FIMCAR XIII: Cost Benefit Analysis

Although the number of road accident casualties in Europe is falling the problem still remains substantial. In 2011 there were still over 30,000 road accident fatalities [EC 2012]. Approximately half of these were car occupants and about 60 percent of these occurred in frontal impacts. The next stage to improve a car’s safety performance in frontal impacts is to improve its compatibility for car-to-car impacts and for collisions against objects and HGVs. Compatibility consists of improving both a car’s self and partner protection in a manner such that there is good interaction with the collision partner and the impact energy is absorbed in the car’s frontal structures in a controlled way which results in a reduction of injuries. Over the last ten years much research has been performed which has found that there are four main factors related to a car’s compatibility [Edwards 2003, Edwards 2007]. These are structural interaction potential, frontal force matching, compartment strength and the compartment deceleration pulse and related restraint system performance. The objective of the FIMCAR FP7 EC-project was to develop an assessment approach suitable for regulatory application to control a car’s frontal impact and compatibility crash performance and perform an associated cost benefit analysis for its implementation

Discriminating Phytoplankton Functional Types (PFTs) in the Coastal Ocean Using the Inversion Algorithm Phydotax and Airborne Imaging Spectrometer Data

There is a need in the Biological Oceanography community to discriminate among phytoplankton groups within the bulk chlorophyll pool to understand energy flow through ecosystems, to track the fate of carbon in the ocean, and to detect and monitor-for harmful algal blooms (HABs). The ocean color community has responded to this demand with the development of phytoplankton functional type (PFT) discrimination algorithms. These PFT algorithms fall into one of three categories depending on the science application: size-based, biogeochemical function, and taxonomy. The new PFT algorithm Phytoplankton Detection with Optics (PHYDOTax) is an inversion algorithm that discriminates taxon-specific biomass to differentiate among six taxa found in the California Current System: diatoms, dinoflagellates, haptophytes, chlorophytes, cryptophytes, and cyanophytes. PHYDOTax was developed and validated in Monterey Bay, CA for the high resolution imaging spectrometer, Spectroscopic Aerial Mapping System with On-board Navigation (SAMSON - 3.5 nm resolution). PHYDOTax exploits the high spectral resolution of an imaging spectrometer and the improved spatial resolution that airborne data provides for coastal areas. The objective of this study was to apply PHYDOTax to a relatively lower resolution imaging spectrometer to test the algorithm's sensitivity to atmospheric correction, to evaluate capability with other sensors, and to determine if down-sampling spectral resolution would degrade its ability to discriminate among phytoplankton taxa. This study is a part of the larger Hyperspectral Infrared Imager (HyspIRI) airborne simulation campaign which is collecting Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) imagery aboard NASA's ER-2 aircraft during three seasons in each of two years over terrestrial and marine targets in California. Our aquatic component seeks to develop and test algorithms to retrieve water quality properties (e.g. HABs and river plumes) in both marine and in-land water bodies. Results presented are from the 10 April 2013 overflight of the Monterey Bay region and focus primarily on the first objective - sensitivity to atmospheric correction. On-going and future work will continue to evaluate if PHYDOTax can be applied to historical (SeaWiFS and MERIS), existing (MODIS, VIIRS, and HICO), and future (PACE, GEO-CAPE, and HyspIRI) satellite sensors. Demonstration of cross-platform continuity may aid in calibration and validation efforts of these sensors

Characterising the burden of chronic kidney disease among people with type 2 diabetes in England: a cohort study using the Clinical Practice Research Datalink.

OBJECTIVES: To describe prevalence of chronic kidney disease (CKD), demographic and clinical characteristics, treatment patterns and rates of cardiovascular and renal complications for patients with type 2 diabetes (T2D) treated in routine clinical care. DESIGN: Repeat cross-sectional study (6 monthly cross-sections) and cohort study from 1 January 2017 to 31 December 2019. SETTING: Primary care data from English practices contributing to the UK Clinical Practice Research Datalink linked to Hospital Episode Statistics and Office for National Statistics mortality data. PARTICIPANTS: Patients with T2D aged >18 years, at least one year of registration data. PRIMARY AND SECONDARY OUTCOMES: Primary outcome was prevalence of CKD defined as chronic kidney disease epidemiology collaboration (CKD-EPI) estimated glomerular filtration rate <60 mL/min/1.73 m2, and/or urinary albumin creatinine ratio ≥3 mg/mmol in the past 24 months. Secondary outcomes were prescriptions of medications of interest and clinical and demographic characteristics in the past 3 months.In the cohort study rates of renal and cardiovascular complications, all-cause mortality and hospitalisations over the study period were compared among those with and without CKD. RESULTS: There were 574 190 eligible patients with T2D as of 1 January 2017 and 664 296 as of 31 December 2019. Estimated prevalence of CKD across the study period was stable at approximately 30%. Medication use was stable over time in people with CKD and T2D, with low use of steroidal mineralocorticoid receptor antagonists (approximately 4.5% across all time points) and a low use but steady increase in use of sodium-glucose co-transporter-2 inhibitors (from 2.6% to 6.2%). Rates of all complications were higher in those with CKD at the start of the study period, with increasing rates, with increased severity of CKD, heart failure and albuminuria. CONCLUSIONS: The burden of CKD in patients with T2D is high and associated with substantially increased rates of complications particularly in those with comorbid heart failure

Invasive Streptococcus pneumoniae in Children, Malawi, 2004–2006

Of 176 invasive Streptococcus pneumoniae isolates from children in Malawi, common serotypes were 1 (23%), 6A/B (18%), 14 (6%), and 23F (6%). Coverage with the 7-valent pneumococcal conjugate vaccine (PCV) was 39%; PCV10 and PCV13 increased coverage to 66% and 88%, respectively. We found chloramphenicol resistance in 27% of isolates and penicillin nonsusceptibility in 10% (by using meningitis breakpoints); all were ceftriaxone susceptible

Informing National Health Service patients about participation in clinical research: A comparison of opt-in and opt-out approaches across the United Kingdom

Objective: Recruitment to clinical research in the NHS remains challenging. One barrier is accessing patients to discuss research participation. Two general approaches are used in the UK to facilitate this: an ‘opt-in’ approach (when clinicians communicate research opportunities to patients) and an ‘opt-out’ approach (all patients have the right to be informed of relevant research opportunities). No evidence-based data are available, however, to inform the decision about which approach is preferable. This study aimed to collect information from ‘opt-in’ and ‘opt-out’ Trusts and identify which of the two approaches is optimal for ensuring NHS patients are given opportunities to discuss research participation. Method: This sequential mixed methods study comprised three phases: (1) an Appreciative Inquiry across UK Trusts, and (2) online surveys and (3) focus groups with NHS staff and patients at a representative mental health Trust. Results: The study was conducted between June and October 2019. Out of seven NHS Mental Health Trusts contacted (three ‘opt-out’ and four ‘opt-in’), only four took part in phase 1 of the study and three of them were ‘opt-out’ Trusts. Benefits of an ‘opt-out’ approach included greater inclusivity of patients and the removal of research gatekeepers, whilst the involvement of research-active clinicians and established patient-clinician relationships were cited as important to ‘opt-in’ success. Phase 2 and 3 were conducted at a different Trust (Oxford Health NHS Foundation Trust, OHNHSFT) which was using an ‘opt-in’ approach. Of 333 staff and member survey responders, 267 (80.2%) favoured moving to an ‘opt-out’ approach (phase 2). Nineteen staff and 16 patients and carers participated in focus groups (phase 3). Concern was raised by staff regarding the lack of time for clinical research, with clinical work taking precedence over research; patients were concerned about a lack of research activity; all considered research to be beneficial and were supportive of a move to ‘opt-out’. Conclusion: Findings suggest that ‘opt-out’ is more beneficial than ‘opt-in’, with the potential to vastly increase patient access to research opportunities and to enable greater equality of information provision for currently marginalised groups. This should ensure that healthcare research is more representative of the entire population, including those with a mental health diagnosis

NASA COAST and OCEANIA Airborne Missions Support Ecosystem and Water Quality Research in the Coastal Zone

NASA has a continuing requirement to collect high-quality in situ data for the vicarious calibration of current and next generation ocean color satellite sensors and to validate the algorithms that use the remotely sensed observations. Recent NASA airborne missions over Monterey Bay, CA, have demonstrated novel above- and in-water measurement capabilities supporting a combined airborne sensor approach (imaging spectrometer, microradiometers, and a sun photometer). The results characterize coastal atmospheric and aquatic properties through an end-to-end assessment of image acquisition, atmospheric correction, algorithm application, plus sea-truth observations from state-of-the-art instrument systems. The primary goal is to demonstrate the following in support of calibration and validation exercises for satellite coastal ocean color products: 1) the utility of a multi-sensor airborne instrument suite to assess the bio-optical properties of coastal California, including water quality; and 2) the importance of contemporaneous atmospheric measurements to improve atmospheric correction in the coastal zone. The imaging spectrometer (Headwall) is optimized in the blue spectral domain to emphasize remote sensing of marine and freshwater ecosystems. The novel airborne instrument, Coastal Airborne In-situ Radiometers (C-AIR) provides measurements of apparent optical properties with high dynamic range and fidelity for deriving exact water leaving radiances at the land-ocean boundary, including radiometrically shallow aquatic ecosystems. Simultaneous measurements supporting empirical atmospheric correction of image data are accomplished using the Ames Airborne Tracking Sunphotometer (AATS-14). Flight operations are presented for the instrument payloads using the Center for Interdisciplinary Remotely-Piloted Aircraft Studies (CIRPAS) Twin Otter flown over Monterey Bay during the seasonal fall algal bloom in 2011 (COAST) and 2013 (OCEANIA) to support bio-optical measurements of phytoplankton for coastal zone research

Disruption of tRNA biogenesis enhances proteostatic resilience, improves later-life health, and promotes longevity

tRNAs are evolutionarily ancient molecular decoders essential for protein translation. In eukaryotes, tRNAs and other short, noncoding RNAs are transcribed by RNA polymerase (Pol) III, an enzyme that promotes ageing in yeast, worms, and flies. Here, we show that a partial reduction in Pol III activity specifically disrupts tRNA levels. This effect is conserved across worms, flies, and mice, where computational models indicate that it impacts mRNA decoding. In all 3 species, reduced Pol III activity increases proteostatic resilience. In worms, it activates the unfolded protein response (UPR) and direct disruption of tRNA metabolism is sufficient to recapitulate this. In flies, decreasing Pol III’s transcriptional initiation on tRNA genes by a loss-of-function in the TFIIIC transcription factor robustly extends lifespan, improves proteostatic resilience and recapitulates the broad-spectrum benefits to late-life health seen following partial Pol III inhibition. We provide evidence that a partial reduction in Pol III activity impacts translation, quantitatively or qualitatively, in both worms and flies, indicating a potential mode of action. Our work demonstrates a conserved and previously unappreciated role of tRNAs in animal ageing

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy