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"Wells, Christopher"
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Following Grandfather
Jennie is as close to her grandfather as a mouse can be, and when he suddenly dies she keeps thinking she sees him turning a corner, sitting on a bench, heading for the pier, or walking along their beloved beach, seeking the elusive Queen's teacup seashell.
Book
COVID-19 Reducing the Risks: Telemedicine is the New Norm for Surgical Consultations and Communications
IntroductionCOVID-19, a worldwide pandemic, has enforced a national lockdown in the UK which produced a paradigm shift about the way medical practitioners would perform consultations and communication with their patients. Senior authors realised that in lockdown there was only one option to see a patient: virtual consultation via telecommunication technologies. This paper will discuss the current benefits and considerations of Telemedicine, particularly in plastic surgery, to decipher the next route of action to further validate its use for future implementation.MethodA detailed literature review was carried out comparing papers from 1992 to 2020. A survey of 122 consultant plastic surgeons found an encouraging result as 70% positively embraced the suggestion of Telemedicine in their current practice.DiscussionTelemedicine produced equal or improved patient satisfaction. Its utilisation reduced cost for patient, clinic and consultant. With accessibility to a large percentage of the population, Telemedicine enables infection control and adherence to social distancing during COVID-19. Considerations include dependability on internet access, legal aspects, cyber security and General Data Protection Regulation (GDPR), the inability to perform palpation or physical inspection and psychological impacts on the patient.ConclusionIn modern times, Telemedicine has become more accessible and COVID-19 has made it more applicable than ever before. More in-depth research is needed for validation of this technique within plastic surgery. While maintaining quality of care and a vital role in social distancing, there is a strong need for standardisation of Telemedicine processes, platforms, encryption and data storage.Level of Evidence VThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Journal Article
Looking for Friends, Fans, and Followers? Social Media Use in Public and Nonprofit Human Services
This article uses interviews and Internet data to examine social media use among nonprofit organizations and county departments involved in the delivery of human services in a six-county area in south-central New York State. Social media use was modest, with nonprofit organizations much more likely to use it than county departments. Organizations used social media primarily to market organizational activities, remain relevant to key constituencies, and raise community awareness. Most organizations either had a narrow view of social media's potential value or lacked a long-term vision. Barriers to use included institutional policies, concerns about the inappropriateness of social media for target audiences, and client confidentiality. Findings build on recent research regarding the extent to which nonprofit organizations and local governments use social media to engage stakeholders. Future research should investigate not only the different ways organizations use social media but also whether organizations use it strategically to advance organizational goals.
Journal Article
Urban allies : ten brand-new collaborative stories
These collaborative stories unite two beloved characters from two different urban fantasy series in each of ten electrifying new stories.
Book
Local and remote climate impacts of future African aerosol emissions
The potential future trend in African aerosol emissions is uncertain, with a large range found in future scenarios used to drive climate projections. The future climate impact of these emissions is therefore uncertain. Using the Shared Socioeconomic Pathway (SSP) scenarios, transient future experiments were performed with the UK Earth System Model (UKESM1) to investigate the effect of African emissions following the high emission SSP370 scenario as the rest of the world follows the more sustainable SSP119, relative to a global SSP119 control. This isolates the effect of Africa following a relatively more polluted future emissions pathway. Compared to SSP119, SSP370 projects higher non-biomass-burning (non-BB) aerosol emissions, but lower biomass burning emissions, over Africa. Increased shortwave (SW) absorption by black carbon aerosol leads to a global warming, but the reduction in the local incident surface radiation close to the emissions is larger, causing a local cooling effect. The local cooling persists even when including the higher African CO2 emissions under SSP370 than SSP119. The global warming is significantly higher by 0.07 K when including the non-BB aerosol increases and higher still (0.22 K) when including all aerosols and CO2. Precipitation also exhibits complex changes. Northward shifts in the Inter-tropical Convergence Zone (ITCZ) occur under relatively warm Northern Hemisphere land, and local rainfall is enhanced due to mid-tropospheric instability from black carbon absorption. These results highlight the importance of future African aerosol emissions for regional and global climate and the spatial complexity of this climate influence.
Journal Article
Significant human health co-benefits of mitigating African emissions
Future African aerosol emissions, and therefore air pollution levels and health outcomes, are uncertain and understudied. Understanding the future health impacts of pollutant emissions from this region is crucial. Here, this research gap is addressed by studying the range in the future health impacts of aerosol emissions from Africa in the Shared Socioeconomic Pathway (SSP) scenarios, using the UK Earth System Model version 1 (UKESM1), along with human health concentration–response functions. The effects of Africa following a high-pollution aerosol pathway are studied relative to a low-pollution control, with experiments varying aerosol emissions from industry and biomass burning. Using present-day demographics, annual deaths within Africa attributable to ambient particulate matter are estimated to be lower by 150 000 (5th–95th confidence interval of 67 000–234 000) under stronger African aerosol mitigation by 2090, while those attributable to O3 are lower by 15 000 (5th–95th confidence interval of 9000–21 000). The particulate matter health benefits are realised predominantly within Africa, with the O3-driven benefits being more widespread – though still concentrated in Africa – due to the longer atmospheric lifetime of O3. These results demonstrate the important health co-benefits from future emission mitigation in Africa.
Journal Article
RVX-208, an inhibitor of BET transcriptional regulators with selectivity for the second bromodomain
Bromodomains have emerged as attractive candidates for the development of inhibitors targeting gene transcription. Inhibitors of the bromo and extraterminal (BET) family recently showed promising activity in diverse disease models. However, the pleiotropic nature of BET proteins regulating tissue-specific transcription has raised safety concerns and suggested that attempts should be made for domain-specific targeting. Here, we report that RVX-208, a compound currently in phase II clinical trials, is a BET bromodomain inhibitor specific for second bromodomains (BD2s). Cocrystal structures revealed binding modes of RVX-208 and its synthetic precursor, and fluorescent recovery after photobleaching demonstrated that RVX-208 displaces BET proteins from chromatin. However, gene-expression data showed that BD2 inhibition only modestly affects BET-dependent gene transcription. Our data demonstrate the feasibility of specific targeting within the BET family resulting in different transcriptional outcomes and highlight the importance of BD1 in transcriptional regulation.
Journal Article
Prophylactic Procurement of University Students in Southern Ethiopia: Stigma and the Value of Condom Machines on Campus
Risky sexual behavior among Ethiopian university students, especially females, is a major contributor to young adult morbidity and mortality. Ambaw et al. found that female university students in Ethiopia may fear the humiliation associated with procuring condoms. A study in Thailand suggests condom machines may provide comfortable condom procurement, but the relevance to a high-risk African context is unknown. The objective of this study was to examine if the installation of condom machines in Ethiopia predicts changes in student condom uptake and use, as well as changes in procurement related stigma.
Students at a large urban university in Southern Ethiopia completed self reported surveys in 2010 (N = 2,155 surveys) and again in 2011 (N = 2,000), six months after the installation of condom machines. Mann-Whitney and Chi-square tests were conducted to evaluate significant changes in student sexual behavior, as well as condom procurement and associated stigma over the subsequent one year period.
After installing condom machines, the average number of trips made to procure condoms on-campus significantly increased 101% for sexually active females and significantly decreased 36% for sexually active males. Additionally, reports of condom use during last sexual intercourse showed a non-significant 4.3% increase for females and a significant 9.0% increase for males. During this time, comfort procuring condoms and ability to convince sexual partners to use condoms were significantly higher for sexually active male students. There was no evidence that the condom machines led to an increase in promiscuity.
The results suggest that condom machines may be associated with more condom procurement among vulnerable female students in Ethiopia and could be an important component of a comprehensive university health policy.
Journal Article
Invasive seaweeds transform habitat structure and increase biodiversity of associated species
1. The visual landscape of marine and terrestrial systems is changing as a result of anthropogenic factors. Often these shifts involve introduced species that are morphologically dissimilar to native species, creating a unique biogenic structure and habitat for associated species within the landscape. While community-level changes as a result of introduced species have been documented in both terrestrial and marine systems, it is still unclear how long-term shifts in species composition will affect habitat complexity or its potential to influence the biodiversity of species that occur at the base of the food web. 2. We analysed quadrat photos collected at several subtidal sites in the Gulf of Maine over a 30+ year period, and collected individual seaweed species to determine their complexity and the biodiversity of meso-invertebrates associated with each species. 3. By coupling the relationship of 30+ years of shifts in seaweed assemblages, morphological structure of the seaweed assemblage, and their meso-invertebrates, we determined introduced seaweeds have increased by up to 90%, corresponding to a rise in two-dimensional (2D) structure, and a decline in canopy height of subtidal rocky habitats. The highly complex two-dimensional habitat provided by introduced filamentous red seaweeds supports two to three times more meso-invertebrate individuals and species that form the base of the food web than simpler forms of morphological habitat. 4. Synthesis. The present study demonstrates a long-term shift in foundation species towards a dominance of invasive seaweeds that directly reduce canopy height and increase the 2D biogenic structure of the habitat. These introduced seaweeds harbour greater biodiversity of species found at the base of the food web than seaweeds with simpler forms such as the native kelp species. Such shifts in habitat structure will propagate to food webs by influencing the structure of lower trophic-level meso-invertebrates and indirectly upper trophic-level species that feed on these invertebrates and use the seaweed structure as refuge.
Journal Article