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Health systems worldwide are implementing lung cancer screening programmes to identify early-stage lung cancer and maximise patient survival. Volumetry is recommended for follow-up of pulmonary nodules and outperforms other measurement methods. However, volumetry is known to be influenced by multiple factors. The objectives of this systematic review (PROSPERO CRD42022370233) are to summarise the current knowledge regarding factors that influence volumetry tools used in the analysis of pulmonary nodules, assess for significant clinical impact, identify gaps in current knowledge and suggest future research. Five databases (Medline, Scopus, Journals@Ovid, Embase and Emcare) were searched on the 21st of September, 2022, and 137 original research studies were included, explicitly testing the potential impact of influencing factors on the outcome of volumetry tools. The summary of these studies is tabulated, and a narrative review is provided. A subset of studies (n = 16) reporting clinical significance were selected, and their results were combined, if appropriate, using meta-analysis. Factors with clinical significance include the segmentation algorithm, quality of the segmentation, slice thickness, the level of inspiration for solid nodules, and the reconstruction algorithm and kernel in subsolid nodules. Although there is a large body of evidence in this field, it is unclear how to apply the results from these studies in clinical practice as most studies do not test for clinical relevance. The meta-analysis did not improve our understanding due to the small number and heterogeneity of studies testing for clinical significance.Critical relevance statementMany studies have investigated the influencing factors of pulmonary nodule volumetry, but only 11% of these questioned their clinical relevance in their management. The heterogeneity among these studies presents a challenge in consolidating results and clinical application of the evidence.Key points• Factors influencing the volumetry of pulmonary nodules have been extensively investigated.• Just 11% of studies test clinical significance (wrongly diagnosing growth).• Nodule size interacts with most other influencing factors (especially for smaller nodules).• Heterogeneity among studies makes comparison and consolidation of results challenging.• Future research should focus on clinical applicability, screening, and updated technology.

Background The acceptance of coronary CT angiogram (CCTA) scans in the management of stable angina has led to an exponential increase in studies performed and reported incidental findings, including pulmonary nodules (PN). Using low-dose CT scans, volumetry tools are used in growth assessment and risk stratification of PN between 5 and 8 mm in diameter. Volumetry of PN could also benefit from the increased temporal resolution of CCTA scans, potentially expediting clinical decisions when an incidental PN is first detected on a CCTA scan, and allow for better resource management and planning in a Radiology department. This study aims to investigate how cardiopulmonary hemodynamic factors impact the volumetry of PN using CCTA scans. These factors include the cardiac phase, vascular distance from the main pulmonary artery (MPA) to the nodule, difference of the MPA diameter between systole and diastole, nodule location, and cardiomegaly presence. Materials and methods Two readers reviewed all CCTA scans performed from 2016 to 2019 in a tertiary hospital and detected PN measuring between 5 and 8 mm in diameter. Each observer measured each nodule using two different software packages and in systole and diastole. A multiple linear regression model was applied, and inter-observer and inter-software agreement were assessed using intraclass correlation. Results A total of 195 nodules from 107 patients were included in this retrospective, cross-sectional and observational study. The regression model identified the vascular distance (p < 0.001), the difference of the MPA diameter between systole and diastole (p < 0.001), and the location within the lower or posterior thirds of the field of view (p < 0.001 each) as affecting the volume measurement. The cardiac phase was not significant in the model. There was a very high inter-observer agreement but no reasonable inter-software agreement between measurements. Conclusions PN volumetry using CCTA scans seems to be sensitive to cardiopulmonary hemodynamic changes independently of the cardiac phase. These might also be relevant to non-gated scans, such as during PN follow-up. The cardiopulmonary hemodynamic changes are a new limiting factor to PN volumetry. In addition, when a patient experiences an acute or deteriorating cardiopulmonary disease during PN follow-up, these hemodynamic changes could affect the PN growth estimation.

BackgroundRecent recommendations for lung nodule management include volumetric analysis using tools that present intrinsic measurement variability, with possible impacts on clinical decisions and patient safety. This study was conducted to evaluate whether changes in the attenuation of the lung parenchyma adjacent to a nodule affect the performance of nodule segmentation using computed tomography (CT) studies and volumetric tools.MethodsTwo radiologists retrospectively applied two commercially available volumetric tools for the assessment of lung nodules with diameters of 5–8 mm detected by low-dose chest CT during a lung cancer screening program. The radiologists recorded the success and adequacy of nodule segmentation, nodule volume, manually and automatically (or semi-automatically) obtained long- and short-axis measurements, mean attenuation of adjacent lung parenchyma, and presence of interstitial lung abnormalities or disease, emphysema, pleural plaques, and linear atelectasis. Regression analysis was performed to identify predictors of good nodule segmentation using the volumetric tools. Interobserver and intersoftware agreement on good nodule segmentation was assessed using the intraclass correlation coefficient.ResultsIn total, data on 1265 nodules (mean patient age, 68.3 ± 5.1 years; 70.2% male) were included in the study. In the regression model, attenuation of the adjacent lung parenchyma was highly significant (odds ratio 0.987, p < 0.001), with a large effect size. Interobserver and intersoftware agreement on good segmentation was good, although one software package performed better and measurements differed consistently between software packages.ConclusionFor lung nodules with diameters of 5–8 mm, the likelihood of good segmentation declines with increasing attenuation of the adjacent parenchyma.

The media often makes sense of violence in terms of 'randomness' and 'evil'. But the reality, as the contributors to The Meanings of Violence demonstrate, is far more complex. Drawing on the diverse subject matter of the ESRC's Violence Research Programme - from interviews with killers to discussions with children in residential facilities - this volume locates the meaning of violence within social contexts, identities and social divisions. It aims to break open our way of speaking about violence and demonstrate the value in exploring the multiple, contradictory and complex meanings of violence in society. The wide range of topics include: *Prostitute and client violence *Violence amongst young people at school and on the streets *Violence in bars and nightclubs *Violence in prison *Racist and homophobic violence This book will be fascinating reading for students of criminology and academics working in the field of violent crime.

1. Human disturbance has been associated with declines in breeding success in numerous species and is of general concern to conservationists. However, the current framework for predicting and minimizing disturbance effects is weak and there is considerable uncertainty about why animals are disturbed by people in the first place. 2. We developed a behavioural model of perceived predation risk as a framework for understanding the effects of disturbance on cliff-nesting birds. This encompassed the concept that the effects of disturbance should increase with increasing numbers of visitors, and decrease with distance from the nest, an insight ignored in current conservation practice. 3. The predictions of this model were tested using field data on nesting success in two species of seabird, kittiwake Rissa tridactyla and guillemot Uria aalge. Statistical models of nesting success in both species suggested that perceived predation risk is a good predictor of the effects of disturbance. 4. Synthesis and applications. Our findings suggest that fixed set-back distances and buffer zones are likely to be inappropriate conservation measures in situations where the numbers of visitors to wildlife areas fluctuates spatially and temporally, as is generally the case. In managing access to wildlife areas there is a need to ensure that larger parties of visitors are kept further away from the nesting areas of vulnerable species or that set-back distances are determined for the largest party likely to visit the site.

Wastewater-based epidemiology (WBE) has emerged as an effective environmental surveillance tool for predicting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease outbreaks in high-income countries (HICs) with centralized sewage infrastructure. However, few studies have applied WBE alongside epidemic disease modelling to estimate the prevalence of SARS-CoV-2 in low-resource settings. This study aimed to explore the feasibility of collecting untreated wastewater samples from rural and urban catchment areas of Nagpur district, to detect and quantify SARS-CoV-2 using real-time qPCR, to compare geographic differences in viral loads, and to integrate the wastewater data into a modified Susceptible-Exposed-Infectious-Confirmed Positives-Recovered (SEIPR) model. Of the 983 wastewater samples analyzed for SARS-CoV-2 RNA, we detected significantly higher sample positivity rates, 43.7% (95% confidence interval (CI) 40.1, 47.4) and 30.4% (95% CI 24.66, 36.66), and higher viral loads for the urban compared with rural samples, respectively. The Basic reproductive number, R 0 , positively correlated with population density and negatively correlated with humidity, a proxy for rainfall and dilution of waste in the sewers. The SEIPR model estimated the rate of unreported coronavirus disease 2019 (COVID-19) cases at the start of the wave as 13.97 [95% CI (10.17, 17.0)] times that of confirmed cases, representing a material difference in cases and healthcare resource burden. Wastewater surveillance might prove to be a more reliable way to prepare for surges in COVID-19 cases during future waves for authorities.

There is a wealth of evidence for a lifespan penalty when environmental conditions influence an individual's growth trajectory, such that growth rate is accelerated to attain a target size within a limited time period. Given this empirically demonstrated relationship between accelerated growth and lifespan, and the links between lifespan and telomere dynamics, increased telomere loss could underpin this growth–lifespan trade. We experimentally modified the growth trajectory of nestling zebra finches ( Taeniopygia guttata ), inducing a group of nestlings to accelerate their growth between 7 and 15 days of age, the main phase of body growth. We then sequentially measured their telomere length in red blood cells at various time points from 7 days to full adulthood (120 days). Accelerated growth between 7 and 15 days was not associated with a detectable increase in telomere shortening during this period compared with controls. However, only in the treatment group induced to show growth acceleration was the rate of growth during the experimental period positively related to the amount of telomere shortening between 15 and 120 days. Our findings provide evidence of a long-term influence of growth rate on later-life telomere shortening, but only when individuals have accelerated growth in response to environmental circumstances.

Renewable biomass plays a crucial role in transitioning toward climate-friendly heating sources; however, not without its collateral damage in terms of the disproportionately high effects on local air quality. The associated proliferation of residential heating appliances around the world, including developed regions like Europe, where an estimated 70 million are housed, does not appear to be abating. Here, we identify super self-concentrating ambient pollution events whereby solid-fuel residential heating haze is infused with a hitherto unaccounted for firelighter smoke that contributes additional adsorbing black carbon. This black carbon-organic aerosol combination results in a strong positive radiative forcing (up to 149 W m −2 ) and alters the boundary layer thermodynamics sufficiently so as to further suppress pollutant dilution and dispersion leading to extraordinary high submicron particulate matter (PM 1 : 166 µg m −3 ). Unfortunately, there is no silver lining in this cloud until the promotion of solid biomass fires with firelighters for ignition is replaced by a co-benefit policy.

There is a wealth of evidence for a lifespan penalty when environmental conditions influence an individual’s growth trajectory, such that growth rate is accelerated to attain a target size within a limited time period. Given this empirically demonstrated relationship between accelerated growth and lifespan, and the links between lifespan and telomere dynamics, increased telomere loss could underpin this growth–lifespan trade. We experimentally modified the growth trajectory of nestling zebra finches (Taeniopygia guttata), inducing a group of nestlings to accelerate their growth between 7 and 15 days of age, the main phase of body growth. We then sequentially measured their telomere length in red blood cells at various time points from 7 days to full adulthood (120 days). Accelerated growth between 7 and 15 days was not associated with a detectable increase in telomere shortening during this period compared with controls. However, only in the treatment group induced to show growth acceleration was the rate of growth during the experimental period positively related to the amount of telomere shortening between 15 and 120 days. Our findings provide evidence of a long-term influence of growth rate on later-life telomere shortening, but only when individuals have accelerated growth in response to environmental circumstances.

Innate and adaptive immune cells modulate the severity of autosomal dominant polycystic kidney disease (ADPKD), a common kidney disease with inadequate treatment options. ADPKD has parallels with cancer, in which immune checkpoint inhibitors have been shown to reactivate CD8+ T cells and slow tumor growth. We have previously shown that in PKD, CD8+ T cell loss worsens disease. This study used orthologous early-onset and adult-onset ADPKD models (Pkd1 p.R3277C) to evaluate the role of immune checkpoints in PKD. Flow cytometry of kidney cells showed increased levels of programmed cell death protein 1 (PD-1)/cytotoxic T lymphocyte associated protein 4 (CTLA-4) on T cells and programmed cell death ligand 1 (PD-L1)/CD80 on macrophages and epithelial cells in Pkd1RC/RC mice versus WT, paralleling disease severity. PD-L1/CD80 was also upregulated in ADPKD human cells and patient kidney tissue versus controls. Genetic PD-L1 loss or treatment with an anti-PD-1 antibody did not impact PKD severity in early-onset or adult-onset ADPKD models. However, treatment with anti-PD-1 plus anti-CTLA-4, blocking 2 immune checkpoints, improved PKD outcomes in adult-onset ADPKD mice; neither monotherapy altered PKD severity. Combination therapy resulted in increased kidney CD8+ T cell numbers/activation and decreased kidney regulatory T cell numbers correlative with PKD severity. Together, our data suggest that immune checkpoint activation is an important feature of and potential novel therapeutic target in ADPKD.