Towards revised physically based parameter estimation methods for the Pitman monthly rainfall-runoff model

This paper presents a preliminary stage in the development of an alternative parameterisation procedure for the Pitman monthly rainfall runoff model which enjoys popular use in water resource assessment in Southern Africa. The estimation procedures are based on the premise that it is possible to use physical basin properties directly in the quantification of the soil moisture accounting, runoff, and recharge and infiltration parameters. The results for selected basins show that the revised parameters are at least as good as current regionalised sets or give satisfactory results in areas where no regionalised parameters exist

Precursory scale increase and long-term seismogenesis in California and Northern Mexico

A sudden increase in the scale of seismicity has occurred as a long-term precursor to twelve major earthquakes in California and Northern Mexico. These include all earthquakes along the San Andreas system during 1960-2000 with magnitude M •6.4. The full list is as follows: Colorado Delta, 1966, M 6.3; Borrego Mt., 1968, M 6.5; San Fernando, 1971, M 6.6; Brawley, 1979, M 6.4; Mexicali, 1980, M 6.1; Coalinga, 1983, M 6.7; Superstition Hills, 1987, M 6.6; Loma Prieta, 1989, M 7.0; Joshua Tree, 1992, M 6.1; Landers, 1992, M 7.3; Northridge, 1994, M 6.6; Hector Mine, 1999, M 7.1. Such a Precursory Scale Increase () was inferred from the modelling of long-term seismogenesis as a three-stage faulting process against a background of self-organised criticality. The location, onset-time and level of • are predictive of the location, time and magnitude of the future earthquake. Precursory swarms, which occur widely in subduction regions, are a special form of • ; the more general form is here shownto occur frequently in a region of continental transform. Other seismicity precursors, including quiescence and foreshocks, contribute to or modulate the increased seismicity that characterises • . The area occupied by • is small compared with those occupied by the seismicity precursors known as AMR, M8 and LURR. Further work is needed to formulate as a testable hypothesis, and to carry out the appropriate forecasting tests

Bath's law Derived from the Gutenberg-Richter law and from Aftershock Properties

The empirical Bath's law states that the average difference in magnitude between a mainshock and its largest aftershock is 1.2, regardless of the mainshock magnitude. Following Vere-Jones [1969] and Console et al. [2003], we show that the origin of Bath's law is to be found in the selection procedure used to define mainshocks and aftershocks rather than in any difference in the mechanisms controlling the magnitude of the mainshock and of the aftershocks. We use the ETAS model of seismicity, which provides a more realistic model of aftershocks, based on (i) a universal Gutenberg-Richter (GR) law for all earthquakes, and on (ii) the increase of the number of aftershocks with the mainshock magnitude. Using numerical simulations of the ETAS model, we show that this model is in good agreement with Bath's law in a certain range of the model parameters.Comment: major revisions, in press in Geophys. Res. Let

MASS TIMBER CONSTRUCTION IN AUSTRALIA AND NEW ZEALAND—STATUS, AND ECONOMIC AND ENVIRONMENTAL INFLUENCES ON ADOPTION

Mass timber construction in Australia and New Zealand uses three main materials—laminated veneer lumber, glue laminated timber and cross-laminated timber (CLT). This article focuses on the use of mass timber in nonresidential construction—the use in single-family homes and apartments is not considered. In Australia and New Zealand, mass timber building technology has moved from being technologically possible to being a feasible alternative to reinforced concrete and steel construction. It has not taken over a large market share in either market and, as such, has not been a disruptive technology. The major changes in this market in the past 5-10 yr in Australia and New Zealand have been the development of new industrial capacity in CLT and the acquisition of computer controlled machining equipment to facilitate prefabrication of wooden building components. The development of new codes and standards and design guides is underway. The drivers of future growth in market share are expected to include more clients putting a higher weight on the various environmental benefits of building in wood, reduction in the real and perceived professional risk for builders and architects specifying mass timber construction, and fuller participation in the supply chain for timber buildings (from design to construction) by timber building specialists. Government policies to encourage the use of timber may also be helpful. Engineers and architects will continue to learn—through experience—how to optimize building construction methods to take advantage of the specific features and qualities of timber as a construction method. 

Mental health in hospital emergency departments: cross-sectional analysis of attendances in England 2013/2014

Objective: To describe the population of patients who attend emergency departments (ED) in England for mental health reasons. / Methods: Cross-sectional observational study of 6 262 602 ED attendances at NHS (National Health Service) hospitals in England between 1 April 2013 and 31 March 2014. We assessed the proportion of attendances due to psychiatric conditions. We compared patient sociodemographic and attendance characteristics for mental health and non-mental health attendances using logistic regression. / Results: 4.2% of ED attendances were attributable to mental health conditions (median 3.2%, IQR 2.6% to 4.1%). Those attending for mental health reasons were typically younger (76.3% were aged less than 50 years), of White British ethnicity (73.2% White British), and resident in more deprived areas (59.9% from the two most deprived Index of Multiple Deprivation quintiles (4 and 5)). Mental health attendances were more likely to occur ‘out of hours’ (68.0%) and at the weekend (31.3%). Almost two-thirds were brought in by ambulance. A third required admission, but around a half were discharged home. / Conclusions: This is the first national study of mental health attendances at EDs in England. We provide information for those planning and providing care, to ensure that clinical resources meet the needs of this patient group, who comprise 4.2% of attendances. In particular, we highlight the need to strengthen the availability of hospital and community care ‘out of hours.

‘Sons of athelings given to the earth’: Infant Mortality within Anglo-Saxon Mortuary Geography

FOR 20 OR MORE YEARS early Anglo-Saxon archaeologists have believed children are underrepresented in the cemetery evidence. They conclude that excavation misses small bones, that previous attitudes to reporting overlook the very young, or that infants and children were buried elsewhere. This is all well and good, but we must be careful of oversimplifying compound social and cultural responses to childhood and infant mortality. Previous approaches have offered methodological quandaries in the face of this under-representation. However, proportionally more infants were placed in large cemeteries and sometimes in specific zones. This trend is statistically significant and is therefore unlikely to result entirely from preservation or excavation problems. Early medieval cemeteries were part of regional mortuary geographies and provided places to stage events that promoted social cohesion across kinship systems extending over tribal territories. This paper argues that patterns in early Anglo-Saxon infant burial were the result of female mobility. Many women probably travelled locally to marry in a union which reinforced existing social networks. For an expectant mother, however, the safest place to give birth was with experience women in her maternal home. Infant identities were affected by personal and legal association with their mother’s parental kindred, so when an infant died in childbirth or months and years later, it was their mother’s identity which dictated burial location. As a result, cemeteries central to tribal identities became places to bury the sons and daughters of a regional tribal aristocracy

How far back do we need to look to capture diagnoses in electronic health records? A retrospective observational study of hospital electronic health record data

Objectives: Analysis of routinely collected electronic health data is a key tool for long-term condition research and practice for hospitalised patients. This requires accurate and complete ascertainment of a broad range of diagnoses, something not always recorded on an admission document at a single point in time. This study aimed to ascertain how far back in time electronic hospital records need to be interrogated to capture long-term condition diagnoses. Design: Retrospective observational study of routinely collected hospital electronic health record data. Setting: Queen Elizabeth Hospital Birmingham (UK)-linked data held by the PIONEER acute care data hub. Participants: Patients whose first recorded admission for chronic obstructive pulmonary disease (COPD) exacerbation (n=560) or acute stroke (n=2142) was between January and December 2018 and who had a minimum of 10 years of data prior to the index date. Outcome measures: We identified the most common International Classification of Diseases version 10-coded diagnoses received by patients with COPD and acute stroke separately. For each diagnosis, we derived the number of patients with the diagnosis recorded at least once over the full 10-year lookback period, and then compared this with shorter lookback periods from 1 year to 9 years prior to the index admission. Results: Seven of the top 10 most common diagnoses in the COPD dataset reached >90% completeness by 6 years of lookback. Atrial fibrillation and diabetes were >90% coded with 2–3 years of lookback, but hypertension and asthma completeness continued to rise all the way out to 10 years of lookback. For stroke, 4 of the top 10 reached 90% completeness by 5 years of lookback; angina pectoris was >90% coded at 7 years and previous transient ischaemic attack completeness continued to rise out to 10 years of lookback. Conclusion: A 7-year lookback captures most, but not all, common diagnoses. Lookback duration should be tailored to the conditions being studied

Training opportunities in thoracic ultrasound for respiratory trainees: are current guidelines practical?

Respiratory trainees in the UK face challenges in meeting current Royal College of Radiologists (RCR) Level 1 training requirements for thoracic ultrasound (TUS) competence, specified as attending 'at least one session per week over a period of no less than 3 months, with approximately five scans per session performed by the trainee (under supervision of an experienced practitioner)'. We aimed to clarify where TUS training opportunities currently exist for respiratory registrars.This is an Open Access article. Click on the Publisher URL to access the full-text

Predicting the Risk of Disease Recurrence and Death Following Curative-intent Radiotherapy for Non-small Cell Lung Cancer: The Development and Validation of Two Scoring Systems From a Large Multicentre UK Cohort

AIMS: There is a paucity of evidence on which to produce recommendations on neither the clinical nor the imaging follow-up of lung cancer patients after curative-intent radiotherapy. In the 2019 National Institute for Health and Care Excellence lung cancer guidelines, further research into risk-stratification models to inform follow-up protocols was recommended. MATERIALS AND METHODS: A retrospective study of consecutive patients undergoing curative-intent radiotherapy for non-small cell lung cancer from 1 October 2014 to 1 October 2016 across nine UK trusts was carried out. Twenty-two demographic, clinical and treatment-related variables were collected and multivariable logistic regression was used to develop and validate two risk-stratification models to determine the risk of disease recurrence and death. RESULTS: In total, 898 patients were included in the study. The mean age was 72 years, 63% (562/898) had a good performance status (0-1) and 43% (388/898), 15% (134/898) and 42% (376/898) were clinical stage I, II and III, respectively. Thirty-six per cent (322/898) suffered disease recurrence and 41% (369/898) died in the first 2 years after radiotherapy. The ASSENT score (age, performance status, smoking status, staging endobronchial ultrasound, N-stage, T-stage) was developed, which stratifies the risk for disease recurrence within 2 years, with an area under the receiver operating characteristic curve (AUROC) for the total score of 0.712 (0.671-0.753) and 0.72 (0.65-0.789) in the derivation and validation sets, respectively. The STEPS score (sex, performance status, staging endobronchial ultrasound, T-stage, N-stage) was developed, which stratifies the risk of death within 2 years, with an AUROC for the total score of 0.625 (0.581-0.669) and 0.607 (0.53-0.684) in the derivation and validation sets, respectively. CONCLUSIONS: These validated risk-stratification models could be used to inform follow-up protocols after curative-intent radiotherapy for lung cancer. The modest performance highlights the need for more advanced risk prediction tools

Randomised trial of indwelling pleural catheters for refractory transudative pleural effusions

Objective: Refractory symptomatic transudative pleural effusions are an indication for pleural drainage. There has been supportive observational evidence for the use of indwelling pleural catheters (IPCs) for transudative effusions, but no randomised trials. We aimed to investigate the effect of IPCs on breathlessness in patients with transudative pleural effusions when compared with standard care. / Methods: A multicentre randomised controlled trial, in which patients with transudative pleural effusions were randomly assigned to either an IPC (intervention) or therapeutic thoracentesis (TT; standard care). The primary outcome was mean daily breathlessness score over 12 weeks from randomisation. / Results: 220 patients were screened from April 2015 to August 2019 across 13 centres, with 33 randomised to intervention (IPC) and 35 to standard care (TT). Underlying aetiology was heart failure in 46 patients, liver failure in 16 and renal failure in six. In primary outcome analysis, the mean±sd breathlessness score over the 12-week study period was 39.7±29.4 mm in the IPC group and 45.0±26.1 mm in the TT group (p=0.67). Secondary outcomes analysis demonstrated that mean±sd drainage was 17 412±17 936 mL and 2901±2416 mL in the IPC and TT groups, respectively. A greater proportion of patients had at least one adverse event in the IPC group (p=0.04). / Conclusion: We found no significant difference in breathlessness over 12 weeks between IPCs or TT. TT is associated with fewer complications and IPCs reduced the number of invasive pleural procedures required. Patient preference and circumstances should be considered in selecting the intervention in this cohort