Technology in neurology

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Long-term distributions of individual wave and crest heights

This is the final version of the article. Available from Elsevier via the DOI in this record.This paper considers three types of method for calculating return periods of individual wave and crest heights. The methods considered differ in the assumptions made about serial correlation in wave conditions. The long-term distribution of individual waves is formed under the assumption that either (1) individual waves, (2) the maximum wave height in each sea state or (3) the maximum wave height in each storm are independent events. The three types of method are compared using long time series of synthesised storms, where the return periods of individual wave heights are known. The methods which neglect serial correlation in sea states are shown to produce a positive bias in predicted return values of wave heights. The size of the bias is dependent on the shape of the tail of the distribution of storm peak significant wave height, with longer-tailed distributions resulting in larger biases. It is shown that storm-based methods give accurate predictions of return periods of individual wave heights. In particular, a Monte Carlo storm-based method is recommend for calculating return periods of individual wave and crest heights. Of all the models considered, the Monte Carlo method requires the fewest assumptions about the data, the fewest subjective judgements from the user and is simplest to implement.This work was partly funded through EPSRC grant EP/R007519/1

Simultaneous selection with fixed culling levels in the case of correlated traits

International audienc

Assessment of extreme and metocean conditions in the Maldives for OTEC applications

This is the final version. Available on open access from Wiley via the DOI in this recordThe Maldives is a group of tropical atolls, considered globally to be one of the most desirable holiday destinations. There is an urgent requirement to decrease their dependency on fossil fuels that are currently the main source of energy, and a number of renewable energy alternatives are being evaluated. Among these, due to the favorable oceanographic and bathymetric conditions, ocean thermal energy conversion (OTEC) systems represent a viable opportunity for clean and reliable power. However, the stresses the OTEC platform will need to endure during adverse environmental conditions are not well defined. The magnitude of these stresses will then have a direct influence on the design of the OTEC device. In order to overcome this uncertainty, this paper uses hindcast data sets from global weather and ocean models to assess the metocean conditions of the Maldives, with particular reference to extreme conditions. After selecting a suitable location for the deployment of the devices, return values calculated using the peaks‐over‐threshold (POT) methodology are estimated for wind, waves, and currents. The 100‐year return value for the significant wave height is found to be 4.5 m, with a joint occurrence of energy periods between 7.5 and 8.5 seconds, whereas the 100‐year return wind has a velocity of 17.8 m/s and the 100‐year return current of 1.9 m/s. The directionality of these extreme events is also considered, showing the southern and western sub‐quadrants as the prevailing sources, which provides essential information for positioning of the platform. Additional evaluations of tropical revolving storms (TRS) and variations in temperature and salinity patterns are also provided over a 1500‐m water column; temperature varies by approximately 24°C, and salinity by around 2 ppt, showing the suitability of OTEC platforms in the Maldives. This work is therefore of interest to offshore renewable energy stakeholders interested in developing a project in the Maldives or those conducting an analogous analysis in other locations.European Regional Development Fund (ERDF

Quantifying the effects of wave-current interactions on tidal energy resource at sites in the English Channel using coupled numerical simulations

This is the final version. Available on open access from MDPI via the DOI in this recordNumerical modeling of currents and waves is used throughout the marine energy industry for resource assessment. This study compared the output of numerical flow simulations run both as a standalone model and as a two-way coupled wave–current simulation. A regional coupled flow-wave model was established covering the English Channel using the Delft D-Flow 2D model coupled with a SWAN spectral wave model. Outputs were analyzed at three tidal energy sites: Alderney Race, Big Roussel (Guernsey), and PTEC (Isle of Wight). The difference in the power in the tidal flow between coupled and standalone model runs was strongly correlated to the relative direction of the waves and currents. The net difference between the coupled and standalone runs was less than 2.5%. However, when wave and current directions were aligned, the mean flow power was increased by up to 7%, whereas, when the directions were opposed, the mean flow power was reduced by as much as 9.6%. The D-Flow Flexible Mesh model incorporates the effects of waves into the flow calculations in three areas: Stokes drift, forcing by radiation stress gradients, and enhancement of the bed shear stress. Each of these mechanisms is discussed. Forcing from radiation stress gradients is shown to be the dominant mechanism affecting the flow conditions at the sites considered, primarily caused by dissipation of wave energy due to white-capping. Wave action is an important consideration at tidal energy sites. Although the net impact on the flow power was found to be small for the present sites, the effect is site specific and may be significant at sites with large wave exposure or strong asymmetry in the flow conditions and should thus be considered for detailed resource and engineering assessments.European Regional Development Fund (ERDF

Mental distress in the general population in Zambia: Impact of HIV and social factors

<p>Abstract</p> <p>Background</p> <p>Population level data on mental health from Africa are limited, but available data indicate mental problems to represent a substantial public health problem. The negative impact of HIV on mental health suggests that this could particularly be the case in high prevalence populations. We examined the prevalence of mental distress, distribution patterns and the ways HIV might influence mental health among men and women in a general population.</p> <p>Methods</p> <p>The relationship between HIV infection and mental distress was explored using a sample of 4466 participants in a population-based HIV survey conducted in selected rural and urban communities in Zambia in 2003. The Self-reporting questionnaire-10 (SRQ-10) was used to assess global mental distress. Weights were assigned to the SRQ-10 responses based on DSM IV criteria for depression and a cut off point set at 7/20 for probable cases of mental distress. A structural equation modeling (SEM) was established to assess the structural relationship between HIV infection and mental distress in the model, with maximum likelihood ratio as the method of estimation.</p> <p>Results</p> <p>The HIV prevalence was 13.6% vs. 18% in the rural and urban populations, respectively. The prevalence of mental distress was substantially higher among women than men and among groups with low educational attainment vs. high. The results of the SEM showed a close fit with the data. The final model revealed that self-rated health and self perceived HIV risk and worry of being HIV infected were important mediators between underlying factors, HIV infection and mental distress. The effect of HIV infection on mental distress was both direct and indirect, but was particularly strong through the indirect effects of health ratings and self perceived risk and worry of HIV infection.</p> <p>Conclusion</p> <p>These findings suggest a strong effect of HIV infection on mental distress. In this population where few knew their HIV status, this effect was mediated through self-perceptions of health status, found to capture changes in health perceptions related to HIV, and self-perceived risk and worry of actually being HIV infected.</p

COMPETENCY-BASED TRAINING IN NURSING: LIMITS AND POSSIBILITIES

Objective To analyze the possibilities and limits of competency-based training in nursing. Method An integrative review of the literature on the subject was carried out, and an analysis was made of the results of a survey evaluating a nursing course based on areas of competency. A dialog was then established between the review and the results of the research. Results On the question of which theoretical type of competency the articles from the literature relate to, there is a predominance of the constructivist perspective, followed by the functionalist approach and the dialog-based approach. In the dialog between the literature and the research, limits and possibilities were observed in the development of a training by areas of competency. Conclusion The dialog-based approach to competency is the proposition that most approximates to the profile defined by the National Curriculum Guidelines for training in nursing, and this was also identified in the evaluation survey that was studied. However, it is found that there are aspects on better work is needed, such as: partnership between school and the workplace, the role of the teacher, the role of the student, and the process of evaluation

Radiotherapy Versus Inguinofemoral Lymphadenectomy as Treatment for Vulvar Cancer Patients With Micrometastases in the Sentinel Node: Results of GROINSS-V II

PURPOSE: The Groningen International Study on Sentinel nodes in Vulvar cancer (GROINSS-V)-II investigated whether inguinofemoral radiotherapy is a safe alternative to inguinofemoral lymphadenectomy (IFL) in vulvar cancer patients with a metastatic sentinel node (SN). METHODS: GROINSS-V-II was a prospective multicenter phase-II single-arm treatment trial, including patients with early-stage vulvar cancer (diameter < 4 cm) without signs of lymph node involvement at imaging, who had primary surgical treatment (local excision with SN biopsy). Where the SN was involved (metastasis of any size), inguinofemoral radiotherapy was given (50 Gy). The primary end point was isolated groin recurrence rate at 24 months. Stopping rules were defined for the occurrence of groin recurrences. RESULTS: From December 2005 until October 2016, 1,535 eligible patients were registered. The SN showed metastasis in 322 (21.0%) patients. In June 2010, with 91 SN-positive patients included, the stopping rule was activated because the isolated groin recurrence rate in this group went above our predefined threshold. Among 10 patients with an isolated groin recurrence, nine had SN metastases > 2 mm and/or extracapsular spread. The protocol was amended so that those with SN macrometastases (> 2 mm) underwent standard of care (IFL), whereas patients with SN micrometastases (≤ 2 mm) continued to receive inguinofemoral radiotherapy. Among 160 patients with SN micrometastases, 126 received inguinofemoral radiotherapy, with an ipsilateral isolated groin recurrence rate at 2 years of 1.6%. Among 162 patients with SN macrometastases, the isolated groin recurrence rate at 2 years was 22% in those who underwent radiotherapy, and 6.9% in those who underwent IFL (P = .011). Treatment-related morbidity after radiotherapy was less frequent compared with IFL. CONCLUSION: Inguinofemoral radiotherapy is a safe alternative for IFL in patients with SN micrometastases, with minimal morbidity. For patients with SN macrometastasis, radiotherapy with a total dose of 50 Gy resulted in more isolated groin recurrences compared with IFL

Circular RNA detection identifies circPSEN1 alterations in brain specific to autosomal dominant Alzheimer's disease

Background: Autosomal-dominant Alzheimer's disease (ADAD) is caused by pathogenic mutations in APP, PSEN1, and PSEN2, which usually lead to an early age at onset (< 65). Circular RNAs are a family of non-coding RNAs highly expressed in the nervous system and especially in synapses. We aimed to investigate differences in brain gene expression of linear and circular transcripts from the three ADAD genes in controls, sporadic AD, and ADAD. Methods: We obtained and sequenced RNA from brain cortex using standard protocols. Linear counts were obtained using the TOPMed pipeline; circular counts, using python package DCC. After stringent quality control (QC), we obtained the counts for PSEN1, PSEN2 and APP genes. Only circPSEN1 passed QC. We used DESeq2 to compare the counts across groups, correcting for biological and technical variables. Finally, we performed in-silico functional analyses using the Circular RNA interactome website and DIANA mirPath software. Results: Our results show significant differences in gene counts of circPSEN1 in ADAD individuals, when compared to sporadic AD and controls (ADAD = 21, AD = 253, Controls = 23-ADADvsCO: log2FC = 0.794, p = 1.63 × 10-04, ADADvsAD: log2FC = 0.602, p = 8.22 × 10-04). The high gene counts are contributed by two circPSEN1 species (hsa_circ_0008521 and hsa_circ_0003848). No significant differences were observed in linear PSEN1 gene expression between cases and controls, indicating that this finding is specific to the circular forms. In addition, the high circPSEN1 levels do not seem to be specific to PSEN1 mutation carriers; the counts are also elevated in APP and PSEN2 mutation carriers. In-silico functional analyses suggest that circPSEN1 is involved in several pathways such as axon guidance (p = 3.39 × 10-07), hippo signaling pathway (p = 7.38 × 10-07), lysine degradation (p = 2.48 × 10-05) or Wnt signaling pathway (p = 5.58 × 10-04) among other KEGG pathways. Additionally, circPSEN1 counts were able to discriminate ADAD from sporadic AD and controls with an AUC above 0.70. Conclusions: Our findings show the differential expression of circPSEN1 is increased in ADAD. Given the biological function previously ascribed to circular RNAs and the results of our in-silico analyses, we hypothesize that this finding might be related to neuroinflammatory events that lead or that are caused by the accumulation of amyloid-beta