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The missing link in biogeographic reconstruction: Accounting for lineage extinction rewrites history
Get PDFAimIn the most widely used family of methods for ancestral range estimation (ARE), dispersal, speciation and extirpation events are estimated from information on extant lineages. However, this approach fails to consider the geographic distribution of extinct species and their position on the phylogenetic tree, an omission that could compromise reconstruction. Here, we present a method that models the geographic distribution of extinct species and we quantify the potential inaccuracy in ancestral range estimation when extinction rates are above zero.LocationGlobal applications, with an example from the Americas.TaxonAll taxa, with an example from hummingbirds (Amazilia).MethodsMethods capable of explicitly modelling extinct branches along with their reconstructed geographic information (GeoSSE) have been overlooked in ARE analysis, perhaps due to the inherent complexity of implementation. We develop a user-friendly platform, which we term LEMAD (Lineage Extinction Model of Ancestral Distribution) that generalizes the likelihood described in GeoSSE for any number of areas and under several sets of geographic assumptions. We compare LEMAD and extinction-free approaches using extensive simulations under different macroevolutionary scenarios. We apply our method to revisit the historical biogeography of Amazilia hummingbirds.ResultsWe find that accounting for the lineages removed from a tree by extinction improves reconstructions of ancestral distributions, especially when rates of vicariant speciation are higher than rates of in situ speciation, and when rates of extinction and range evolution are high. Rates of in situ and vicariant speciation are accurately estimated by LEMAD in all scenarios. North America as the most likely region for the common ancestor of hummingbirds.Main conclusionsMethods that neglect lineage extinction are less likely to accurately reconstruct true biogeographic histories of extant clades. Our findings on an empirical dataset reconcile the Eurasian origin of Amazilia with biogeographic reconstructions when lineage extinction is considered
Interventions for and experiences of shared decision-making underpinning reproductive health, family planning options and pregnancy for women with or at high risk of kidney disease:a systematic review and qualitative framework synthesis
Get PDFOBJECTIVE: To determine intervention effects and synthesise qualitative research that explored women with or at high risk of kidney disease experiences of shared decision-making in relation to their reproductive health, family planning options and pregnancy.DESIGN: A systematic review of interventions and a qualitative evidence synthesis.DATA SOURCES: We searched Cochrane, CINAHL, MEDLINE, Scopus, ProQuest, Elsevier, PubMed, ScienceDirect and Web of Science.ELIGIBILITY CRITERIA: Shared decision-making interventions and qualitative studies related to reproductive health involving women with or at high risk of kidney disease published from 1980 until January 2021 in English (clinical settings, global perspective).DATA EXTRACTION AND SYNTHESIS: Titles were screened against the inclusion criteria and full-text articles were reviewed by the whole team. Framework synthesis was undertaken.RESULTS: We screened 1898 studies. No evidence-based interventions were identified. 18 qualitative studies were included, 11 kidney disease-specific studies and 7 where kidney disease was a common comorbidity. Women frequently felt unprepared and uninformed about their reproductive options. Conversations with healthcare professionals were commonly described as frustrating and unhelpful, often due to a perceived loss of autonomy and a mismatch in preferences and life goals. Examples of shared decision-making were rare. Kidney disease exacerbated societal expectations of traditional gender roles (eg, wife, mother, carer) including capability to have children and associated factors, for example, parenting, (sexual) relationships, body image and independent living (including financial barriers to starting a family). Local interventions were limited to types of counselling. A new health system model was developed to support new interventions.CONCLUSION: There is a clear need to establish new interventions, test those already in development and develop new clinical guidance for the management of women with or at high risk of kidney disease in relation to their reproductive health, including options to preserve fertility earlier. Other health conditions with established personalised reproductive care packages, for example, cancer, could be used to benchmark kidney practice alongside the new model developed here.</p
Cost-Effectiveness and Cost–Benefit Analyses of Providing Menstrual Cups and Sanitary Pads to Schoolgirls in Rural Kenya
Get PDFObjective: To analyze the relative value of providing menstrual cups and sanitary pads to primary schoolgirls.Design: Cost-effectiveness and cost–benefit analyses of three-arm single-site open cluster randomized controlled pilot study providing menstrual cups or sanitary pads for 1 year.Participants: Girls 14–16 years of age enrolled across 30 primary schools in rural western Kenya.Methods: Cost-effectiveness analysis was conducted based on the health effects (reductions in disability-adjusted life years [DALYs]) and education effects (reductions in school absenteeism) of both interventions. The health and education benefits were separately valued and compared with relative program costs.Results: Compared with the control group, the cost of menstrual cups was estimated at 24,000 for sanitary pads. The benefit of the menstrual cup program (1.4 DALYs averted, 95% confidence interval [CI]: −4.3 to 3.1) was higher compared with a sanitary pad program (0.48 DALYs averted, 95% CI: −4.2 to 2.3), but the health effects of both interventions were not statistically significant likely due to the limited statistical power. Using point estimates, the menstrual cup intervention was cost-effective in improving health outcomes (300/student-school year in reducing school absenteeism. When considering improvements in future earnings from reduced absenteeism, the sanitary pad program had a net benefit of +32,000 to +$169,000).Conclusions: The menstrual cup may provide a cost-effective solution for menstrual hygiene management in low-income settings. This study outlines a methodology for future analyses of menstrual hygiene interventions and highlights several knowledge gaps that need to be addressed. Trial registration: ISRCTN17486946
Patterns of prescribing in primary care leading to high-dose opioid regimens.
Get PDFBackground: There are concerns about continuing increases in the number of patients prescribed long-term opioids and the prescribing of “strong” opioids for chronic pain. Little is known about patients who are prescribed long-term, high-dose drugs.Aim: To understand patterns of opioid prescribing that lead to long-term, high-dose use.Design and Setting: A mixed-method study of the opioid prescription histories of patients using high doses in a North Wales GP practice.Method: All patients on high-dose opioids during the census week were identified. Summary graphs of the prescription histories were prepared. Qualitative analysis was conducted individually by four researchers. A workshop was held to arrive at a consensus about common features and to inform further quantitative analysis.Results: A quarter of high-dose regimens were initiated outside the practice, either in a different primary care practice or in secondary care. The majority of the remaining patients showed a pattern of dose increases to high levels over a short period (median 3.5 months). None showed a pattern of gradual increases over a longer timescale. Most of the patients remained on high doses continuously once a daily dose of ≥120mg oral morphine equivalent was reached.Conclusion: These findings suggest that high-dose opioid regimens develop quickly in response to unknown clinical factors. An expected insidious upward drift in dose was not seen. The findings have implications for the prevention of potentially dangerous long-term high-dose opioid prescribing. A dose of 60mg oral morphine equivalent or more is suggested as a useful “red flag”.<br/
Crisis Ocean Modelling with a Relocatable Operational Forecasting System and Its Application to the Lakshadweep Sea (Indian Ocean)
Get PDFThis study presents the Relocatable Operational Ocean Model (ReOMo), which can be used as a Crisis Ocean Modelling System in any region of the global ocean that is free from ice. ReOMo can be quickly nested into an existing coarser resolution (parent) model. The core components of ReOMo are the NEMO hydrodynamic model and Rose-Cylc workflow management software. The principal innovative feature of ReOMo is the use of the Nesting with Data Assimilation (NDA) algorithm, which is based on the model-to-model assimilation technique. The NDA utilises the full 3D set of field variables from the parent model rather than just the 2D boundary conditions. Therefore, ReOMo becomes physically aware of observations that have been assimilated and dynamically balanced in the external model. The NDA also reduces the spatial phase shift of ocean features known as the ‘double penalty effect’. In this study, ReOMo was implemented for the Lakshadweep Sea in the Indian Ocean at 1/20°, 1/60°, or 1/120° resolution with and without model-to-model data assimilation. ReOMo is computationally efficient, and it was validated against a number of observational data sets to show good skills with an additional benefit of having better resolution than the parent model
Psychiatry's need for Vergangenheitsbewältigung: ‘culture wars’, cognitive dissonance and coming to terms with the past
Get PDFUK psychiatry's sense of self rests on being part of a socially progressive national tradition. This makes it difficult to engage with more critical narratives. The process of analysing and accepting psychiatry's past can help our profession to get closer to its real self and on a path to a better future
Percussion Nd:YAG Laser-incision of Radiata Pine: Effects of Laser Processing Parameters and Wood Anatomy
Get PDFLaser-incision is gaining recognition in the timber processing industry as a preferred and competitive technique for increasing uptake of chemical and preservative treatments.This work details percussion Nd:YAG laser-incision of Radiata Pine, conductedat different wavelengths, incident laser energies and focal point positions. Forthe first time, the effect of wood anatomy (latewood and earlywood tissues) on the efficiency and quality of Nd:YAG laser-incision of Radiata Pine is explored. Nd:YA laser wavelengths of 1064 nm (fundamental wavelength), 532 nm (second harmonic) and 355 nm (third harmonic) were used to understand their effect on laser-incised hole characteristics. A maximum laser-incised hole diameter of ~ 2.5 mm was measured at 1064 nm for 700 pulses. The presence of earlywood and latewood had a distinct effect on hole shape evolution, showing the importance of wood anatomy in the process of percussion Nd:YAG laser-incision. Ultra-violet (UV) radiation (355 nm) was the preferred wavelength for laser-incision of Radiata Pine as it gave rise to less carbonisation, less tapering and a uniform incision along the length of the laser-incised holes. Maximum depth of the laser-incised hole was measured (~ 20 mm) using the 355 nm wavelength. Incident laser energy, wavelength and wood anatomy had a dominant roll in laser-incision hole size, shape and quality. This demonstrates the critical effect of wood anatomy on the laser-incision process when considering and utilising laser technology to produce incisions for the wood treatment and wood preservation industries
Understanding rural-urban transitions in the Global South through Peri-Urban Turbulence
Get PDFMuch previous research has problematized the use of a binary urban–rural distinction to describe human settlement patterns in and around cities. Peri-urban zones, on the edge of urban settlements, are important both in the sheer magnitude of human population and in terms of being home to vulnerable populations with high rates of poverty. This Perspective presents a framework that conceptualizes rural–urban transition through the prism of shifts in natural, engineered and institutional infrastructure to explain the processes of rapid change and the dip in service provision often found in peri-urban areas in the Global South. We draw on examples related to the provision of water and sanitation to illustrate the theory and discuss its implications for future research on the peri-urban. A research agenda is set out that emphasizes the importance of studying early warning signs of service dips using systems theory concepts such as flickering and critical slowing down. Through such approaches, research can better predict and explain what we call peri-urban turbulence and inform the development of mitigation strategies to reduce the vulnerabilities that peri-urban residents too often face during periods of rural–urban transitio
Circular use of feed by-products from alcohol production mitigates water scarcity
Get PDFThe distillery sector is among the biggest industrial water users in the United Kingdom (UK) and simultaneously delivers valuable by-products traditionally used for cattle feed, but in recent years increasingly for bioenergy generation. Our research provides new insight into these two aspects of alcohol production by 1) presenting the first water scarcity footprint of Scottish single malt whisky, and 2) comparing potential avoided water scarcity impacts through the use of by-products to replace different feeds and energy carriers.We applied Life Cycle Assessment, including a water scarcity footprint (AWARE methodology) and carbon footprint, using primary data from a Scottish whisky distillery. By-products used for feed were considered to replace imported soybean meal from the Americas or rape meal from Europe combined with UK grown barley to balance protein and metabolisable energy substitution. Alternative by-product use for biogas production replaced conventional heat and electricity generation, or transport fuel with the digestate substituting mineral fertilisers.The water scarcity footprint of 1 litre of pure alcohol is 0.79 m3 world eq., with the majority of water used for cooling, highlighting a hotspot for water conservation. The carbon footprint is 4.4 kg CO2 eq., predominantly caused by heating with gas oil. By-product use as animal feed, replacing soybean meal and barley, offsets up to 47% of the water scarcity footprint and 32% of the carbon footprint of alcohol production. Using by-products for bioenergy generates smaller offsets. Water reuse and heat recovery measures should be investigated as priorities to reduce the environmental footprint of whisky. Feeding all cereal based by-products from UK potable alcohol production to cattle could save 370M m3 world eq., or 37% of the UK’s water scarcity footprint attributable to imported soy feed.The distillery sector is among the biggest industrial water user in the United Kingdom (UK) and simultaneously delivers valuable by-products traditionally used for cattle feed, but in recent years increasingly for bioenergy generation. Our research provides new insight into these two aspects of alcohol production by 1) presenting the first water scarcity footprint of Scottish single malt whisky, and 2) comparing potential avoided water scarcity impacts through the use of by-products to replace different feeds and energy carriers. We applied Life Cycle Assessment, including a water scarcity footprint (AWARE methodology) and carbon footprint, using primary data from a Scottish whisky distillery. By-products used for feed were considered to replace imported soybean meal from the Americas or rapemeal from Europe combined with UK grown barley to balance protein and metabolisable energy substitution. Alternative by-product use for biogas production replaced conventional heat and electricity generation, or transport fuel with the digestate substituting mineral fertilisers. The water scarcity footprint of 1 litre of pure alcohol is 0.79 m3 world eq., with the majority of water used for cooling, highlighting a hotspot for water conservation. The carbon footprint is 4.4 kg CO2 eq., predominantly caused by heating with gas oil. By-product use as animal feed, replacing soybean meal and barley, offsets up to 47% of the water scarcity footprint and 32% of the carbon footprint of alcohol production. Using by-products for bioenergy generates smaller offsets. Water reuse and heat recovery measures should be investigated as priorities to reduce the environmental footprint of whisky. Feeding all cereal based by-products from UK potable alcohol production to cattle could save 370 M m3 world eq., or 37% of the UK's water scarcity footprint attributable to imported soy feed