Copper Mining in the Bronze Age at Mynydd Parys, Anglesey, Wales

Acknowledgements This article was researched and written by David Jenkins. The final editing was undertaken by Andrew Davidson and Jane Kenney (Gwynedd Archaeological Trust) and Dr Simon Timberlake (Early Mines Research Group and McDonald Institute, University of Cambridge), who contributed additional background information. Further contributions and corrections were provided by Peter Marshall (Historic England) and Tim Mighall (University of Aberdeen) who oversaw the palaeoenvironmental study. Cadw generously funded the work through grant aid. The suggestion to edit and publish the article came from John Llywelyn Williams, who has worked closely with David Jenkins on this and a number of other significant projects. The editors are also very grateful for the help and encouragement provided by Paul Jenkins (David’s son). Members of the Parys Underground Group, particularly Oliver Burrows, and the Early Mines Research Group have helped source illustrations, provided corrections and comments, and supported the work. Thanks also to Anglesey Mining plc.Peer reviewedPostprin

Mycobacterium ulcerans in the elderly: more severe disease and suboptimal outcomes

Mycobacterium ulcerans is an infection that can affect all age-groups. It causes necrosis of skin and soft-tissue often resulting in severe outcomes and long-term disability. However, due to the majority of infections worldwide occurring in children and young adults, there is a paucity of information available in elderly patients. It is important that elderly patients are not neglected as the clinical presentation and treatment outcomes may differ significantly from younger patients related to relative immune defficiencies, co-morbidities and increased potential for drug interactions. We specifically examined patients with M. ulcerans disease aged ≥ 65 years and showed that they comprise a significant proportion of patients affected in Australian populations. They present with more severe and advanced disease forms, and suffer from increased toxicity and reduced effectiveness of the currently recommended treatments. Therefore, our study demonstrates that increased efforts are required to diagnose M. ulcerans disease earlier in elderly populations, and that research is urgently required to develop more effective and less toxic treatments for this age-group

The diversity of kilonova emission in short gamma-ray bursts

The historic first joint detection of both gravitational-wave and electromagnetic emission from a binary neutron star merger cemented the association between short gamma-ray bursts (SGRBs) and compact object mergers, as well as providing a well-sampled multi-wavelength light curve of a radioactive kilonova (KN) for the first time. Here, we compare the optical and near-infrared light curves of this KN, AT 2017gfo, to the counterparts of a sample of nearby (z < 0.5) SGRBs to characterize their diversity in terms of their brightness distribution. Although at similar epochs AT 2017gfo appears fainter than every SGRB-associated KN claimed so far, we find three bursts (GRBs 050509B, 061201, and 080905A) where, if the reported redshifts are correct, deep upper limits rule out the presence of a KN similar to AT 2017gfo by several magnitudes. Combined with the properties of previously claimed KNe in SGRBs this suggests considerable diversity in the properties of KN drawn from compact object mergers, despite the similar physical conditions that are expected in many NS–NS mergers. We find that observer angle alone is not able to explain this diversity, which is likely a product of the merger type (NS–NS versus NS–BH) and the detailed properties of the binary (mass ratio, spins etc.). Ultimately disentangling these properties should be possible through observations of SGRBs and gravitational-wave sources, providing direct measurements of heavy element enrichment throughout the universe

Using a stair horizontal-vertical illusion to increase foot clearance over an inconsistently taller stair-riser

Introduction: Stair falls can be caused by inconsistent stair dimensions. During ascent, inconsistently taller stair risers lead to reduced foot clearances as the inconsistency goes unnoticed. A stair horizontal-vertical illusion increases perceived riser heights and foot clearance and could offset reduced foot clearances over inconsistently taller risers, though this might impact other stair safety measures. Method: Twelve participants (age: 22 (3) years) ascended a seven-step staircase under three conditions: i) all steps consistent in riser height (consistent), ii) a 1cm increase in step 5 riser height (inconsistent) and iii) a 1cm increase in step 5 riser height, superimposed with a stair horizontal-vertical illusion (illusion). Vertical foot clearance, foot overhang, and margins of stability were assessed over step 4, 5 and 6. Perceived riser height due to the illusion was determined through a computer perception test. A One-Way Repeated Measures ANOVA compared biomechanical variables between conditions. A One Sample t test compared perceived riser height to the true height. Results: Over the inconsistent step 5, foot clearance reduced by 0.8cm compared to consistent. Illusion increased foot clearance by 1.1cm and decreased foot overhang by 4% compared to inconsistent. On step 4 the illusion led to more anterior instability compared to inconsistent. Illusion and inconsistent led to more mediolateral stability compared to consistent. The illusion increased perceived riser height by 12%. Discussion: Foot clearance reductions over inconsistently taller risers can be offset by a stair horizontal-vertical illusion. Additional benefits included a safer foot overhang and unaffected stability over the inconsistent riser. Changes to step 4 stability might have resulted from leaning forward to look at the step 5 illusion. The stair horizontal-vertical illusion could be a practical solution for inconsistently taller stair risers, where a rebuild is usually the only solution

Adaptation and qualitative evaluation of the BETTER intervention for chronic disease prevention and screening by public health nurses in low income neighbourhoods : views of community residents

The adaptation phase is one component of a study funded as a grant proposal entitled 'Advancing Cancer Prevention Among Deprived Neighbourhoods' by the Canadian Cancer Society Research Institute grant #704042 and by the Canadian Institutes of Health Research Institute of Cancer grant OCP #145450. Aisha Lofters is supported by a CIHR New Investigator Award, as a Clinician Scientist by the Department of Family and Community Medicine, University of Toronto, and as Chair in Implementation Science at the Peter Gilgan Centre for Women’s Cancers at Women’s College Hospital in partnership with the Canadian Cancer Society. Dr. Andrew Pinto holds a Canadian Institutes of Health Research Applied Public Health Chair and is supported as a Clinician-Scientist in the Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, and supported by the Department of Family and Community Medicine, St. Michael’s Hospital, and the Li Ka Shing Knowledge Institute, St. Michael’s Hospital. He is also the Associate Director for Clinical Research at the University of Toronto Practice-Based Research Network. Lawrence Paszat is supported by a Clinician Scientist award funded by the Ontario Ministry of Health and Long Term Care.Background The BETTER intervention is an effective comprehensive evidence-based program for chronic disease prevention and screening (CDPS) delivered by trained prevention practitioners (PPs), a new role in primary care. An adapted program, BETTER HEALTH, delivered by public health nurses as PPs for community residents in low income neighbourhoods, was recently shown to be effective in improving CDPS actions. To obtain a nuanced understanding about the CDPS needs of community residents and how the BETTER HEALTH intervention was perceived by residents, we studied how the intervention was adapted to a public health setting then conducted a post-visit qualitative evaluation by community residents through focus groups and interviews. Methods We first used the ADAPT-ITT model to adapt BETTER for a public health setting in Ontario, Canada. For the post-PP visit qualitative evaluation, we asked community residents who had received a PP visit, about steps they had taken to improve their physical and mental health and the BETTER HEALTH intervention. For both phases, we conducted focus groups and interviews; transcripts were analyzed using the constant comparative method. Results Thirty-eight community residents participated in either adaptation (n = 14, 64% female; average age 54 y) or evaluation (n = 24, 83% female; average age 60 y) phases. In both adaptation and evaluation, residents described significant challenges including poverty, social isolation, and daily stress, making chronic disease prevention a lower priority. Adaptation results indicated that residents valued learning about CDPS and would attend a confidential visit with a public health nurse who was viewed as trustworthy. Despite challenges, many recipients of BETTER HEALTH perceived they had achieved at least one personal CDPS goal post PP visit. Residents described key relational aspects of the visit including feeling valued, listened to and being understood by the PP. The PPs also provided practical suggestions to overcome barriers to meeting prevention goals. Conclusions Residents living in low income neighbourhoods faced daily stress that reduced their capacity to make preventive lifestyle changes. Key adapted features of BETTER HEALTH such as public health nurses as PPs were highly supported by residents. The intervention was perceived valuable for the community by providing access to disease prevention. Trial registration #NCT03052959, 10/02/2017.Peer reviewe

Emergency management in health: key issues and challenges in the UK

Background Emergency planning in the UK has grown considerably in recent years, galvanised by the threat of terrorism. However, deficiencies in NHS emergency planning were identified and the evidence-base that underpins it is questionable. Inconsistencies in terminologies and concepts also exist. Different models of emergency management exist internationally but the optimal system is unknown. This study examines the evidence-base and evidence requirements for emergency planning in the UK health context. Methods The study involved semi-structured interviews with key stakeholders and opinion leaders. Purposive sampling was used to obtain a breadth of views from various agencies involved in emergency planning and response. Interviews were then analysed using a grounded approach using standard framework analysis techniques. Results We conducted 17 key informant interviews. Interviewees identified greater gaps in operational than technical aspects of emergency planning. Social and behavioural knowledge gaps were highlighted with regards to how individuals and organisations deal with risk and behave in emergencies. Evidence-based approaches to public engagement and for developing community resilience to disasters are lacking. Other gaps included how knowledge was developed and used. Conflicting views with regards to the optimal configuration and operation of the emergency management system were voiced. Conclusions Four thematic categories for future research emerged: (i) Knowledge-base for emergency management: Further exploration is needed of how knowledge is acquired, valued, disseminated, adopted and retained. (ii) Social and behavioural issues: Greater understanding of how individuals approach risk and behave in emergencies is required. (iii) Organisational issues in emergencies: Several conflicting organisational issues were identified; value of planning versus plans, flexible versus standardized procedures, top-down versus bottom-up engagement, generic versus specific planning, and reactive versus proactive approaches to emergencies. (iv) Emergency management system: More study is required of system-wide issues relating to system configuration and operation, public engagement, and how emergency planning is assessed

Estimating the NIH Efficient Frontier

Background: The National Institutes of Health (NIH) is among the world’s largest investors in biomedical research, with a mandate to: “…lengthen life, and reduce the burdens of illness and disability.” Its funding decisions have been criticized as insufficiently focused on disease burden. We hypothesize that modern portfolio theory can create a closer link between basic research and outcome, and offer insight into basic-science related improvements in public health. We propose portfolio theory as a systematic framework for making biomedical funding allocation decisions–one that is directly tied to the risk/reward trade-off of burden-of-disease outcomes. Methods and Findings: Using data from 1965 to 2007, we provide estimates of the NIH “efficient frontier”, the set of funding allocations across 7 groups of disease-oriented NIH institutes that yield the greatest expected return on investment for a given level of risk, where return on investment is measured by subsequent impact on U.S. years of life lost (YLL). The results suggest that NIH may be actively managing its research risk, given that the volatility of its current allocation is 17% less than that of an equal-allocation portfolio with similar expected returns. The estimated efficient frontier suggests that further improvements in expected return (89% to 119% vs. current) or reduction in risk (22% to 35% vs. current) are available holding risk or expected return, respectively, constant, and that 28% to 89% greater decrease in average years-of-life-lost per unit risk may be achievable. However, these results also reflect the imprecision of YLL as a measure of disease burden, the noisy statistical link between basic research and YLL, and other known limitations of portfolio theory itself. Conclusions: Our analysis is intended to serve as a proof-of-concept and starting point for applying quantitative methods to allocating biomedical research funding that are objective, systematic, transparent, repeatable, and expressly designed to reduce the burden of disease. By approaching funding decisions in a more analytical fashion, it may be possible to improve their ultimate outcomes while reducing unintended consequences

Shepherding sub-Saharan Africa's wildlife through peak anthropogenic pressure toward a green anthropocene

Sub-Saharan Africa’s (SSA’s) iconic biodiversity is of immense potential global value but is jeopardized by increasing anthropogenic pressures. Elevated consumption in wealthier countries and the demands of international corporations manifest in significant resource extraction from SSA. Biodiversity in SSA also faces increasing domestic pressures, including rapidly growing human populations. The demographic transition to lower fertility rates is occurring later and slower in SSA than elsewhere, and the continent’s human population may quadruple by 2100. SSA’s biodiversity will therefore pass through a bottleneck of growing anthropogenic pressures, while also experiencing intensifying effects of climate change. SSA’s biodiversity could be severely diminished over the coming decades and numerous species pushed to extinction. However, the prospects for nature conservation in SSA should improve in the long term, and we predict that the region will eventually enter a Green Anthropocene. Here, we outline critical steps needed to shepherd SSA’s biodiversity into the Green Anthropocene epoch.http://www.annualreviews.orgam2023Mammal Research InstituteZoology and Entomolog

Swift XRT Observations of the Afterglow of GRB 050319

Swift discovered the high redshift GRB 050319 with the Burst Alert Telescope and began observing with its narrow field instruments only 225 s after the burst onset. The afterglow X-ray emission was monitored by the XRT up to 28 days after the burst. The light curve shows a decay with three different phases, each characterized by a distinct slope: an initial steep decay with a power law index of ~ 5.5, a second phase characterized by a flat decay slope of \~ 0.54, and a third phase with a decay slope of ~ 1.14. During the first phase the spectral energy distribution is softer than in the following two phases and the photon index is consistent with the GRB prompt spectrum. The extrapolation of the BAT light curve to the XRT band suggests that the initial fast decaying phase of the XRT afterglow might be the low energy tail of the prompt emission. The second break in the afterglow light curve occurs about 27000 s after the burst. The spectral energy distribution before and after the second break does not change and it can be tentatively interpreted as a jet break or the end of a delayed or continuous energy injection phase.Comment: 15 pages, 2 figures. Accepted for publication in Ap