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The U.S. Environmental Protection Agency’s Endocrine Disruptor Screening Program (EDSP) is tasked with assessing chemicals for their potential to perturb endocrine pathways, including those controlled by androgen receptor (AR). To address challenges associated with traditional testing strategies, EDSP is considering in vitro high-throughput screening assays to screen and prioritize chemicals more efficiently. The ability of these assays to accurately reflect chemical interactions in nonmammalian species remains uncertain. Therefore, a goal of the EDSP is to evaluate how broadly results can be extrapolated across taxa. To assess the cross-species conservation of AR-modulated pathways, computational analyses and systematic literature review approaches were used to conduct a comprehensive analysis of existing in silico, in vitro, and in vivo data. First, molecular target conservation was assessed across 585 diverse species based on the structural similarity of ARs. These results indicate that ARs are conserved across vertebrates and are predicted to share similarly susceptibility to chemicals that interact with the human AR. Systematic analysis of over 5000 published manuscripts was used to compile in vitro and in vivo cross-species toxicity data. Assessment of in vitro data indicates conservation of responses occurs across vertebrate ARs, with potential differences in sensitivity. Similarly, in vivo data indicate strong conservation of the AR signaling pathways across vertebrate species, although sensitivity may vary. Overall, this study demonstrates a framework for utilizing bioinformatics and existing data to build weight of evidence for cross-species extrapolation and provides a technical basis for extrapolating hAR-based data to prioritize hazard in nonmammalian vertebrate species.

Vaginal vault perforation and evisceration of abdominal contents is a rare but well recognised complication of hysterectomy. We presented a rare case of a 40-year-old female with isolated omental prolapse 10 months post open abdominal hysterectomy after penile-vaginal intercourse. Early identification, initiation of antibiotics and operative management are critical to sepsis source control.

This issue of ATR considers numerous instances in which economic historians and historians of capitalism have turned to architecture as evidence of the workings of economic and financial systems. This collective position paper stems from the attempt to engage more directly with these disciplines; an attempt that was first manifested in the symposium “Built Orders of Finance, Risk and Racial Capitalism,” held online in early 2022. How are built orders shaped by processes of financialization, actuarial calculations of risk and the conditions of racial capitalism? How do built orders mobilize specific economic regimes? What kinds of evidence can be enlisted to discern the constitutive relationships established and maintained between architecture and regimes of finance? What scales are implied in these relationships? What is involved in their historicization? This article invites future conversations between the fields of scholarship it canvases to more comprehensively apprehend the terms, conditions, and histories of financialized space.

Today Richard Rogers + Partners’ Underwriting Room at Lloyd’s of London—known as “the Room”—is recognized as an icon of the High Tech movement, its modernity aestheticized through intersecting banks of escalators and a soaring twelve-story atrium. Yet on closer inspection, this interior represents a less satisfactory compromise. The product of years of protracted negotiations with a three hundred-year-old institution, the Room was conceived at a moment when the concept of risk, and the foundations of the insurance market, were transformed due to environmental crises, technological innovations and global financial deregulation. This paper contends that the changing nature of risk was mitigated through complex consultations over the design of the Room, simultaneously demanding new architectural solutions, whilst preserving the institution’s spatial and object-oriented rituals and mythologies. It concludes that the new Room, and the design process underpinning it, was a mode of institutional risk management in an age of uncertainty.

Background Saliva is easily obtainable non-invasively and potentially suitable for detecting both current and previous SARS-CoV-2 infection, but there is limited evidence on the utility of salivary antibody testing for community surveillance. Methods We established 6 ELISAs detecting IgA and IgG antibodies to whole SARS-CoV-2 spike protein, to its receptor binding domain region and to nucleocapsid protein in saliva. We evaluated diagnostic performance, and using paired saliva and serum samples, correlated mucosal and systemic antibody responses. The best-performing assays were field-tested in 20 household outbreaks. Results We demonstrate in test accuracy (N = 320), spike IgG (ROC AUC: 95.0%, 92.8–97.3%) and spike IgA (ROC AUC: 89.9%, 86.5–93.2%) assays to discriminate best between pre-pandemic and post COVID-19 saliva samples. Specificity was 100% in younger age groups (0–19 years) for spike IgA and IgG. However, sensitivity was low for the best-performing assay (spike IgG: 50.6%, 39.8–61.4%). Using machine learning, diagnostic performance was improved when a combination of tests was used. As expected, salivary IgA was poorly correlated with serum, indicating an oral mucosal response whereas salivary IgG responses were predictive of those in serum. When deployed to household outbreaks, antibody responses were heterogeneous but remained a reliable indicator of recent infection. Intriguingly, unvaccinated children without confirmed infection showed evidence of exposure almost exclusively through specific IgA responses. Conclusions Through robust standardisation, evaluation and field-testing, this work provides a platform for further studies investigating SARS-CoV-2 transmission and mucosal immunity with the potential for expanding salivo-surveillance to other respiratory infections in hard-to-reach settings.

1. Pollinating insects provide economic value by improving crop yield. They are also functionally and culturally important across ecosystems outside of cropland. To understand landscape-level drivers of pollinator declines, and guide policy and intervention to reverse declines, studies must cover (a) multiple insect and plant taxa and (b) a range of agricultural and semi-natural land uses. Furthermore, in an era of woodland restoration initiatives and rewilding ideologies, the contribution of woodland and woody linear features (WLFs; e.g. hedgerows) to pollinator abundance demands further investigation. 2. We demonstrate fine-scale analysis of high-quality, co-located measurements from a national environmental survey. We relate pollinator transect counts to ground-truth habitat and WLF maps across 300 1 km squares in Wales, UK. We look at effects of habitat type, flower cover, WLF density and habitat diversity on summer abundance (July and August) of eight insect groups, representing three insect orders (Lepidoptera, Hymenoptera and Diptera). 3. Compared with improved grassland (the dominant habitat in Wales), pollinator abundance is consistently higher in cropland and woodland—especially broadleaved woodland. For mining bees and two hoverfly groups, abundance is predicted to be at least 1.5× higher in woodland ecosystems than elsewhere. Furthermore, we estimate contributions of WLFs to abundance in agriculturally improved habitats to be up to 14% for honeybees and up to 21% for hoverflies. 4. The abundance of all insect groups increases with flower cover, which is a key mechanism through which woodland, cropland and grassland support pollinators. Importantly, we observe diminishing returns of increasing flower cover for abundance of non-Apis pollinator groups, expecting roughly twice the increase in abundance per % flower cover from 0% to 5%, as compared with 10% to 15%. However, the shape of the relationship was inverted for honeybees, which showed steeper increases in abundance at higher flower cover. 4. Synthesis and applications: We provide a holistic view of the drivers of pollinator abundance in Wales, in which flower cover, woodland, hedgerows and cropland are critical. We propose a key role for woodland creation, hedge-laying and farmland heterogeneity within future land management incentive schemes. Finally, we suggest targeting of interventions to maximise benefits for non-Apis pollinators. Specifically, increasing floral provision in areas where existing flower cover is low—for example, in flower-poor improved grasslands—could effectively increase pollinator abundance and diversity while prioritising wild over managed species.

ObjectivesTo explore public reactions to the COVID-19 pandemic across diverse ethnic groups.DesignRemote qualitative interviews and focus groups in English or Punjabi. Data were transcribed and analysed through inductive thematic analysis.SettingEngland and Wales, June to October 2020.Participants100 participants from 19 diverse ‘self-identified’ ethnic groups.ResultsDismay, frustration and altruism were reported across all ethnic groups during the first 6–9 months of the COVID-19 pandemic. Dismay was caused by participants’ reported individual, family and community risks, and loss of support networks. Frustration was caused by reported lack of recognition of the efforts of ethnic minority groups (EMGs), inaction by government to address COVID-19 and inequalities, rule breaking by government advisors, changing government rules around: border controls, personal protective equipment, social distancing, eating out, and perceived poor communication around COVID-19 and the Public Health England COVID-19 disparities report (leading to reported increased racism and social isolation). Altruism was felt by all, in the resilience of National Health Service (NHS) staff and their communities and families pulling together. Data, participants’ suggested actions and the behaviour change wheel informed suggested interventions and policies to help control COVID-19.ConclusionTo improve trust and compliance future reports or guidance should clearly explain any stated differences in health outcomes by ethnicity or other risk group, including specific messages for these groups and concrete actions to minimise any risks. Messaging should reflect the uncertainty in data or advice and how guidance may change going forward as new evidence becomes available. A contingency plan is needed to mitigate the impact of COVID-19 across all communities including EMGs, the vulnerable and socially disadvantaged individuals, in preparation for any rise in cases and for future pandemics. Equality across ethnicities for healthcare is essential, and the NHS and local communities will need to be supported to attain this.

Herein we present the synthesis, structure and NMR and mass spectroscopic analyses of the antioxidant 2-(3,5-dimethoxyphenyl)-2,3-dihydroquinolin-4(1H)-one (1), a member of the 2-aryl-2,3-dihydroquinolin-4(1H)-one family of molecules that have been shown to display a range of potent biological properties. The title molecule, prepared by an alternative methodology to that recently reported, crystallizes in the centrosymmetric space group P21/c with unit cell dimensions a = 11.775(17) A, b = 5.3592(8) A, c = 22.462(3) A and β = 96.576(11)°. Close analysis of the solid state structure reveals an array of weak N–H∙∙∙O hydrogen bonding as well as C–H∙∙∙O, and C–H∙∙∙π interactions between the neighboring molecules. The presence of 1 was also confirmed via NMR and mass spectroscopic analyses. Herein we present the solid state structure and results of mass spectroscopic and nuclear magnetic resonance analyses of the powerful antitumor compound 2-(3,5-dimethoxyphenyl)-2,3-dihydroquinolin-4(1H)-one prepared by an alternative synthetic avenue.

Tumor Associated Macrophages (TAMs), copiously found in the Tumor Microenvironment (TME) are key players in creating an immunosuppressive environment, increasing angiogenesis and metastasis in prostate cancer (PCa). They are plastic in nature and usually exist as, M1 (anti-tumorigenic) or M2 (pro-tumorigenic) phenotype, with relative abundance of M2. In this study, we aimed to explore the phenotypic effects of TAMs on PCa and investigate the potential of glycyrrhizin, a natural compound, to reprogram M2 TAMs, as a feasible treatment approach against PCa. THP-1 monocytes and RAW 264.7 were used to study macrophage differentiation and glycyrrhizin-mediated repolarization. THP-1 cells were cultured in conditioned media (CM) of LNCaP and BPH-Cd to obtain PCa associated macrophages. Flow cytometric analysis revealed increase in expression of surface markers CD32, CD64, CD206 and CD163 confirming M1/M2 differentiation. qPCR analysis also demonstrated upregulation of CD80, CD86, CD68, TGF-β and IL10. M2 markers such as CD68, CD163, CCL2, CCL5 and TGF-β were expressed in BPH-Cd TAMs. LNCaP TAMs also co-expressed CD68 and CD163. In spheroid assay on BPH-Cd cells, treatment with BPH-Cd TAM resulted in abnormally shaped, enlarged spheroids. Furthermore, the CM enhanced migration of BPH-Cd cells in transwell migration assay and downregulated P21 in western blot analysis, thus confirming its tumor-promoting role. MTT assay performed prior to studying the polarization potential of glycyrrhizin showed an increase in viability of glycyrrhizin-treated THP-1 and RAW 264.7 and selectively promoted viability in M1. The M1-polarizing properties of glycyrrhizin was revealed in the qPCR analysis of glycyrrhizin-treated M0 macrophages. The reduction in the size of the spheroids and decreased migration of BPH-Cd upon treatment with glycyrrhizin-treated M0 CM confirmed the same. Differentiation media (DM) of glycyrrhizin-treated M2 TAMs resulted in smaller, disintegrated BPH-Cd spheroids indicating possible reprogramming effect. Interestingly, glycyrrhizin-treated M2 CM downregulated the gene expression of stemness-associated markers such as NANOG, SNAIL, OCT3/4 and COX2 with concurrent suppression of EMT marker, N-Cadherin in LNCaP cells. Cell cycle analysis on LNCaP revealed a decrease in the percentage of cells in S phase compared to glycyrrhizin-treated M2 CM, suggesting hindered proliferation. A notable observation to help understand the plausible mechanism of M2 TAM suppression was the decrease in Reactive Oxygen Species (ROS) levels in glycyrrhizin-treated M1 and M2 TAMs derived from THP-1 cells. The glycyrrhizin-mediated inhibition of ROS was also confirmed in RAW 264.7. In conclusion, our findings suggest that glycyrrhizin could potentially reprogram TAMs to intercept proliferation, metastasis and stemness characteristics in PCa. Citation Format: Amy Thomas, Gnanasekar Munirathinam. Reprogramming M2-like tumor associated macrophages using a natural compound, glycyrrhizin, as a potential therapeutic strategy against prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2334.

Background In sub-Saharan Africa, the use of skin-lightening products (SLPs) for cosmetic purposes has become common practice among women with dark skin tones. Despite the associated risks, the practice is still significantly increasing in Africa. The objective of this study was to determine the knowledge, perceptions and practice toward skin lightening among young adults. Methods A cross-sectional survey among health science students at a tertiary institution in the Western Cape of South Africa was conducted. Results A total of 401 participants were included in the sample. There was a low prevalence (12%) of skin-lightening practice among students, which could possibly be a result of students being aware of the associated side effects. Participants believed that family and friends are most likely to influence this behavior (48%) and perceived that individuals who practice skin lightening do so because this provides a more fashionable look (76%). Men and women were found to be equally likely to use SLPs, and those residing in urban settings are 10 times more likely to engage in the practice compared with rural dwellers. Conclusion This study contributes valuable information on the phenomenon of skin lightening among a diverse group of young adults. The results highlight the influential role social media platforms and family members play in motivating use of SLPs. Furthermore, the equal likelihood of use among both sexes suggests that the practice is growing among males.

Noise pollution from road traffic is ubiquitous in modern cities and is the second greatest environmental risk to health in Western Europe. Urban woodland can provide substantial noise mitigation if located properly, yet such considerations are often absent from the urban planning process. Current approaches for quantifying this important ecosystem service (ES) do not account adequately for important spatial factors and are unable to identify effectively the best locations to place new woodland for noise mitigation. We present new methods, in which we exploit the concept of least-cost-distance, to map and value the mitigating effect of urban woodland, and to identify optimal locations to place new woodland. Applying these methods, we show that urban woodland currently provides Birmingham City (UK) with over GBP 3.8 million in noise mitigation benefits, annually. We also show that our new ‘opportunity’ mapping methods effectively identify the best locations for new woodland, achieving close to a maximum service with less than a quarter of the additional woodland needed to achieve it. This has important implications for the design and implementation of urban tree planting for noise mitigation, and these methods can be adapted for other ES, allowing consideration of multiple service outcomes.

The ACROBAT pilot trial of early cryoprecipitate for severe postpartum haemorrhage used deferred consent procedures. Pretrial discussions with a patient and public involvement group found mixed views towards deferred consent. This study aimed to build an understanding of how the deferred consent procedures worked in practice, to inform plans for a full-scale trial.Qualitative interview study within a cluster-randomised pilot trial, involving four London maternity services.Individual interviews were conducted postnatally with 10 women who had received blood transfusion for severe postpartum haemorrhage and had consented to the trial. We also interviewed four 'recruiters'-two research midwives and two clinical trials practitioners who conducted trial recruitment.Consent procedures in the ACROBAT pilot trial were generally acceptable and the intervention was viewed as low risk, but most women did not remember much about the consent conversation. As per trial protocol, recruiters sought to consent women before hospital discharge, but this time pressure had to be balanced against the need to ensure women were not approached when distressed or very unwell. Extra efforts had to be made to communicate trial information to women due to the exhaustion of their recovery and competing demands for their attention. Participant information was further complicated by explanations about the cluster design and change in transfusion process, even though the consent sought was for access to medical data.Our findings indicate that deferred consent procedures raise similar concerns as taking consent when emergency obstetric research is occurring-that is, the risk that participants may conflate research with clinical care, and that their ability to process trial information may be impacted by the stressful nature of recovery and newborn care. A future trial may support more meaningful informed consent by extending the window of consent discussion and ensuring trial information is minimal and easy to understand.ISRCTN12146519.

BACKGROUND: Repeat expansion disorders affect about 1 in 3000 individuals and are clinically heterogeneous diseases caused by expansions of short tandem DNA repeats. Genetic testing is often locus-specific, resulting in underdiagnosis of people who have atypical clinical presentations, especially in paediatric patients without a previous positive family history. Whole genome sequencing is increasingly used as a first-line test for other rare genetic disorders, and we aimed to assess its performance in the diagnosis of patients with neurological repeat expansion disorders.METHODS: We retrospectively assessed the diagnostic accuracy of whole genome sequencing to detect the most common repeat expansion loci associated with neurological outcomes (AR, ATN1, ATXN1, ATXN2, ATXN3, ATXN7, C9orf72, CACNA1A, DMPK, FMR1, FXN, HTT, and TBP) using samples obtained within the National Health Service in England from patients who were suspected of having neurological disorders; previous PCR test results were used as the reference standard. The clinical accuracy of whole genome sequencing to detect repeat expansions was prospectively examined in previously genetically tested and undiagnosed patients recruited in 2013-17 to the 100 000 Genomes Project in the UK, who were suspected of having a genetic neurological disorder (familial or early-onset forms of ataxia, neuropathy, spastic paraplegia, dementia, motor neuron disease, parkinsonian movement disorders, intellectual disability, or neuromuscular disorders). If a repeat expansion call was made using whole genome sequencing, PCR was used to confirm the result.FINDINGS: The diagnostic accuracy of whole genome sequencing to detect repeat expansions was evaluated against 793 PCR tests previously performed within the NHS from 404 patients. Whole genome sequencing correctly classified 215 of 221 expanded alleles and 1316 of 1321 non-expanded alleles, showing 97·3% sensitivity (95% CI 94·2-99·0) and 99·6% specificity (99·1-99·9) across the 13 disease-associated loci when compared with PCR test results. In samples from 11 631 patients in the 100 000 Genomes Project, whole genome sequencing identified 81 repeat expansions, which were also tested by PCR: 68 were confirmed as repeat expansions in the full pathogenic range, 11 were non-pathogenic intermediate expansions or premutations, and two were non-expanded repeats (16% false discovery rate).INTERPRETATION: In our study, whole genome sequencing for the detection of repeat expansions showed high sensitivity and specificity, and it led to identification of neurological repeat expansion disorders in previously undiagnosed patients. These findings support implementation of whole genome sequencing in clinical laboratories for diagnosis of patients who have a neurological presentation consistent with a repeat expansion disorder.FUNDING: Medical Research Council, Department of Health and Social Care, National Health Service England, National Institute for Health Research, and Illumina.

ObjectivesTo explore attitudes and intentions towards COVID-19 vaccination, and influences and sources of information about COVID-19 across diverse ethnic groups (EGs) in the UK.DesignRemote qualitative interviews and focus groups (FGs) conducted June-October 2020 before UK COVID-19 vaccine approval. Data were transcribed and analysed through inductive thematic analysis.SettingGeneral public in the community across England and Wales.Participants100 participants from 19 self-identified EGs with spoken English or Punjabi.ResultsMistrust and doubt were common themes across all EGs including white British and minority EGs, but more pronounced amongst Bangladeshi, Pakistani, Black ethnicities and Travellers. Many participants shared concerns about perceived lack of information about COVID-19 vaccine safety, efficacy and potential unknown adverse effects. Across EGs participants stated occupations with public contact, older adults and vulnerable groups should be prioritised for vaccination. Perceived risk, social influences, occupation, age, co-morbidities and engagement with healthcare influenced participants’ intentions to accept vaccination once available; all Jewish FG participants intended to accept, while all Traveller FG participants indicated they probably would not.Facilitators to COVID-19 vaccine uptake across all EGs included: desire to return to normality and protect health and wellbeing; perceived higher risk of infection; evidence of vaccine safety and efficacy; vaccine availability and accessibility.COVID-19 information sources were influenced by social factors, culture and religion and included: friends, family; media and news outlets; and research literature. Participants across most different EGs were concerned about misinformation or had negative attitudes towards the media.ConclusionsDuring vaccination programme roll-out, including boosters, commissioners and vaccine providers should provide accurate information, authentic community outreach, and use appropriate channels to disseminate information and counter misinformation. Adopting a context-specific approach to vaccine resources, interventions and policies and empowering communities has potential to increase trust in the programme.Article summary: strengths and limitationsThis is amongst the largest qualitative studies on attitudes to the COVID-19 pandemic in the UK general public across ethnic groups (EGs), ages and religions, adding insights from a broader range of participants.Qualitative methodology enabled discussion of participants’ responses around COVID-19 vaccination, probing to collect rich data to inform recommendations across EGs.Most data collection was undertaken in English, possibly excluding sectors of the population who may access COVID-19 information through different sources due to language.Data collection was June-October 2020 before COVID-19 vaccines were licensed. Attitudes are highly responsive to current information around a COVID-19 vaccine, as well as the state of the pandemic and perceived risk. Data were collected prior to much of the intervention work, putting the attitudes and intentions expressed in this study in a context of minimal community engagement and support. This provides a baseline snapshot of attitudes, providing the option to explore and assess the impact of such interventions.Socioeconomic data and index of multiple deprivation were not collected, limiting the ability to determine a possible accumulative effect of factors such as socioeconomic status, ethnicity and age.

ObjectivesTo explore public reactions to the COVID-19 pandemic across diverse ethnic groups.DesignRemote qualitative interviews and focus groups in English or Punjabi. Data were transcribed and analysed through inductive thematic analysis.SettingEngland and Wales June-October 2020.Participants100 participants from 19 diverse ‘self-identified’ ethnic groups.ResultsDismay, frustration and altruism were reported across all ethnic groups during the first six to nine months of the COVID-19 pandemic. Dismay was caused by participants’ reported individual, family and community risks, and loss of support networks. Frustration was caused by reported lack of recognition of the efforts of minority ethnic groups (MEGs), inaction by government to address COVID-19 and inequalities, rule breaking by government advisors, changing government rules around: border controls, personal protective equipment, social distancing, eating out, and perceived poor communication around COVID-19 and the Public Health England (PHE) COVID-19 disparities report (leading to reported increased racism and social isolation). Altruism was felt by all, in the resilience of NHS staff and their communities and families pulling together. Data, participants suggested actions, and the Behaviour Change Wheel informed suggested interventions and policies to help control COVID-19.ConclusionTo maintain public trust, it is imperative that governmental bodies consider vulnerable groups, producing clear COVID-19 control guidance with contingency, fiscal, service provision and communication policies for the next rise in COVID-19 cases. This needs to be combined with public interventions including information, education, modelling and enablement of infection prevention through local community involvement and persuasion techniques or incentivisation. Government policy needs to review and include town and social planning leading to environmental restructuring that facilitates infection prevention control. This includes easy access to hand-washing facilities in homes, work, all food providers and shopping centres; toilet facilities as our Travellers mentioned, and adequate living accommodation and work environment facilitating IPC for all.Strengths and limitationsThis is amongst the largest qualitative studies on attitudes to the COVID-19 pandemic in the UK general public across ethnic groups, ages and religions, adding insights to previous smaller qualitative studies, from a broader range of participants.The qualitative methodology allowed us to discuss participants’ responses around the COVID-19 pandemic, probing their answers to obtain detailed data to inform needs across ethnic groups.Most data collection was undertaken in English and therefore excludes non-English speaking sectors of the population who may have experienced the COVID-19 pandemic differently.We did not obtain the views of older members of the population over 70 years, who were most at risk.The data reflect public perceptions six to nine months into the pandemic when some of the social distancing rules had been relaxed in England; as the pandemic progresses attitudes and needs may well change.

Over the last decade many ecosystem service (ES) models have been developed to inform sustainable land and water use planning. However, uncertainty in the predictions of any single model in any specific situation can undermine their utility for decision-making. One solution is creating ensemble predictions, which potentially increase accuracy, but how best to create ES ensembles to reduce uncertainty is unknown and untested. Using ten models for carbon storage and nine for water supply, we tested a series of ensemble approaches against measured validation data in the UK. Ensembles had at minimum a 5–17% higher accuracy than a randomly selected individual model and, in general, ensembles weighted for among model consensus provided better predictions than unweighted ensembles. To support robust decision-making for sustainable development and reducing uncertainty around these decisions, our analysis suggests various ensemble methods should be applied depending on data quality, for example if validation data are available.

BackgroundSocial contact survey data forms a core component of modern epidemic models: however, there has been little assessment of the potential biases in such data.MethodsWe conducted focus groups with university students who had (n=13) and had not (n=14) completed a social contact survey during the COVID-19 pandemic. Qualitative findings were explored quantitatively by analysing participation data.ResultsThe opportunity to contribute to COVID-19 research, to be heard and feel useful were frequently reported motivators for participating in the contact survey. Reductions in survey engagement following lifting of COVID-19 restrictions may have occurred because the research was perceived to be less critical and/ or because the participants were busier and had more contacts. Having a high number of contacts to report, uncertainty around how to report each contact, and concerns around confidentiality were identified as factors leading to inaccurate reporting. Focus groups participants thought that financial incentives or provision of study results would encourage participation.ConclusionsIncentives could improve engagement with social contact surveys. Qualitative research can inform the format, timing, and wording of surveys to optimise completion and accuracy.Graphical abstract

BackgroundThe Omicron variant of SARS-CoV-2 infection poses substantial challenges to public health. In England, “plan B” mitigation measures were introduced in December 2021 including increased home working and face coverings in shops, but stopped short of restrictions on social contacts. The impact of voluntary risk mitigation behaviours on future SARS-CoV-2 burden is unknown.MethodsWe developed a rapid online survey of risk mitigation behaviours during the winter 2021 festive period and deployed in two longitudinal cohort studies in the UK (Avon Longitudinal Study of Parents and Children (ALSPAC) and TwinsUK/Covid Symptom Study (CSS) Biobank) in December 2021. Using an individual-based, probabilistic model of COVID-19 transmission between social contacts with SARS-CoV-2 Omicron variant parameters and realistic vaccine coverage in England, we describe the potential impact of the SARS-CoV-2 Omicron wave in England in terms of the effective reproduction number and cumulative infections, hospital admissions and deaths. Using survey results, we estimated in real-time the impact of voluntary risk mitigation behaviours on the Omicron wave in England, if implemented for the entire epidemic wave.ResultsOver 95% of survey respondents (NALSPAC=2,686 and NTwins=6,155) reported some risk mitigation behaviours, with vaccination and using home testing kits reported most frequently. Less than half of those respondents reported that their behaviour was due to “plan B”. We estimate that without risk mitigation behaviours, the Omicron variant is consistent with an effective reproduction number between 2.5 and 3.5. Due to the reduced vaccine effectiveness against infection with the Omicron variant, our modelled estimates suggest that between 55% and 60% of the English population could be infected during the current wave, translating into between 15,000 and 46,000 cumulative deaths, depending on assumptions about vaccine effectiveness. We estimate that voluntary risk reduction measures could reduce the effective reproduction number to between 1.8 and 2.2 and reduce the cumulative number of deaths by up to 24%.ConclusionsWe conclude that voluntary measures substantially reduce the projected impact of the SARS-CoV-2 Omicron variant, but that voluntary measures alone would be unlikely to completely control transmission.

The importance of soils to society has gained increasing recognition over the past decade, with the potential to contribute to most of the United Nations’ Sustainable Development Goals (SDGs). With unprecedented and growing demands for food, water and energy, there is an urgent need for a global effort to address the challenges of climate change and land degradation, whilst protecting soil as a natural resource. In this paper, we identify the contribution of soil science over the past decade to addressing gaps in our knowledge regarding major environmental challenges: climate change, food security, water security, urban development, and ecosystem functioning and biodiversity. Continuing to address knowledge gaps in soil science is essential for the achievement of the SDGs. However, with limited time and budget, it is also pertinent to identify effective methods of working that ensure the research carried out leads to real-world impact. Here, we suggest three strategies for the next decade of soil science, comprising a greater implementation of research into policy, interdisciplinary partnerships to evaluate function trade-offs and synergies between soils and other environmental domains, and integrating monitoring and modelling methods to ensure soil-based policies can withstand the uncertainties of the future. Highlights: We highlight the contributions of soil science to five major environmental challenges since 2010. Researchers have contributed to recommendation reports, but work is rarely translated into policy. Interdisciplinary work should assess trade-offs and synergies between soils and other domains. Integrating monitoring and modelling is key for robust and sustainable soils-based policymaking.

IntroductionWomen with gestational diabetes are at increased risk of developing type 2 diabetes later in life. In at-risk general populations, Mediterranean-style diet helps prevent type 2 diabetes. But its effect on postnatal women with a history of gestational diabetes is not known. Prior to a full-scale trial on Mediterranean-style diet in the postnatal period to prevent type 2 diabetes, a feasibility study is required to assess the acceptability of the diet and evaluate the trial processes.Methods and analysisMEditerranean diet for pReventIon of type 2 diabeTes is a single-arm feasibility study (65 women) with qualitative evaluation of women who have recently given birth and had gestational diabetes. The intervention is a Mediterranean-style diet supplemented with nuts and olive oil, with dietary advice and an action plan. A dedicated Health Coach will interact with participants through an interactive lifestyle App. Women will follow the intervention from 6 to 13 weeks post partum until 1 year post partum. The primary outcomes are rates of recruitment, follow-up, adherence and attrition. The secondary outcomes are maternal dysglycaemia, cost and quality of life outcomes, and acceptability of the intervention to participants, and to healthcare professionals delivering the intervention. Feasibility outcomes will be reported using descriptive statistics.Ethics and disseminationEthical approval was obtained through the South Central—Berkshire Research Ethics Committee (19/SC/0064). Study findings will be disseminated via publication in peer-reviewed journals, as well as via newsletters made available to participants and members of Katie’s Team (a women’s health patient and public advisory group).Trial registration numberISRCTN40582975.

We investigate the impact of vaccination and asymptomatic testing uptake on SARS-CoV-2 transmission in a university student population using a stochastic compartmental model. We find that the magnitude and timing of outbreaks is highly variable depending on the transmissibility of the most dominant strain of SARS CoV-2 and under different vaccine uptake levels and efficacies. When delta is the dominant strain, low level interventions (no asymptomatic testing, 30% vaccinated with a vaccine that is 80% effective at reducing infection) lead to 53-71% of students become infected during the first term. Asymptomatic testing is most useful when vaccine uptake is low: when 30% of students are vaccinated, 90% uptake of asymptomatic testing leads to almost half the case numbers. With high interventions (90% using asymptomatic testing, 90% vaccinated) cumulative incidence is 7-9%, with around 80% of these cases estimated to be asymptomatic. However, under emergence of a new variant that is at least twice as transmissible as delta and with the vaccine efficacy against infection reduced to 55%, large outbreaks are likely in universities, even with very high (90%) uptake of vaccination and 100% uptake of asymptomatic testing. If vaccine efficacy against infection against this new variant is higher (70%), then outbreaks can be mitigated if there is least 50% uptake of asymptomatic testing additional to 90% uptake of vaccination. Our findings suggest that effective vaccination is critical for controlling SARS-CoV-2 transmission in university settings with asymptomatic testing ranging from additionally useful to critical, depending on effectiveness and uptake of vaccination. Other measures may be necessary to control outbreaks under the emergence of a more transmissible variant with vaccine escape.

In many countries, an extensive vaccination programme has substantially reduced the public-health impact of SARS-CoV-2, limiting the number of hospital admissions and deaths compared to an unmitigated epidemic. Ensuring a low-risk transition from the current situation to one in which SARS-CoV-2 is endemic requires maintenance of high levels of population immunity. The observed waning of vaccine efficacy over time suggests that booster doses may be required to maintain population immunity especially in the most vulnerable groups. Here, using data and models for England, we consider the dynamics of COVID-19 over a two-year time-frame, and the role that booster vaccinations can play in mitigating the worst effects. We find that boosters are necessary to suppress the imminent wave of infections that would be generated by waning vaccine efficacy. Projecting further into the future, the optimal deployment of boosters is highly sensitive to their long-term action. If protection from boosters wanes slowly (akin to protection following infection) then a single booster dose to the over 50s may be all that is needed over the next two-years. However, if protection wanes more rapidly (akin to protection following second dose vaccination) then annual or even biannual boosters are required to limit subsequent epidemic peaks an reduce the pressure on public health services.

Sustainable use of land is central to achieving the United Nations Sustainable Development Goals (SDG). However, implementation of policy targeting SDG delivery can be driven off track by external factors. There is a pressing need for rapid, adaptable modelling approaches to support policy development against a background of dynamic changes in environmental and political conditions. An example is the imminent departure of the UK from the EU (Brexit), which requires responsive inputs of robust evidence to inform decision making. We combine existing agri-economic modelling with well-tested environmental models, driven by farm survey and landscape data in an adaptive, participatory approach to assess potential agricultural sector responses to Brexit. We explore potential Brexit impacts on land use, environmental outcomes and agricultural jobs in Wales, UK, where agriculture is dominated by animal production on grassland systems. Three potential post-Brexit trade agreements scenarios are considered: EU Deal; No Deal; and Multilateral Free Trade Agreements. For each scenario potential changes in animal numbers in livestock systems in Wales are converted to predicted land use change at field and farm scale and combined with national data sources and models to explore consequences for the environment and jobs. Potential changes in grazing animal numbers range between − 30% (sheep for No Deal and MFTA) and + 53% (No Deal dairy), affecting 3% (EU Deal) to 17% (No Deal) of agricultural land and creating potential losses of 700 (EU Deal) to 7000 (MFTA) full time jobs. Environmental outcomes are mixed, with reductions in greenhouse gas emissions (− 1% EU deal to − 16% MFTA) and variable impacts on pollutant loads to water (N ranges + 3% for No Deal to − 14% for MFTA) across all scenarios. Air pollution is most scenario dependent (+ 11% No Deal to − 12% MFTA), and biodiversity showed a mixed response to each scenario. The findings of this study support Welsh government in developing programmes to manage the Brexit transition proactively, mitigating risks to the environment, rural communities and agricultural sector..

We propose a way to synthesize different approaches to globally map land degradation by combining vegetation and soil indicators into a consistent framework for assessing land degradation as an environmental ‘debt’. our combined approach reveals a broader lens for land degradation through global change, in particular, identifying hot-spots for the different kinds of land degradation., Global Change Biology, 27 (21), ISSN:1354-1013, ISSN:1365-2486