Macronutrient balance mediates trade-offs between immune function and life history traits

1. Diet and health are intimately linked and recent studies have found that caloric restriction can affect immune function. However, when given a choice between diets that differ in their macronutrient composition, pathogen-infected individuals can select a diet that improves their survival, suggesting that the nutritional composition of the diet, as well as its calorie content, can play a role in defence against disease. Moreover, as individuals change their diet when infected, it suggests that a diet that is optimal for growth is not optimal for immunity, leading to trade-offs.
2. Currently, our knowledge of the effects of diet on immunity is limited because previous experiments have manipulated either single nutrients or the calorie content of the diet without considering their interactive effects. By simultaneously manipulating both the diet composition (quality) and its caloric density (quantity), in both naive and immune-challenged insects, we asked how do diet quality and quantity influence an individual's ability to mount an immune response? And to what extent are allocation trade-offs driven by quantity- versus quality-based constraints?
3. We restricted individuals to 20 diets varying in their protein and carbohydrate content and used 3D response surfaces to visualize dietary effects on larval growth and immune traits. Our results show that both constitutive and induced immune responses are not limited by the total quantity of nutrients consumed, but rather different traits respond differently to variation in the ratios of macronutrients (diet quality), and peak in different regions of macronutrient space. The preferred dietary composition therefore represents a compromise between the nutritional requirements of growth and immune responses. We also show that a non-pathogenic immune challenge does not affect diet choice, rather immune-challenged insects modify their allocation of nutrients to improve their immune response.
4. Our results indicate that immune traits are affected by the macronutrient content of the diet and that no diet can simultaneously optimize all components of the immune system. To date the emphasis has been on the effects of micronutrients in improving immunity, our findings indicate that this must be widened to include the neglected impact of macronutrients on defence against disease.

'Murder or Mercy?' an innovative module helping UK medical students to articulate their own ethical standpoints regarding end-of-life decisions

Objectives This student selected component (SSC) was designed to equip United Kingdom (UK) medical students to respond ethically and with sensitivity to requests they might receive as qualified doctors in regard to euthanasia and assisted dying. The aim was to expose students to relevant opinions and experiences and to provide opportunities to explore and justify their own views and rehearse ethical decision making in a safe learning environment. Method The module is delivered by specialists from a number of disciplines including law, theology, medicine and nursing, each providing students with a working knowledge allowing them to actively discuss cases, articulate their own views and practise ethical reasoning through group and individual study. Visits to local intensive care units, palliative care wards and hospices are integrated effectively with theory. Student assessment comprises a dissertation, student-led debate and reflective commentary. Module impact was evaluated by analysis of student coursework and a questionnaire. Results Students found the content stimulating and relevant to their future career and agreed that the module was well-structured and that learning outcomes were achieved. They greatly appreciated the clinical context provided by the visits and opportunities to apply ethical reasoning to real cases and to debate ethical issues with peers. Students reported an increased discernment of the ethical and legal position and practical considerations and a greater awareness of the range of professional and lay viewpoints held. Student perceptions were confirmed on analysis of their submitted coursework. Many participants were less strongly in favour of euthanasia and assisted dying on module completion than at the outset but all felt better equipped to justify their own viewpoint and to respond appropriately to patient requests. Conclusions The multi-disciplinary nature of this course is helpful in preparing students to deal effectively and sensitively with ethical dilemmas they will encounter in their medical career. Use of an integrated, learner-centred approach equips students to actively engage with their peers in discussion of such issues and to formulate and defend their own position.

Birth order and childhood type 1 diabetes risk: A pooled analysis of 31 observational studies

Background: The incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis of previous studies. Methods: Relevant studies published before January 2010 were identified from MEDLINE, Web of Science and EMBASE. Authors of studies provided individual patient data or conducted pre-specified analyses. Meta-analysis techniques were used to derive combined odds ratios (ORs), before and after adjustment for confounders, and investigate heterogeneity. Results: Data were available for 6 cohort and 25 case-control studies, including 11 955 cases of type 1 diabetes. Overall, there was no evidence of an association prior to adjustment for confounders. After adjustment for maternal age at birth and other confounders, a reduction in the risk of diabetes in second-or later born children became apparent [fully adjusted OR=0.90 95% confidence interval (CI) 0.83-0.98; P=0.02] but this association varied markedly between studies (I 2=67%). An a priori subgroup analysis showed that the association was stronger and more consistent in children <5years of age (n=25 studies, maternal age adjusted OR=0.84 95% CI 0.75, 0.93; I 2=23%). Conclusion: Although the association varied between studies, there was some evidence of a lower risk of childhood onset type 1 diabetes with increasing birth order, particularly in children aged <5 years. This finding could reflect increased exposure to infections in early life in later born children. Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2010; all rights reserved.

Regenerative Medicine and New Labour Life Science Policy: Rhetorics of Success, Narratives of Sustainability and Survival

Advances in stem cell science and tissue engineering are being turned into applications and products through a novel medical paradigm known as regenerative medicine. This paper begins by examining the vulnerabilities and risks encountered by the regenerative medicine industry during a pivotal moment in its scientific infancy: the 2000s. Under the auspices of New Labour, British medical scientists and life science innovation firms associated with regenerative medicine, received demonstrative rhetorical pledges of support, aligned with the publication of a number of government initiated reports presaged by Bioscience 2015: Improving National Health, Increasing National Wealth. The Department of Health and the Department of Trade and Industry (and its successors) held industry consultations to determine the best means by which innovative bioscience cultures might be promoted and sustained in Britain. Bioscience 2015 encapsulates the first chapter of this sustainability narrative. By 2009, the tone of this storyline had changed to one of survivability. In the second part of the paper, we explore the ministerial interpretation of the ‘bioscience discussion cycle’ that embodies this narrative of expectation, using a computer-aided content analysis programme. Our analysis notes that the ministerial interpretation of these reports has continued to place key emphasis upon the distinctive and exceptional characteristics of the life science industries, such as their ability to perpetuate innovations in regenerative medicine and the optimism this portends – even though many of the economic expectations associated with this industry have remained unfulfilled.

The Architecture of Home in Cairo: Socio-Spatial Practice of the Hawari's Everyday Life

The hawari of Cairo - narrow non-straight alleyways - are the basic urban units that have formed the medieval city since its foundation back in 969 AD. Until early in the C20th, they made up the primary urban divisions of the city and were residential in nature. Contemporary hawari, by contrast, are increasingly dominated by commercial and industrial activity. This medieval urban maze of extremely short, broken, zigzag streets and dead ends are defensible territories, powerful institutions, and important social systems. While the hawari have been studied as an exemplar for urban structure of medieval Islamic urbanism, and as individual building typologies, this book is the first to examine in detail the socio-spatial practice of the architecture of home in the city. It investigates how people live, communicate and relate to each other within their houses or shared spaces of the alleys, and in doing so, to uncover several new socio-spatial dimensions and meanings in this architectural form.

In an attempt to re-establish the link between architecture past and present, and to understand the changing social needs of communities, this book uncovers the notion of home as central to understand architecture in such a city with long history as Cairo. It firstly describes the historical development of the domestic spaces (indoor and outdoor), and provides an inclusive analysis of spaces of everyday activities in the hawari of old Cairo. It then broadens its analysis to other parts of the city, highlighting different customs and representations of home in the city at large. Cairo, in the context of this book, is represented as the most sophisticated urban centre in the Middle East with different and sometimes contrasting approaches to the architecture of home, as a practice and spatial system.

In order to analyse the complexity and interconnectedness of the components and elements of the hawari as a 'collective home', it layers its narratives of architectural and social developments as a domestic environment over the past two hundred years, and in doing so, explores the in-depth social meaning and performance of spaces, both private and public.

EQUILIBRIUM STUDIES ON COLORIMETRIC PLASTIC FILM SENSORS FOR CARBON-DIOXIDE

The equilibrium responses of three new colorimetric plastic film sensors for CO2 as a function of % CO2 and temperature are described. The results fit a model in which there is a 1:1 equilibrium reaction between the deprotonated form of the dye (present in the film as an ion pair) and CO2. The 0-50% and 0-90% response and recovery times of each of these films when exposed to an alternating atmosphere of air and 5% CO2 are determined and in two cases are typically less than 3 s. The shelf life of the films is long (many months); however, prolonged use of the films leads to the permanent generation of the protonated form of the dye over a period of 20-100 h. A possible cause of this latter effect is discussed.

Retrofit versus new-build house using life-cycle assessment

This paper reports the findings of research on the environmental performance of two case-study houses, a retrofit and new build. The retrofit was completed to a Passivhaus standard while the new build was completed to current Irish building regulations. Environmental performance of the retrofit and new build was measured using life-cycle assessments, examining the assembly, operational and end-of-life stage over life spans of 50 and 80 years. Using primary information, life-cycle assessment software and life-cycle assessment databases the environmental impacts of each stage were modelled. The operational stage of both case studies was found to be the source of the most significant environmental damage, followed by the assembly and the end-of-life stage respectively. The relative importance of the assembly and end-of-life stage decreased as the life span increased. It was found that the retrofit house studied outperformed the new build in the assembly and operational stage, whereas the new build performed better in the end-of-life stage; however, this is highly sensitive, depending on the standards to which both are completed. Operational energy savings pre- and post-retrofit were significant, indicating the future potential for adoption of high-quality retrofitting practices.

Life history variation in Dasya ocellata (Dasyaceae, Rhodophyta)

Four of the five members of the Dasyaceae found in the British Isles, Dasya corymbifera J. Agardh, Dasya hutchinsiae Harvey, Dasya punicea Meneghini ex Zanardini and Heterosiphonia plumosa (Ellis) Batters, appear to have Polysiphonia-type life histories on the basis of evidence from field collections of tetrasporophytes and gametophytes. In collections from the British Isles of the fifth species, Dasya ocellata (Grateloup) Harvey, only tetrasporophytes have ever been observed, but there are two reports of gametophytes in this species from further south in Europe. Dasya ocellata tetraspores were isolated into culture from populations in Strangford Lough, Northern Ireland, and Agadir, Morocco, where one female thallus was collected amongst tetrasporophytes. Dasya ocellata from Ireland underwent a direct tetraspore-to-tetrasporophyte life history, which was followed through two complete cycles. Karyological studies showed that meiosis does not occur during tetrasporangial development: tetrasporangia are mitotic, with c. 64 small chromosomes. Comparison with chromosome numbers in meiotic tetrasporangia of D. hutchinsiae (n = c. 32) showed that this is the diploid chromosome complement. Tetraspores from the Moroccan isolate, by contrast, gave rise to gametophytes (although only the males became fertile) and tetrasporophyte recycling did not occur. Thalli sampled from a population in southern Portugal consisted only of tetrasporophytes. Dasya ocellata, like many members of the Ceramiales, shows intraspecific life history variability; a sexual life history apparently occurs only in southern populations.

Life history of the rare red alga Tsengia bairdii (=Platoma bairdii) (Nemastomataceae, Rhodophyta) from Scotland

A single thallus of the rare red seaweed Tsengia bairdii (Farlow) K. Fan et Y.Fan( Platoma bairdii (Farlow) Kuckuck) (Nemastomataceae) was collected on a subtidal pebble on the west coast of Scotland. The terete gelatinous axes, which were only 7 mm high, were monoecious. They bore numerous cystocarps and a few spermatangia, which represent the first observation of male structures in this genus. Released carpospores grew into expanded basal discs that gave rise to erect axes bearing irregularly cruciate tetrasporangia. irregularly cruciate to zonate tetrasporangia were also formed on these basal discs. Karyological studies on dividing tetrasporocytes showed about 25 bodies, identified as paired meiotic chromosomes on the basis of their size in comparison to mitotic and meiotic chromosomes in other red algal species. These observations confirm the isomorphic life history inferred from early field collections and show that this species is monoecious. Tsengia bairdii is an extremely rare seaweed in Europe - it seems to be confined to sublittoral cobbles and has a temporally patchy distribution.

Visual function and dysfunction in early and late age-related maculopathy

Late age-related maculopathy (ARM) is responsible for the majority of blind registrations in the Western world among persons over 50 years of age. It has devastating effects on quality of life and independence and is becoming a major public health concern. Current treatment options are limited and most aim to slow progression rather than restore vision; therefore, early detection to identify those patients most suitable for these interventions is essential. In this work, we review the literature encompassing the investigation of visual function in ARM in order to highlight those visual function parameters which are affected very early in the disease process. We pay particular attention to measures of acuity, contrast sensitivity (CS), cone function, electrophysiology, visual adaptation, central visual field sensitivity and metamorphopsia. We also consider the impact of bilateral late ARM on visual function as well as the relationship between measures of vision function and self-reported visual functioning. Much interest has centred on the identification of functional changes which may predict progression to neovascular disease; therefore, we outline the longitudinal studies, which to date have reported dark-adaptation time, short-wavelength cone sensitivity, colour-match area effect, dark-adapted foveal sensitivity, foveal flicker sensitivity, slow recovery from glare and slower foveal electroretinogram implicit time as functional risk factors for the development of neovascular disease. Despite progress in this area, we emphasise the need for longitudinal studies designed in light of developments in disease classification and retinal imaging, which would ensure the correct classification of cases and controls, and provide increased understanding of the natural course and progression of the disease and further elucidate the structure-function relationships in this devastating disorder.

Real-life Social Attention in Children with Autism Spectrum Disorders

Autism is a neuro-developmental disorder defined by atypical social behaviour, of which atypical social attention behaviours are among the earliest clinical markers (Volkmar et al., 1997). Eye tracking studies using still images and movie clips have provided a method for the precise quantification of atypical social attention in ASD. This is generally characterised by diminished viewing of the most socially pertinent regions (eyes), and increased viewing of less socially informative regions (body, background, objects) (Klin et al., 2002; Riby & Hancock, 2008, 2009). Ecological validity within eye tracking studies has become an increasingly important issue. As of yet, however, little is known about the precise nature of the atypicalities of social attention in ASD in real-life. Objectives: To capture and quantify gaze patterns for children with an ASD within a real life setting, compared to two Typically Developing (TD) comparison groups. Methods: Nine children with an ASD were compared to two age matched TD groups – a verbal (N=9) and a non-verbal (N=9) comparison group. A real-life scenario was created involving an experimenter posing as a magician, and consisted of 3 segments: a conversation segment; a magic trick segment; and a puppet segment. The first segment explored children’s attentional preferences during a real-life conversation; the magic trick segment explored children’s use of the eyes as a communicative cue, and the puppet segment explored attention capture. Finally, part of the puppet section explored children’s use of facial information in response to an unexpected event. Results: The most striking difference between the groups was the diminished viewing of the eyes by the ASD group in comparison to both control groups. This was found particularly during the conversation segment, but also during the magic trick segment, and during the puppet segment. When in conversation, participants with ASD were found to spend a greater proportion time looking off-screen, in comparison to TD participants. There was also a tendency for the ASD group to spend a greater proportion of time looking to the mouth of the experimenter. During the magic trick segment, despite the fact that the eyes were not predictive of a correct location, both TD comparison groups continued to use the eyes as a communicative cue, whereas the ASD group did not. In the puppet segment, all three groups spent a similar amount of time looking between the puppet and regions of the experimenter’s face. However, in response to an unexpected event, the ASD group were significantly slower to fixate back on the experimenter’s face. Conclusions: The results demonstrate the reduced salience of socially pertinent information for children with ASD in real life, and they provide support for the findings from previous eye tracking studies involving scene viewing. However, the results also highlight a pattern looking off-screen for both the TD and ASD groups. This eye movement behaviour is likely to be associated specifically with real-life interaction, as it has functional relevance (Doherty-Sneddon et al., 2002). However, the fact that it is significantly increased in the ASD group has implications for their understanding of real life social interactions.