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A recent study shows that chemokine receptor 1 (CCR1) plays a role in eosinophilic inflammation and that its ligand CCL15 is increased in asthmatic eosinophils (Du et al.). A companion study reports that N-truncated forms of CCL15 generated by tissue proteases induce biased CCR1 signaling (Shao et al.). These insights may provide the basis for the generation of more effective CCR antagonists as an oral therapy for asthma.

Candidates for liver transplantation (LT) with hepatocellular carcinoma (HCC) undergo a large number of diagnostic and interventional radiology procedures. A significant proportion of such procedures involve ionizing radiation with increased lifetime risk of cancer. The objective of our study was to review LT candidates with HCC to quantify ionizing radiation doses from different radiology procedures performed at a single transplant center.We retrospectively reviewed 179 adult patients with HCC (median age 58.6 years [IQR, 55-62]; 155 [86.6%] males) who were accepted for LT between April 2010 and Dec 2018. Radiology procedures and radiation doses were retrieved and the total and median radiation effective dose in millisieverts (mSv) were calculated for different procedures. Exposure to ionizing radiation was categorized based on previously reported thresholds.We assessed 9,986 radiology procedures for our cohort. Patients had a median effective dose prior to transplantation of 254 mSv (IQR, 130-421) with an annualized rate of 152 mSv (IQR, 92-266). Patient median dose increased to 316 mSv (IQR, 159-478) when including exposures post-LT within the study period. 85% of overall exposure was in the extremely high exposure category (100 mSv). Interventional procedures represented 13% of procedures with substantial radiation and contributed to 45% of radiation exposure while abdominal CTs represented 39% of total procedures and contributed to 45% of radiation exposure.Patients with HCC considered for LT undergo radiology procedures with significant cumulative radiation exposure. Attempts to reduce radiation exposure are suggested by minimizing unnecessary procedures and utilizing ones without ionizing radiation. Improving interventional techniques to reduce radiation doses is needed without compromising treatment delivery.

Background: There are conflicting findings regarding the impact of residential mobility on immunisationstatus. Our aim was to determine whether there was any association between residential mobility andtake up of immunisations and whether they were delayed in administration.\ud \ud Methods: We carried out a cohort analysis of children born in Wales, UK. Uptake and time of immunisationwere collected electronically. We defined frequent movers as those who had moved: 2 or more times inthe period prior to the final scheduled on-time date (4 months) for 5 in 1 vaccinations; and 3 or moretimes in the period prior to the final scheduled on-time date (12 months) for MMR, pneumococcal andmeningitis C vaccinations. We defined immunisations due at 2–4 months delayed if they had not beengiven by age 1; and those due at 12–13 months as delayed if they had not been given by age 2.\ud \ud Results: Uptake rates of routine immunisations and whether they were given within the specified time-frame were high for both groups. There was no increased risk (odds ratios (95% confidence intervals)between frequent movers compared to non-movers for the uptake of: primary MMR 1.08 (0.88–1.32);booster Meningitis C 1.65 (0.93–2.92); booster pneumococcal 1.60 (0.59–4.31); primary 5 in 1 1.28(0.92–1.78); and timeliness: primary MMR 0.92 (0.79–1.07); booster Meningitis C 1.26 (0.77–2.07);booster pneumococcal 1.69 (0.23–12.14); and primary 5 in 1 1.04 (0.88–1.23).\ud \ud Discussion: Findings suggest that children who move home frequently are not adversely affected in termsof the uptake of immunisations and whether they were given within a specified timeframe. Both werehigh and may reflect proactive behaviour in the primary healthcare setting to meet Government coveragerates for immunisation.

Robust Generalised Cross-Validation was proposed recently as a method for determining near optimal regularisation parameters in inverse problems. It was introduced to overcome a problem with the regular Generalised Cross-Validation method in which the function that is minimised to obtain the regularisation parameter often has a broad, flat minimum, resulting in a poor estimate for the parameter. The robust method defines a new function to be minimised which has a narrower minimum, but at the expense of introducing a new parameter called the robustness parameter.In this study, the Robust Generalised Cross-Validation method is applied to the inverse problem of electrocardiology. It is demonstrated that, for realistic situations, the robustness parameter can be set to zero. With this choice of robustness parameter, it is shown that the robust method is able to obtain estimates of the regularisation parameter in the inverse problem of electrocardiology that are comparable to, or better than, many of the standard methods that are applied to this inverse problem. HighlightsRobust Generalised Cross-Validation (RGCV) is introduced to ECG Imaging.RGCV is compared to more common methods for two heart beat scenarios.Zero order Tikhonov regularisation is the basis for the comparison.Various levels of white noise and geometric noise are considered.RGCV produces accurate and consistent epicardial potential distributions.

Less Favoured Areas (LFA) were designated to support farming activity on land with limited productive potential. However, progressive land abandonment in these areas questions the rationale and targeting of support payments to maintain viable farming enterprises. Using micro level data on farm businesses over the period 2003-2016 matched to land capability and spatial data we identify the distribution of viable and vulnerable enterprises in Less Favoured Areas. We find five categories of household based on progressive quality of life thresholds, namely i. vulnerable, ii. sustainable, iii. viable, iv. resilient, and v. robust. A proportional odds model measured the effect of biophysical and remote disadvantage on predicting these states of viability, along with farm family lifecycle factors. Whilst we would expect higher proportions of disadvantaged farmland to be negatively related to viability, when combined with rural remoteness this increases the magnitude of the effect. However, clear succession planning and tenancy arrangements suggest that approaches to management of the business and the farm family life-cycle may overcome some of these disadvantages. These results have to be considered against the UK’s planned withdrawal from the Common Agricultural Policy. This offers opportunities to provide a more nuanced approach to targeting and supporting disadvantaged regions beyond current criteria. However, there would seem to be dissonance between the proposed payment for public goods agenda, which is results orientated, and support for correcting natural disadvantages where opportunities for delivery of these public goods will be limited.

This study contributes to the household food waste literature by helping us to understand the personal and social factors that influence our use of expiry-date labels on dairy products. It uses an extended theory of planned behaviour (TPB) model with the additional variables of habit and food waste attitudes as well as two upstream expiry-date behaviours, checking date labels in shops and checking date labels in the fridge. Data was collected from consumers in a two-stage survey. Results indicate that both intentions and habit had a relatively strong influence on behaviour, as did the upstream expiry-date behaviours of checking date labels in shops and checking date labels in the fridge. Attitudes, food waste attitudes, and social norms were all found to be associated with intentions whereas perceived behavioural control (PBC) was not found to be associated with either intentions of behaviour. These findings have implications for our understanding of behaviours associated with food waste and therefore for food waste reduction policy and communication efforts.

Despite being commonly used, the term failure to thrive (FTT) has no consistent definition. In its broadest sense, FTT refers to poor growth in infants and young children. Although FTT defies attempts at a strict definition and its effect on future growth and development remains unclear, the assessment of growth remains a central part of routine clinical practice and health professionals are frequently required to assess a child who is thought to be growing poorly. This review describes the comprehensive and multidisciplinary clinical assessment that is required to identify specific underlying causes including illnesses and adverse social and other environmental factors. Most children with suspected FTT will be normal children who are constitutionally small or have slow growth and only reassurance is required. For those with underlying causes, careful clinical assessment informs appropriate management, which usually requires multidisciplinary input.

Background The 2006 Cooksey review of UK health research identified the NHS cradle-to-grave records of the 60 million UK residents as having the greatest potential to reinvigorate the UK research environment. Subsequently, national and regional e-health research units were set up across the UK, including in Wales, the Secure Anonymised Information Linkage (SAIL) system. We aim to draw attention to the uses, findings, and research potential of the SAIL system. Methods The SAIL system is a suite of privacy-protecting technologies, including multistage encryption in which unique anonymised numbers replace individual, household, and organisational identities (appendix). There is strong input from patient and public representatives and an independent panel that scrutinised proposals. Many different health, educational attainment, and housing datasets are included in SAIL, which now supports various research designs including pure population-based electronic cohorts, traditional cohorts, embedded individual and cluster randomised trials, and assessments of natural experiments. Examples from more than 50 studies supported so far include the Wales Electronic Cohort for Children (WECC), NIHR-funded evaluations of natural experiments (housing improvement and changes in alcohol outlet density), cluster randomised trials of prehospital care, and an assessment of the Welsh Government Flying Start childhood initiative. We will focus on some of the results from WECC. Findings WECC contains anonymised records of the 804 290 children living in Wales between 1990 and 2008 compiled from nine datasets (linkage rate >97% for three population registers: births, NHS registrations, and community child dataset). 590 042 children were born in Wales, and electronic education records were available for 122 817 born after 1994. This analysis will focus on the effect of pregnancy, birth, and childhood factors on health status and educational attainment to key stage 1 (age 7 years). For example, very low birthweight (hazard ratio [HR] 2·4, 95% CI 1·9–2·9), prematurity (3·07, 2·76–3·41, for Interpretation The SAIL system provides a research efficient e-cohort platform on which it is possible to embed intervention trials and assess the effect of natural experiments and multisectoral policy initiatives on health, educational, and other population outcomes. Funding The Health Information Research Unit at Swansea University receives funding for operation of SAIL from the National Institute of Social Care and Health Research. Two multifinder initiatives, DECIPHer and CIPHER, contributed to studies included in the abstract. Additional funders were Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Chief Scientist Office (Scottish Government), the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, NIHR, and the Wellcome Trust.