Obesity associated severe asthma represents a distinct clinical phenotype - Analysis of the British Thoracic Society Difficult Asthma Registry patient cohort according to body mass index

BACKGROUND: Obesity has emerged as a risk factor for the development of asthma and it may also influence asthma control and airways inflammation. However, the role of obesity in severe asthma remains unclear. OBJECTIVE: To explore the association between obesity (defined by BMI) and severe asthma. METHODS: Data from the National Registry for dedicated UK Difficult Asthma Services were used to compare patient demographics, disease characteristics and healthcare utilisation between three body mass index (BMI) categories (normal weight: 18.5 -24.99, overweight: 25 -29.99, obese: =30) in a well characterised group of severe asthmatic adults. RESULTS: The study population consisted of 666 severe asthmatics with a median BMI of 29.8 (interquartile range 22.5 -34.0). The obese group exhibited greater asthma medication requirements in terms of maintenance corticosteroid therapy (48.9% versus 40.4% and 34.5% in the overweight and normal weight groups, respectively), steroid burst therapy and short-acting ß2-agonist (SABA) use per day. Significant differences were seen with gastro-oesophageal reflux disease (GORD) (53.9% versus 48.1% and 39.7% in the overweight and normal weight groups, respectively) and proton pump inhibitor (PPI) use. Bone density scores were higher in the obese group, whilst pulmonary function testing revealed a reduced FVC and raised Kco. Serum IgE levels decreased with increasing BMI and the obese group were more likely to report eczema, but less likely to have a history of nasal polyps. CONCLUSIONS: Severe asthmatics display particular characteristics according to BMI that support the view that obesity associated severe asthma may represent a distinct clinical phenotype.1Royal Brompton Hospital, London, UK;2Department of Computing, Imperial College, UK3Airways Disease, National Heart & Lung Institute, Imperial College, UK;4Centre for infection and immunity, Queen's University of Belfast, UK;5University of Leicester, UK;6The University of Manchester and University Hospital of South Manchester, UK;7Birmingham Heartlands Hospital, University of Birmingham, UK;8Gartnavel General Hospital, University of Glasgow, UK;9Glasgow Royal Infirmary, Glasgow, UKCorrespondence: Dr Andrew N. Menzies-Gow, Royal Brompton Hospital, Fulham Road, London SW3 6HP.

From Negation to Agreement: Revisiting the Problem of Sources for Socio-Historical Linguistics

In this article we review recent work on the history of French negation in relation to three key issues in socio-historical linguistics: identifying appropriate sources, interpreting scant or anomalous data, and interpreting generational differences in historical data. We then turn to a new case study, that of verbal agreement with la plupart, to see whether this can shed fresh light on these issues. We argue that organising data according to the author’s date of birth is methodologically sounder than according to date of publication. We explore the extent to which different genres and text types reflect changing patterns of usage and suggest that additional, different case-studies are required in order to make more secure generalisations about the reliability of different sources.

Metabolomic Profiling of In Vivo Plasma Responses to DioxinAssociated Dietary Contaminant Exposure in Rats: Implications for Identification of Sources of Animal and Human Exposure

Dioxin contamination of the food chain typically occurs when cocktails of combustion residues or polychlorinated biphenyl (PCB) containing oils become incorporated into animal feed. These highly toxic compounds are bioaccumulative with small amounts posing a major health risk. The ability to identify animal exposure to these compounds prior to their entry into the food chain may be an invaluable tool to safeguard public health. Dioxin-like compounds act by a common mode of action and this suggests that markers or patterns of response may facilitate identification of exposed animals. However, secondary co-contaminating compounds present in typical dioxin sources may affect responses to compounds. This study has investigated for the first time the potential of a metabolomics platform to distinguish between animals exposed to different sources of dioxin contamination through their diet. Sprague-Dawley rats were given feed containing dioxin-like toxins from hospital incinerator soot, a common PCB oil standard and pure 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) (normalized at 0.1 µg/kg TEQ) and acquired plasma was subsequently biochemically profiled using ultra high performance liquid chromatography (UPLC) quadropole time-of-flight-mass spectrometry (QTof-MS). An OPLS-DA model was generated from acquired metabolite fingerprints and validated which allowed classification of plasma from individual animals into the four dietary exposure study groups with a level of accuracy of 97-100%. A set of 24 ions of importance to the prediction model, and which had levels significantly altered between feeding groups, were positively identified as deriving from eight identifiable metabolites including lysophosphatidylcholine (16:0) and tyrosine. This study demonstrates the enormous potential of metabolomic-based profiling to provide a powerful and reliable tool for the detection of dioxin exposure in food-producing animals.

Screening-detected non-symptomatic breast cancer: a case history

Alice is a 65 year-old woman who was recalled for further investigations following a routine screening mammogram, which showed a 25 mm mass in her left breast. This case history will report on the further investigations and surgery required to manage this infiltrating ductal carcinoma. The histopathology report will be analysed to provide a rationale for future treatment with radiotherapy, and Alice's expected prognosis will be presented using the Nottingham Prognostic Index. Alice's psychological support needs will identified and the appropriate interventions will be discussed with a particular focus on Alice's history of depression. The supportive and educational role of the breast care nurse and the multidisciplinary team will be highlighted throughout the study.

Film, history and education website

This website, which forms part of a wider AHRC-funded project, provides a range of historical resources including interpretative essays, archival sources, recorded debates and further information to support the The enigma of Frank Ryan documentary (Desmond Bell, 2012). The website is designed to encourage film viewers to make their own assessments of the wider historical issues with which the films engage.

Long-term mass balance of perennial firn and ice in an Alpine cave (Austria):Constraints from radiocarbon-dated wood fragments

Hundsalm ice cave located at 1520 m altitude in a karst region of western Austria contains up to 7-m-thick deposits of snow, firn and congelation ice. Wood fragments exposed in the lower parts of an ice and firn wall were radiocarbon accelerator mass spectrometry (AMS) dated. Although the local stratigraphy is complex, the 19 individual dates - the largest currently available radiocarbon dataset for an Alpine ice cave - allow to place constraints on the accumulation and ablation history of the cave ice. Most of the cave was either ice free or contained only a small firn and ice body during the 'Roman Warm Period'; dates of three wood fragments mark the onset of firn and ice build-up in the 6th and 7th century ad. In the central part of the cave, the oldest samples date back to the 13th century and record ice growth coeval with the onset of the 'Little Ice Age'. The majority of the ice and firn deposit, albeit compromised by a disturbed stratigraphy, appears to have been formed during the subsequent centuries, supported by wood samples from the 15th to the 17th century. The oldest wood remains found so far inside the ice is from the end of the Bronze Age and implies that local relics of prehistoric ice may be preserved in this cave. The wood record from Hundsalm ice cave shows parallels to the Alpine glacier history of the last three millennia, for example, the lack of preserved wood remains during periods of known glacier minima, and underscores the potential of firn and ice in karst cavities as a long-term palaeoclimate archive, which has been degrading at an alarming rate in recent years. © The Author(s) 2013.

Seismic Assessment of a Steel Braced Plan Mass Symmetric/Asymmetric Building Structure

This paper presents a seismic response investigation into a code designed concentrically braced frame structure that is subjected to but not designed for in-plan mass eccentricity. The structure has an accidental uneven distribution of mass in plan resulting in an increased torsional component of vibration. The level of inelasticity that key structural elements in plan mass asymmetric structures are subjected to is important when analysing their ability to sustain uneven seismic demands. In-plan mass asymmetry of moment resisting frame and shear wall type structures have received significant investigation, however, the plan asymmetric response of braced frame type structures is less well understood. A three-dimensional non-linear time history analysis (NLTHA) model is created to capture the torsional response of the plan mass asymmetric structure to quantify the additional ductility demand, interstorey drifts and floor rotations. Results show that the plan mass asymmetric structure performs well in terms of ductility demand, but poorly in terms of interstorey drifts and floor rotations when compared to the plan mass symmetric structure. New linear relationships are developed between the normalised ductility demand and normalised slenderness of the bracing on the sides of the plan mass symmetric/asymmetric structures that the mass is distributed towards and away from.

Characterisation of deuterium spectra from laser driven multi-species sources by employing differentially filtered image plate detectors in Thomson spectrometers

A novel method for characterising the full spectrum of deuteron ions emitted by laser driven multi-species ion sources is discussed. The procedure is based on using differential filtering over the detector of a Thompson parabola ion spectrometer, which enables discrimination of deuterium ions from heavier ion species with the same charge-to-mass ratio (such as C^{6 +}, O^{8 +}, etc.). Commonly used Fuji Image plates were used as detectors in the spectrometer, whose absolute response to deuterium ions over a wide range of energies was calibrated by using slotted CR-39 nuclear track detectors. A typical deuterium ion spectrum diagnosed in a recent experimental campaign is presented, which was produced from a thin deuterated plastic foil target irradiated by a high power laser.

Land use history of Village Bay, Hirta, St Kilda World Heritage Site:A palynological investigation of plaggen soils

This paper presents findings based on a palynological investigation of artificially accreting (plaggen) soils from the settlement of Village Bay, Hirta, in the St Kilda archipelago, which was perhaps the most distant and inhospitable outpost of sustained human habitation in the British Isles. The soils were developed principally through the addition of turf ash and seabird waste, although some ash may have been derived from upland peats. It is assumed that the woodland pollen signal (much lower in the soils than in an upland peat site nearby) represents off-island sources. Corylus avellana-type pollen (frequent in upland sites), along with Potentilla-type, may provide markers in the Village Bay profiles for the addition of ashed hillside turf, and possibly peat, to the plaggen soils. Cereal-type pollen is well represented through the profiles and is often strongly associated with the record for Chrysanthemum segetum (corn marigold), a frequent indicator of arable land. The Brassicaceae signal may partly reflect the cultivation of cabbages; Chelidonium majus (greater celandine) may have been grown for medicinal use. Soil mixing has rendered radiocarbon dating meaningless at this site, but the establishment of a change in cultivation regime before AD 1830 may have been identified from the patterns of pollen concentration and preservation in the profiles. © 2008 Elsevier B.V. All rights reserved.

Balancing the (carbon) budget: Using linear inverse models to estimate carbon flows and mass-balance 13C:15N labelling experiments in low oxygen sediments.

Over 1 million km² of seafloor experience permanent low-oxygen conditions within oxygen minimum zones (OMZs). OMZs are predicted to grow as a consequence of climate change, potentially affecting oceanic biogeochemical cycles. The Arabian Sea OMZ impinges upon the western Indian continental margin at bathyal depths (150 - 1500 m) producing a strong depth dependent oxygen gradient at the sea floor. The influence of the OMZ upon the short term processing of organic matter by sediment ecosystems was investigated using in situ stable isotope pulse chase experiments. These deployed doses of ¹³C:¹⁵N labeled organic matter onto the sediment surface at four stations from across the OMZ (water depth 540 - 1100 m; [O₂] = 0.35 - 15 μM). In order to prevent experimentally anoxia, the mesocosms were not sealed. ¹³C and ¹⁵N labels were traced into sediment, bacteria, fauna and ¹³C into sediment porewater DIC and DOC. However, the DIC and DOC flux to the water column could not be measured, limiting our capacity to obtain mass-balance for C in each experimental mesocosm. Linear Inverse Modeling (LIM) provides a method to obtain a mass-balanced model of carbon flow that integrates stable-isotope tracer data with community biomass and biogeochemical flux data from a range of sources. Here we present an adaptation of the LIM methodology used to investigate how ecosystem structure influenced carbon flow across the Indian margin OMZ. We demonstrate how oxygen conditions affect food-web complexity, affecting the linkages between the bacteria, foraminifera and metazoan fauna, and their contributions to benthic respiration. The food-web models demonstrate how changes in ecosystem complexity are associated with oxygen availability across the OMZ and allow us to obtain a complete carbon budget for the stationa where stable-isotope labelling experiments were conducted.

1916: A Global History

The mud-filled, blood-soaked trenches of the Low Countries and North-Eastern Europe were essential battlegrounds during the First World War, but the war reached many other corners of the globe, and events elsewhere significantly affected its course.

Covering the twelve months of 1916, eminent historian Keith Jeffery uses twelve moments from a range of locations and shows how they reverberated around the world. As well as discussing better-known battles such as Gallipoli, Verdun and the Somme, Jeffery examines Dublin, for the Easter Rising, East Africa, the Italian front, Central Asia and Russia, where the killing of Rasputin exposed the internal political weakness of the country's empire. And, in charting a wide range of wartime experience, he studies the 'intelligence war', naval engagements at Jutland and elsewhere, as well as the political consequences that ensued from the momentous US presidential election.

Using an extraordinary range of military, social and cultural sources, and relating the individual experiences on the ground to wider developments, these are the stories lost to history, the conflicts that spread beyond the sphere of Europe and the moments that transformed the war. - See more at: http://www.bloomsbury.com/uk/1916-9781408834305/#sthash.axFq0psR.dpuf

The ejected mass distribution of Type Ia supernovae: a significant rate of non-Chandrasekhar-mass progenitors

The ejected mass distribution of Type Ia supernovae (SNe Ia) directly probes progenitor evolutionary history and explosion mechanisms, with implications for their use as cosmological probes. Although the Chandrasekhar mass is a natural mass scale for the explosion of white dwarfs as SNe Ia, models allowing SNe Ia to explode at other masses have attracted much recent attention. Using an empirical relation between the ejected mass and the light-curve width, we derive ejected masses Mej and 56Ni masses MNi for a sample of 337 SNe Ia with redshifts z <0.7 used in recent cosmological analyses. We use hierarchical Bayesian inference to reconstruct the joint Mej-MNi distribution, accounting for measurement errors. The inferred marginal distribution of Mej has a long tail towards sub-Chandrasekhar masses, but cuts off sharply above 1.4 M⊙. Our results imply that 25-50 per cent of normal SNe Ia are inconsistent with Chandrasekhar-mass explosions, with almost all of these being sub-Chandrasekhar mass; super-Chandrasekhar-mass explosions make up no more than 1 per cent of all spectroscopically normal SNe Ia. We interpret the SN Ia width-luminosity relation as an underlying relation between Mej and MNi, and show that the inferred relation is not naturally explained by the predictions of any single known explosion mechanism.

Life history of turbot in Icelandic waters: Intra- and inter-population genetic diversity and otolith tracking of environmental temperatures

The stock structure of turbot was investigated between samples from S-Norway, the Irish Sea and the Kattegat, using 12 microsatellite loci and compared to the turbot caught in Icelandic waters. Highly significant genetic differentiation was observed between samples from Kattegat and other areas. Significant genetic differentiation was also observed between the Irish Sea sample on one hand and Iceland and S-Norway on the other hand. No significant genetic differentiation was observed between Iceland and S-Norway. Otoliths of 25 turbot, age ranging from 3 to 19 years, were subjected to nearly 300 mass spectrometry determinations of stable oxygen and carbon isotopes. Oxygen isotope composition (δ¹⁸O) in the otolith samples was used to estimate ambient temperature at time of otolith accretion, and yielded estimated temperatures experienced by the turbot ranging from 3 to 15°C. Overall, the genetic analysis indicates panmixia between turbot in Icelandic and Norwegian waters. While the extensive migration of larvae between Norway and Iceland is unlikely, passive drift of turbot larva from other areas (e.g. Ireland) cannot be ruled out.