Catalyzed Gasoline Particulate Filters Reduce Secondary Organic Aerosol Production from Gasoline Direct Injection Vehicles

The effects of photochemical aging on exhaust emissions from two light-duty vehicles with gasoline direct injection (GDI) engines equipped with and without catalyzed gasoline particle filters (GPFs) were investigated using a mobile environmental chamber. Both vehicles with and without the GPFs were exercised over the LA92 drive cycle using a chassis dynamometer. Diluted exhaust emissions from the entire LA92 cycle were introduced to the mobile chamber and subsequently photochemically reacted. It was found that the addition of catalyzed GPFs will significantly reduce tailpipe particulate emissions and also provide benefits in gaseous emissions, including nonmethane hydrocarbons (NMHC). Tailpipe emissions composition showed important changes with the use of GPFs by practically eliminating black carbon and increasing the fractional contribution of organic mass. Production of secondary organic aerosol (SOA) was reduced with GPF addition, but was also dependent on engine design which determined the amount of SOA precursors at the tailpipe. Our findings indicate that SOA production from GDI vehicles will be reduced with the application of catalyzed GPFs through the mitigation of reactive hydrocarbon precursors

Learning from Safeguarding Adult Reviews about Transitional Safeguarding: Building an evidence base

Purpose: The purpose of this paper is to set out the evidence base to date for Transitional Safeguarding in order to support authors of Safeguarding Adult Reviews (SARs) where Transitional Safeguarding is a key theme in the review. Design/methodology/approach: The paper draws on key evidence from several published sources about Transitional Safeguarding in England. This evidence is presented in the paper as a framework for analysis to support SAR authors. It follows the same four domain framework used in other adult safeguarding reviews: direct work with individuals; team around the person; organisational support for team members; and governance. This framework was then applied to two SARs written by two of the article’s authors. Findings: The framework for analysis for Transitional Safeguarding SARs was applied as part of the methodology of two separate SARs regarding three young people. Key reflections from applying the framework to both SARs are identified and discussed. These included: providing an effective framework for analysis which all participants could utilise; and a contribution for developing knowledge. Whilst many issues arising for safeguarding young people are similar to those for other adults, there are some unique features. The ways in which the gaps between children and adults systems play out through inter-agency and multi-professional working, as well as how ‘lifestyle choices’ of young people are understood and interpreted are key issues. Practical Implications: This paper presents an evidence base regarding Transitional Safeguarding for SAR authors who are tasked with completing a SAR where Transitional Safeguarding is a key theme. Originality and value: The paper draws together key literature and evidence about Transitional Safeguarding practice with young people. It argues that this framework for analysis provides SAR authors with a useful tool to support their analysis in this complex area of practice

Comparison of long and short axis quantification of left ventricular volume parameters by cardiovascular magnetic resonance, with ex-vivo validation

<p>Abstract</p> <p>Background</p> <p>The purpose of the study was to compare the accuracy and evaluation time of quantifying left ventricular (LV), left atrial (LA) volume and LV mass using short axis (SAX) and long axis (LAX) methods when using cardiovascular magnetic resonance (CMR).</p> <p>Materials and methods</p> <p>We studied 12 explanted canine hearts and 46 patients referred for CMR (29 male, age 47 ± 18 years) in a clinical 1.5 T CMR system, using standard cine sequences. In standard short axis stacks of various slice thickness values in dogs and 8 mm slice thickness (gap 2 mm) in patients, we measured LV volumes using reference slices in a perpendicular, long axis orientation using certified software. Volumes and mass were also measured in six radial long axis (LAX) views.</p> <p>LV parameters were also assessed for intra- and inter-observer variability. In 24 patients, we also analyzed reproducibility and evaluation time of two very experienced (> 10 years of CMR reading) readers for SAX and LAX.</p> <p>Results</p> <p>In the explanted dog hearts, there was excellent agreement between ex vivo data and LV mass and volume data as measured by all methods for both, LAX (r²= 0.98) and SAX (r²= 0.88 to 0.98). LA volumes, however, were underestimated by 13% using the LAX views. In patients, there was a good correlation between all three assessed methods (r²≥ 0.95 for all). In experienced clinical readers, left-ventricular volumes and ejection fraction as measured in LAX views showed a better inter-observer reproducibility and a 27% shorter evaluation time.</p> <p>Conclusion</p> <p>When compared to an ex vivo standard, both, short axis and long axis techniques are highly accurate for the quantification of left ventricular volumes and mass. In clinical settings, however, the long axis approach may be more reproducible and more time-efficient. Therefore, the rotational long axis approach is a viable alternative for the clinical assessment of cardiac volumes, function and mass.</p

An integrated model of care for neurological infections: the first six years of referrals to a specialist service at a university teaching hospital in Northwest England

Background A specialist neurological infectious disease service has been run jointly by the departments of infectious disease and neurology at the Royal Liverpool University Hospital since 2005. We sought to describe the referral case mix and outcomes of the first six years of referrals to the service. Methods Retrospective service review. Results Of 242 adults referred to the service, 231 (95 %) were inpatients. Neurological infections were confirmed in 155 (64 %), indicating a high degree of selection before referral. Viral meningitis (35 cases), bacterial meningitis (33) and encephalitis (22) accounted for 38 % of referrals and 61 % of confirmed neurological infections. Although an infrequent diagnosis (n = 19), neurological TB caused the longest admission (median 23, range 5 – 119 days). A proven or probable microbiological diagnosis was found in 100/155 cases (64.5 %). For the whole cohort, altered sensorium, older age and longer hospital stay were associated with poor outcome (death or neurological disability); viral meningitis was associated with good outcome. In multivariate analysis altered sensorium remained significantly associated with poor outcome, adjusted odds ratio 3.04 (95 % confidence interval 1.28 – 7.22, p = 0.01). Conclusions A service of this type provides important specialist care and a focus for training and clinical research on complex neurological infections

Performing thinking in action: the meletē of live coding

Within this article, live coding is conceived as a meletē, an Ancient Greek term used to describe a meditative thought experiment or exercise in thought, especially understood as a preparatory practice supporting other forms of critical — even ethical — action. Underpinned by the principle of performing its thinking through 'showing the screen', live coding involves 'making visible' the process of its own unfolding through the public sharing of live decision-making within improvisatory performance practice. Live coding can also be conceived as the performing of 'thinking-in-action', a live and embodied navigation of various critical thresholds, affordances and restraints, where its thinking-knowing cannot be easily transmitted nor is it strictly a latent knowledge or 'know how' activated through action. Live coding involves the live negotiation between receptivity and spontaneity, between the embodied and intuitive, between an immersive flow experience and split-attention, between human and machine, the known and not yet known. Moreover, in performing 'thinking-in-action', live coding emerges as an experimental site for reflecting on different perceptions and possibilities of temporal experience within live performance: for attending to the threshold between the live and mediated, between present and future-present, proposing even a quality of atemporality or aliveness

How many steps/day are enough? for adults

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions or translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognize that "some physical activity is better than none" while maintaining a focus on time spent in moderate-to-vigorous physical activity (MVPA). Thus, the purpose of this review was to update our existing knowledge of "How many steps/day are enough?", and to inform step-based recommendations consistent with current physical activity guidelines. Normative data indicate that healthy adults typically take between 4,000 and 18,000 steps/day, and that 10,000 steps/day is reasonable for this population, although there are notable "low active populations." Interventions demonstrate incremental increases on the order of 2,000-2,500 steps/day. The results of seven different controlled studies demonstrate that there is a strong relationship between cadence and intensity. Further, despite some inter-individual variation, 100 steps/minute represents a reasonable floor value indicative of moderate intensity walking. Multiplying this cadence by 30 minutes (i.e., typical of a daily recommendation) produces a minimum of 3,000 steps that is best used as a heuristic (i.e., guiding) value, but these steps must be taken over and above habitual activity levels to be a true expression of free-living steps/day that also includes recommendations for minimal amounts of time in MVPA. Computed steps/day translations of time in MVPA that also include estimates of habitual activity levels equate to 7,100 to 11,000 steps/day. A direct estimate of minimal amounts of MVPA accumulated in the course of objectively monitored free-living behaviour is 7,000-8,000 steps/day. A scale that spans a wide range of incremental increases in steps/day and is congruent with public health recognition that "some physical activity is better than none," yet still incorporates step-based translations of recommended amounts of time in MVPA may be useful in research and practice. The full range of users (researchers to practitioners to the general public) of objective monitoring instruments that provide step-based outputs require good reference data and evidence-based recommendations to be able to design effective health messages congruent with public health physical activity guidelines, guide behaviour change, and ultimately measure, track, and interpret steps/day

Evolutionary-thinking in agricultural weed management

Agricultural weeds evolve in response to crop cultivation. Nevertheless, the central importance of evolutionary ecology for understanding weed invasion, persistence and management in agroecosystems is not widely acknowledged. This paper calls for more evolutionarily-enlightened weed management, in which management principles are informed by evolutionary biology to prevent or minimize weed adaptation and spread. As a first step, a greater knowledge of the extent, structure and significance of genetic variation within and between weed populations is required to fully assess the potential for weed adaptation. The evolution of resistance to herbicides is a classic example of weed adaptation. Even here, most research focuses on describing the physiological and molecular basis of resistance, rather than conducting studies to better understand the evolutionary dynamics of selection for resistance. We suggest approaches to increase the application of evolutionary-thinking to herbicide resistance research. Weed population dynamics models are increasingly important tools in weed management, yet these models often ignore intrapopulation and interpopulation variability, neglecting the potential for weed adaptation in response to management. Future agricultural weed management can benefit from greater integration of ecological and evolutionary principles to predict the long-term responses of weed populations to changing weed management, agricultural environments and global climate

Biodiversity, cultural pathways, and human health: a framework.

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.Direct contact with biodiversity is culturally important in a range of contexts. Many people even join conservation organisations to protect biodiversity that they will never encounter first-hand. Despite this, we have little idea how biodiversity affects people's well-being and health through these cultural pathways. Human health is sensitive to apparently trivial psychological stimuli, negatively affected by the risk of environmental degradation, and positively affected by contact with natural spaces. This suggests that well-being and health should be affected by biodiversity change, but few studies have begun to explore these relationships. Here, we develop a framework for linking biodiversity change with human cultural values, well-being, and health. We argue that better understanding these relations might be profoundly important for biodiversity conservation and public health.Natural Environment Research CouncilEuropean Regional Development Fund Programme 2007 to 2013European Social Fund Convergence Programme for Cornwall and the Isles of Scilly

Miscellaneous Rheumatic Diseases [73-83]: 73. Is There a Delay in Specialist Referral of Hot Swollen Joint?

Background: Patients with acute, hot, swollen joints commonly present to general practitioners, emergency departments and/or acute admitting teams rather than directly to rheumatology. It is imperative to consider septic arthritis in the differential diagnosis of these patients. The British Society of Rheumatology (BSR) has produced guidelines for the management of this condition, which include recommendations for early specialist referral and joint aspiration of all patients with suspected septic arthritis. We examined whether the initial management of patients with acute hot swollen joint(s) at University College London Hospital (UCLH) follows BSR guidelines. Methods: For the period Feb to Nov 2009, appropriate patients were identified by searching the UCLH database using the diagnostic terms, "pyogenic arthritis”, "septic arthritis” and "gout”; and from all joint aspirate requests sent to microbiology. Medical notes were obtained and any patients who had elective arthroscopies or chronic (> 6 weeks) symptoms were excluded. Data were collected on the time taken from the onset of symptoms to specialist (orthopaedic/rheumatology) referral and joint aspiration, collection of blood cultures and antibiotic treatment with or without microbiology advice. Results: Twenty patients were identified with hot swollen (18 monoarticular, 3 prosthetic) joint(s) of < 2 weeks duration. Of whom, 3/20 (15%) were admitted directly to rheumatology, 7/20 (35%) to the acute admissions unit, 3/20 (15%) to orthopaedic, 4/20 (20%) to a medical team and 1/20 (5%) to general surgery. In 19 (95%) cases, specialist (rheumatology/orthopaedic) advice was sought. Of 14 cases not seen directly by specialists 9 (64%) were referred at 24-48 h and 5 (36%) at 48-192 h. All 20 patients had joint aspiration. In 9/20 (45%) of cases, joint aspiration was performed in less than 6 h, 3/20 (15%) cases at 6-24h and 6/20 (30%) cases at 24-192 h and was not recorded in two patients. Of these, crystals were identified in two and one was culture positive. Blood cultures were received for only 6/20 (30%) of cases and only clearly documented to have been taken prior to antibiotic therapy and none were positive. Of 14/20 (70%) started on antibiotic treatment empirically, only 6 (42%) were preceded by joint aspiration. In the 6 patients not treated with antibiotics due to low index of suspicion of septic arthritis, synovial fluid and blood cultures were negative. Microbiology advice was sought in 10/20 (50%) of cases by the admitting teams but the timing of this advice is unclear. Conclusions: Despite the provision of 24 h rheumatology and orthopaedic cover at UCLH, we found a significant delay in acute medical firms seeking specialist advice on the management of patients with acute, hot swollen joints with subsequent deviation from BSR guidelines. Consequently, we plan to increase awareness of these guidelines amongst medical firms at UCLH. Disclosure statement: All authors have declared no conflicts of interes