeing in healthy participants

The influence of temporal resolution on crop yield estimation with Earth Observation data assimilation

Crop growth simulation models are often used to estimate crop yield.For most models, this requires crop, water, and soil management information, though this information is often lacking in many regions of the world. Assimilation of Earth observation (EO) data in crop growth models can generate field-level yield estimates over large areas. The use of EO for assimilation often requires a trade-off between spatial and temporal resolution. Spatiotemporal data fusion can provide higher spatial (≤30m) and temporal resolution data to avoid this trade-off. In this study, we evaluated the timing and frequency of EO data assimilation in the Simple Algorithm for Yield Estimation (SAFY) in a persistently cloudy and fragmented agroecosystem of Ethiopia for 2019 and 2020 growing seasons. We used Landsat and MODIS data fusion to obtain frequent and spatially detailed LAI estimates and assimilated at each main maize growth stage to evaluate the effect of timing and frequency of LAI assimilation. The jointing to grain filling stage observations were more important (RMSE = 117 g/m2, rRMSE = 16%) than other growth stages to improve yield estimation. Using LAI estimates at key crop growth stages was more influential than the frequency of LAI estimates. Reasonably accurate yield estimation (rRMSE = 20%) was obtained using the pre-peak growth stage LAI observations, suggesting that the method is suitable for in-season yield forecasting. LAI retrieval errors from EO data, particularly at the early and late growth stages, were the source of yield estimation uncertainty. Therefore, assimilation of other EO-derived biophysical variables and improving LAI retrieval accuracy from EO data could further improve crop growth model performance in smallholder agricultural systems

You say you want a data revolution? Taking on food systems accountability

Dramatic improvements in data availability and quality are needed to meet the challenge of monitoring and analyzing food systems, so that appropriate policies and actions to improve human and planetary health can be identified and data-informed accountability mechanisms put in place to strengthen food systems governance. Studying food systems is complex due to diverse actors and interlinking processes that operate on multiple spatial and temporal scales, and their multiple outcomes, which may be subject to hidden feedback mechanisms and tradeoffs. However, descriptive research to characterize food system components and make comparisons across geography, income groups, and population groups is an important foundation. The first part of this article details a series of critical data gaps and limitations that are currently hindering food systems learning and accountability, also comparing these gaps across regions and income groups. The second part of the article introduces the Food Systems Dashboard, a new data visualization tool that aims to improve access to and usage of food systems-related data, thus strengthening the data value chain and better informing policies and actions intended to improve diets, nutrition, livelihoods, and environmental sustainability.1

Wernicke's Encephalopathy: 'plus ca change, plus c'est la meme chose'

Aims: To develop clinical guidelines to identify individuals who misuse alcohol and are at risk of developing Wernicke's Encephalopathy (WE). Method: Non-systematic literature review of studies which includes a careful clinical record of the development of signs and symptoms of thiamine deficiency and in which the diagnosis of WE has been confirmed at autopsy. Results: The review of the clinical findings in cases of WE, diagnosed at autopsy, shows a consistent pattern of signs and symptoms. The pattern appears to be similar regardless of whether the thiamine deficiency is related to nutritional problems alone or associated with alcohol misuse. Conclusions: The assessment of the degree of thiamine deficiency and the diagnosis of WE remain a clinical evaluation, and guidelines are suggested to help the clinician. Since neurotoxicity due to the metabolism of excessive alcohol in patients with chronic and severe alcohol dependence may be an important factor in determining long-term outcome of treatment, this must form part of the overall evaluation

Microplastics on the menu: Plastics pollute Indonesian Manta Ray and Whale Shark feeding grounds

The implications of plastic pollution, including microplastics, on marine ecosystems and species are increasingly seen as an environmental disaster. Yet few reports focus on filter-feeding megafauna in regions heavily impacted by plastic pollution, such as Indonesia in the Coral Triangle, a global marine biodiversity hotspot. Here, we evaluate plastic abundance and characterize debris from feeding grounds for manta rays Mobula alfredi and whale sharks Rhincodon typus in three coastal locations in Indonesia: Nusa Penida Marine Protected Area, Komodo National Park, and Pantai Bentar, East Java. A 200 μm plankton net was used to sample the top 0.5 m of the water column (‘trawl survey’) and floating plastics were assessed along ∼440 m long transects (‘visual survey’) during the Indonesian north-west (wet) and south-east (dry) monsoon seasons during 2016–2018. Microplastics were identified visually, measured and categorized from trawl samples, and larger floating plastics were counted and categorized visually from boats. Plastic abundance ranged widely from 0.04 to 0.90 pieces m–3 (trawl survey) and 210 to 40,844 pieces km–2 (visual survey). Results from linear models showed significant seasonal and location differences in estimated plastic abundance for trawl and visual surveys in Nusa Penida and Komodo. Plastic abundance was up to ∼ 44 times higher in the wet than the dry season, with the largest seasonal effect observed in Nusa Penida. Overall, small pieces  50% combined) were the most prevalent plastics. Theoretical plastic ingestion rates were calculated using estimated filtration volumes of manta rays and whale sharks and the mean plastic abundance in their feeding grounds. Upper plastic ingestion estimates for manta rays were ∼63 and 25 pieces h–1 for Nusa Penida and Komodo locations, respectively, and ∼137 pieces h–1 for whale sharks in Java. Analysis of manta ray egested material confirmed plastic ingestion, the consequences of which might include exposure to toxic plastic additives and adhered persistent organic pollutants. Communicating this information to communities who stand to benefit from healthy megafauna populations might help local governments as they work toward reducing plastics in the marine environment

Low bandgap mid-infrared thermophotovoltaic arrays based on InAs

We demonstrate the first low bandgap thermophotovoltaic (TPV) arrays capable of operating with heat sources at temperatures as low as 345 °C, which is the lowest ever reported. The individual array elements are based on narrow band gap InAs/InAs0.61Sb0.13P0.26 photodiode structures. External power conversion efficiency was measured to be ∼3% from a single element at room temperature, using a black body at 950 °C. Both 25-element and 65-element arrays were fabricated and exhibited a TPV response at different source temperatures in the range 345–950 °C suitable for electricity generation from waste heat and other applications

Angular dependence of domain wall resistivity in SrRuO3_{{\bf 3}} films

${\rm SrRuO_3}$ is a 4d itinerant ferromagnet (T$_{c}$ $\sim$150 K) with stripe domain structure. Using high-quality thin films of SrRuO$_{3}$ we study the resistivity induced by its very narrow ($\sim 3$ nm) Bloch domain walls, $\rho_{DW}$ (DWR), at temperatures between 2 K and T$_{c}$ as a function of the angle, $\theta$, between the electric current and the ferromagnetic domains walls. We find that $\rho_{DW}(T,\theta)=\sin^2\theta \rho_{DW}(T,90)+B(\theta)\rho_{DW}(T,0)$ which provides the first experimental indication that the angular dependence of spin accumulation contribution to DWR is $\sin^2\theta$. We expect magnetic multilayers to exhibit a similar behavior.Comment: 5 pages, 5 figure

How do cities approach policy innovation and policy learning? A study of 30 policies in Northern Europe and North America

This paper reports on a study of current practice in policy transfer, and ways in which its effectiveness can be increased. A literature review identifies important factors in examining the transfer of policies. Results of interviews in eleven cities in Northern Europe and North America investigate these factors further. The principal motivations for policy transfer were strategic need and curiosity. Local officials and politicians dominated the process of initiating policy transfer, and local officials were also the leading players in transferring experience. A range of information sources are used in the search process but human interaction was the most important source of learning for two main reasons. First, there is too much information available through the Internet and the search techniques are not seen to be wholly effective in identifying the necessary information. Secondly, the information available on websites, portals and even good practice guides is not seen to be of mixed quality with risks of focussing only on successful implementation and therefore subject to some bias. Officials therefore rely on their trusted networks of peers for lessons as here they can access the ‘real implementation’ story and the unwritten lessons. Organisations which have a culture that is supportive of learning from elsewhere had strong and broad networks of external contacts and resourced their development whilst others are more insular or inward looking and reluctant to invest in policy lessons from elsewhere. Solutions to the problems identified in the evidence base are proposed

CTCF genetic alterations in endometrial carcinoma are pro-tumorigenic

CTCF is a haploinsufficient tumour suppressor gene with diverse normal functions in genome structure and gene regulation. However the mechanism by which CTCF haploinsufficiency contributes to cancer development is not well understood. CTCF is frequently mutated in endometrial cancer. Here we show that most CTCF mutations effectively result in CTCF haploinsufficiency through nonsense-mediated decay of mutant transcripts, or loss-of-function missense mutation. Conversely, we identified a recurrent CTCF mutation K365T, which alters a DNA binding residue, and acts as a gain-of-function mutation enhancing cell survival. CTCF genetic deletion occurs predominantly in poor prognosis serous subtype tumours, and this genetic deletion is associated with poor overall survival. In addition, we have shown that CTCF haploinsufficiency also occurs in poor prognosis endometrial clear cell carcinomas and has some association with endometrial cancer relapse and metastasis. Using shRNA targeting CTCF to recapitulate CTCF haploinsufficiency, we have identified a novel role for CTCF in the regulation of cellular polarity of endometrial glandular epithelium. Overall, we have identified two novel pro-tumorigenic roles (promoting cell survival and altering cell polarity) for genetic alterations of CTCF in endometrial cance