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Quantifying the hydraulic conditions that govern discolouration material behaviour in drinking water distribution systems
Get PDFRecurring consumer complaints of discoloured water indicate a key management challenge for drinking water distribution systems (DWDS). This research examines the causes by investigating and quantifying the impacts of hydraulic conditions on the transition of material between the bulk water and infrastructure surfaces. It is the first to acknowledge and differentiate between particulate accumulation and mobilisation due to the processes of sedimentation and cohesive layers and provide evidenced based operation and maintenance guidelines to improve discolouration management. With the range of physical, chemical and biological interactions within DWDS the specific processes enabling particles to remain on pipe surfaces are not investigated or quantified here with the focus on delivering evidence based practical support. Results from 8 independent week long trials incorporating 18 hydraulic profiles in a full sized and extensively monitored experimental pipe-loop with flow control precision of 0.002 m s−1 and using discolouration material collected from multiple operational networks are presented. Reynolds number is proposed to best describe the limit of sedimentation as a measure of the turbulence forces that are balanced by the self-weight forces. Shear stress, that quantifies surface forces, is proposed to best describe mobilisation. For practical guidelines and uptake these can be converted to velocities. Sedimentation was found to dominate up to a Reynolds number of 15 100 (0.25 m s−1, 0.21 N m−2); above this cohesive layers were dominant. This indicates discolouration risks from sedimentation, likely in the tertiary zones of a DWDS, may be mitigated if flows regularly attain these values. Material accumulated following sedimentation was shown to be effectively removed by a shear stress of 0.77 N m−2 (0.5 m s−1, Re 30 300), representing an idealised flushing value as forces above this showed negligible benefit on their removal. No effective upper flushing value was found in these trials for effective full mobilisation of cohesive layers
Functional neuroimaging as a biomarker of non-invasive brain stimulation in upper limb recovery after stroke: a systematic review and narrative discussion
Get PDFIntroduction: Stroke is a leading cause of adult-onset disability. Non-invasive brain stimulation (NIBS) techniques such as repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and transcutaneous vagus nerve stimulation (tVNS) are promising adjuncts to upper limb rehabilitation. The use of functional neuroimaging through task functional MRI (fMRI) or functional near-infrared spectroscopy (fNIRS) allows the visualisation of cortical activation patterns associated with stroke-related impairment and recovery. The present study comprehensively reviews the evidence base for the effects of NIBS on clinical and functional neuroimaging outcomes after stroke. Methods: Systematic searches were carried out in MEDLINE and EMBASE via Ovid. Inclusion criteria were clinical trials of adults with stroke and arm weakness undergoing NIBS, with clinical measures of arm function and neuroimaging outcome measures that included either task fMRI or task fNIRS. Two authors independently carried out study screening, risk of bias assessments, and data collection for clinical and neuroimaging outcomes pre- and post-intervention. Results: A total of 17 studies (12 rTMS, 5 tDCS), including 495 participants, met the inclusion criteria. Fifteen studies used task fMRI and four used task fNIRS. Improvements in arm-related motor activity were observed following both rTMS and tDCS. Most studies reported increased activation in ipsilesional sensorimotor areas alongside reductions in contralesional activation. Discussion: rTMS and tDCS may improve upper limb recovery in people with stroke. The increase in the laterality index towards activation of the ipsilesional hemisphere suggests that these NIBS techniques may facilitate neural reorganisation and restoration of motor networks in the affected hemisphere
Lessons learnt about implementing LEGO based therapy (Play Brick Therapy) based on fidelity data and experience from a large school-based randomised controlled trial
Get PDFIntroduction
LEGO® based therapy, a social skills program for autistic children and young people, involves collaborative LEGO® building with adult guidance. This paper examines how well the program was delivered in a recent school randomised controlled trial and explores areas for improvement in implementation. The main trial results are published elsewhere.
Methods
The I-SOCIALISE trial investigated LEGO® based therapy for autistic children in schools. Researchers recruited 98 schools and randomly assigned them to deliver LEGO® based therapy or usual care. LEGO® based therapy sessions lasted one hour per week for 12 weeks with groups of 3 children. Schools received a 3-hour training session and a manual. Researchers measured fidelity to the LEGO® based therapy programme using self-reported checklists and video analysis. Research team insight and experience of the delivery of the training and intervention are included in this paper.
Results
LEGO® based therapy was delivered to autistic children in schools with high fidelity according to facilitators and independent reviewers. Most groups (69%) received all 12 sessions, and nearly all groups received the minimum dose of 6 sessions (93%). Sessions typically lasted about an hour and had 1–2 autistic children. Facilitators were mostly teaching assistants with moderate experience in autism. Over 90% of sessions included core elements like group building and social interaction. There were disagreements between facilitators and reviewers on adherence to some program elements like rewards and discussing roles.
Discussion
LEGO® based therapy was delivered with high fidelity in a large school trial, but there were areas for improvement, such as facilitator training and focus on social interaction for and between children. The authors suggest that facilitators may have been more focused on completing LEGO® builds than on facilitating meaningful social interaction and play between children. Three hours of training may not have been enough to prepare facilitators for their role. The study also did not capture young people’s experience of the program, which is important for understanding its effectiveness and impact. Future research should explore how to better measure these aspects and develop a stronger theory of how LEGO® based therapy works
Beyond Prototypicality: Identity Leadership Is About Shaping and Embedding a Sense of Social Identity, Not Just Representing It
Get PDFResearch inspired by the social identity theory of leadership has focused predominantly on the importance of a leader being seen to be representative of the groups they lead. However, beyond this, research suggests that leaders also need to create, advance, and embed a sense of shared social identity in those groups. In the present research, we explore how these different facets of identity leadership combine to form distinct leader profiles. We draw on two heterogeneous independent samples from the Global Identity Leadership Development project (N = 7682; N = 7855) to explore profiles of leaders’ engagement in identity leadership. In both studies, a latent profile analysis of the results of a CFA using a bifactor‐(S − 1) model was conducted. In each case, the analysis identified two different predominant identity leadership profiles: ‘engaged identity leaders’ and ‘moderate‐inconsistent identity leaders’. Employees working with engaged identity leaders reported substantially more positive job‐related attitudes. The results were very similar across the two studies and suggest that this profile analysis is generalizable. The findings support suggestions that identity leadership is multidimensional rather than solely a matter of identity prototypicality
A Fully-Integrated Near-Field Sensor for Permittivity-Based Imaging
No full textThis paper presents a fully integrated near-field sensor for permittivity-based imaging. The sensor comprises a 32×32 pixel array, with each pixel integrating a free-running 320GHz oscillator, a split-ring resonator (SRR), and a power detector. We demonstrate, for the first time in the terahertz regime, the sensor’s ability to distinguish between tissue types in heterogeneous samples (e.g., lean muscle and fat), as well as to perform real-time dielectric fingerprinting of homogeneous materials without the need for raster scanning
Factors affecting gluten-free dietary adherence in patients with neurological gluten-related disease
Get PDFBackground/Objectives: The gluten-free diet (GFD) is the primary treatment for patients with neurological gluten-related disease, which may occur with or without coeliac disease (CD). Dietary adherence is arguably most important in such patients, as ongoing gluten exposures have been shown to exacerbate irreversible neurological deterioration. We utilised a cross-sectional postal questionnaire to explore factors affecting dietary adherence in a large sample of such patients, highlighting potential areas of dietetic need.
Methods: Patients returned a postal questionnaire (N = 225), which assessed self-reported GFD adherence by the Biagi scale and a visual analogue scale. CD status was ascertained, alongside symptomatology and mood (via the Hospital Anxiety and Depression Scale). Dietary knowledge was tested by a “quiz” where respondents identified which of 10 foodstuffs should be avoided on a GFD.
Results: Self-reported adherence was high across the cohort, but was significantly higher in those with CD than those without. Patients with CD more often reported a number of gastrointestinal symptoms as acute reactions if they were to eat gluten. Similarly, the CD subgroup reported greater overall acute discomfort following gluten, while across the cohort greater such discomfort correlated with greater dietary adherence. Overall, 6.2% of the participants both reported strict diets (scoring ≥ 90 on the visual analogue scale) but via the quiz indicated an erroneous belief that they could eat a gluten-containing foodstuff. Lower adherence was correlated with higher depressive scores, with post hoc analyses finding that this was driven by patients without CD.
Conclusions: This study highlights a need for increased dietary support in patients with neurological gluten sensitivity, particularly when there is no co-diagnosis of CD. Therapies targeting depression may additionally bolster dietary adherence
Observation of quantum effects on radiation reaction in strong fields
Get PDFRadiation reaction, the force experienced by an accelerated charge due to radiation emission, has long been the subject of extensive theoretical and experimental research. Experimental verification of a quantum, strong-field description of radiation reaction is fundamentally important, and has wide-ranging implications for astrophysics, laser-driven particle acceleration, next-generation particle colliders and inverse-Compton photon sources for medical and industrial applications. However, the difficulty of accessing regimes where strong field and quantum effects dominate inhibited previous efforts to observe quantum radiation reaction in charged particle dynamics with high significance. We report a high significance (> 5σ) observation of strong-field radiation reaction on electron spectra where quantum effects are substantial. We obtain quantitative, strong evidence favouring the quantum-continuous and quantum-stochastic models over the classical model; the quantum models perform comparably. The lower electron energy losses predicted by the quantum models account for their improved performance. Model comparison was performed using a novel Bayesian framework, which has widespread utility for laser-particle collision experiments, including those utilising conventional accelerators, where some collision parameters cannot be measured directly
Factors associated with timely complementary feeding among children aged 6–23 months in Kenya; a cross-sectional study
Get PDFINTRODUCTION: Adequate nutrition is essential for proper growth, development, and disease prevention during the first 1000 days of life. Introducing solid, semi-solid, or liquid foods in addition to breast milk, also known as complementary feeding (CF), earlier or later than the recommended 6 months, is associated with poor nutritional outcomes in children under the age of two. Given the limited evidence, this study aimed to determine the factors associated with timely complementary feeding in children aged 6-23 months. METHODS: We used data from the first round of Kenya's 2017 Performance Monitoring for Action (PMA) survey. The dependent variable, timely CF, was defined as "the introduction of other feeds apart from breast milk at 6 months." Frequencies, percentages, and 95% confidence intervals were used to describe the sample characteristics and prevalence of timely CF. Univariable and multivariable logistic regression analyses were performed to examine the determinants of timely complementary feeding. RESULTS: Of the 3,084 mothers included in the study, most were married (82.1%), aged 20-34 years (78.8%), and unemployed (75.5%). The overall weighted prevalence of timely CF was 51.7% (95% CI 47.6, 55.9), with a higher prevalence among the richest (66.6%), urban residents (60.6%), and mothers with a tertiary education (61.1%). After adjusting for other covariates, mothers aged 20-34 years had lower odds of practicing timely complementary feeding than those aged 35-49 years (aOR = 0.72, 95% CI: 0.52-0.99). Similarly, children from wealthier households were more likely to receive timely complementary feeding, with the odds increasing across wealth quintiles from the poorer (aOR = 1.69, 95% CI: 1.30-2.19) to the richest (aOR = 3.32, 95% CI: 1.97-5.60). CONCLUSION: Timely complementary feeding remains suboptimal in Kenya despite strong policy frameworks, indicating implementation gaps and the need for targeted interventions to address socioeconomic and regional disparities
UK consensus guidelines for multidisciplinary care of children and young people with achondroplasia: a modified Delphi process
Get PDFBackground
Achondroplasia (ACH), the most common skeletal dysplasia, arises from gain-of-function variants in the fibroblast growth factor receptor 3 gene. Children with ACH experience lifelong medical, functional and psychosocial challenges requiring coordinated and anticipatory care. Although international guidance exists, the UK lacks national clinical care recommendations specific to its healthcare systems.
Objective
To develop UK-specific, multidisciplinary clinical recommendations for the care of children and young people (CYP) with ACH.
Methods
The UK Achondroplasia Network developed guidance in stages: stakeholder mapping of the care pathway, integration of contemporary literature with clinical expertise to draft age-specific guidance and Delphi statements, and a modified Delphi process with 25 multidisciplinary experts. The Delphi process involved two voting rounds and an in-person meeting, with consensus defined as ≥80% agreement.
Results
In the first Delphi round, all 20 statements achieved consensus; nine achieved 100% agreement. To strengthen consensus, after meeting in person, 17 statements were refined (four were divided into two statements), one created and one removed, resulting in 24 statements for Round 2; all achieved consensus, with 21 reaching 100% agreement. The guidance outlines age-specific monitoring and referral from infancy to adolescence. Recommendations address medical management of complications, psychosocial support, educational planning and transfer to adult care.
Conclusion
These are the first UK-specific multidisciplinary recommendations for the care of CYP with ACH. Aligned with international best practices and tailored to UK healthcare systems, they support anticipatory care, promote independence and enhance health and psychosocial outcomes. The guidelines offer a foundation for service planning, standardisation and equitable care
Persisting modulation of interdecadal Pacific oscillation on near‐future winter precipitation projections in Northern Europe
Get PDFEuropean winter precipitation profoundly influences regional hydroclimate, yet the relative roles of internal variability and external forcing in its decadal changes remain elusive. Using large-ensemble climate simulations, we identify the Interdecadal Pacific Oscillation (IPO) as a potential driver of interdecadal changes in winter northern European precipitation. During the 1980–2014 IPO phase transition, internal variability induced a drying trend of −0.07 mm day−1 (35 years)−1, offsetting a concurrent externally forced wetting trend of +0.19 mm day−1 (35 years)−1. This influence arises from IPO-related modulation of atmospheric circulation and moisture transport. The persistence of IPO–WNEP linkages into 2015–2050 suggests that internal variability may continue to shape near-future hydroclimate. Accounting for IPO-related influences reduces projection uncertainty by 30% historically and 20% in the near future. These results highlight the critical role of internal variability in long-term European precipitation trends and emphasize its relevance for regional water resource planning
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