10 research outputs found
Alkaline-encrusted pyelitis and cystitis: an easily missed and life-threatening urinary infection
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Management, research and budgetting of aggregates in shelf seas related to end-users (Marebasse)
No full textSustainable management of the Belgian exclusive economic zone (EEZ) has become important increasingly. This is due mainly to higher exploitation demands of marine aggregates, but also the dredging industry imposes high stresses on the seafloor. To anticipate on future developments, including the implantation of windmill farms, efficient evaluation tools and strategies of seabed nature and dynamics are needed, based on the best available science.A three-tiered approach was followed, corresponding to three spatial scales: broad-based, regional and site-specific. On the scale of the Belgian part of the North Sea (BPNS), sediment transport models were further developed to evaluate large-scale sedimentary processes and to provide a baseline for any detailed investigation. On a regional scale, evaluation tools and strategies were developed within the view of the optimisation of environmental (impact) assessments. New site investigations integrated results from state-of-the-art geo-acoustical and terrain verification tools and from a multisensor benthic lander, equipped with hydrodynamic and sediment transport instrumentation. To assess the environmental impact of aggregate extraction, multidisciplinary research was carried through national and international cooperation. Knowledge was integrated on the physical, geomorphological, sedimentological and biological nature of the seafloor. Valorisation of the results comprised a series of thematic maps on the nature and dynamics of the BPNS and a suite of recommendations on sustainable management and exploitation of the EEZ. The latter include criteria to select most appropriate locations for aggregate extraction and dredging/dumping operations whilst minimising environmental effects. However, sustainability can be ensured only if good management/policy practices are in place and implemented in a structural way
Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry
Get PDFAims The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. Methods and results Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (inhospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, prehospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. Conclusion The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality
Split Genders: Medical versus Legal Understanding of Gender Identity (De Lege Lata and De Lege Ferenda)
Get PDFFor centuries, the law accepted the legal gender of an individual that was indicated at birth by the appearance of their genitalia and stated on their birth certificate. Nowadays, however, we have plenty of scientific, medical and psychological evidence (and thus reasons) to revise the adopted way of thinking about legal gender to associate it more with gender identity. Most people do not perceive a potential conflict between genital sex and gender identity, because their genital sex is consistent with their gender identity. Trans- and intersex comunnity needs recognition of their gender identity independent of their genital sex as a condition for a life of self-determination, personal freedom, respect and dignity; these are, after all, values that are extremely important for the law. The purpose of this analysis is to determine whether the concept of gender identity is perceived generally in the Polish language and the Polish legal system in a way that takes into account current medical knowledge and the legitimate needs of the individual. 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Relationships between faunal assemblages and habitat types in Broke Inlet, Western Australia
Get PDFThe work for this thesis was undertaken in Broke Inlet, a seasonally-open estuary on the south coast of Western Australia and the only estuary in that region which is regarded as “near-pristine” (Commonwealth of Australia, 2002). The only previous seasonal studies of the environmental and biotic characteristics of this estuary involved broad-based descriptions of the trends in salinity, temperature and ichthyofaunal characteristics at a limited number of sites. Furthermore, no attempt has been made to identify statistically the range of habitats present in the nearshore and offshore waters of this system, and the extents to which the characteristics of the fish and benthic invertebrate faunas are related to habitat type. These types of data provide not only reliable inventories of the habitat and faunal characteristics of Broke Inlet, but also a potential basis for predicting the likely impact of anthropogenic and climatic changes in Broke Inlet in the future.
The main aims of this thesis were as follows. (1) To use the method of Valesini et al. (2010), which employs enduring environmental characteristics, to identify quantitatively the range of habitats present throughout the nearshore and offshore waters of Broke Inlet. The enduring environmental characteristics represent three broad categories, i.e. the location of any site in terms of its proximity to marine and freshwater sources, the degree of exposure to wave activity and the type of substrate and/or submerged vegetation. (2) To test the hypothesis that the species richness, density, diversity and species compositions of the fish and benthic macroinvertebrate faunas differ among habitat types, seasons and, in the case of the fish fauna, also years. (3) To test the hypothesis that the pattern of relative differences among habitat types, as exhibited by their faunal compositions, is correlated with that defined by their (i) enduring environmental characteristics and (ii) non-enduring environmental characteristics (water physico-chemical variables and sediment characteristics).
A high resolution satellite image and a digital elevation model of Broke Inlet were used to measure the enduring environmental characteristics at 104 and 36 widely-distributed sites in nearshore and offshore waters, respectively. These data were used to construct separate Manhattan distance matrices for nearshore and offshore waters, which were then subjected to the CLUSTER and SIMPROF routines in PRIMER v6 to identify the various groups of sites that did not differ significantly in their environmental characteristics and which were thus considered to represent habitat types. Twelve and four distinct habitat types were identified in nearshore and offshore waters, respectively.
The ichthyofaunas at sites representing 11 nearshore (A-K) and three offshore (A-C) habitat types were sampled seasonally for two consecutive years using seine and gill nets, respectively. A total of 83,047 fish was collected from nearshore waters, representing 27 species from 19 families, with 99.6% of those fish belonging to six species which represent the Atherinidae (Atherinosoma elongata, Leptatherina wallacei and Leptatherina presbyteroides) or Gobiidae (Afurcagobius suppositus, Pseudogobius olorum and Favonigobius lateralis) and complete their life cycles within the estuary. Each of these species were found at each nearshore habitat type, except for P. olorum, which was not caught at habitat A.
The species richness, density and diversity of the nearshore fish fauna differed significantly among habitats, seasons and years, with habitat being the most influential factor. Generally, mean species richness and density were greatest at habitat types located in the entrance channel (B, G and H) and/or on the southern shore of the basin (C and G), while the fish assemblages were most depauperate at habitats near freshwater sources (A and J).
The nearshore ichthyofaunal composition of Broke Inlet differed significantly among habitats, seasons and years, with the first again being the most influential. However, the extents of the overall differences in composition during each sampling occasion were moderate. The lack of very pronounced ichthyofaunal differences among the various habitat types reflects the widespread distributions and high abundances of the above atherinid and gobiid species, and particularly of A. elongata and L. wallacei, which typified the fish fauna of each habitat type on almost all sampling occasions. The most distinctive of the faunas were those at habitat types in the entrance channel, where L. presbyteroides and F. lateralis, which are typically found in higher salinities, were in their greatest densities, and where several marine straggler species, such as the labrids Notolabrus parilus and Achoerodus gouldii, were occasionally caught. Seasonal and inter-annual changes in ichthyofaunal composition were small and often not consistent across habitats.
The pattern of relative differences among nearshore habitats in terms of their ichthyofaunal composition was correlated at a moderate level with that defined by their enduring environmental characteristics in all but one of the eight seasons. Such indicate that the ichthyofaunal composition likely to be found at any site in the nearshore waters of Broke Inlet at any time of year can be predicted, simply by assigning that site to its most appropriate habitat type on the basis of its enduring environmental characteristics. Differences in ichthyofaunal composition among habitat types were also correlated, but to a slightly greater extent, with those among the suite of non-enduring water physico-chemical variables, with salinity and the biomass of macrophytes being particularly relevant.
Gill netting in the three offshore habitats yielded 1,050 fish representing 31 species. Species richness, catch rates and diversity all varied significantly among habitats, with the values for each of these biotic characteristics always being greatest at habitat A in the entrance channel and lowest at habitat B near the Shannon River mouth. These biotic variables did not always vary, however, among seasons and/or years. In contrast to the situation in nearshore waters, the offshore ichthyofauna comprised mainly marine estuarine-opportunists and marine stragglers, which contributed 84% to the number of species and 80% to the total number of fishes. The contribution of individuals belonging to the marine straggler guild was only 5% and no estuarine resident species were caught.
Ichthyofaunal composition in offshore waters differed significantly among habitats, seasons and years, with habitat being the most influential factor. Faunal composition only differed among habitats in spring and autumn, and even then the extent of those differences was low. During those seasons, habitat B contained the most distinct and depauperate fauna, which was typified mainly by Mugil cephalus and Aldrichetta forsteri. In contrast, the fish assemblages at habitats A and C were also typified by Arripis georgianus, Arripis truttaceus, Rhabdosargus sarba, Pagrus auratus, Pseudocaranx dentex and Engraulis australis.
The pattern of relative differences among offshore sites in terms of their ichthyofaunal composition was significantly correlated with that defined by their enduring environmental characteristics only in autumn, but was moderately correlated with that exhibited by the suite of non-enduring water physico-chemical variables in each season except summer.
Seasonal sampling of benthic macroinvertebrates at six of the nearshore habitat types (A, C, D, F, H and K) for a year yielded 7,485 individuals representing 28 species and seven phyla and, at the three offshore habitat types (A-C), 2,459 individuals representing 26 species and eight phyla. Polychaetes (64 and 57%) and crustaceans (24 and 34%) were the most abundant taxa in nearshore and offshore waters, respectively. The mean density of invertebrates in the nearshore waters did not differ significantly among habitats, but did vary significantly among seasons, and was greatest in summer. The mean densities of invertebrates in offshore waters did not differ significantly, however, among habitats or seasons.
The compositions of nearshore benthic macroinvertebrate assemblages differed significantly among habitats and, less conspicuously, seasons. Comparisons between the faunal compositions in each pair of habitats in spring and summer were almost invariably significantly different and to a moderate extent. However, such pairwise comparisons were rarely significant in autumn and winter. Habitats A and K contained the most distinct and depauperate invertebrate fauna, comprising mainly the polychaete Capitella capitata and amphipod Corophium minor, whereas the other habitats also contained large numbers of the polychaete Ceratonereis aequisetis. In offshore waters, the composition of the benthic macroinvertebrate assemblages differed to a low to moderate degree among habitats, with habitat B containing the most distinct fauna due to large densities of C. minor. The extent of seasonal differences in these faunal compositions was small.
The pattern of relative differences among nearshore habitats in terms of their benthic macroinvertebrate composition was highly correlated with that defined by both their (i) enduring environmental characteristics and (ii) non-enduring water physico-chemical and sediment characteristics in spring and/or summer. Although the faunal and enduring environmental data were not correlated at offshore sites, the fauna and non-enduring environmental variables at those sites were correlated to a moderate extent.
In summary, the composition of the nearshore fish fauna at any site in Broke Inlet at any time of year can now be predicted by allocating that site to a particular habitat type on the basis of its enduring environmental characteristics. The less consistent spatial correlations between the compositions of the offshore fish fauna and benthic macroinvertebrate faunas and the enduring environmental variables largely reflected the ubiquitous nature of the majority of the abundant species representing those faunas, i.e. they are typically at least moderately abundant in all habitats and thus have no strong preferences for a particular habitat type
Investigating the effects of large wood and forest management on flood risk and flood hydrology
No full textThe changes to catchment scale flood risk following river restoration works, including the addition of large wood logjams to the channel, are poorly quantified in the literature. Key concerns following river restoration for river managers and other stakeholders are changes to flood hydrology at the reach and catchment scale and changes in the mobility of large wood pieces. The effects of accumulations of large wood (logjams) on local flood hydrology have been documented in the literature, showing logjams slow flood wave travel time and increase the duration and extent of local overbank inundation. Modelling studies conducted at a reach scale have shown that these local effects can slow flood wave travel time through a reach and delay the timing of flood peak discharge at the reach outflow. How these local and reach scale effects translate to the catchment scale remains to be illustrated in the literature.In this thesis a combination of field and modelling studies are used to; elucidate the link between logjam form and function, to quantify the mobility of pieces of large wood relative to their physical characteristics, to predict the changes in floodplain forest restoration over time and to provide predictions of changes to catchment scale flood hydrology following river restoration at a range of scales and locations.It is shown that logjams inducing a step in the water profile are most effective at creating diverse geomorphology and habitats. Logjams were found to account for 65% of flow resistance in forested river channels, rising to 75-98% of flow resistance where the logjam was inducing a step in the water profile.Large wood in small forested river channels was found to be highly mobile with 75% of pieces moving, with the longest transport length of 5.6km. Large wood mobility is governed primarily by the length of a piece of wood with wood in excess of 1.5x channel width a threshold for a lower probability of movement.Hydrological modelling using OVERFLOW shows that reach scale river restoration can lead to modest changes in catchment scale flood hydrology. It is concluded that flood risk management can incorporate river restoration, but that results are likely to be unpredictable if engineered logjams are used alone. Substantial benefits in reducing catchment outflow peak discharge (up to 5% reduction) are modelled for floodplain forest restoration at the sub-catchment scale (10-15% of catchment area), rising to up to 10% reductions as the forest matures and becomes more complex
Presentation, care and outcomes of patients with NSTEMI according to World Bank country income classification: the ACVC-EAPCI EORP NSTEMI Registry of the European Society of Cardiology.
No full textCohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry.
No full textInternational audienceAbstract Aims The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. Methods and results Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. Conclusion The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality
