A baseline study of metal contamination along the Namibian coastline for Perna perna and Choromytilus meridionalis.

The use of bivalves such as the brown mussel (Perna perna) and the black mussel (Choromytilus meridionalis) is common in the study of marine pollution and the effect of these pollutants on ecosystems and are important in both economic and ecological roles. Namibian marine ecosystems are threatened by pollution from mining, commercial fishing and population growth. The aims of this study were to determine baseline metal concentrations, spatial variation and variation between species. Metal levels in C. meridionalis from Guano Platform (GP) are the lowest of all the sites. The most polluted sites are Rocky Point (RP), Halifax Island (HIL) and between Walvis Bay and Swakopmund (WS). The bioaccumulation of metals between P. perna and C. meridionalis were not uniform for all metals. Overall the study indicates the condition of the coastline to be mostly normal, with Cd and Pb levels being of concern

What Drives Responses to Willingness-to-pay Questions? A Methodological Inquiry in the Context of Hypertension Self-management

Background: The use of economic evaluation to determine the cost-effectiveness of health interventions is recommended by decision-making bodies internationally. Understanding factors that explain variations in costs and benefits is important for policy makers. Objective: This work aimed to test a priori hypotheses defining the relationship between benefits of using self-management equipment (measured using the willingness-to-pay (WTP) approach) and a number of demographic and other patient factors. Methods: Data for this study were collected as part of the first major randomised controlled trial of self-monitoring combined with self-titration in hypertension (TASMINH2). A contingent valuation framework was used with patients asked to indicate how much they were willing to pay for equipment used for self-managing hypertension. Descriptive statistics, simple statistical tests of differences and multivariate regression were used to test six a priori hypotheses. Results: 393 hypertensive patients (204 in the intervention and 189 in the control) were willing to pay for self-management equipment and 85% of these (335) provided positive WTP values. Three hypotheses were accepted: higher WTP values were associated with being male, higher household incomes and satisfaction with the equipment. Prior experiences of using this equipment, age and changes in blood pressure were not significantly related to WTP. Conclusion: The majority of hypertensive patients who had taken part in a self-management study were prepared to purchase the self-monitoring equipment using their own funds, more so for men, those with higher incomes and those with greater satisfaction. Further research based on bigger and more diverse populations is recommended

Mechanism of action of 5-arninosalicylic acid

5-Aminosalicylic Acid (5-ASA) has been used for over 50 years in the treatment of inflammatory bowel disease in the pro-drug form sulphasalazine (SASP). SASP is also used to treat rheumatoid arthritis. However whether the therapeutic properties of SASP are due to the intact molecule, the 5-ASA or sulphapyridine components is unknown. Several mechanisms of action have been proposed for 5-ASA and SASP including interference in the metabolism of arachidonic acid to prostaglandins and leukotrienes, scavenging,of reactive oxygen species, effects on leucocyte function and production of cytokines. However, it is unlikely that the anti-inflammatory properties of SASP and 5-ASA are due to several different properties but more likely that a single property of 5-ASA explains the theraapeutic effects of 5-ASA and SASP. Reactive oxygen species (ROS) are involved in the metabolism of prostaglandins and leukotrienes and can act as second messengers, and so the scavenging of ROS may be the single mechanism of action of 5-ASA that gives rise to its antiinflammatory effects in both inflammatory bowel disease and rheumatoid arthritis

Self-Monitoring of Blood Pressure in Hypertension: A UK Primary Care Survey

This study aimed to determine the prevalence of Self-Monitoring Blood Pressure amongst people with hypertension using a cross-sectional survey. Of the 955 who replied (53%), 293 (31%) reported that they self-monitored blood pressure. Nearly 60% (198/331) self-monitored at least monthly. Diabetic patients monitoring their blood glucose were five times more likely than those not monitoring to monitor their blood pressure. Self-monitoring is less common in the UK than internationally, but is practiced by enough people to warrant greater integration into clinical practice

The magmatic plumbing system of the Askja central volcano, Iceland

The magmatic plumbing system beneath Askja, a volcano in the central Icelandic highlands, is imaged using local earthquake tomography. We use a catalog of more than 1300 earthquakes widely distributed in location and depth to invert for the P wave velocity (Vp) and the Vp/Vs ratio. Extensive synthetic tests show that the minimum size of any velocity anomaly recovered by the model is ~4 km in the upper crust (depth < 8 km below sea level (bsl)), increasing to ~10 km in the lower crust at a depth of 20 km bsl. The plumbing system of Askja is revealed as a series of high-Vp/Vs ratio bodies situated at discrete depths throughout the crust to depths of over 20 km. We interpret these to be regions of the crust which currently store melt with melt fractions of ~10%. The lower crustal bodies are all seismically active, suggesting that melt is being actively transported in these regions. The main melt storage regions lie beneath Askja volcano, concentrated at depths of 5 km bsl with a smaller region at 9 km bsl. Their total volume is ~100 km3. Using the recorded waveforms, we show that there is also likely to be a small, highly attenuating magmatic body at a shallower depth of about 2 km bsl

Paper Session III-B - Ultrasonic Correlation Bolt Tension Analyzer

We describe our efforts in the development of an improved ultrasonic bolt tension analyzer (bolt gage) for use in precision tensioning of bolts in critical applications. This new instrument uses correlation techniques to ameliorate the peak jumping problems usually associated with ultrasonic bolt gages. Our instrument has been put through substantial (though not exhaustive) tests, with very good results

Trends in healthcare use in children aged less than 15 years; a population-based cohort study in England from 2007 to 2017

Objective To describe changing use of primary care in relation to use of urgent care and planned hospital services by children aged less than 15 years in England in the decade following major primary care reforms from 2007 to 2017 Design Population-based retrospective cohort study. Methods We used linked data from the Clinical Practice Research Datalink to study children’s primary care consultations and use of hospital care including emergency department (ED) visits, emergency and elective admissions to hospital and outpatient visits to specialists. Results Between 1 April 2007 and 31 March 2017, there were 7 604 024 general practitioner (GP) consultations, 981 684 ED visits, 287 719 emergency hospital admissions, 2 253 533 outpatient visits and 194 034 elective admissions among 1 484 455 children aged less than 15 years. Age-standardised GP consultation rates fell (−1.0%/year) to 1864 per 1000 child-years in 2017 in all age bands except infants rising by 1%/year to 6722 per 1000/child-years in 2017. ED visit rates increased by 1.6%/year to 369 per 1000 child-years in 2017, with steeper rises of 3.9%/year in infants (780 per 1000 child-years in 2017). Emergency hospital admission rates rose steadily by 3%/year to 86 per 1000 child-years and outpatient visit rates rose to 724 per 1000 child-years in 2017. Conclusions Over the past decade since National Health Service primary care reforms, GP consultation rates have fallen for all children, except for infants. Children’s use of hospital urgent and outpatient care has risen in all ages, especially infants. These changes signify the need for better access and provision of specialist and community-based support for families with young children

Intrathecal B-cell activation in LGI1 antibody encephalitis.

ObjectiveTo study intrathecal B-cell activity in leucine-rich, glioma-inactivated 1 (LGI1) antibody encephalitis. In patients with LGI1 antibodies, the lack of CSF lymphocytosis or oligoclonal bands and serum-predominant LGI1 antibodies suggests a peripherally initiated immune response. However, it is unknown whether B cells within the CNS contribute to the ongoing pathogenesis of LGI1 antibody encephalitis.MethodsPaired CSF and peripheral blood (PB) mononuclear cells were collected from 6 patients with LGI1 antibody encephalitis and 2 patients with other neurologic diseases. Deep B-cell immune repertoire sequencing was performed on immunoglobulin heavy chain transcripts from CSF B cells and sorted PB B-cell subsets. In addition, LGI1 antibody levels were determined in CSF and PB.ResultsSerum LGI1 antibody titers were on average 127-fold higher than CSF LGI1 antibody titers. Yet, deep B-cell repertoire analysis demonstrated a restricted CSF repertoire with frequent extensive clusters of clonally related B cells connected to mature PB B cells. These clusters showed intensive mutational activity of CSF B cells, providing strong evidence for an independent CNS-based antigen-driven response in patients with LGI1 antibody encephalitis but not in controls.ConclusionsOur results demonstrate that intrathecal immunoglobulin repertoire expansion is a feature of LGI1 antibody encephalitis and suggests a need for CNS-penetrant therapies