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Previous observational studies suggested that vitamin D may control the absorption of iron (Fe) by inhibition of hepcidin, but the causal relevance of these associations is uncertain. Using placebo-controlled randomisation, we assessed the effects of supplementation with vitamin D on biochemical markers of Fe status and erythropoiesis in community-dwelling older people living in the UK. The BEST-D trial, designed to establish the optimum dose of vitamin D3 for future trials, had 305 participants, aged 65 years or older, randomly allocated to 4000 IU vitamin D3 (n 102), 2000 IU vitamin D3 (n 102) or matching placebo (n 101). We estimated the effect of vitamin D allocation on plasma levels of hepcidin, soluble transferrin receptor (sTfR), ferritin, Fe, transferrin, saturated transferrin (TSAT%) and the sTfR–ferritin index. Despite increases in 25-hydroxy-vitamin D, neither dose had significant effects on biochemical markers of Fe status or erythropoiesis. Geometric mean concentrations were similar in vitamin D3 arms v. placebo for hepcidin (20·7 [se 0·90] v. 20·5 [1·21] ng/ml), sTfR (0·69 [0·010] v. 0·70 [0·015] µg/ml), ferritin (97·1 [2·81] v. 97·8 [4·10] µg/l) and sTfR–ferritin ratio (0·36 [0·006] v. 0·36 [0·009]), respectively, while arithmetic mean levels were similar for Fe (16·7 [0·38] v. 17·3 [0·54] µmol/l), transferrin (2·56 [0·014] v. 2·60 [0·021] g/dl) and TSAT% (26·5 [0·60] v. 27·5 [0·85]). The proportions of participants with ferritin < 15 µg/l and TSAT < 16 % were unaltered by vitamin D3 suggesting that 12 months of daily supplementation with moderately high doses of vitamin D3 are unlikely to alter the Fe status of older adults.
Edited by
Randall Lesaffer, KU Leuven & Tilburg University,Anne Peters, Max Planck Institute for Comparative Public Law and International Law, Heidelberg
This chapter periodises the British historiography of international law in five parts. Its first period extends from Robert Ward’s Enquiry into the Foundation and History of the Law of Nations in Europe (1795) to Thomas Erskine Holland’s Oxford inaugural lecture on Alberico Gentili (1874), and traces the gradual professionalisation of the discipline and its historical strain. The second part examines the entanglement of empire and historicism in British international legal historiography from around 1870 to roughly 1920. The third part treats the symbolic coming of age of British international legal historiography, between the founding of the British Yearbook of International Law in 1920, and Hersch Lauterpacht’s pivotal enunciation of the so-called ‘Grotian’ tradition of international law after the Second World War. The fourth part explores the history of international law in the succeeding ‘age of Lauterpacht’ up to c. 1960, when historiographical advances came increasingly from the semi-periphery rather than the centre and from disciplines other than international law. The fifth part takes stock of the transdisciplinary ‘turn’ to the history of international law in the British world and the chapter concludes with reflections on the nascent field of comparative international legal history in the light of British developments over the longue durée.
Hard-to-treat childhood cancers are those where standard treatment options do not exist and the prognosis is poor. Healthcare professionals (HCPs) are responsible for communicating with families about prognosis and complex experimental treatments. We aimed to identify HCPs’ key challenges and skills required when communicating with families about hard-to-treat cancers and their perceptions of communication-related training.
Methods
We interviewed Australian HCPs who had direct responsibilities in managing children/adolescents with hard-to-treat cancer within the past 24 months. Interviews were analyzed using qualitative content analysis.
Results
We interviewed 10 oncologists, 7 nurses, and 3 social workers. HCPs identified several challenges for communication with families including: balancing information provision while maintaining realistic hope; managing their own uncertainty; and nurses and social workers being underutilized during conversations with families, despite widespread preferences for multidisciplinary teamwork. HCPs perceived that making themselves available to families, empowering them to ask questions, and repeating information helped to establish and maintain trusting relationships with families. Half the HCPs reported receiving no formal training for communicating prognosis and treatment options with families of children with hard-to-treat cancers. Nurses, social workers, and less experienced oncologists supported the development of communication training resources, more so than more experienced oncologists.
Significance of results
Resources are needed which support HCPs to communicate with families of children with hard-to-treat cancers. Such resources may be particularly beneficial for junior oncologists and other HCPs during their training, and they should aim to prepare them for common challenges and foster greater multidisciplinary collaboration.
Female fertility is a complex trait with age-specific changes in spontaneous dizygotic (DZ) twinning and fertility. To elucidate factors regulating female fertility and infertility, we conducted a genome-wide association study (GWAS) on mothers of spontaneous DZ twins (MoDZT) versus controls (3273 cases, 24,009 controls). This is a follow-up study to the Australia/New Zealand (ANZ) component of that previously reported (Mbarek et al., 2016), with a sample size almost twice that of the entire discovery sample meta-analysed in the previous article (and five times the ANZ contribution to that), resulting from newly available additional genotyping and representing a significant increase in power. We compare analyses with and without male controls and show unequivocally that it is better to include male controls who have been screened for recent family history, than to use only female controls. Results from the SNP based GWAS identified four genomewide significant signals, including one novel region, ZFPM1 (Zinc Finger Protein, FOG Family Member 1), on chromosome 16. Previous signals near FSHB (Follicle Stimulating Hormone beta subunit) and SMAD3 (SMAD Family Member 3) were also replicated (Mbarek et al., 2016). We also ran the GWAS with a dominance model that identified a further locus ADRB2 on chr 5. These results have been contributed to the International Twinning Genetics Consortium for inclusion in the next GWAS meta-analysis (Mbarek et al., in press).
Most contemporary students and proponents of cosmopolitanism would identify it as a philosophy of peace, based on mutual tolerance, recognition, dialogue and commitment to global justice. This chapter argues that, though true, this account of cosmopolitanism is historically incomplete and conceptually truncated. It shows how such a pacific conception of cosmopolitanism had to be positively argued for in the Enlightenment against currents of cosmopolitanism reaching back to the Stoics that presented it as conflictual and conflicted. In particular, it argues that there has been a long and complex relationship between conceptions of cosmopolitanism and ideas of civil war from ancient Rome to our own age of “Global Civil War.” It presents the darker side of cosmopolitanism as a philosophy of conflict as well as compromise, of war as well as peace and of civil war as well as of civilisation and civility.
Nutrition during the periconceptional period influences postnatal cardiovascular health. We determined whether in vitro embryo culture and transfer, which are manipulations of the nutritional environment during the periconceptional period, dysregulate postnatal blood pressure and blood pressure regulatory mechanisms. Embryos were either transferred to an intermediate recipient ewe (ET) or cultured in vitro in the absence (IVC) or presence of human serum (IVCHS) and a methyl donor (IVCHS+M) for 6 days. Basal blood pressure was recorded at 19–20 weeks after birth. Mean arterial pressure (MAP) and heart rate (HR) were measured before and after varying doses of phenylephrine (PE). mRNA expression of signaling molecules involved in blood pressure regulation was measured in the renal artery. Basal MAP did not differ between groups. Baroreflex sensitivity, set point, and upper plateau were also maintained in all groups after PE stimulation. Adrenergic receptors alpha-1A (αAR1A), alpha-1B (αAR1B), and angiotensin II receptor type 1 (AT1R) mRNA expression were not different from controls in the renal artery. These results suggest there is no programmed effect of ET or IVC on basal blood pressure or the baroreflex control mechanisms in adolescence, but future studies are required to determine the impact of ET and IVC on these mechanisms later in the life course when developmental programming effects may be unmasked by age.
Oceanic Histories is the first comprehensive account of world history focused not on the land but viewed through the 70% of the Earth's surface covered by water. Leading historians trace the history of the Indian, Pacific, and Atlantic Oceans and seas, from the Arctic and the Baltic to the South China Sea and the Sea of Japan/Korea's East Sea, over the longue durée. Individual chapters trace the histories and the historiographies of the various oceanic regions, with special attention given to the histories of circulation and particularity, the links between human and non-human history and the connections and comparisons between parts of the World Ocean. Showcasing oceanic history as a field with a long past and a vibrant future, these authoritative surveys, original arguments and guides to research make this volume an indispensable resource for students and scholars alike.
This article responds to a variety of criticisms of our thesis that the longue durée is returning after a period of retreat, and that this return provides a necessary means to revive the discipline of history as a critical human science. We argue that the longue durée has different meanings in distinct historical traditions and that its importance for non-academic audiences will not be the same as for an academic readership. We also suggest that the longue durée should be combined with other historical time-scales (including those covered by microhistory), and that this combination can help us all to better understand the present in light of the past and then orient ourselves toward the future. In sum, we argue that the revenant longue durée can be one means, among others, to address the widespread “crisis of the humanities” that has been discerned by scholars around the world.