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Evaluating the impact of cenobamate in the management in patients with drug resistant focal epilepsy – a retrospective real world observational study of patients attending NHS Greater Glasgow and Clyde
No full textIntroduction:
Cenobamate (CNB) is the latest ASM to be licensed in the UK as an adjunctive treatment for adults with focal epilepsy. Early clinical trials have been encouraging with up to 50.4 % of patients showing a 50 % improvement at 12 weeks and 71 % were still receiving Cenobamate at 48 months. Regulatory studies of this nature provide useful information, but real-world data is often more informative.
Since Scottish Medicine Consortium approval in 2022, we have been collecting audit data on outcomes from patients receiving cenobamate.
Methods:
Adult patients were included if they received at least one prescription for cenobamate between March 2022 and April 2024 and had at least 12 months of data available before their first prescription.
Patients dispensed cenobamate were identified from the national Prescribing Information System (PIS) to ensure complete patient capture.
A manual review of electronic patient records was undertaken. The primary outcome of interest was change in seizure frequency on a stable dose. Secondary outcomes included epilepsy-related admissions, changes in ASMs and healthcare resource utilisation costs.
Results:
145 patients received at least 1 CNB prescription, 144 of whom had reached an endpoint. 94/144 (65.2 %) had a favourable response. The median length of treatment was 655 days (range 180–922 days), with a median dose of 150 mg/d (range 25–400 mg/d). The median number of previous ASM was 5 (1−13).
48/145 (33.1 %) discontinued CNB – 35 due to adverse effects, 6 due to lack of efficacy. 2 patients died.
Early analysis suggest a reduction in Health care resource use although long term follow up is required.
Conclusion:
These results offer insights for clinicians regarding the real-world effectiveness, retention rates, and healthcare cost implications of CNB therapy in a cohort consisting largely of patients with severe drug resistant epilepsy. Further studies are ongoing to assess the efficacy of CNB when used earlier and also to provide a comprehensive assessment of health care resource use in this real world settings
Repurposing planetary sunshade sailcraft from displaced Sun–Earth L1 for the deflection of asteroid 2024 YR4
Get PDFThis study examines the feasibility of repurposing sailcraft from a planetary sunshade constellation at a displaced Sun-Earth L1 for asteroid deflection. If pre-positioned in interplanetary space for climate mitigation, such sailcraft offer the possibility for rapid redirection toward hazardous near-Earth objects without the need for new launches. The kinetic-energy impactor method is selected as the deflection mechanism, leveraging the high terminal velocities achievable by solar sailcraft. The case of asteroid 2024 YR4 serves as a representative short-warning scenario, having initially shown a 1.5% Earth impact probability on 22 December 2032. The respective sailcraft impactor mass is 55kg.
The calculation of time-of-flight-optimised transfer trajectories is accomplished through the implementation of the InTrance (Intelligent Trajectory optimisation using neurocontroller evolution) optimisation tool, thereby enabling a solar sailcraft impact mission with a scheduled departure on 3 February 2028. The anticipated arrival at the asteroid is on 1 December 2028, with interception at a relative velocity of 16.23km s-1. Deflection effectiveness is quantified as the miss distance between the nominal and the deflected asteroid trajectories, evaluated at the closest approach. Using this metric, it is shown that a deflection of two Earth radii can be achieved within roughly two days applying two impactors per day. A B-plane analysis confirms the coherent displacement of the encounter geometry, and Monte Carlo simulations yield a single-impactor hit probability of approximately ≈ 0.5%. The findings emphasise the strategic value of large-scale solar sailcraft infrastructures as dual-use assets, demonstrating their potential for both climate intervention and rapid-response planetary defence
Wide-field and non-invasive imaging of brain tumours with scattered light techniques
Get PDFThe ability to identify tumour tissue in a label-free, contactless, and real-time manner is much needed in tumour resection surgery. Current techniques cause interruptions to surgical flow and have high false positive rates, which can cause collateral damage to healthy brain tissue. We propose laser light scattering techniques, such as diffuse correlation spectroscopy and laser speckle contrast imaging, to image mechanical stiffness differences in the brain’s surface associated with tumour tissue. We validate the optimal processing technique quantitatively with a controlled experiment in which paraformaldehyde was used to induce a change in tissue stiffness in ex vivo mouse brains. We then demonstrate that the technique applies to tumour localisation using ex vivo mouse models with real tumours. Qualitative comparisons with magnetic resonance imaging indicate accurate tumour localisation using only surface stiffness changes to underlying tumours. We also demonstrate sub-millimetre precision when imaging brain slices
Pre-stimulus alpha power modulates trial-by-trial variability in theta rhythmic multisensory entrainment strength and theta-induced memory effect
Get PDFBinding multisensory information into episodic memory depends partly on the timing of the hippocampal theta rhythm which provides time windows for synaptic modification. In humans, theta rhythmic sensory stimulation (RSS) enhances episodic memory when the stimuli are synchronised across the visual and auditory domain compared to when they are out-of-synchrony. However, recent studies show mixed evidence if the improvement in episodic memory is the result of modulating hippocampal theta activity. In the current study, we investigated whether pre-stimulus brain state could explain part of this variance in the neural and behavioural effects induced by the RSS, via recording 24 participants’ brain activity with MEG during a multisensory theta RSS memory paradigm. Our findings suggest that pre-stimulus alpha power modulates entrainment strength in sensory regions, which in turn predicts subsequent memory formation. These findings suggest that for non-invasive brain stimulation tools to be effective it is crucial to consider brain-state dependent effects
Cell wall water shields stomata against falling leaf airspace humidity
No full textNo abstract available
Holocene patterns of peat accumulation in Peruvian Amazonia
Get PDFPeatlands accumulate and store carbon over centuries to tens of millennia. Analysing the age structure of peatlands helps us to understand their genesis, development, and stability as carbon stores, and informs peatland management. Here we analyse new and previously published radiocarbon dates from peatlands in the Pastaza-Marañón Basin in Peru, the largest known peatland complex in Amazonia. We show that peatlands here are younger (< c. 8900 and frequently <2500 years old) than in many other parts of the tropics. Basal peat ages in extant peatlands vary depending on the geomorphological stability of the landscape, with younger basal dates typically occurring close to active river floodplains and older basal dates in more stable contexts. The data indicate that within individual peatlands, peat initiation may occur synchronously across a basin, or peat may spread laterally from one or more nucleation sites. Only two out of seven well-dated records show clear hiatuses in past peat accumulation, suggesting that carbon sequestration in some, but not all peatlands has been vulnerable to landscape hydrological change or climate change. Peatland ecosystems in the region are economically important sources of non-timber forest products, which it may be possible to harvest sustainably without biomass loss or drainage, but our analysis indicates that the peat itself accumulates too slowly to be considered as a renewable resource on economically meaningful timescales
SoTL in Practice: What Can I Do?
No full textThis CMBE Community Meeting builds on the earlier SoTL session to begin identifying potential topics for inquiry and support attendees to start their own SoTL projects.
The 90-minute workshop aims to begin developing shared ideas and resources that are relevant to UK and international business school contexts.
Attendance at the earlier SoTL session is not mandatory
Intersections of Environmental and Language Justice Exploring Policy, Pedagogy and Activism
No full textSteady-state and pulsed performance results of a tripropellant autophage engine architecture
No full textThis paper discusses the design, development, and testing of a novel tripropellant autophage-hybrid rocket propulsion system. An autophage, or self-consuming, rocket uses its own fuselage mass as fuel. This concept operates by continuously melting the polymer fuselage at the engine interface, consuming it as soon as it is no longer needed to house the other propellants, and injecting it into the engine itself. The vehicle gets shorter during the ascent. The architecture reduces structural mass fraction, approaches infinite staging, and provides a route toward the miniaturization of launch vehicles for small satellites seeking rapid low-Earth-orbit access. The reduction in rocket length throughout the flight may also increase maneuverability, with applications in defense systems. This report presents the performance of a 100 N autophage engine in hot-fire test campaigns. The tests were performed in a laboratory environment and showed an autophage contribution (i.e., the fraction of fuselage being consumed as additional fuel) of between 5.1 and 15.7% of the total propellant mass during steady-state operation. A total of five tests operated the engine across a range of inlet conditions as well as in pulsed mode. The performance results of these tests form an operational baseline for future work on scaling the autophage architecture to a higher thrust class
A review of prototyping in extended reality: linking immersive design to physical fabrication
Get PDFExtended Reality (XR) shows great potential in the manufacturing industry. It can help designers make initial proposals and iterations at low cost before manufacturers and investors decide whether to invest in research, development or production. According to the literature, prototyping in XR is easier to use than three-dimensional (3D) modelling with a personal computer and more capable of displaying 3D structures than paper drawing. In this comprehensive review, we systematically surveyed 68 manuscripts that met our search criteria on prototyping in XR, and discussed the possibility of transferring created virtual prototypes from XR to physical fabrication. We addressed five research questions about the main elements, display devices, user interaction methods, fabrication links, and future challenges. Based on these questions, we identified a clear technology trend with Head-Mounted Displays (HMDs) being used in more than half the studies (53%). Our analysis also shows that nearly half the literature (32 of the 68 articles) focus on ‘Model Construction and Rendering’, whereas the crucial ‘Link to Fabrication’ is addressed in only 10% of studies, highlighting a critical gap. In view of these latest developments and gaps, we speculate on the challenges and opportunities in the field of prototyping in XR, especially in linking extended reality to fabrication, with the aim of guiding researchers towards new research directions
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