Amateur runners more influenced than elite runners by temperature and air pollution during the UK's Great North Run half marathon.

The short- and long-term impacts of air pollution on human health are well documented and include cardiovascular, neurological, immune system and developmental damage. Additionally, the irritant qualities of air pollutants can cause respiratory and cardiovascular distress. This can be heightened during exercise and especially so for those with respiratory conditions such as asthma. Meteorological conditions have also been shown to adversely impact athletic performance; but research has mostly examined the impact of pollution and meteorology on marathon times or running under laboratory settings. This study focuses on the half marathon distance (13.1 miles/21.1 km) and utilises the Great North Run held in Newcastle-upon-Tyne, England, between 2006 and 2019. Local meteorological (temperature, relative humidity, heat index and wind speed) and air quality (ozone, nitrogen dioxide and PM2.5) data is used in conjunction with finishing times of the quickest and slowest amateur participants, along with the elite field, to determine the extent to which each group is influenced in real-world conditions. Results show that increased temperatures, heat index and ozone concentrations are significantly detrimental to amateur half marathon performances. The elite field meanwhile is influenced by higher ozone concentrations. It is thought that the increased exposure time to the environmental conditions contributes to this greater decrease in performance for the slowest participants. For elite athletes that are performing closer to their maximal capacity (VO2 max), the higher ozone concentrations likely results in respiratory irritation and decreased performance. Nitrogen dioxide and PM2.5 pollution showed no significant relationship with finishing times. These results provide additional insight into the environmental effects on exercise, which is particularly important under the increasing effects climate change and regional air pollution. This study can be used to inform event organisation and start times for both mass participation and major elite events with the aim to reduce heat- and pollution-related incidents.

The Diamond League athletic series: does the air quality sparkle?

Urban air pollution can have negative short- and long-term impacts on health, including cardiovascular, neurological, immune system and developmental damage. The irritant qualities of pollutants such as ozone (O3), nitrogen dioxide (NO2) and particulate matter (PM) can cause respiratory and cardiovascular distress, which can be heightened during physical activity and particularly so for those with respiratory conditions such as asthma. Previously, research has only examined marathon run outcomes or running under laboratory settings. This study focuses on elite 5-km athletes performing in international events at nine locations. Local meteorological and air quality data are used in conjunction with race performance metrics from the Diamond League Athletics series to determine the extent to which elite competitors are influenced during maximal sustained efforts in real-world conditions. The findings from this study suggest that local meteorological variables (temperature, wind speed and relative humidity) and air quality (ozone and particulate matter) have an impact on athletic performance. Variation between finishing times at different race locations can also be explained by the local meteorology and air quality conditions seen during races.

STAT6 knockdown using multiple siRNA sequences inhibits proliferation and induces apoptosis of human colorectal and breast cancer cell lines.

The transcription factor STAT6 is strongly expressed in various tumours and is most highly expressed in human malignant lymphomas and pancreatic, colorectal, prostate and breast cancers. STAT6 is associated with cancer cell proliferation, an increased malignancy and poor prognosis. Thus, techniques aimed at reducing or blocking STAT6 expression may be useful in treating STAT6high cancers. Among these cancers, colorectal and breast cancers represent two of the most common worldwide and their incidence is increasing every year. In 2018, colorectal and breast cancers represented 10.2% and 11.6% of all new cases of cancer diagnosed, respectively. In this study, four proprietary STAT6 specific small interfering RNA (siRNA) sequences were tested in vitro using the human colon adenocarcinoma cell line, HT-29, and the breast/duct carcinoma cell line, ZR-75-1. Decreases in STAT6 mRNA and protein levels were analysed to confirm the transfection was successful and STAT6 knockdown effects were measured by analysing cell proliferation and apoptosis. Results showed that 100nM siRNA concentration was the most effective and, although all individual sequences were capable of significantly inhibiting cell proliferation, STAT6 siRNA sequences 1 and 4 had the largest effects. STAT6 silencing also significantly induced apoptotic events. In conclusion, these results demonstrate that STAT6 siRNA sequences are capable of inhibiting proliferation of and inducing apoptosis of HT-29 colorectal cancer cells and ZR-75-1 breast cancer cells, halving the number of cancer cells in a short period of time. These experiments will be repeated in other STAT6high cancers in vitro, and animal studies in immunocompromised mice have been planned using xenografts of STAT6-expressing human colorectal and breast cancer cells. The STAT6 siRNA sequences therefore represent a potential treatment for STAT6high colorectal and breast cancers and a wide variety of other STAT6-expressing cancers.

A systems framework for national assessment of climate risks to infrastructure.

Extreme weather causes substantial adverse socio-economic impacts by damaging and disrupting the infrastructure services that underpin modern society. Globally, $2.5tn a year is spent on infrastructure which is typically designed to last decades, over which period projected changes in the climate will modify infrastructure performance. A systems approach has been developed to assess risks across all infrastructure sectors to guide national policy making and adaptation investment. The method analyses diverse evidence of climate risks and adaptation actions, to assess the urgency and extent of adaptation required. Application to the UK shows that despite recent adaptation efforts, risks to infrastructure outweigh opportunities. Flooding is the greatest risk to all infrastructure sectors: even if the Paris Agreement to limit global warming to 2°C is achieved, the number of users reliant on electricity infrastructure at risk of flooding would double, while a 4°C rise could triple UK flood damage. Other risks are significant, for example 5% and 20% of river catchments would be unable to meet water demand with 2°C and 4°C global warming respectively. Increased interdependence between infrastructure systems, especially from energy and information and communication technology (ICT), are amplifying risks, but adaptation action is limited by lack of clear responsibilities. A programme to build national capability is urgently required to improve infrastructure risk assessment.This article is part of the theme issue 'Advances in risk assessment for climate change adaptation policy'.

The Effects of Heat Advection on UK Weather and Climate Observations in the Vicinity of Small Urbanized Areas.

Weather and climate networks traditionally follow rigorous siting guidelines, with individual stations located away from frost hollows, trees or urban areas. However, the diverse nature of the UK landscape suggests that the feasibility of siting stations that are truly representative of regional climate and free from distorting local effects is increasingly difficult. Whilst the urban heat island is a well-studied phenomenon and usually accounted for, the effect of warm urban air advected downwind is rarely considered, particularly at rural stations adjacent to urban areas. Until recently, urban heat advection (UHA) was viewed as an urban boundary-layer process through the formation of an urban plume that rises above the surface as it is advected. However, these dynamic UHA effects are shown to also have an impact on surface observations. Results show a significant difference in temperatures anomalies ( p < 0.001 ) between observations taken downwind of urban and rural areas. For example, urban heat advection from small urbanized areas ( ∼ 1 km 2 ) under low cloud cover and wind speeds of 2-3 m s - 1 is found to increase mean nocturnal air temperatures by 0.6 ∘ C at a horizontal distance of 0.5 km. Fundamentally, these UHA results highlight the importance of careful interpretation of long-term temperature data taken near small urban areas.

The Birmingham Urban Climate Laboratory-A high density, urban meteorological dataset, from 2012-2014.

There is a paucity of urban meteorological observations worldwide, hindering progress in understanding and mitigating urban meteorological hazards and extremes. High quality urban datasets are required to monitor the impacts of climatological events, whilst providing data for evaluation of numerical models. The Birmingham Urban Climate Laboratory was established as an exemplar network to meet this demand for urban canopy layer observations. It comprises of an array of 84 wireless air temperature sensors nested within a coarser array of 24 automatic weather stations, with observations available between June 2012 and December 2014. data routinely underwent quality control, follows the ISO 8601 naming format and benefits from extensive site metadata. The data have been used to investigate the structure of the urban heat island in Birmingham and its associated societal and infrastructural impacts. The network is now being repurposed into a testbed for the assessment of crowd-sourced and satellite data, but the original dataset is now available for further analysis, and an open invitation is extended for its academic use.

Standard of Care in Pediatrics: Integrating Family-Centred Care and Social Determinants of Health.

In pediatric healthcare, there is a recognized need to address social determinants of health (SDOH) to positively influence child health and development. In addition, family-centred care (FCC) recognizes the value of the family unit in affecting individual patient experiences of illness and care. However, pediatric healthcare that incorporates principles of FCC and SDOH may be interpreted as calling on clinicians to deviate from or add to practices that form an accepted standard of care. This paper explores the legal and ethical considerations of doing so and describes practical responses to these challenging situations.

Poverty and pediatric palliative care: what can we do?

It has been recognized that families of children with life-limiting health conditions struggle with significant financial demands, yet may not have awareness of resources available to them. Additionally, health care providers may not be aware of the socioeconomic needs of families they care for. This article describes a mixed-methods study examining the content validity and utility for health care providers of a poverty screening tool and companion resource guide for the pediatric palliative care population. The study found high relevance and validity of the tool. Significant barriers to implementing the screening tool in clinical practice were described by participants, including: concerns regarding time required, roles and responsibilities, and discomfort in asking about income. Implications for practice and suggestions for improving the tool are discussed. Screening and attention to the social determinants of health lie within the scope of practice of all health care providers. Social workers can play a leadership role in this work.

Hospital-legal partnership at Toronto Hospital for Sick Children: the first Canadian experience.

Operating a hospital-legal partnership on a pro bono basis positively impacts patients' families by providing legal assistance for non-medical issues that affect the health of their children and their ability to care for their children. This article describes a formative evaluation of the first hospital-legal partnership in Canada, established at The Hospital for Sick Children in Toronto in 2009, which was carried out through file reviews and interviews with staff, lawyers and family members. The early indications of success of this partnership suggest that its use as a template for similar programs at other Canadian healthcare institutions should be considered.

Including the urban heat island in spatial heat health risk assessment strategies: a case study for Birmingham, UK.

BACKGROUND: Heatwaves present a significant health risk and the hazard is likely to escalate with the increased future temperatures presently predicted by climate change models. The impact of heatwaves is often felt strongest in towns and cities where populations are concentrated and where the climate is often unintentionally modified to produce an urban heat island effect; where urban areas can be significantly warmer than surrounding rural areas. The purpose of this interdisciplinary study is to integrate remotely sensed urban heat island data alongside commercial social segmentation data via a spatial risk assessment methodology in order to highlight potential heat health risk areas and build the foundations for a climate change risk assessment. This paper uses the city of Birmingham, UK as a case study area. RESULTS: When looking at vulnerable sections of the population, the analysis identifies a concentration of "very high" risk areas within the city centre, and a number of pockets of "high risk" areas scattered throughout the conurbation. Further analysis looks at household level data which yields a complicated picture with a considerable range of vulnerabilities at a neighbourhood scale. CONCLUSIONS: The results illustrate that a concentration of "very high" risk people live within the urban heat island, and this should be taken into account by urban planners and city centre environmental managers when considering climate change adaptation strategies or heatwave alert schemes. The methodology has been designed to be transparent and to make use of powerful and readily available datasets so that it can be easily replicated in other urban areas.

The impact of climate change on winter road maintenance and traffic accidents in West Midlands, UK.

Winter weather can be a significant cause of road traffic accidents. This paper uses UKCIP climate change scenarios and a temporal analogue to investigate the relationship between temperature and severe road accidents in the West Midlands, UK. This approach also allows quantification of the changes in the severity of the winter season over the next century in the region. It is demonstrated that the predicted reduction in the number of frost days should in turn reduce the number of road accidents caused due to slipperiness by approximately 50%. However, the paper concludes by warning against complacency in winter maintenance regimes. A warmer climate may result in budget cuts for highway maintenance which in turn may well reverse declining accident trends.

Evidence for a role of the adenosine 5'-triphosphate-binding cassette transporter A1 in the externalization of annexin I from pituitary folliculo-stellate cells.

Annexin 1 (ANXA1) has a well-demonstrated role in early delayed inhibitory feedback of glucocorticoids in the pituitary. ANXA1 is located in folliculo-stellate (FS) cells, and glucocorticoids act on these cells to externalize and stimulate the synthesis of ANXA1. However, ANXA1 lacks a signal sequence so the mechanism by which ANXA1 is externalized from FS cells was unknown and has been investigated. The ATP-binding cassette (ABC) transporters are a large group of transporters with varied roles that include the externalization of proteins. Glucocorticoid-induced externalization of ANXA1 from an FS cell line (TtT/GF) and rat anterior pituitary was blocked by glyburide, which inhibits ABC transporters. Glyburide also blocked the glucocorticoid inhibition of forskolin-stimulated ACTH release from pituitary tissue in vitro. RT-PCR revealed mRNA and Western blotting demonstrated protein for the ATP binding cassette A1 (ABCA1) transporter in mouse FS, TtT/GF, and A549 lung adenocarcinoma cells from which glucocorticoids also induce externalization of ANXA1. In TtT/GF cells, immunofluorescence labeling revealed a near total colocalization of cell surface ANXA1 and ABCA1. We conclude that ANXA1, which mediates the early delayed feedback of glucocorticoids in the anterior pituitary, is externalized from FS cells by an ABC transporter and that the ABCA1 transporter is a likely candidate.

Externalization of annexin I from a folliculo-stellate-like cell line.

Our recent studies on rat pituitary tissue suggest that the annexin I-dependent inhibitory actions of glucocorticoids may not be exerted directly on endocrine cells but indirectly via folliculo-stellate (FS) cells. FS cells contain glucocorticoid receptors and abundant annexin I. We have studied the localization of annexin I in FS cells and the ability of dexamethasone to induce annexin I secretion by an FS (TtT/GF) cell line, using Western blotting and immunofluorescence microscopy. Exposure of TtT/GF cells to dexamethasone (0.1 micro M, 3 h) caused an increase in the amount of annexin I protein in the intracellular compartment and attached to the surface of the cells. In nonpermeabilized cells, immunofluorescence labeling revealed that annexin I immunoreactivity was associated with the cell surface and concentrated in focal patches on the ends of cytoplasmic processes; dexamethasone (0.1 micro M, 3 h) increased both the number and intensity of these foci. Immunogold electron microscopy confirmed in anterior pituitary tissue the presence of immunoreactive-annexin at the surface of FS cell processes contacting endocrine cells. These data support our hypothesis that annexin I is released by FS cells in response to glucocorticoids to mediate glucocorticoid inhibitory actions on pituitary hormone release via a juxtacrine mechanism.