Feeder Bluffs on Puget Sound: Tools for Improved Management

Much of Puget Sound’s shoreline consists of mixed sand and gravel beaches, dominated by longshore sediment transport and organized into hundreds of discrete littoral cells. Sediment supply within these cells is often provided by erosion of the steep coastal bluffs, which are composed of abundant, coarse-grained Pleistocene sediment. Bluffs that provide beach sediment are referred to as feeder bluffs and are important to the long-term maintenance of Puget Sound beaches. At the same time, development of Puget Sound’s shoreline has led to widespread construction of seawalls and revetments to control bluff erosion, with the unintended consequence of reducing natural sources of beach sediment. Coastal managers are concerned that this will adversely impact beach conditions. Impair nearshore ecological functions, and reduce resilience to rising sea level. Until recently, regional mapping of feeder bluffs existed. In 2012-2013, we combined existing information with new data and completed a sound-wide coverage of eroding bluffs, along with related beach and coastal landforms. Mapping was conducted using detailed field observations, supplemented with geologic information and aerial photographs. Bluffs were categorized based on their potential ability to deliver beach sediment. We found that of Puget Sound’s 4000 km of shoreline, about 2200 km are beaches. Of these about 600 km are feeder bluffs and about 50 km were mapped as exceptional. About 35% of the region’s beaches were mapped as modified or armored. The maps of feeder bluffs will be provided on Ecology’s online Coastal Atlas, allowing access and integration with other nearshore data. In addition, web-based material provides background information on geology and beaches and guidance on how to interpret and apply his information. This will assist planners and resource managers in improving shoreline management, assessing Puget Sound nearshore health, and identifying coastal restoration priorities

What influences adherence to guidance for post-operative instillation of intravesical chemotherapy to bladder cancer patients?

Open Access via the Jisc Wiley Agreement Wellcome Trust - Institutional Strategic Support Fund (GrantNumber(s): 204815/Z/16/A)Peer reviewedPostprintPublisher PD

The ALLEGRO trial : a placebo controlled randomised trial of intravenous lidocaine in accelerating gastrointestinal recovery after colorectal surgery

Acknowledgements The authors wish to acknowledge the following persons who have helped deliver the ALLEGRO trial: the programming team based in the Centre for Healthcare Randomised Trials, for their work in developing the study web portal; Sharon Wren and Zoe Batham for their administrative support; ACCORD in Edinburgh; the Perioperative Medicine Clinical Trials Network (POMCTN) for adopting the trial for promotion; and the local recruiting teams and participants. We are also indebted to the late Professor Kenneth Fearon, University of Edinburgh, for protocol development and study design. The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the Health Technology Assessment Programme, National Institute for Health Research (NIHR), NHS or the Department of Health. Funding The trial is funded by the NIHR Health and Technology Assessment programme, project number 15/130/95. The funding body had no role in the design of the study, collection of data or the writing of this paper, nor will the funding body have a role in analysis, interpretation of data or in writing future manuscripts. The co-sponsors are University of Edinburgh & Lothian Health Board (AC- CORD), The Queen’s Medical Research Institute, 47 Little France Crescent, Ed- inburgh EH16 4TJ.Peer reviewedPublisher PD

A core outcome set for localised prostate cancer effectiveness trials

Objective: To develop a core outcome set (COS) applicable for effectiveness trials of all interventions for localised prostate cancer. Background: Many treatments exist for localised prostate cancer, although it is unclear which offers the optimal therapeutic ratio. This is confounded by inconsistencies in the selection, definition, measurement and reporting of outcomes in clinical trials. Subjects and methods: A list of 79 outcomes was derived from a systematic review of published localised prostate cancer effectiveness studies and semi-structured interviews with 15 prostate cancer patients. A two-stage consensus process involving 118 patients and 56 international healthcare professionals (HCPs) (cancer specialist nurses, urological surgeons and oncologists) was undertaken, consisting of a three-round Delphi survey followed by a face-to-face consensus panel meeting of 13 HCPs and 8 patients. Results: The final COS included 19 outcomes. Twelve apply to all interventions: death from prostate cancer, death from any cause, local disease recurrence, distant disease recurrence/metastases, disease progression, need for salvage therapy, overall quality of life, stress urinary incontinence, urinary function, bowel function, faecal incontinence, sexual function. Seven were intervention-specific: perioperative deaths (surgery), positive surgical margin (surgery), thromboembolic disease (surgery), bothersome or symptomatic urethral or anastomotic stricture (surgery), need for curative treatment (active surveillance), treatment failure (ablative therapy), and side effects of hormonal therapy (hormone therapy). The UK-centric participants may limit the generalisability to other countries, but trialists should reason why the COS would not be applicable. The default position should not be that a COS developed in one country will automatically not be applicable elsewhere. Conclusion: We have established a COS for trials of effectiveness in localised prostate cancer, applicable across all interventions which should be measured in all localised prostate cancer effectiveness trials

Photodynamic versus white light-guided treatment of non-muscle invasive bladder cancer: a study protocol for a randomised trial of clinical and cost-effectiveness

Bladder cancer is the most frequently occurring tumour of the urinary system. Ta, T1 tumours and carcinoma in situ (CIS) are grouped as non-muscle invasive bladder cancer (NMIBC), which can be effectively treated by transurethral resection of bladder tumour (TURBT). There are limitations to the visualisation of tumours with conventional TURBT using white light illumination within the bladder. Incomplete resections occur from the failure to identify satellite lesions or the full extent of the tumour leading to recurrence and potential risk of disease progression. To improve complete resection, photodynamic diagnosis (PDD) has been proposed as a method that can enhance tumour detection and guide resection. The objective of the current research is to determine whether PDD-guided TURBT is better than conventional white light surgery and whether it is cost-effective.This article is freely available via Open Access. Click on the publisher URL to access the full-text from the publisher's site

An International Collaborative Consensus Statement on En Bloc Resection of Bladder Tumour Incorporating Two Systematic Reviews, a Two-round Delphi Survey and a Consensus Meeting

Funding/Support and role of the sponsor: This study was supported by the General Research Fund/Early Career Scheme of the Research Grants Council, Hong Kong, China (reference no. 24116518).Peer reviewedPostprin

Using dissolved H₂O in rhyolitic glasses to estimate palaeo-ice thickness during a subglacial eruption at Bláhnúkur(Torfajökull, Iceland)

The last decade has seen the refinement of a technique for reconstructing palaeo-ice thicknesses based on using the retained H2O and CO2 content in glassy eruptive deposits to infer quenching pressures and therefore ice thicknesses. The method is here applied to Bláhnúkur, a subglacially erupted rhyolitic edifice in Iceland. A decrease in water content from ~0.7 wt.% at the base to ~0.3 wt.% at the top of the edifice suggests that the ice was 400 m thick at the time of the eruption. As Bláhnúkur rises 350 m above the surrounding terrain, this implies that the eruption occurred entirely within ice, which corroborates evidence obtained from earlier lithofacies studies. This paper presents the largest data set (40 samples) so far obtained for the retained volatile contents of deposits from a subglacial eruption. An important consequence is that it enables subtle but significant variations in water content to become evident. In particular, there are anomalous samples which are either water-rich (up to 1 wt.%) or water-poor (~0.2 wt.%), with the former being interpreted as forming intrusively within hyaloclastite and the latter representing batches of magma that were volatile-poor prior to eruption. The large data set also provides further insights into the strengths and weaknesses of using volatiles to infer palaeo-ice thicknesses and highlights many of the uncertainties involved. By using examples from Bláhnúkur, the quantitative use of this technique is evaluated. However, the relative pressure conditions which have shed light on Bláhnúkur’s eruption mechanisms and syn-eruptive glacier response show that, despite uncertainties in absolute values, the volatile approach can provide useful insight into the mechanisms of subglacial rhyolitic eruptions, which have never been observed