45 research outputs found
Sea-level rise will likely accelerate rock coast cliff retreat rates
Coastal response to anthropogenic climate change is of central importance to the infrastructure and inhabitants in these areas. Despite being globally ubiquitous, the stability of rock coasts has been largely neglected, and the expected acceleration of cliff erosion following sea-level rise has not been tested with empirical data, until now. We have optimised a coastal evolution model to topographic and cosmogenic radionuclide data to quantify cliff retreat rates for the past 8000 years and forecast rates for the next century. Here we show that rates of cliff retreat will increase by up to an order of magnitude by 2100 according to current predictions of sea-level rise: an increase much greater than previously predicted. This study challenges conventional coastal management practices by revealing that even historically stable rock coasts are highly sensitive to sea-level rise and should be included in future planning for global climate change response
Direct Simulation of a Solidification Benchmark Experiment
International audienceA solidification benchmark experiment is simulated using a three-dimensional cellular automaton-finite element solidification model. The experiment consists of a rectangular cavity containing a Sn-3 wt pct Pb alloy. The alloy is first melted and then solidified in the cavity. A dense array of thermocouples permits monitoring of temperatures in the cavity and in the heat exchangers surrounding the cavity. After solidification, the grain structure is revealed by metallography. X-ray radiography and inductively coupled plasma spectrometry are also conducted to access a distribution map of Pb, or macrosegregation map. The solidification model consists of solutions for heat, solute mass, and momentum conservations using the finite element method. It is coupled with a description of the development of grain structure using the cellular automaton method. A careful and direct comparison with experimental results is possible thanks to boundary conditions deduced from the temperature measurements, as well as a careful choice of the values of the material properties for simulation. Results show that the temperature maps and the macrosegregation map can only be approached with a three-dimensional simulation that includes the description of the grain structure
Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group
Objective Alcohol-related liver disease (ALD) is the most
common cause of liver-related ill health and liver-related
deaths in the UK, and deaths from ALD have doubled
in the last decade. The management of ALD requires
treatment of both liver disease and alcohol use; this
necessitates effective and constructive multidisciplinary
working. To support this, we have developed quality
standard recommendations for the management of ALD,
based on evidence and consensus expert opinion, with the
aim of improving patient care.
Design A multidisciplinary group of experts from the
British Association for the Study of the Liver and British
Society of Gastroenterology ALD Special Interest Group
developed the quality standards, with input from the
British Liver Trust and patient representatives.
Results The standards cover three broad themes: the
recognition and diagnosis of people with ALD in primary
care and the liver outpatient clinic; the management of
acutely decompensated ALD including acute alcoholrelated hepatitis and the posthospital care of people
with advanced liver disease due to ALD. Draft quality
standards were initially developed by smaller working
groups and then an anonymous modified Delphi voting
process was conducted by the entire group to assess
the level of agreement with each statement. Statements
were included when agreement was 85% or greater.
Twenty-four quality standards were produced from this
process which support best practice. From the final
list of statements, a smaller number of auditable key
performance indicators were selected to allow services to
benchmark their practice and an audit tool provided.
Conclusion It is hoped that services will review their
practice against these recommendations and key
performance indicators and institute service development
where needed to improve the care of patients with ALD
A global research priority agenda to advance public health responses to fatty liver disease
Background & aims
An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community.
Methods
Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy.
Results
The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of âagreeâ responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement (âagreeâ + âsomewhat agreeâ); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% âagreeâ), 13 priorities had 90% combined agreement.
Conclusions
Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health communityâs efforts to advance and accelerate responses to this widespread and fast-growing public health threat.
Impact and implications
An estimated 38% of adults and 13% of children and adolescents worldwide have fatty liver disease, making it the most prevalent liver disease in history. Despite substantial scientific progress in the past three decades, the burden continues to grow, with an urgent need to advance understanding of how to prevent, manage, and treat the disease. Through a global consensus process, a multidisciplinary group agreed on 28 research priorities covering a broad range of themes, from disease burden, treatment, and health system responses to awareness and policy. The findings have relevance for clinical and non-clinical researchers as well as funders working on fatty liver disease and non-communicable diseases more broadly, setting out a prioritised, ranked research agenda for turning the tide on this fast-growing public health threat