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The COVID-19 pandemic has resulted in the rapid development of a range of vaccines against SARS-CoV-2. Vaccine induced immune thrombocytopenia and thrombosis (VITT) is a rare but life-threatening complication of primarily adenoviral based vaccines, associated with the presence of antibodies to a PF4/polyanion neoepitope, measured by ELISA assays. Presented are serial anti-PF4/polyanion antibodies, platelet and D-dimer measurements in a large cohort of patients and their relation to relapse. 51% of patients using the Stago assay had a persistently positive anti-PF4/polyanion levels 100 days post diagnosis whilst 94% of patients monitored using the Immucor assay remain positive. The median duration of positivity of the PF4 assay is 87 days with 72% of patients remaining positive after a median duration of follow up of 105 days. The use of plasma exchange appeared to reduce anti-PF4/polyanion levels and increase platelet counts in the acute setting more rapidly than other therapies. The rate of relapse in this study was 12.6% with all relapsed cases showing persistently positive PF4 antibodies and falling platelet counts. Only one case had extension of their thrombosis. Overall, despite the persistence of PF4 antibodies in 72% of patients, the rate of relapse is low and does not appear to result in recrudescence of the aggressive clinical picture seen at index presentation. Monitoring of these patients in the UK cohort is ongoing and will aid definition of the natural history of this novel condition.

The global acceleration of freshwater salinisation due to human activities such as agriculture, resource extraction, and urbanisation and its amplification by climate change is unequivocal. Although research in this field is growing, there are key aspects at the ecological and evolutionary levels that remain unaddressed. Increasing salinisation is a problem as it can increase the stress or mortality of freshwater organisms, leading to a loss of diversity and/or functionality of freshwater ecosystems but also the services and benefits to human societies that they provide. We identify the main gaps of recent research and suggest a research agenda to facilitate future research efforts in order to achieve a more comprehensive understanding on freshwater salinisation. The widespread salinisation of freshwater ecosystems poses a major threat to the biodiversity, functioning, and services that they provide. Human activities promote freshwater salinisation through multiple drivers (e.g., agriculture, resource extraction, urbanisation) that are amplified by climate change. Due to its complexity, we are still far from fully understanding the ecological and evolutionary consequences of freshwater salinisation. Here, we assess current research gaps and present a research agenda to guide future studies. We identified different gaps in taxonomic groups, levels of biological organisation, and geographic regions. We suggest focusing on global- and landscape-scale processes, functional approaches, genetic and molecular levels, and eco-evolutionary dynamics as key future avenues to predict the consequences of freshwater salinisation for ecosystems and human societies.

Sussex Archaeological Collections, 21, 138-158

Wessex Archaeology was commissioned by Intertek on behalf of National Grid Viking Link Ltd and Energinet.dk to prepare a marine archaeological Technical Report including a high-level Environmental Impact Assessment for the proposed Viking Link submarine cable corridor that will in turn inform an Environmental Report. The proposed cable route would run from Bicker Fen, Lincolnshire to Revsing in Jutland, Denmark. This Technical Report considers an area that is limited to the High Water Mark on the Lincolnshire coast to the United Kingdom Exclusive Economic Zone. The Technical Report comprises relevant legislation and guidance; a methodology, an archaeological baseline; an assessment of the value and sensitivity of the heritage assets identified within the assessed area; and a high-level environmental appraisal.