New Villagers

It was a gorgeous day in Dubrovnik, Croatia. Brooke Barker, senior in management and international business, kayaked to the Island of Lokrum, the wind blew through her hair as she paddled to keep up with the group. Upon reaching the island, she began the trek to the top, where she ran into some local daredevils preparing to jump into the deep blue water of the Adriatic Sea 35 feet below. Intrigued, Brooke decided to join them

Characterizing Sleep Spindles in Sheep.

Sleep spindles are distinctive transient patterns of brain activity that typically occur during non-rapid eye movement (NREM) sleep in humans and other mammals. Thought to be important for the consolidation of learning, they may also be useful for indicating the progression of aging and neurodegenerative diseases. The aim of this study was to characterize sleep spindles in sheep (Ovis aries). We recorded electroencephalographs wirelessly from six sheep over a continuous period containing 2 nights and a day. We detected and characterized spindles using an automated algorithm. We found that sheep sleep spindles fell within the classical range seen in humans (10-16 Hz), but we did not see a further separation into fast and slow bands. Spindles were detected predominantly during NREM sleep. Spindle characteristics (frequency, duration, density, topography) varied between individuals, but were similar within individuals between nights. Spindles that occurred during NREM sleep in daytime were indistinguishable from those found during NREM sleep at night. Surprisingly, we also detected numerous spindle-like events during unequivocal periods of wake during the day. These events were mainly local (detected at single sites), and their characteristics differed from spindles detected during sleep. These "wake spindles" are likely to be events that are commonly categorized as "spontaneous alpha activity" during wake. We speculate that wake and sleep spindles are generated via different mechanisms, and that wake spindles play a role in cognitive processes that occur during the daytime

OpenET : filling a critical data gap in water management for the western United States.

The lack of consistent, accurate information on evapotranspiration (ET) and consumptive use of water by irrigated agriculture is one of the most important data gaps for water managers in the western United States (U.S.) and other arid agricultural regions globally. The ability to easily access information on ET is central to improving water budgets across the West, advancing the use of data-driven irrigation management strategies, and expanding incentive-driven conservation programs. Recent advances in remote sensing of ET have led to the development of multiple approaches for field-scale ET mapping that have been used for local and regional water resource management applications by U.S. state and federal agencies. The OpenET project is a community-driven effort that is building upon these advances to develop an operational system for generating and distributing ET data at a field scale using an ensemble of six well-established satellite-based approaches for mapping ET. Key objectives of OpenET include: Increasing access to remotely sensed ET data through a web-based data explorer and data services; supporting the use of ET data for a range of water resource management applications; and development of use cases and training resources for agricultural producers and water resource managers. Here we describe the OpenET framework, including the models used in the ensemble, the satellite, meteorological, and ancillary data inputs to the system, and the OpenET data visualization and access tools. We also summarize an extensive intercomparison and accuracy assessment conducted using ground measurements of ET from 139 flux tower sites instrumented with open path eddy covariance systems. Results calculated for 24 cropland sites from Phase I of the intercomparison and accuracy assessment demonstrate strong agreement between the satellite-driven ET models and the flux tower ET data. For the six models that have been evaluated to date (ALEXI/DisALEXI, eeMETRIC, geeSEBAL, PT-JPL, SIMS, and SSEBop) and the ensemble mean, the weighted average mean absolute error (MAE) values across all sites range from 13.6 to 21.6 mm/month at a monthly timestep, and 0.74 to 1.07 mm/day at a daily timestep. At seasonal time scales, for all but one of the models the weighted mean total ET is within ±8% of both the ensemble mean and the weighted mean total ET calculated from the flux tower data. Overall, the ensemble mean performs as well as any individual model across nearly all accuracy statistics for croplands, though some individual models may perform better for specific sites and regions. We conclude with three brief use cases to illustrate current applications and benefits of increased access to ET data, and discuss key lessons learned from the development of OpenET

Public health impacts of city policies to reduce climate change:Findings from the URGENCHE EU-China project

Climate change is a global threat to health and wellbeing. Here we provide findings of an international research project investigating the health and wellbeing impacts of policies to reduce greenhouse gas emissions in urban environments.; Five European and two Chinese city authorities and partner academic organisations formed the project consortium. The methodology involved modelling the impact of adopted urban climate-change mitigation transport, buildings and energy policy scenarios, usually for the year 2020 and comparing them with business as usual (BAU) scenarios (where policies had not been adopted). Carbon dioxide emissions, health impacting exposures (air pollution, noise and physical activity), health (cardiovascular, respiratory, cancer and leukaemia) and wellbeing (including noise related wellbeing, overall wellbeing, economic wellbeing and inequalities) were modelled. The scenarios were developed from corresponding known levels in 2010 and pre-existing exposure response functions. Additionally there were literature reviews, three longitudinal observational studies and two cross sectional surveys.; There are four key findings. Firstly introduction of electric cars may confer some small health benefits but it would be unwise for a city to invest in electric vehicles unless their power generation fuel mix generates fewer emissions than petrol and diesel. Second, adopting policies to reduce private car use may have benefits for carbon dioxide reduction and positive health impacts through reduced noise and increased physical activity. Third, the benefits of carbon dioxide reduction from increasing housing efficiency are likely to be minor and co-benefits for health and wellbeing are dependent on good air exchange. Fourthly, although heating dwellings by in-home biomass burning may reduce carbon dioxide emissions, consequences for health and wellbeing were negative with the technology in use in the cities studied.; The climate-change reduction policies reduced CO2 emissions (the most common greenhouse gas) from cities but impact on global emissions of CO2 would be more limited due to some displacement of emissions. The health and wellbeing impacts varied and were often limited reflecting existing relatively high quality of life and environmental standards in most of the participating cities; the greatest potential for future health benefit occurs in less developed or developing countries

Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials

Background: Statin therapy has been shown to reduce major vascular events and vascular mortality in a wide range of individuals, but there is uncertainty about its efficacy and safety among older people. We undertook a meta-analysis of data from all large statin trials to compare the effects of statin therapy at different ages. Methods: In this meta-analysis, randomised trials of statin therapy were eligible if they aimed to recruit at least 1000 participants with a scheduled treatment duration of at least 2 years. We analysed individual participant data from 22 trials (n=134 537) and detailed summary data from one trial (n=12 705) of statin therapy versus control, plus individual participant data from five trials of more intensive versus less intensive statin therapy (n=39 612). We subdivided participants into six age groups (55 years or younger, 56–60 years, 61–65 years, 66–70 years, 71–75 years, and older than 75 years). We estimated effects on major vascular events (ie, major coronary events, strokes, and coronary revascularisations), cause-specific mortality, and cancer incidence as the rate ratio (RR) per 1·0 mmol/L reduction in LDL cholesterol. We compared proportional risk reductions in different age subgroups by use of standard χ2 tests for heterogeneity when there were two groups, or trend when there were more than two groups. Findings: 14 483 (8%) of 186 854 participants in the 28 trials were older than 75 years at randomisation, and the median follow-up duration was 4·9 years. Overall, statin therapy or a more intensive statin regimen produced a 21% (RR 0·79, 95% CI 0·77–0·81) proportional reduction in major vascular events per 1·0 mmol/L reduction in LDL cholesterol. We observed a significant reduction in major vascular events in all age groups. Although proportional reductions in major vascular events diminished slightly with age, this trend was not statistically significant (ptrend=0·06). Overall, statin or more intensive therapy yielded a 24% (RR 0·76, 95% CI 0·73–0·79) proportional reduction in major coronary events per 1·0 mmol/L reduction in LDL cholesterol, and with increasing age, we observed a trend towards smaller proportional risk reductions in major coronary events (ptrend=0·009). We observed a 25% (RR 0·75, 95% CI 0·73–0·78) proportional reduction in the risk of coronary revascularisation procedures with statin therapy or a more intensive statin regimen per 1·0 mmol/L lower LDL cholesterol, which did not differ significantly across age groups (ptrend=0·6). Similarly, the proportional reductions in stroke of any type (RR 0·84, 95% CI 0·80–0·89) did not differ significantly across age groups (ptrend=0·7). After exclusion of four trials which enrolled only patients with heart failure or undergoing renal dialysis (among whom statin therapy has not been shown to be effective), the trend to smaller proportional risk reductions with increasing age persisted for major coronary events (ptrend=0·01), and remained non-significant for major vascular events (ptrend=0·3). The proportional reduction in major vascular events was similar, irrespective of age, among patients with pre-existing vascular disease (ptrend=0·2), but appeared smaller among older than among younger individuals not known to have vascular disease (ptrend=0·05). We found a 12% (RR 0·88, 95% CI 0·85–0·91) proportional reduction in vascular mortality per 1·0 mmol/L reduction in LDL cholesterol, with a trend towards smaller proportional reductions with older age (ptrend=0·004), but this trend did not persist after exclusion of the heart failure or dialysis trials (ptrend=0·2). Statin therapy had no effect at any age on non-vascular mortality, cancer death, or cancer incidence. Interpretation: Statin therapy produces significant reductions in major vascular events irrespective of age, but there is less direct evidence of benefit among patients older than 75 years who do not already have evidence of occlusive vascular disease. This limitation is now being addressed by further trials. Funding: Australian National Health and Medical Research Council, National Institute for Health Research Oxford Biomedical Research Centre, UK Medical Research Council, and British Heart Foundation

American Gut: an Open Platform for Citizen Science Microbiome Research

McDonald D, Hyde E, Debelius JW, et al. American Gut: an Open Platform for Citizen Science Microbiome Research. mSystems. 2018;3(3):e00031-18

OpenSAFELY: Risks of COVID-19 hospital admission and death for people with learning disabilities - a cohort study

AbstractObjectivesTo assess the association between learning disability and risk of hospitalisation and mortality from COVID-19 in England among adults and children.DesignWorking on behalf of NHS England, two cohort studies using patient-level data for &gt;17 million people from primary care electronic health records were linked with death data from the Office for National Statistics and hospitalization data from NHS Secondary Uses Service using the OpenSAFELY platform.SettingGeneral practices in England which use TPP software.ParticipantsParticipants were males and females, aged up to 105 years, from two cohorts: (1) wave 1, registered with a TPP practice as of 1st March 2020 and followed until 31st August, 2020; (2) wave 2 registered 1st September 2020 and followed until 31st December 2020 (for admissions) or 8th February 2021 (for deaths). The main exposure group was people included on a general practice learning disability register (LDR), with a subgroup of people classified as having profound or severe learning disability. We also identified patients with Down syndrome and cerebral palsy (whether or not on the learning disability register).Main outcome measures(i) COVID-19 related death, (ii) COVID-19 related hospitalisation. Non-COVID-19 related death was also explored.ResultsIn wave 1, of 14,301,415 included individuals aged 16 and over, 90,095 (0.63%) were identified as being on the LDR. 30,173 COVID-related hospital admissions, 13,919 COVID-19 related deaths and 69,803 non-COVID deaths occurred; of which 538 (1.8%), 221 (1.6%) and 596 (0.85%) were among individuals on the LDR, respectively. In wave 2, 27,611 COVID-related hospital admissions, 17,933 COVID-19 related deaths and 54,171 non-COVID deaths occurred; of which 383 (1.4%), 260 (1.4%) and 470 (0.87%) were among individuals on the LDR. Wave 1 hazard ratios for individuals on the LDR, adjusted for age, sex, ethnicity and geographical location, were 5.3 (95% confidence interval (CI) 4.9, 5.8) for COVID-19 related hospital admissions and 8.2 (95% CI: 7.1, 9.4) for COVID-19 related death. Wave 2 produced similar estimates. Associations were stronger among those classed as severe-profound and among those in residential care. Down syndrome and cerebral palsy were associated with increased hazard of both events in both waves; Down syndrome to a much greater extent. Hazards of non-COVID-19 related death followed similar patterns with weaker associations.ConclusionsPeople with learning disabilities have markedly increased risks of hospitalisation and mortality from COVID-19. This raised risk is over and above that seen for non-COVID causes of death. Ensuring prompt access to Covid-19 testing and health care and consideration of prioritisation for COVID-19 vaccination and other targeted preventive measures are warranted.</jats:sec

Case fatality risk of the SARS-CoV-2 variant of concern B.1.1.7 in England, 16 November to 5 February.

The SARS-CoV-2 B.1.1.7 variant of concern (VOC) is increasing in prevalence across Europe. Accurate estimation of disease severity associated with this VOC is critical for pandemic planning. We found increased risk of death for VOC compared with non-VOC cases in England (hazard ratio: 1.67; 95% confidence interval: 1.34-2.09; p < 0.0001). Absolute risk of death by 28 days increased with age and comorbidities. This VOC has potential to spread faster with higher mortality than the pandemic to date