Combining short-range dispersion simulations with fine-scale meteorological ensembles: probabilistic indicators and evaluation during a ⁸⁵Kr field campaign

Numerical atmospheric dispersion models (ADMs) are used for predicting the health and environmental consequences of nuclear accidents in order to anticipate countermeasures necessary to protect the populations. However, these simulations suffer from significant uncertainties, arising in particular from input data: weather conditions and source term. Meteorological ensembles are already used operationally to characterize uncertainties in weather predictions. Combined with dispersion models, these ensembles produce different scenarios of radionuclide dispersion, called “members”, representative of the variety of possible forecasts. In this study, the fine-scale operational weather ensemble AROME-EPS (Applications of Research to Operations at Mesoscale-Ensemble Prediction System) from Météo-France is coupled with the Gaussian puff model pX developed by the IRSN (French Institute for Radiation Protection and Nuclear Safety). The source term data are provided at 10 min resolution by the Orano La Hague reprocessing plant (RP) that regularly discharges 85Kr during the spent nuclear fuel reprocessing process. In addition, a continuous measurement campaign of 85Kr air concentration was recently conducted by the Laboratory of Radioecology in Cherbourg (LRC) of the IRSN, within 20 km of the RP in the North-Cotentin peninsula, and is used for model evaluation. This paper presents a probabilistic approach to study the meteorological uncertainties in dispersion simulations at local and medium distances (2–20 km). First, the quality of AROME-EPS forecasts is confirmed by comparison with observations from both Météo-France and the IRSN. Then, the probabilistic performance of the atmospheric dispersion simulations was evaluated by comparison to the 85Kr measurements carried out during a period of 2 months, using two probabilistic scores: relative operating characteristic (ROC) curves and Peirce skill score (PSS). The sensitivity of dispersion results to the method used for the calculation of atmospheric stability and associated Gaussian dispersion standard deviations is also discussed. A desirable feature for a model used in emergency response is the ability to correctly predict exceedance of a given value (for instance, a dose guide level). When using an ensemble of simulations, the “decision threshold” is the number of members predicting an event above which this event should be considered probable. In the case of the 16-member dispersion ensemble used here, the optimal decision threshold was found to be 3 members, above which the ensemble better predicts the observed peaks than the deterministic simulation. These results highlight the added value of ensemble forecasts compared to a single deterministic one and their potential interest in the decision process during crisis situations.</p

Early weight gain trajectories in first episode anorexia:Predictors of outcome for emerging adults in outpatient treatment

Plain English summary A key feature of anorexia nervosa (AN) is an unhealthily low body weight. Previous studies show that more weight gained early in inpatient treatment leads to better outcomes. This study tried to see if this was also true for outpatients receiving treatment for the first time. All participants were emerging adults between the ages of 16 and 25 who had been ill for less than 3 years. Weight was recorded across the first 12 weekly treatment sessions. Statistics showed that the patients fit roughly into four different groups in early treatment, each with different starting weights and rates of weight gain in the first 12 treatment sessions. The group a patient belonged to could sometimes be predicted by vomiting behaviours, level of depression, and patients’ perception of parental tolerance and expectations at the start of treatment. Out of the four groups, three did relatively well 1 year later, but one small group of patients did not. This small group had a higher starting weight than many of the other groups but did not gain any weight across the first 12 sessions. These patients could benefit from a change or increase in the amount or intensity of treatment after the first 12 treatment session

The First Episode Rapid Early Intervention for Eating Disorders - Upscaled study: Clinical outcomes

BACKGROUND: First Episode Rapid Early Intervention for Eating Disorders (FREED) is a service model and care pathway for emerging adults aged 16 to 25‐years with a recent onset eating disorder (ED) of <3 years. A previous single‐site study suggests that FREED significantly improves clinical outcomes compared to treatment‐as‐usual (TAU). The present study (FREED‐Up) assessed the scalability of FREED. A multi‐centre quasi‐experimental pre‐post design was used, comparing patient outcomes before and after implementation of FREED in participating services. METHODS: FREED patients (n = 278) were consecutive, prospectively ascertained referrals to four specialist ED services in England, assessed at four time points over 12 months on ED symptoms, mood, service utilization and cost. FREED patients were compared to a TAU cohort (n = 224) of similar patients, identified retrospectively from electronic patient records in participating services. All were emerging adults aged 16–25 experiencing a first episode ED of <3 years duration. RESULTS: Overall, FREED patients made significant and rapid clinical improvements over time. 53.2% of FREED patients with anorexia nervosa reached a healthy weight at the 12‐month timepoint, compared to only 17.9% of TAU patients (X2 [1, N = 107] = 10.46, p < .001). Significantly fewer FREED patients required intensive (i.e., in‐patient or day‐patient) treatment (6.6%) compared to TAU patients (12.4%) across the follow‐up period (X2 [1, N = 40] = 4.36, p = .037). This contributed to a trend in cost savings in FREED compared to TAU (−£4472, p = .06, CI −£9168, £233). DISCUSSION: FREED is robust and scalable and is associated with substantial improvements in clinical outcomes, reduction in inpatient or day‐patient admissions, and cost‐savin

Assessing implementation fidelity in the First Episode Rapid Early Intervention for Eating Disorders service model

BACKGROUND: The First Episode Rapid Early Intervention for Eating Disorders (FREED) service model is associated with significant reductions in wait times and improved clinical outcomes for emerging adults with recent-onset eating disorders. An understanding of how FREED is implemented is a necessary precondition to enable an attribution of these findings to key components of the model, namely the wait-time targets and care package. AIMS: This study evaluated fidelity to the FREED service model during the multicentre FREED-Up study. METHOD: Participants were 259 emerging adults (aged 16-25 years) with an eating disorder of <3 years duration, offered treatment through the FREED care pathway. Patient journey records documented patient care from screening to end of treatment. Adherence to wait-time targets (engagement call within 48 h, assessment within 2 weeks, treatment within 4 weeks) and care package, and differences in adherence across diagnosis and treatment group were examined. RESULTS: There were significant increases (16-40%) in adherence to the wait-time targets following the introduction of FREED, irrespective of diagnosis. Receiving FREED under optimal conditions also increased adherence to the targets. Care package use differed by component and diagnosis. The most used care package activities were psychoeducation and dietary change. Attention to transitions was less well used. CONCLUSIONS: This study provides an indication of adherence levels to key components of the FREED model. These adherence rates can tentatively be considered as clinically meaningful thresholds. Results highlight aspects of the model and its implementation that warrant future examination

A procedurális emlékezet szerepe a testkép zavaraiban = The role of procedural memory in trouble of body picture

Az evészavarok egyik vezető betegségfenntartó tényezője a betegek torzult, diszfunkcionális kogníciója. Ezen belül is kiemelendők a táplálékfelvételi viselkedés zavaraival és a testélménnyel kapcsolatban lévő, a zavarok létrejöttében kulcsszerepet játszó kognitív disztorziók, melyek az információfeldolgozási folyamatokon belül elsősorban a perceptuális élményfeldolgozást érintik és evészavaros betegeknél a testkép speciális zavarában mutatkoznak meg. A kognitív információfeldolgozást a sémák irányítják, amelyekben a selfről való komplex tudás szerveződik. A sémák procedurális ismeretanyagot is hordoznak, úgy mint motoros készségeket, szokásokat, szabályokat, célképzeteket, döntéshozatali stratégiákat. Ezek alapján felmerül, hogy az evészavarokra jellemző viselkedéses rutincselekvések, mint például a diétázás, falásroham, önhánytatás a testkép sémáján belül procedurális élményanyagként kódolódhat és a munkamemóriában automatikusan a többi explicit tudással és emlékkel együtt aktiválódik. Elméleti áttekintésünkben ezeknek a prekognitív folyamatoknak keressük a helyét és szerepét az evészavaros betegekre jellemző kognitív információfeldolgozási jellegzetességek kialakításában

Recognition of Human Proinsulin Leader Sequence by Class I–Restricted T-Cells in HLA-A*0201 Transgenic Mice and in Human Type 1 Diabetes

OBJECTIVE— A restricted region of proinsulin located in the B chain and adjacent region of C-peptide has been shown to contain numerous candidate epitopes recognized by CD8+ T-cells. Our objective is to characterize HLA class I–restricted epitopes located within the preproinsulin leader sequence

Preferential Entry of Botulinum Neurotoxin A Hc Domain through Intestinal Crypt Cells and Targeting to Cholinergic Neurons of the Mouse Intestine

Botulism, characterized by flaccid paralysis, commonly results from botulinum neurotoxin (BoNT) absorption across the epithelial barrier from the digestive tract and then dissemination through the blood circulation to target autonomic and motor nerve terminals. The trafficking pathway of BoNT/A passage through the intestinal barrier is not yet fully understood. We report that intralumenal administration of purified BoNT/A into mouse ileum segment impaired spontaneous muscle contractions and abolished the smooth muscle contractions evoked by electric field stimulation. Entry of BoNT/A into the mouse upper small intestine was monitored with fluorescent HcA (half C-terminal domain of heavy chain) which interacts with cell surface receptor(s). We show that HcA preferentially recognizes a subset of neuroendocrine intestinal crypt cells, which probably represent the entry site of the toxin through the intestinal barrier, then targets specific neurons in the submucosa and later (90–120 min) in the musculosa. HcA mainly binds to certain cholinergic neurons of both submucosal and myenteric plexuses, but also recognizes, although to a lower extent, other neuronal cells including glutamatergic and serotoninergic neurons in the submucosa. Intestinal cholinergic neuron targeting by HcA could account for the inhibition of intestinal peristaltism and secretion observed in botulism, but the consequences of the targeting to non-cholinergic neurons remains to be determined

fMRI scanner noise interaction with affective neural processes

The purpose of the present study was the investigation of interaction effects between functional MRI scanner noise and affective neural processes. Stimuli comprised of psychoacoustically balanced musical pieces, expressing three different emotions (fear, neutral, joy). Participants (N=34, 19 female) were split into two groups, one subjected to continuous scanning and another subjected to sparse temporal scanning that features decreased scanner noise. Tests for interaction effects between scanning group (sparse/quieter vs continuous/noisier) and emotion (fear, neutral, joy) were performed. Results revealed interactions between the affective expression of stimuli and scanning group localized in bilateral auditory cortex, insula and visual cortex (calcarine sulcus). Post-hoc comparisons revealed that during sparse scanning, but not during continuous scanning, BOLD signals were significantly stronger for joy than for fear, as well as stronger for fear than for neutral in bilateral auditory cortex. During continuous scanning, but not during sparse scanning, BOLD signals were significantly stronger for joy than for neutral in the left auditory cortex and for joy than for fear in the calcarine sulcus. To the authors' knowledge, this is the first study to show a statistical interaction effect between scanner noise and affective processes and extends evidence suggesting scanner noise to be an important factor in functional MRI research that can affect and distort affective brain processes

Anaerobic digestion and gasification of seaweed

The potential of algal biomass as a source of liquid and gaseous biofuels is a highly topical theme, with over 70 years of sometimes intensive research and considerable financial investment. A wide range of unit operations can be combined to produce algal biofuel, but as yet there is no successful commercial system producing such biofuel. This suggests that there are major technical and engineering difficulties to be resolved before economically viable algal biofuel production can be achieved. Both gasification and anaerobic digestion have been suggested as promising methods for exploiting bioenergy from biomass, and two major projects have been funded in the UK on the gasification and anaerobic digestion of seaweed, MacroBioCrude and SeaGas. This chapter discusses the use of gasification and anaerobic digestion of seaweed for the production of biofuel