Noise Properties of Superconducting Coplanar Waveguide Microwave Resonators

We have measured noise in thin-film superconducting coplanar waveguide resonators. This noise appears entirely as phase noise, equivalent to a jitter of the resonance frequency. In contrast, amplitude fluctuations are not observed at the sensitivity of our measurement. The ratio between the noise power in the phase and amplitude directions is large, in excess of 30 dB. These results have important implications for resonant readouts of various devices such as detectors, amplifiers, and qubits. We suggest that the phase noise is due to two-level systems in dielectric materials.Comment: 4 pages, 3 figures, accepted for publication in Applied Physics Letter

Protection of Karst in the Philippines

The article presents an overview of the current status of karst protection in the Philippines. Prior studies indicate that of the 35,000km2 of karst landscape in the country, about 29% is protected . However, protection of karst has not to date been a priority of the Philippine government, and the country has no existing legislation that is directly decreed for protection and conservation of karstlands. Most contemporary karst protection is indirect, in that the karst is located within protected areas established for other, although often related reasons, such as ecological conservation, water supply protection and tourism. However, it appears that the Philippine government is gradually recognizing explicitly the need to protect karst landscapes. The establishment of the National Caves and Cave Resources Management and Protection Act in 2001 and the inclusion of karst water resources in the country’s National Action Plan (NAP) under the United Nations Convention to Combat Desertification (UNCCD) are significant steps towards explicit protection of karst areas. Although the existing legislation only addresses specific facets of karst landscape, it may stimulate additional programs and legislation that will more broadly protect karst landscapes nationally

Effects of elevational range shift on the morphology and physiology of a carabid beetle invading the sub-Antarctic Kerguelen Islands.

Climatic changes can induce geographic expansion and altitudinal shifts in the distribution of invasive species by offering more thermally suitable habitats. At the remote sub-Antarctic Kerguelen Islands, the predatory insect Merizodus soledadinus (Coleoptera: Carabidae), introduced in 1913, rapidly invaded coastal habitats. More recent colonisation of higher elevation habitats by this species could be underlain by their increased thermal suitability as the area has warmed. This study compared the effect of elevational range shift on the morphology and physiology of adult M. soledadinus sampled along two altitudinal transects (from the foreshore to 250 m a.s.l.) and a horizontal lowland transect orthogonal to the seashore (400 m length). Although high inter-individual and inter-transect variations in the traits examined were present, we observed that body mass of males and females tended to decrease with elevation, and that triglyceride contents decreased with distance from the shore. Moreover, protein contents of females as well as those of 26 metabolites were influenced significantly by distance to the foreshore. These results suggest that future climate change at the Kerguelen Islands will further assist the colonisation of lowland inland and higher altitude habitats by this aggressively invasive predator, by making previously sub-optimal habitats progressively more suitable

A feasibility study to explore the governance processes required for linkage between dental epidemiological, and birth cohort, data in the UK

Birth cohort initiatives, such as ‘Born in Bradford’, provide a unique opportunity to study the influence of socio-economic and environmental factors acting in pregnancy, birth and infancy on the development of dental caries in later life. This paper describes a feasibility study which established the processes required, and outcomes of, successful linkage of oral health data collected by the 2013 three-year-old national dental epidemiology survey with the Born in Bradford birth cohort database. The necessary processes included achieving research permissions and ethical approval; creation of a data sharing agreement; ensuring data security and encrypted data transfer. With regard to the outcomes, a robust a priori statistical plan was developed. 152 three-year-old children were examined for the 2013 dental epidemiology survey in Bradford, and of those, 69 parents consented to data linkage believing that their child was part of the Born in Bradford cohort. However, only 36 of these 69 children were participating in the cohort. Of these, six children had obvious dentinal caries experience (dmft >0). There was insufficient power with such small numbers, to examine the association between birthweight and dental caries at the age of three-years-old. Key learning points from this feasibility study have informed the design of a larger study to link the 2014/5 five-year-old dental epidemiology surveys with the Born in Bradford cohort. This paper reveals the important methodological considerations for future data linkages between routine health data and research data

Delirium in HIV-infected patients admitted to acute medical wards post universal access to antiretrovirals in South Africa

Background. Delirium is associated with increased mortality and length of hospital stay. Limited data are available from HIV-infected acute hospital admissions in developing countries. We conducted a prospective study of delirium among acute medical admissions in South Africa (SA), a developing country with universal antiretroviral therapy (ART) access and high burdens of tuberculosis (TB) and non-communicable disease.Objectives. To identify the prevalence of, risk factors for and outcomes of delirium in HIV-infected individuals in acute general medical admissions.Methods. Three cohorts of adult acute medical admissions to Groote Schuur and Victoria Wynberg hospitals, Cape Town, SA, were evaluated for prevalent delirium within 24 hours of admission. Reference delirium testing was performed by either consultant physicians or neuropsychologists, using the Confusion Assessment Method.Results. The study included 1 182 acute medical admissions, with 318 (26.9%) HIV-infected. The median (interquartile range) age and CD4 count were 35 (30 - 43) years and 132 (61 - 256) cells/µL, respectively, with 140/318 (44.0%) using ART on admission. The prevalence of delirium was 17.6% (95% confidence interval (CI) 13.7 - 22.1) among HIV-infected patients, and delirium was associated with increased inpatient mortality. In multivariable logistic regression analysis, factors associated with delirium were age ≥55 years (adjusted odds ratio (aOR) 6.95 (95% CI 2.03 - 23.67); p=0.002), and urea ≥15 mmol/L (aOR 4.83 (95% CI 1.7 - 13.44); p=0.003), while ART use reduced risk (p=0.014). A low CD4 count, an unsuppressed viral load and active TB were not predictors of delirium; nor were other previously reported risk factors such as non-opportunistic acute infections or polypharmacy.Conclusions. Delirium is common and is associated with increased mortality in HIV-infected acute medical admissions in endemic settings, despite increased ART use. Older HIV-infected patients with renal dysfunction are at increased risk for inpatient delirium, while those using ART on admission have a reduced risk

An exploration of the use of photobiomodulation for management of oral mucositis in children and young people undergoing cancer treatment in the UK

PURPOSE: Oral mucositis affects up to 80% of children and young people (CYP) receiving chemotherapy. This can result in pain, reduced oral intake and, in severe cases, hospitalisation for parental nutrition and pain relief. Photobiomodulation is recommended by multiple bodies for mucositis management for those undergoing cancer treatments. The current use of photobiomodulation within the UK, and the barriers and facilitators to implementation is unknown. METHOD: An online mixed-methods survey was administered to representatives from the Children's Cancer and Leukaemia Group (CCLG) between October 2021 and March 2022. This explored: use of photobiomodulation, planned future use, barriers and facilitators to implementation and dental assessment. Quantitative data underwent descriptive statistics. Barriers and facilitators to the implementation of photobiomodulation were analysed using the Theoretical Domains Framework (TDF). RESULTS: All UK CCLG centres responded (n = 20, a response rate of 100%). Two units in Scotland were delivering photobiomodulation. A further four units were planning to implement a service. Most units, 65% (n = 13) utilised specialist Paediatric Dentistry services for dental assessment. In the TDF analysis, five domains were most frequently populated: knowledge, skills, environmental context and resources, social influences, and social/professional role and identity. CONCLUSION: Photobiomodulation was only available in Scotland in two children's cancer units. Lack of knowledge and skills, and insufficient environmental resources were identified as barriers. Collaboration with paediatric dental services was identified as a facilitator. The establishment of a national network of Paediatric Dentists and Oncologists would promote collaboration to standardise protocols and to address the identified barriers to wider implementation of photobiomodulation

Prevalence and outcome of delirium among acute general medical inpatients in Cape Town, South Africa

Background. Delirium is a common, serious, underdiagnosed condition in medical and surgical inpatients with acute conditions. It is associated with increased risk of mortality and morbidity. Data of geriatric cohorts are largely limited to developed countries.Objectives. To describe prevalence, risk factors and outcomes of delirium among general medical patients admitted to two hospitals in Cape Town, South Africa.Methods. This was a prospective cohort study of patients with acute conditions admitted to a general medical inpatient service in secondary- and tertiary-level public hospitals in the Metro West area of Cape Town. Patients ≥18 years of age were recruited daily from all acute medical admissions. Patients were excluded if they were aphasic or their Glasgow coma scale was <8/15. Delirium was diagnosed using the validated confusion assessment method (CAM) tool and performed by trained neuropsychologists. Demographic data were collected by a clinical team and short- and long-term mortality data were obtained using linkage analysis of hospitalised patients and routinely collected provincial death certification records.Results. The median age of inpatients was 51 (interquartile range 36 - 65) years, 29% were HIV-infected and the overall prevalence of delirium was 12.3%. Multivariate predictors of delirium included the presence of an indwelling urinary catheter (odds ratio (OR) 4.47; confidence interval (CI) 2.43 - 8.23), admission with a central nervous system disease (OR 4.34; CI 2.79 - 7.90), pre-existing cognitive impairment (OR 3.02; CI 1.22 - 7.43) and immobility (OR 1.88; CI 1.01 - 3.51). HIV infection was not associated with increased risk of delirium. Delirium was associated with an increased risk of inhospital (delirium v. no delirium: 29% v. 12%; p<0.01) and 12-month (30% v. 20%; p<0.01) mortality, as well as increased length of hospital stay (7 days v. 5 days; p<0.01).Conclusions. In this cohort of medical inpatients (relatively young and with a high HIV prevalence) 1 of 8 (12.3%) patients was delirious. Delirium was associated with adverse outcomes. Delirium risk factors in this young cohort were similar to those in geriatric cohorts in developed countries, and neither HIV nor opportunistic infections increased risk