143174 research outputs found
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Simulation of the impacts of constructed wetlands on river flow using WSIMOD
No full textIncreased demands for land use in urban development have reduced the extent of open water bodies in recent decades, leading to more frequent extreme flows in urban rivers. Urban nature-based solutions, such as constructed wetlands, have the potential to provide significant water management benefits if implemented on a large scale, well-maintained, and used sustainably. However, their actual benefits in urban water systems have not been adequately evaluated, and the underlying mechanisms remain underexplored. These limitations hinder the effective planning of the integration methods for constructed wetlands. To assess the water management benefits of constructed wetlands at the catchment scale, this study analyses river flow data collected before and after wetland construction in Enfield, London. The Water Systems Integrated Modelling (WSIMOD) framework is used to simulate the integrated catchment water cycle, and the constructed wetlands module is conceptualised and included in the WSIMOD to evaluate their interactions within the urban catchment water cycle. Scenarios are designed to assess the impacts of varying configurations and sizes of the wetlands on the river flow. The findings indicate that constructed wetlands are observed to attenuate river flow peaks and increase low flows. Constructed wetlands reduce the frequency of river flow peaks at the catchment scale; results show that in the case of Enfield, converting 1% of the catchment area to wetlands can decrease high flows (10% exceedance probability) by 18–23% and increase low flows (90% exceedance probability) by 35–50%, reducing the flashiness of the urban water cycle. Incorporating wetlands arranged in parallel exhibits superior performance in attenuating flow peaks compared to wetlands arranged in series, as the wetlands placed in parallel can provide more space to store rapidly generated runoff. The results quantified the effects of constructed wetlands on high and low flows in the urban water system, using the WSIMOD to provide recommendations on wetland connection modes for decision-making
Addressing uncertainty in hereditary colorectal cancer: the role of a regional expert multidisciplinary team meeting
No full textThere is frequent uncertainty in both the precise quantification of risk, and the application of clinical interventions, designed to mitigate increased heritable colorectal cancer (CRC) susceptibility. We evaluated the role of a collaborative specialist multidisciplinary team meeting (MDM) for familial and hereditary CRC, led by the St Mark’s Hospital Centre for Familial Intestinal Cancer specifically in supporting the clinical management of uncertainty. A retrospective thematic analysis of meeting outcomes from inception in June 2020 until March 2023 was performed. Descriptive statistics were employed to ascertain clinicopathological data, clinical queries and whether MDM recommendations were outside the scope of current guidelines. In total 260 cases were discussed from 13 regional institutions. A prior personal history of cancer was present in 215 (82.6%), and a family history of CRC in 107(41.2%) and non-CRC 27(10.4%) cases. In thematic analysis uncertainty related to indications for genetic testing was considered in 148 (56.9%) of cases, with unexplained mismatch repair deficiency (u-dMMR) in 78 (30%) of cases, and resolution of molecular interpretation in 61 (23.5%). Surveillance related queries represented 55 (21.1%), and mainstreaming 29 (11%) of cases. Management was recommended beyond the scope of existing guidelines in 64 (24.6%) cases. This regional hereditary CRC MDM provides clinicians with support in areas of uncertainty in diagnosis and clinical management, supporting clinical decision-making where evidence and clinical guidelines may be limited. This model could be replicated to support complexity in clinical care in other geographical regions or other health conditions
Adult glioblastoma in England: Incidence, treatment, and outcomes with novel population-based strata
No full textIntroduction
Malignant brain tumours are the leading cause of cancer death in the under 40’s and they have the highest average-years of life lost. England has a long-running system for national cancer data collection. In this work we present data on incidence, treatment and survival in all adult glioblastoma patients in England diagnosed between 2013 and 2018.
Methods
GlioCova uses a linked pseudo-anonymised data set of all adult patients in England diagnosed with a primary brain tumour between 2013 and 2018. We identified all patients with a glioblastoma (GBM) based on ICD-10 diagnosis and tumour morphology.
Results
In the 6-year period of the study (2013–2018 inclusive), 15,181 patients were diagnosed with a GBM in England. The national age-standardised incidence was 4.98 adult glioblastoma patients per 100,000 per year, with men having a higher incidence than women (6.3 and 3.8 respectively). Overall, 79 % of patients received treatment (76 % female vs. 81 % male, p = 0.22), with younger patients more likely to be treated than older patients. Median overall survival was 16 months in those receiving aggressive treatment, but 7 months in the whole cohort. 21 % of patients received no treatment, and 17 % of patients underwent surgery or biopsy alone.
Conclusion
Age-adjusted incidence of GBM is stable, although absolute numbers are rising, and prognosis remains poor. Only 29 % of patients receive aggressive multi-modality treatment, and we suggest that taking a population-level approach to GBM reveals significant areas for improvement
Remagnetization of serpentinite during deformation: evidence from a fossil oceanic transform fault zone of the Troodos ophiolite
No full textSerpentinization and associated chemical remagnetization of ultramafic rocks are common in tectonically active oceanic zones such as transform zones; however, it remains unclear how chemical remagnetization occurs during the deformation of serpentinite. This study aims to discuss this magnetization process with evidence from a serpentinite shear zone within the fossil transform fault of the Troodos ophiolite. We examine how serpentinite microstructures, serpentine polytypes, iron behaviors, rock magnetic properties and paleomagnetic directions evolve with increasing shearing deformation—a process that provides pathways for serpentinization fluid circulation. As serpentinite deformation increases from massive-fractured serpentinite adjacent to the shear zone to scaly and phyllonitic serpentinites within the shear zone, rock microstructure changes from unoriented mesh textures to oriented ribbon and fibrous structures. Meanwhile, the dominant serpentine mineral shifts from lizardite to chrysotile, indicating dynamic recrystallization during increasing deformation, likely resulting from elevated water/rock ratios driven by hydrothermal circulation. Rock magnetic results suggest that highly deformed scaly and phyllonitic serpentinites contain coarser magnetite grains and higher magnetite concentration compared to the less deformed massive-fractured serpentinites. These coarser magnetite grains are also attributed to higher water/rock ratios within the shear zone. More magnetite forms due to the iron released from the replacement of iron-rich lizardite by iron-poor chrysotile. The formation of magnetite records remagnetization, which helps reconstruct the deformation history of tectonically active zones. For example, paleomagnetic directions of the differentially deformed serpentinites in Troodos ophiolite indicate clockwise block rotations of up to 90°, providing evidence for dextral slip along a fossil transform fault
From reactive to proactive: machine learning models for continuous positive airway pressure adjustments using heart rate variability and oximetry-related parameters
No full textObjective
Current adjustments of continuous positive airway pressure (CPAP) may expose patients to risks of respiratory episodes or oxygen desaturation. Therefore, this study developed machine learning models using leading indicators, such as heart rate variability (HRV) and oximetry-related metrics, to proactively predict optimal adjustment timings.
Methods
CPAP titration data were first collected from a sleep center in northern Taiwan. Subsequently, Continuous HRV and oximetry-related metrics were retrieved (60-s window with 1-s stride) and then labeled based on the presence of pressure adjustments. The dataset, comprising seven HRV and two oximetry-related parameters, was independently divided into training/validation (80%) and test (20%) datasets based on patient information. Five cross-sectional and two time-series models were established. The model with the highest accuracy and area under the receiver operating characteristic curve (AUROC) in the training/validation dataset was applied to the test dataset to investigate feature importance through permutation analysis.
Results
A dataset comprising 14,629 time-series cases from 374 patients undergoing CPAP therapy was obtained. The InceptionTime model outperformed others during the training/validation phase with accuracies of 78.27% and AUROC of 78.07%, and achieved 80.92% accuracy and 76.52% AUROC in the test phase. Feature importance analysis identified peripheral arterial oxygen saturation, its standard deviation over a 60-s window, and normalized power in the very-low-frequency band of HRV as the most impactful predictors.
Conclusions
The findings demonstrated the feasibility of incorporating HRV and oximetry-related metrics, as leading indicators, to proactively predict CPAP adjustment timings. Further research should consider integrating these metrics to improve CPAP therapy
Micromolar concentration affinity study on a benchtop NMR spectrometer with secondary ¹³C labeled hyperpolarized ligands
No full textBenchtop NMR is becoming an increasingly important tool, sometimes providing a simple and low-cost alternative to high-field NMR. The Achilles heel of NMR and even more critically of benchtop NMR is its limited sensitivity. However, when combined with hyperpolarization techniques, the sensitivity boost can provide excellent sensitivity that can even make benchtop NMR compatible with affinity studies for drug discovery. Hyperpolarization by dissolution dynamic nuclear polarization (dDNP) provides a route to enhancing 13C nuclear magnetic resonance (NMR) sensitivity by more than 5 orders of magnitude for a wide range of small molecules on a benchtop NMR system. We show here how ligands can be secondarily labeled with 13C tags and hyperpolarized with conventional dDNP methods. These hyperpolarized ligands display long nuclear spin–lattice relaxation time constants and can therefore be used to probe interactions with target proteins in conventional dDNP settings. The boost in sensitivity combined with the simplicity of the 13C spectra (one peak per ligand) enables detection on an 80 MHz benchtop NMR spectrometer at micromolar concentrations, which may ultimately provide a way of improving and accelerating the discovery of new drug candidates
Social prescribing services for patients with musculoskeletal conditions compared with other long-term health conditions in the UK: a cross-sectional study
No full textIntroduction To examine the profile of social prescribing (SP) services for patients with LTCs and the extent to which equality and benefits of SP services to musculoskeletal conditions (MSK) patients and those with other long-term conditions (LTCs).
Methods This study used routine data from Access Elemental (2017-2022), the most widely used SP software platform in the UK. Our analytical sample was restricted to 4,943 patients with LTCs. We used heat maps to map process information about SP services and conducted logistic regression analyses.
Results The top reason for SP referrals for MSK patients was pain management, while for other LTCs it was to promote nutrition and diet, support emotional wellbeing, and increase social connectedness and support. However, the top interventions for managing MSK were similar to those prescribed for patients with all other LTCs, targeting activities around promoting diet and nutrition, mental health, physical activity, specific illness support, social connectedness and support. We found that compared with people with no MSK conditions and being referred via non-medical routes, those living with MSK and patients who received referrals from medical centres had lower odds of receiving SP services and having their needs met. Patients living in less deprived areas are more likely to receive SP and have needs satisfied than those from more deprived neighbourhoods.
Conclusions SP services do appear to be reaching some patients with MSK conditions, but they are less likely than other LTC patients to receive referrals or have their needs met. This suggests that specialist guidance around supporting MSK patient needs through SP is warranted. Further research is also needed to identify whether the broad types of interventions being prescribed to MSK patients actually meet their initial most common referral need of pain management
Multiple lines of evidence for a hypervelocity impact origin for the Silverpit Crater
No full textAn impact origin for Silverpit Crater, on the UK continental shelf, has been contested over the last two decades, with a lack of definitive evidence – traditionally petrographic evidence of shock metamorphism – to resolve the debate. Here we present 3D seismic, petrographic and biostratigraphic data, and numerical impact simulations to test the impact hypothesis. The seismic data provide exceptional imaging of the entire structure, confirming the presence of a central uplift, annular moat, damage zone and numerous secondary craters on the contemporaneous seabed. The distribution of normal and reverse faults in the brim, and curved radial faults around the central uplift suggest a low-angle impact from the west. The pitted, flat-topped central uplift at the top chalk horizon may indicate significant devolatilization of chalk immediately following impact. Biostratigraphic data confirm that this event occurred during the middle Eocene, between 43-46 million years ago. Petrographic analysis from the reworked ejecta sequence in the nearby 43/25-1 well reveals two grains with shock lamellae, indicating shock pressures of ~10-13 GPa, consistent with results from our numerical models. This combination of data and modelling provide compelling evidence that Silverpit Crater is an exceptionally preserved hypervelocity impact structure
BOWIE-ALIGN: weak spectral features in KELT-7b’s JWST NIRSpec/G395H transmission spectrum imply a high cloud deck or a low-metallicity atmosphere
No full textHot Jupiters and their atmospheres are prime targets for transmission spectroscopy due to their extended atmospheres and the corresponding large signal-to-noise, providing the best possible constraints for the atmospheric carbon-to-oxygen (C/O) ratio and metallicity of exoplanets. Within BOWIE-ALIGN, we aim to compare JWST spectra of a sample of orbitally aligned and misaligned hot Jupiters orbiting F-type stars to probe the link between hot Jupiter atmospheres and planet formation history. Here, we present a near-infrared transmission spectrum of the aligned planet KELT-7b using one transit observed with JWST NIRSpec/G395H. We find weak features, only tentative evidence for H2O and CO2 in the atmosphere of KELT-7b. This poses a challenge to constrain the atmospheric properties of KELT-7b and two possible scenarios emerge from equilibrium chemistry and free chemistry retrievals: a high-altitude cloud deck muting all features or an extremely low metallicity atmosphere, respectively. The retrieved C/O ratios from our data reductions range from 0.43 − 0.74, while the atmospheric metallicity is suggested to be solar to super-solar (1 − 16 × solar). Although these wide constraints prevent detailed conclusions about KELT-7b’s formation history, a solar-to-super-solar metallicity would imply the accretion of solid material during its formation, which is valuable information for the survey’s wider goals of understanding the relative importance of gaseous to solid accretion
