Good or bad vibrations? Impacts of anthropogenic vibration on the marine epibenthos

Anthropogenic activities directly contacting the seabed, such as drilling and pile-driving, produce a significant vibration likely to impact benthic invertebrates. As with terrestrial organisms, vibration may be used by marine species for the detection of biotic and abiotic cues, yet the significance of this and the sensitivities to vibration are previously undocumented for many marine species. Exposure to additional vibration may elicit behavioral or physiological change, or even physical damage at high amplitudes or particular frequencies, although this is poorly studied in underwater noise research. Here we review studies regarding the sensitivities and responses of marine invertebrates to substrate-borne vibration. This includes information related to vibrations produced by those construction activities directly impacting the seabed, such as pile-driving. This shows the extent to which species are able to detect vibration and respond to anthropogenically-produced vibrations, although the short and long-term implications of this are not known. As such it is especially important that the sensitivities of these species are further understood, given that noise and energy-generating human impacts on the marine environment are only likely to increase and that there are now legal instruments requiring such effects to be monitored and controlled.

The consequences of being labelled 'looked-after': Exploring the educational experiences of looked-after children and young people in Wales

The educational experiences and attainment of looked-after children and young people (LACYP) remains an issue of widespread international concern. Within the UK, children and young people in care achieve poorer educational outcomes compared to individuals not in care. Despite proliferation of research documenting the reasons for educational disadvantage amongst this population, there remains limited empirical consideration of the lived experiences of the educational system, as perceived by LACYP themselves. This paper draws upon qualitative research with 67 care-experienced children and young people in Wales. The sample was aged 6-27 years, and comprised 27 females and 40 males. Participants had experienced a range of care placements. Findings focus on how educational policies and practices alienate LACYP from dominant discourses of educational achievement through assignment of the 'supported' subject position, where children and young people are permitted and even encouraged not to succeed academically due to their complex and disrupted home circumstances. However, such diminished expectations are rejected by LACYP, who want to be pushed and challenged in the realisation of their potential. The paper argues that more differentiated understandings of LACYP's aspirations and capabilities need to be embedded into everyday practices, to ensure that effective educational support systems are developed.

Atezolizumab (A) + cobimetinib (C) + vemurafenib (V) in BRAFV600-mutant metastatic melanoma (mel): Updated safety and clinical activity

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Background: Targeted inhibition of MEK with C and BRAF with V in BRAFV600-mutant mel can lead to both anticancer immune activation and direct tumor cell death. A, an anti–PD-L1 monoclonal antibody, inhibits PD-L1/PD-1 signaling. Combining C + V with A may enhance antitumor activity, potentially leading to improved clinical responses and durability. Preliminary data from this phase Ib study (NCT01656642) showed that A + C + V had a manageable safety profile and promising antitumor activity in patients (pts) with untreated BRAFV600-mutant unresectable/metastatic mel, with increases in CD8-positive T-cell infiltration observed after C + V (Sullivan et al SMR 2016). We present updated safety and efficacy data. Methods: Pts received A + C + V after a 28-day run-in with C + V. A was given at 800 mg q2w, C at 60 mg qd for the first 21 days of each 28-day cycle, and V at 960 mg bid during day 1–21 of run-in and 720 mg thereafter. Safety was evaluated in pts who had ≥1 dose of A; efficacy, in pts who had ≥1 dose of A by the data cutoff date and received ≥1 dose of A, C, or V by the dosed-by date. Results: Thirty-four patients were treated and evaluated for both safety and efficacy. Median survival follow-up was 7.1 months (range 2.5–19.9). Elevated AST/ALT, diarrhea, arthralgia, fatigue, photosensitivity, pyrexia, nausea, flu-like symptoms, maculopapular rash, and pruritus were reported as A- and/or C- and/or V-related in > 20% of pts at any grade (G). A/C/V-related G3–4 adverse events (AEs) were seen in 15 pts (44.1%) with the triple combination (none G5). Three serious AEs were A-related. All AEs were manageable and reversible. Elevated ALT/AST (three pts each) and rash (one pt) led to discontinuation of any drug. Unconfirmed RECIST V1.1 responses were observed in 29 pts (85.3%; six complete, 23 partial). Three pts with confirmed partial responses had resolution of target lesions. Twenty of the 29 responding patients continue to respond at the time of the data cutoff. Conclusions: Updated results confirm preliminary findings that A + C + V has a manageable safety profile and promising antitumor activity in pts with BRAFV600-mutant metastatic mel. Continued exploration of A + C + V is warranted. Clinical trial information: NCT01656642.

A randomized controlled feasibility trial exploring partnered ballroom dancing for people with Parkinson's disease

OBJECTIVE

To determine the feasibility of a Dance Centre delivering a programme of mixed dances to people with Parkinson's and identify suitable outcomes for a future definitive trial.

DESIGN

A two-group randomized controlled feasibility trial.

METHODS

People with Parkinson's were randomized to a control or experimental group (ratio 15:35), alongside usual care. In addition, participants in the experimental group danced with a partner for one hour, twice-a-week for 10 weeks; professional dance teachers led the classes and field-notes were kept. Control-group participants were given dance class vouchers at the end of the study. Blinded assessments of balance, mobility and function were completed in the home. Qualitative interviews were conducted with a subsample to explore the acceptability of dance.

RESULTS

A total of 51 people with Parkinson's (25 male) with Hoehn and Yahr scores of 1-3 and mean age of 71 years (range 49-85 years), were recruited to the study. Dance partners were of similar age (mean 68, range 56-91 years). Feasibility findings focused on recruitment (target achieved); retention (five people dropped out of dancing); outcome measures (three measures were considered feasible, changes were recommended). Proposed sample size for a Phase III trial, based on the 6-minute walk test at six months was 220. Participants described dance as extremely enjoyable and the instructors were skilled in instilling confidence and motivation. The main organizational challenges for a future trial were transport and identifying suitable dance partners.

CONCLUSION

We have demonstrated the feasibility of conducting the study through a Dance Centre and recommend a Phase III trial.