Castleman disease and lymphocytic interstitial pneumonia: a complex diagnostic and management challenge

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Patient-centred pharmaceutical design to improve acceptability of medicines : similarities and differences in paediatric and geriatric populations

Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.Patient acceptability of a medicinal product is a key aspect in the development and prescribing of medicines. Children and older adults differ in many aspects from the other age subsets of population and require particular considerations in medication acceptability. This review highlights the similarities and differences in these two age groups in relation to factors affecting acceptability of medicines. New and conventional formulations of medicines are considered regarding their appropriateness for use in children and older people. Aspects of a formulation that impact acceptability in these patient groups are discussed, including, for example, taste/smell/viscosity of a liquid and size/shape of a tablet. A better understanding of the acceptability of existing formulations highlights opportunities for the development of new and more acceptable medicines and facilitates safe and effective prescribing for the young and older populationsPeer reviewedFinal Published versio

User-driven design of decision support systems for polycentric environmental resources management

Open and decentralized technologies such as the Internet provide increasing opportunities to create knowledge and deliver computer-based decision support for multiple types of users across scales. However, environmental decision support systems/tools (henceforth EDSS) are often strongly science-driven and assuming single types of decision makers, and hence poorly suited for more decentralized and polycentric decision making contexts. In such contexts, EDSS need to be tailored to meet diverse user requirements to ensure that it provides useful (relevant), usable (intuitive), and exchangeable (institutionally unobstructed) information for decision support for different types of actors. To address these issues, we present a participatory framework for designing EDSS that emphasizes a more complete understanding of the decision making structures and iterative design of the user interface. We illustrate the application of the framework through a case study within the context of water-stressed upstream/downstream communities in Lima, Peru

Cold-Formed Steel Strength Predictions for Torsion

Locally slender open cross-section members are susceptible to significant twisting and high warping torsion stresses. Torsion considerations are complicated by whether it is derived as a first-order effect from loading or a second-order effect from instability. Previous direct torsion experiments on lipped channels have shown significant inelastic reserve in limited cases. The current design for combined bending and torsion interaction has some limitations, including only considering the first yield in torsion and ignoring the cross-section slenderness in torsion. A parametric study is conducted to predict the torsion capacity in locally slender cross-sections. Shell finite element models of lipped Cee and Zee section members are validated with existing experiments on combined bending and torsion. The validated models are utilized for a parametric study with applied torsion on a range of cross-sections, steel grades, and members lengths to cover the range of practically expected torsional slenderness. A set of bimoment parameters, including yield bimoment, buckling bimoment, and plastic bimoment, are calculated and the ultimate bimoment is determined by performing shell finite element collapse analyses. A simple uniform equation is adopted to predict the bimoment capacity and two bimoment strength curves under torsion only are proposed for local and distortional buckling controlled cases respectively

A comparative analysis of ecosystem services valuation approaches for application at the local scale and in data scarce regions

Despite significant advances in the development of the ecosystem services concept across the science and policy arenas, the valuation of ecosystem services to guide sustainable development remains challenging, especially at a local scale and in data scarce regions. In this paper, we review and compare major past and current valuation approaches and discuss their key strengths and weaknesses for guiding policy decisions. To deal with the complexity of methods used in different valuation approaches, our review uses multiple entry points: data vs simulation, habitat vs system vs place-based, specific vs entire portfolio, local vs regional scale, and monetary vs non-monetary. We find that although most valuation approaches are useful to explain ecosystem services at a macro/system level, an application of locally relevant valuation approaches, which allows for a more integrated valuation relevant to decision making is still hindered by data-scarcity. The advent of spatially explicit policy support systems shows particular promise to make the best use of available data and simulations. Data collection remains crucial for the local scale and in data scarce regions. Leveraging citizen science-based data and knowledge co-generation may support the integrated valuation, while at the same time making the valuation process more inclusive, replicable and policy-oriented

Microbial contamination and efficacy of disinfection procedures of companion robots in care homes

Background Paro and other robot animals can improve wellbeing for older adults and people with dementia, through reducing depression, agitation and medication use. However, nursing and care staff we contacted expressed infection control concerns. Little related research has been published. We assessed (i) how microbiologically contaminated robot animals become during use by older people within a care home and (ii) efficacy of a cleaning procedure. Methods This study had two stages. In stage one we assessed microbial load on eight robot animals after interaction with four care home residents, and again following cleaning by a researcher. Robot animals provided a range of shell-types, including fur, soft plastic, and solid plastic. Stage two involved a similar process with two robot animals, but a care staff member conducted cleaning. The cleaning process involved spraying with anti-bacterial product, brushing fur-type shells, followed by vigorous top-to-tail cleaning with anti-bacterial wipes on all shell types. Two samples were taken from each of eight robots in stage one and two robots in stage two (20 samples total). Samples were collected using contact plate stamping and evaluated using aerobic colony count and identification (gram stain, colony morphology, coagulase agglutination). Colony counts were measured by colony forming units per square centimetre (CFU/cm2). Results Most robots acquired microbial loads well above an acceptable threshold of 2.5 CFU/cm2 following use. The bacteria identified were micrococcus species, coagulase negative staphylococcus, diptheriods, aerobic spore bearers, and staphylococcus aureus, all of which carry risk for human health. For all devices the CFU/cm2 reduced to well within accepted limits following cleaning by both researcher and care staff member. Conclusions Companion robots will acquire significant levels of bacteria during normal use. The simple cleaning procedure detailed in this study reduced microbial load to acceptable levels in controlled experiments. Further work is needed in the field and to check the impact on the transmission of viruses

Sources, mechanisms, and timescales of sediment delivery to a New England salt marsh

© The Author(s), 2022. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Baranes, H., Woodruff, J., Geyer, W., Yellen, B., Richardson, J. & Griswold, F. Sources, mechanisms, and timescales of sediment delivery to a New England salt marsh. Journal of Geophysical Research: Earth Surface, 127, (2022): e2021JF006478, https://doi.org/10.1029/2021jf006478.he availability and delivery of an external clastic sediment source is a key factor in determining salt marsh resilience to future sea level rise. However, information on sources, mechanisms, and timescales of sediment delivery are lacking, particularly for wave-protected mesotidal estuaries. Here we show that marine sediment mobilized and delivered during coastal storms is a primary source to the North and South Rivers, a mesotidal bar-built estuary in a small river system impacted by frequent, moderate-intensity storms that is typical to New England (United States). On the marsh platform, deposition rates, clastic content, and dilution of fluvially-sourced contaminated sediment by marine material all increase down-estuary toward the inlet, consistent with a predominantly marine-derived sediment source. Marsh clastic deposition rates are also highest in the storm season. We observe that periods of elevated turbidity in channels and over the marsh are concurrent with storm surge and high wave activity offshore, rather than with high river discharge. Flood tide turbidity also exceeds ebb tide turbidity during storm events. Timescales of storm-driven marine sediment delivery range from 2.5 days to 2 weeks, depending on location within the estuary; therefore the phasing of storm surge and waves with the spring-neap cycle determines how effectively post-event suspended sediment is delivered to the marsh platform. This study reveals that sediment supply and the associated resilience of New England mesotidal salt marshes involves the interplay of coastal and estuarine processes, underscoring the importance of looking both up- and downstream to identify key drivers of environmental change.The project described in this publication was in part supported by Grant or Cooperative Agreement No. G20AC00071 from the U.S. Geological Survey and a Department of Interior Northeast Climate Adaptation Science Center graduate fellowship awarded to H.E.B (G12AC00001)