Derby maternity deaths might have been prevented – report

The deaths were under the care of University Hospitals of Derby and Burton NHS Foundation Trust over a 16-month period.

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Nurses set for ‘intensive’ talks with government after strike paused

Health Secretary Steve Barclay will meet Royal College of Nursing bosses for talks over pay.

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Excess nutrients lead to dramatic ecosystem changes in Cape Cod’s Waquoit Bay; the bay is a harbinger for estuaries worldwide, say researchers

When the Covid-19 pandemic hit in 2020 with associated travel restrictions, Matthew Long thought his students could shift their overseas research projects to instead study the seagrass meadow ecosystem in Waquoit Bay. It’s a shallow, micro-tidal estuary on the south side of Cape Cod in Massachusetts, near the Woods Hole Oceanographic Institution (WHOI) where Long is an associate scientist in the Marine Chemistry and Geochemistry Department.

However, when Long and his students looked for seagrass meadows where he had seen them in previous years, there were only a few shoots of dying Zostera marina eelgrass, a type of seagrass.

That prompted Long and Jordan Mora, a restoration ecologist with the Association to Preserve Cape Cod, to analyze decades’ worth of local environmental monitoring data to find out what has happened to the estuary. What they determined is that Waquoit Bay has shifted from a benthic to a pelagically-dominated ecosystem due to human causes, including an excess influx of nutrient pollution along with climate change.

That disruption to Waquoit Bay’s ecosystem presents broad concerns about the fate of coastal estuaries worldwide, according to the researchers.

In addition, the researchers point to the importance of tapping into and analyzing long-term monitoring data to better understand the changes to Waquoit Bay and potentially to other estuaries as well.

The water quality and overall health of estuaries continue to degrade due to excess nutrients from leaching septic systems, agricultural runoff, and other anthropogenic sources, the researchers note. In addition, warming water temperatures from climate change, particularly in the northeastern United States, exacerbates the nitrogen loading problem by reducing dissolved oxygen levels and accelerating microbial metabolism which further reduces oxygen levels.

“This shift toward pelagic dominance in Waquoit Bay may indicate that other eutrophic and warming estuaries may also shift toward pelagic dominance in the future, as the Northeastern US is one of the fastest warming,” according to “Deoxygenation, Acidification and Warming in Waquoit Bay, USA, and a Shift to Pelagic Dominance,” a paper co-authored by Long and Mora published in Estuaries and Coasts, the journal of the Coastal and Estuarine Research Federation. “The range of nitrogen loading across the Waquoit Bay sub-watersheds is comparable to the range of nitrogen loading across 90% of the world’s estuaries making it an ideal site for investigating eutrophication impacts.”

The scientists note that their research results in Waquoit Bay “cannot disentangle the contributions of global change or eutrophication to estuary decline. However, they do point to a potential combined effect that may result in other similar estuaries becoming dominated by pelagic metabolism in the future, and the resulting deleterious effects of harmful algal blooms, hypoxia, and the loss of species diversity and ecosystem function.”

The researchers’ analyses revealed recent and unexpectedly large increases in chlorophyll a concentrations, an indicator of microalgal blooms, in the water column throughout the estuary, which coincided with ongoing decreases in macroalgal density on the bottom of the estuary. In addition, the analyses showed an increase in temperature over the last 20 years and significant declines in oxygen and pH levels, among other changes.

The analyses relied on long-term monitoring data collected over decades from two monitoring programs coordinated by the Waquoit Bay National Estuarine Research Reserve, including the reserve’s System-Wide Monitoring Program and the Waquoit BayWatchers, that latter of which is a citizen science water quality monitoring program.

One of the main objectives of the current study was to apply time-series analysis techniques and substantial knowledge about the history of the monitoring programs to reveal long-term trends in water quality, according to the paper. “These methods can be applied to other monitoring data to advance the knowledge gained from similar monitoring programs, enhance our understanding of estuarine biogeochemistry, and investigate estuarine responses to long-term change,” the paper states.

Long said eelgrass provides a number of ecosystem benefits including stabilizing sediments and offering habitat for a variety of organisms. In addition, eelgrass is a great indicator of good estuarine water quality and also serves as a carbon sink.

“Carbon storage is extremely important across the world, and we’re actively trying to figure out ways to store and sequester carbon. Seagrass meadows represent a really significant and efficient carbon storage sink,” Long said. “Let’s not lose the seagrass meadows and the carbon sequestration that we already have in place, and let’s actively maintain and restore seagrass meadows. With the loss of seagrass meadows, such as what we’ve seen in Waquoit Bay, we’re actively releasing that carbon back to the atmosphere.”

Long added that using environmental monitoring data helped to put together the story of the switch from a seagrass-dominated system to a macroalgal-dominated system from the 1980s to the present in Waquoit Bay. Without the long-term data, gradual changes to the system would be more difficult to detect, he said.

“This paper isn’t just significant because it demonstrates that the estuaries on southern Cape Cod, and more generally the northeastern US, are entering a new level of degradation where not even macroalgae or seaweeds can persist, but also because it provides clear evidence that long-term monitoring programs are extremely important and worth maintaining,” said Mora, who worked at the Waquoit Bay National Estuarine Research Reserve for 10 years collecting water quality and submerged vegetation data with visiting scientists, volunteers, and other staff, and witnessed the gradual decline in habitat quality firsthand.

“My hope is that by showing the impact of increasing temperatures on already degraded systems, this paper will help facilitate local and regional management discussions and accelerate the decision-making needed to mitigate the overload of nutrients in our estuaries,” Mora added.

The paper notes that “there is an urgent need to address wastewater handing to improve the estuary, especially in the face of global changes.”

Long said, however, that if local stressors including nutrient pollution can be addressed, and if we can reduce carbon emissions and slow down global warming and the amount of carbon that diffuses into the ocean, “we could turn this situation around before it happens to many similar estuarine systems across the world, preserve the valuable ecological functions of seagrass meadows, and enable their carbon storage potential.”

Funding to support the Marine Biological Laboratory macrophyte data collection was provided by Woods Hole Sea Grant. This research was funded by a WHOI Independent Research and Development grant.?

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Researcher discovers threshold that triggers drought response in forests

Missouri is home to an array of natural resources, with forests among the state’s most valuable ecosystems. As warmer temperatures fueled by climate change affect ecosystems globally, forests are under stress to adapt to these changes and ensure their survival in a warmer world.

In a new study, University of Missouri researcher Jeffrey Wood introduces the “ecosystem wilting point” concept, which explains how whole forests respond to drought. Wood and his research team found that when forests reach their ecosystem wilting point, they are less able to function properly, which includes their ability to absorb carbon dioxide. To learn how the forest behaved during periods of drought, Wood combined measurements of evapotranspiration (the loss of water to the air) and ecosystem water status, which indicates how hydrated the forest is.

“The motivating reason for being able to understand the drought response of forests is that, globally, drought is important now, and it’s not expected to get better,” said Wood, an assistant professor in the College of Agriculture, Food and Natural Resources. “We wanted to develop a better way to understand and characterize these ecosystems, so we can use that information to help with modeling the dynamics of vegetation over time and better understand the future impact on these ecosystems.”

In pursuit of understanding the nuances of forests’ stress, Wood and his co-authors reanalyzed data collected during an extreme drought event that took place in 2012 in Baskett Forest, an outdoor laboratory of 2,266 acres located five miles east of Ashland, Missouri. This study uses a method that was initially developed to understand the interaction between water and an individual cell. That method was later applied to leaves, and then Wood extended it in this study to analyze a whole forest.

In this study, this oak-hickory forest in central Missouri reaches its ecosystem wilting point between 2-4 weeks of extreme drought. At that point, the forest would need soaking rainfall to rejuvenate.

“The ecosystem wilting point is functionally significant in that when the forest passes that threshold, there is a noticeable change in how the forest is behaving,” Wood said. “When you get into that highly stressed state, the forest is quite unresponsive to changes in the environment. So, when the sun comes up, you would tend to think that the forest turns on and starts to photosynthesize, but if the forest is past its ecosystem wilting point, it has a very limited capacity to respond to the changes in light in terms of carbon dioxide uptake because it’s under so much stress.”

This study offers insight into the water relations of whole forests, a useful tool for researchers exploring how forests across the globe handle temperature variations — something Wood emphasizes is important as scientists manage forests in a way that prepares them to better withstand climate change.

“Forests are pretty important; they’re connected to weather and the climate in ways that we still don’t fully understand,” Wood said.

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Sinking tundra surface unlikely to trigger runaway permafrost thaw

Oak Ridge National Laboratory scientists set out to address one of the biggest uncertainties about how carbon-rich permafrost will respond to gradual sinking of the land surface as temperatures rise. Using a high-performance computer simulation, the research team found that soil subsidence is unlikely to cause rampant thawing in the future.

This permanently frozen landscape in the Arctic tundra, which has kept vast amounts of carbon locked away for thousands of years, is at risk of thawing and releasing greenhouse gases into the atmosphere.

The United Nation’s Intergovernmental Panel on Climate Change has identified the possibility of soil subsidence leading to a feedback loop that could trigger a rapid thaw as a major concern in the decades ahead. Accelerated thawing caused by uneven land subsidence has been observed on smaller scales over shorter time frames, but the IPCC’s assessments were uncertain as to what may happen over the long term.

That’s where ORNL stepped in with its Advanced Terrestrial Simulator, or ATS, a highly accurate, physics-based model of the region’s hydrology fed by detailed, real-world measurements to help scientists understand the land’s evolution.

What they found is that even though the ground will continue to sink as big ice deposits melt, the uneven subsidence also leads to a drier landscape and limits the process’s acceleration through the end of the century, as described in the Proceedings of the National Academy of Sciences.

“Improved drainage results in a drier landscape over a decadal timescale, and the process then becomes self-limiting,” said Scott Painter, who leads the Watershed Systems Modeling group at ORNL.

The scientists focused on a large region of the tundra characterized by ice wedges — long pieces of ice that crack the surface and extend belowground to create polygonal forms in the Arctic landscape. The cryo-hydrology simulations were informed by measurements gathered in the polygonal tundra.

The ATS was first developed for the Department of Energy’s NGEE Arctic project led by ORNL, focused on observations, experiments and modeling of the environmental processes at play in the region to improve climate predictions.

“We looked at the microtopography caused by these ice wedges in the subsurface and how that controls the flow of water,” Painter said. “Ours is the first capability to capture the effect of changing microtopography and represent it in climate models.”

Painter added that the team has a high degree of confidence in the model since it was developed for NGEE Arctic and has been evaluated against the project’s real-world observations.

He noted that most models, including ORNL’s, are in agreement in generally projecting large amounts of carbon thaw in the Arctic as temperatures rise. “But here, we have identified that one of the most worrisome processes, this runaway thawing due to subsidence, is unlikely to occur over a long time frame.”

The study pointed out other implications of a drying landscape. “As the polygonal tundra gets very dry, by the year 2100 it could have ecological impacts for migratory birds, which use these ecosystems as breeding grounds,” Painter said.

Other scientists collaborating on the study include ORNL’s Ethan Coon; Ahmad Jan, formerly of ORNL and now at the NOAA-affiliated Office of Water Prediction; and Julie Jastrow of Argonne National Laboratory.

The research was supported by NGEE Arctic, which is sponsored by the DOE Office of Science’s Biological and Environmental Research Program and led by ORNL, and BER’s Environmental System Science Program at Argonne. NGEE Arctic supported the original development of ATS as well as recent enhancements to incorporate subsidence into the model.

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Gambling: Government expected to tighten regulation on sector

A forthcoming government white paper on gambling is expected to tighten regulation in the sector.

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Kettering Hospital ward accused of traumatising children may close

The BBC speaks to about a dozen parents with concerns after children died or became seriously ill.

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Scientists make breakthrough for ‘next generation’ cancer treatment

Scientists at the University of East Anglia are a step closer to creating a new generation of light-activated cancer treatments.

The futuristic sounding treatment would work by switching on LED lights embedded close to a tumour, which would then activate biotherapeutic drugs.

These new treatments would be highly targeted and more effective than current state-of-the-art cancer immunotherapies.

New research published today reveals the science behind this innovative idea.

It shows how the UEA team have engineered antibody fragments — which not only ‘fuse’ with their target but are also light activated.

It means that in future, immunotherapy treatments could be engineered to attack tumours more precisely than ever before.

The principal scientist for this study, Dr Amit Sachdeva, from UEA’s School of Chemistry, said: “Current cancer treatments like chemotherapy kill cancer cells, but they can also damage healthy cells in your body such as blood and skin cells.

“This means that they can cause side effects including hair loss, feeling tired and sick, and they also put patients at increased risk of picking up infections.

“There has therefore been a very big drive to create new treatments that are more targeted and don’t have these unwanted side-effects.

“Several antibodies and antibody fragments have already been developed to treat cancer. These antibodies are much more selective than the cytotoxic drugs used in chemotherapy, but they can still cause severe side effects, as antibody targets are also present on healthy cells.”

Now, the UEA team has engineered one of the first antibody fragments that binds to, and forms a covalent bond with, its target — upon irradiation with UV light of a specific wavelength.

Dr Sachdeva said: “A covalent bond is a bit like melting two pieces of plastic and fusing them together. It means that drug molecules could for example be permanently fixed to a tumour.

“We hope that our work will lead to the development of a new class of highly targeted light-responsive biotherapeutics. This would mean that antibodies could be activated at the site of a tumour and covalently stick to their target upon light activation.

“In other words, you could activate antibodies to attack tumour cells by shining light – either directly on to the skin, in the case of skin cancer, or using small LED lights that could be implanted at the site of a tumour inside the body.

“This would allow cancer treatment to be more efficient and targeted because it means that only molecules in the vicinity of the tumour would be activated, and it wouldn’t affect other cells.

“This would potentially reduce side effects for patients, and also improve antibody residence time in the body.”

“It would work for cancers like skin cancer, or where there is a solid tumour – but not for blood cancers like leukaemia.

“Development of these antibody fragments would not have been possible without pioneering work from several other research groups across the globe who developed and optimised methods for site-specific incorporation of non-natural amino acids into proteins expressed in live cells.

“We employed some of these methods to site-specifically install unique light-sensitive amino acids into antibody fragments.”

If the researchers are successful in the next stages of their work, they hope to see the ‘next generation’ light-activated immunotherapies being used to treat cancer patients within five to 10 years.

This research was funded by the Biotechnology and Biological Sciences Research Council (BBSRC) and the Wellcome Trust. It was led by the University of East Anglia with assistance from the proteomics facility at the John Innes Centre.

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Big rise in long-term sick hitting UK workforce

There are now nearly 2.5 million adults of working age who are long-term sick, official figures show.

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One in three parents may unnecessarily give children fever-reducing medicine

For many children, winter season comes with regular exposure to circulating viruses at school or daycare. And a warm forehead is often one of the first clear signs a child has caught a bug.

But some parents may not be properly measuring or responding to elevated temperatures in children, a new national poll suggests.

While most parents recognize that a low-grade fever helps a child’s body fight off infection, one in three would give fever-reducing medication for spiked temperatures below 100.4 — which isn’t recommended — according to the C.S. Mott Children’s Hospital National Poll on Children’s Health at University of Michigan Health.

Half of parents would also use medicine if the fever was between 100.4 and 101.9 degrees, and a quarter of parents would likely give another dose to prevent the fever from returning.

“Often parents worry about their child having a fever and want to do all they can to reduce their temperature. However, they may not be aware that in general the main reason to treat a fever is just to keep their child comfortable,” said Mott Poll co-director and Mott pediatrician Susan Woolford, M.D.

“Some parents may immediately rush to give their kids medicine but it’s often better to let the fever runs its course. Lowering a child’s temperature doesn’t typically help cure their illness any faster. In fact, a low-grade fever helps fight off the infection. There’s also the risk of giving too much medication when it’s not needed, which can have side effects.”

The report is based on 1,376 responses from parents of children ages 12 and under polled between August and September 2022.

Two in three parents polled say they’re very confident they know whether their child needs medication to reduce a fever. But just over half are sure they understand how temperature readings can change according to the method used.

The method used to take a child’s temperature matters and can affect the accuracy of the measurement, Woolford notes. Parents polled most commonly take their child’s temperature by forehead scan or mouth while less than a sixth use ear, underarm or rectal methods.

Remote thermometers at the forehead or inside the ear canal can be accurate if used correctly. But forehead readings may be inaccurate, Woolford says, if the scanner is held too far away or if the child’s forehead is sweaty. With ear thermometers, which aren’t recommended for newborns, earwax can also interfere with the reading.

For infants and young children, rectal temperatures are most accurate. Once children are able to hold a thermometer in their closed mouth, oral temperatures also are accurate while armpit temperatures are the least accurate method.

“Contact thermometers use electronic heat sensors to record body temperature but temperatures may fluctuate depending on how it’s measured,” Woolford said.

“Regardless of the device used, it’s important that parents review the directions to ensure the method is appropriate for the child’s age and that the device is placed correctly when measuring temperature.”

Three in four parents say they take their child’s temperature as soon as they notice a possible problem, while a little less than a fourth wait to see if the problem continues or worsens before taking the temperature.

Two-thirds of parents also prefer to try methods like a cool washcloth before using fever-reducing medication. Most parents also say they always or usually record the time of each dose and re-take their child’s temperature before giving another dose.

“A quarter of parents would give their child more medicine to prevent a fever from returning even though it doesn’t help them get better,” Woolford said. “If a child is otherwise doing well, parents may consider monitoring them and using alternative interventions to help keep them comfortable.”

However, if a newborn or infant less than three months old has a fever, they should immediately see a health professional, Woolford adds.

She shares more tips on how to handle fevers in kids:

Fevers can help fight infections

A fever can be beneficial, and there are several reasons to let a low-grade fever run its course in older children — mainly because it’s working as a weapon to kill the virus or bacteria causing sickness, Woolford says.

Evidence shows that fevers are part of the immune response to prevent viruses and bacteria from replicating and also produce more white blood cells and antibodies.

Fever-reducing medications also mask symptoms.

“Medications used to lower temperatures also treat pain, but pain is often a sign that helps to locate the source of an infection,” Woolford said. “By masking pain, fever-reducing medication may delay a diagnosis being made and delay receiving treatment if needed.”

She adds that parents may also be tempted to take kids in public when they noticeably seem better after medicine when in fact they’re still highly contagious and may infect others.

If you do use medicine, be careful about not overmedicating

When parents choose to give fever-reducing medication, it’s helpful to keep a log of temperature readings and when medicine was given. This will provide an accurate record in the event that the child’s fever continues for an extended period of time.

Parents of young children in particular should also avoid using combination cold medications along with fever-reducing medications due to the risk of over dosage.

“As we know, all medications can have side effects and we really don’t want children to get too much medication when it’s not necessary,” Woolford said.

When communicating with the child’s provider to help determine the best recommendations about treatment, it’s helpful for parents to share the timeline of the child’s fever, doses of fever-reducing medication, other symptoms and how the child is acting compared to their “usual” behavior.

Try alternatives to relieving child’s discomfort

Parents may consider other interventions to relieve discomfort and aid in more restful sleep instead of medicine, Woolford says.

Such approaches could include keeping their room cool and not letting them overexert themselves, as well as ensuring the child is in light clothing and encouraging them to stay well hydrated with fluids or popsicles.

Be aware of signs to call the doctor

For infants and newborns three months and younger, any sign of a fever should prompt a call to the provider.

For children 4-12 months, parents should consult with a doctor if a fever is accompanied by signs such as decreased activity, increased fussiness, or decreased urine output. Parents should also call if their child has signs of pain or if they are not acting themselves even when their temperature comes down.

Fevers that reach 104 degrees or fevers that remain for an extended period (more than 24 hours for children under two, or more than three days for children ages two and older) should prompt contact with the provider.

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