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The association between fatty acids and prostate cancer remains poorly explored in African-descent populations. Here, we analyze 24 circulating fatty acids in 2934 men, including 1431 prostate cancer cases and 1503 population controls from Ghana and the United States, using CLIA-certified mass spectrometry-based assays. We investigate their associations with population groups (Ghanaian, African American, European American men), lifestyle factors, the fatty acid desaturase ( FADS ) genetic locus, and prostate cancer. Blood levels of circulating fatty acids vary significantly between the three population groups, particularly trans , omega-3 and omega-6 fatty acids. FADS1/2 germline genetic variants and lifestyle factors explain some of the variation in fatty acid levels, with the FADS1/2 locus showing population-specific associations, suggesting differences in their control by germline genetic factors. All trans fatty acids, namely elaidic, palmitelaidic, and linoelaidic acids, associated with an increase in the odds of developing prostate cancer, independent of ancestry, geographic location, or potential confounders. Analyses of the association between fatty acids and prostate cancer have often neglected African patients. Here, the authors analyse 24 circulating fatty acids in Ghanaian, African American, and European American men, and explore the associations with socio-demographic factors, diet, FADS1/2 locus, and prostate cancer.

The United Kingdom’s (UK) clean energy shift to ensure low-carbon and affordable energy supply is regulated by the Energy Act 2013 and the electricity market reform programme. To further this energy shift and to reduce the UK’s dependence on natural gas as an energy source, the (UK) launched its Hydrogen Strategy on 17 August 2021. The rationale for the Strategy is that hydrogen gas is a clean and efficient source of fuel, there is an abundance of hydrogen and that changing from natural gas to hydrogen gas will reduce greenhouse gas emissions. The question raised is whether the Government’s objective of the use of Hydrogen to replace natural gas is an effective strategy to reduce greenhouse emissions caused by heating. The scope of this paper does not include an examination of the role of the oil industry as an energy source. This paper will firstly explain how the UK came to be dependent on the use of natural gas by briefly outlining the history of its development as a form of energy in the UK. It will then focus on considering the advantages and disadvantages of the use of natural gas and of alternatives in the UK for heating. It will assess the efficacy of hydrogen as an alternative to the use of natural gas in the UK for providing energy for heating in terms of reducing its carbon footprint and therefore protecting the environment and the economy.

There is evidence that tumor immunobiology and immunotherapy response may differ between African American and European American prostate cancer patients. Here, we determine if men of African descent harbor a unique systemic immune-oncological signature and measure 82 circulating proteins in almost 3000 Ghanaian, African American, and European American men. Protein signatures for suppression of tumor immunity and chemotaxis are elevated in men of West African ancestry. Importantly, the suppression of tumor immunity protein signature associates with metastatic and lethal prostate cancer, pointing to clinical importance. Moreover, two markers, pleiotrophin and TNFRSF9, predict poor disease survival specifically among African American men. These findings indicate that immune-oncology marker profiles differ between men of African and European descent. These differences may contribute to the disproportionate burden of lethal prostate cancer in men of African ancestry. The elevated peripheral suppression of tumor immunity may have important implication for guidance of cancer therapy which could particularly benefit African American patients. Ancestry-related differences in immunobiology may explain the health disparities observed in prostate cancer patients, with men of African origin bearing the highest prostate cancer burden. By measuring immune-related proteins in serum samples, here the authors report that systemic cytokines linked to suppression of tumor immunity are upregulated in men of African ancestry and associated with reduced survival.

Purpose - The paper will aim to examine the contemporary origins and development of the planning system and housing regulation in England and Ireland. One objective is to broadly explicate how the regulation of housing in England began, with reference to Ireland, and its relationship with the planning system. The other is to outline the swing in England from a hotchpotch decentralised system to a centralised, and back again sharply to decentralised approach to planning and the provision for housing, a swing unparalleled in Ireland.Design methodology approach - The approach is to consider the main influences on the regulation of planning and housing, with reference to historical, social and legal regulatory developments, and to broadly assess the role of centralised and decentralised systems.Findings - The regulation of housing was an incidental product of the regulation of public health. The use of town and country planning principles could have assisted such regulation, but were unpopular until the development of a centralised system of planning in the 20th century. This has led to problems in Ireland for the delivery of local services. The change in England under the Localism Act to decentralized system is unlikely to achieve an effective use of local resources. It is unlikely that unwieldy new systems of decision-making and funding arrangements will improve the provision of housing for low incomes and the poor. A balance between the use of both systems is required.Originality value - This paper assesses the impact of social, historical, administrative and legal changes that have impacted on the progress of the relationship between planning and housing regulation in England and Ireland over the last two centuries until the present day.

The European Union’s revised Waste Framework Directive 2008/98/EC gives priority to waste prevention in its hierarchy of waste management measures. This paper argues that, to this end, the importance of costing and sustaining the natural resources used to demolish and/or produce any kind of infrastructure concerning the architectural, engineering and construction industries, should be factored into Environmental Impact Assessments (EIA), as part of a government’s waste management strategy. In other words, this should be a preliminary aspect of the implementation of a waste management strategy. However, ideally, to fully implement a preventative waste management strategy, the range of projects for which EIA’s are required should not be restricted, but should be extended to any building site. This paper further suggests that EIA’s should be tailored to ensure the sustainability of our natural, used and renewable resources as far as possible. This would assist furthering the goals of the United Nations 2030 Agenda for Sustainable Development. However, to be effective, this approach requires the incorporation of a mandatory protocol involving a process similar to Natural Capital Accounting (NCA) into all associated contracts, standard or bespoke. The scope of this paper will therefore outline what NCA is, and then why it is relevant, considering how it may be used to contribute to a more sustainable EIA for the prevention of waste. It will then briefly consider the role of industry and government before concluding that its implementation should assist the reduction of overall waste of environmental and related resources arising from the said industries. This paper has used a qualitative method based on grounded theory. It involves an exploratory method initially using an inductive approach to generate data, and from this collection of data, key questions are generated to deduce results. The analysis examines, compares and contrasts relevant literature concerning what is NCA as well as how it may be implemented. Research conducted by academics from a range of disciplines, environmental, business, engineering and construction academics, organisations and case studies has been drawn on to consider the transferability of NCA methods to the management of sustainable infrastructure.

Urinary PGE-M is a stable metabolite of prostaglandin E2 (PGE2). PGE2 is a product of the inflammatory COX signaling pathway and has been associated with cancer incidence and metastasis. Its synthesis can be inhibited by aspirin. We investigated the association of PGE-M with lethal prostate cancer in a case–control study of African American (AA) and European American men. We measured urinary PGE-M using mass-spectrometry. Samples were obtained from 977 cases and 1022 controls at the time of recruitment. We applied multivariable logistic and Cox regression modeling to examine associations of PGE-M with prostate cancer and participant survival. Median survival follow-up was 8.4 years, with 246 deaths among cases. Self-reported aspirin use over the past 5 years was assessed with a questionnaire. Race/ethnicity was self-reported. Urinary PGE-M levels did not differ between men with prostate cancer and population-based controls. We observed no association between PGE-M and aggressive disease nor prostate-cancer-specific survival. However, we observed a statistically significant association between higher (>median) PGE-M and all-cause mortality in AA cases who did not regularly use aspirin (HR = 2.04, 95% CI 1.23–3.37). Among cases who reported using aspirin, there was no association. Our study does not support a meaningful association between urinary PGE-M and prostate cancer. Moreover, PGE-M levels were not associated with aggressive prostate cancer. However, the observed association between elevated PGE-M and all-cause mortality in AA non-aspirin users reinforces the potential benefit of aspirin to reduce mortality among AA men with prostate cancer.

Background The International Agency for Research on Cancer classified radon and its decay-products as Group-1-human-carcinogens, and with the current knowledge they are linked specifically to lung cancer. Biokinetic models predict that radon could deliver a carcinogenic dose to breast tissue. Our previous work suggested that low-dose radon was associated with estrogen-receptor (ER)-negative breast cancer risk. However, there is limited research to examine the role of radon in breast cancer biology at the tissue level. We aim to understand molecular pathways linking radon exposure with breast cancer biology using transcriptome-wide-gene-expression from breast tumor and normal-adjacent tissues. Methods Our study included 943 women diagnosed with breast cancer from the Nurses’ Health Study (NHS) and NHSII. We estimated cumulative radon concentration for each participant up-to the year of breast cancer diagnosis by linking residential addresses with a radon exposure model. Transcriptome-wide-gene-expression was measured with the Affymetrix-Glue-Human-Transcriptome-Array-3.0 and Human-Transcriptome-Array-2.0. We performed covariate-adjusted linear-regression for individual genes and further employed pathway-analysis. All analyses were conducted separately for tumor and normal-adjacent samples and by ER-status. Results No individual gene was associated with cumulative radon exposure in ER-positive tumor, ER-negative tumor, or ER-negative normal-adjacent tissues at FDR < 5%. In ER-positive normal-adjacent samples, PLCH 2—reached transcriptome-wide-significance (FDR < 5%). Gene-set-enrichment-analyses identified 2-upregulated pathways (MAPK signaling and phosphocholine biosynthesis) enriched at FDR < 25% in ER-negative tumors and normal-adjacent tissues, and both pathways have been previously reported to play key roles in ionizing radiation induced tumorigenesis in experimental settings. Conclusion Our findings provide insights into the molecular pathways of radon exposure that may influence breast cancer etiology.

AE&TV welcomes letters. They should be concise, typed and are subject to condensation. They must include a valid mailing address AND telephone number. Pseudonyms and initials will not be used. Unpublished letters cannot be acknowledged. E-mail John Dolen at jdolen@sun-sentinel.com, or write to: Arts & Letters, Entertainment Department, Sun-Sentinel, 200 E. Las Olas Blvd., Fort Lauderdale, FL 33301-2293.

Background overview and rationale We co-developed a multi-component virtual care solution (TtLIVE) for the home mechanical ventilation (HMV) population using the aTouchAway™ platform (Aetonix). The TtLIVE intervention includes (1) virtual home visits; (2) customizable care plans; (3) clinical workflows that incorporate reminders, completion of symptom profiles, and tele-monitoring; and (4) digitally secure communication via messaging, audio, and video calls; (5) Resource library including print and audiovisual material. Objectives and brief methods Our primary objective is to evaluate the TtLIVE intervention compared to a usual care control group using an eight-center, pragmatic, parallel-group single-blind (outcome assessors) randomized controlled trial. Eligible patients are children and adults newly transitioning to HMV in Ontario, Canada. Our target sample size is 440 participants (220 each arm). Our co-primary outcomes are a number of emergency department (ED) visits in the 12 months after randomization and change in family caregiver (FC) reported Pearlin Mastery Scale score from baseline to 12 months. Secondary outcomes also measured in the 12 months post randomization include healthcare utilization measured using a hybrid Ambulatory Home Care Record (AHCR-hybrid), FC burden using the Zarit Burden Interview, and health-related quality of life using the EQ-5D. In addition, we will conduct a cost-utility analysis over a 1-year time horizon and measure process outcomes including healthcare provider time using the Care Coordination Measurement Tool. We will use qualitative interviews in a subset of study participants to understand acceptability, barriers, and facilitators to the TtLIVE intervention. We will administer the Family Experiences with Care Coordination (FECC) to interview participants. We will use Poisson regression for a number of ED visits at 12 months. We will use linear regression for the Pearlin Mastery scale score at 12 months. We will adjust for the baseline score to estimate the effect of the intervention on the primary outcomes. Analysis of secondary outcomes will employ regression, causal, and linear mixed modeling. Primary analysis will follow intention-to-treat principles. We have Research Ethics Board approval from SickKids, Children’s Hospital Eastern Ontario, McMaster Children’s Hospital, Children’s Hospital-London Health Sciences, Sunnybrook Hospital, London Health Sciences, West Park Healthcare Centre, and Ottawa Hospital. Discussion This pragmatic randomized controlled single-blind trial will determine the effectiveness and cost-effectiveness of the TtLIVE virtual care solution compared to usual care while providing important data on patient and family experience, as well as process measures such as healthcare provider time to deliver the intervention. Trial registration ClinicalTrials.gov NCT04180722 . Registered on November 27, 2019.

Background: Older adults commonly call 911 because of a ground-level fall and many of these patients are not transported to hospital. Paramedic fall referral to community-based fall prevention teams can mitigate adverse events for those not transported. Our objective was to describe the paramedic referral rate and barriers to the referral process in a provincial emergency medical services (EMS) system. This study is supported by the Trauma Association of Canada Lerners Grant awarded in March 2020. Methods: We will use mixed methods including a retrospective analysis of patients with a ground-level fall and nontransport outcome, and interviews with paramedics. All patients with a fall-related complaint or paramedic-identified fall risk, with nontransport disposition and referral between Feb. 1, 2014, and Feb. 1, 2020, will be included. We will conduct a semistructured interview with paramedics to understand barriers to offering referral. Results: In Nova Scotia, patients who present to paramedics with a fall-related complaint and nontransport disposition can be referred to a fall prevention program in some parts of the province. Previous studies suggest 50% of patients who have fallen will have a relapse call (another 911 call) within 30 days. Paramedic fall referral programs may mitigate this risk. In this study, we will describe the implementation of the program and barriers to referral to develop recommendations to optimize its use. We will determine whether a fall referral leads to a reduction in fall-related EMS use within 12 months of the original call and evaluate factors that may impede fall referral by comparing the characteristics of those offered referral with the characteristics of those who were not. Conclusion: Canadas population is aging. This means that aging-related complaints will become more common. Paramedics can play a proactive role in identifying and referring older adults at risk for age-related health care problems such as falls. Identifying a patient at risk for a fall earlier and intervening may prevent future injurious falls.