Doppler lidar observations of sensible heat flux and intercomparisons with a ground-based energy balance station and WRF model output

This is an open access article - Copyright @ 2009 E. Schweizerbart'sche VerlagsbuchhandlungDuring the Convective and Orographically induced Precipitation Study (COPS), a scanning Doppler lidar was deployed at Achern, Baden-Wüttemberg, Germany from 13th June to 16th August 2007. Vertical velocity profiles ('rays') through the boundary layer were measured every 3 seconds with vertical profiles of horizontal wind velocity being derived from performing azimuth scans every 30 minutes. During Intense Observation Periods radiosondes were launched from the site. In this paper, a case study of convective boundary layer development on 15th July 2007 is investigated. Estimates of eddy dissipation rate are made from the vertically pointing lidar data and used as one input to the velocity-temperature co-variance equation to estimate sensible heat flux. The sensible heat flux values calculated from Doppler lidar data are compared with a surface based energy balance station and output from the Weather Research and Forecasting (WRF) model.Funding is obtained from NER

Monitoring early stage lung disease in cystic fibrosis

PURPOSE OF REVIEW: Early stage lung disease has long been synonymous with infancy and childhood. As diagnosis happens earlier and conventional management improves, we are seeing larger proportions of people with cystic fibrosis (CF) in adolescence and even adulthood with well preserved lung health. The availability of highly effective cystic fibrosis transmembrane conductance regulator modulator drugs for a large proportion of the CF population will impact even further. Transitioning into adult care with 'normal' lung function will become more common. However, it is crucial that we are not blasé about this phase, which sets the scene for future lung health. It is well recognized that lung function assessed by spirometry is insensitive to 'early' changes occurring in the distal, small airways. Much of our learning has come from studies in infants and young children, which have allowed assessment and optimization of alternative forms of monitoring. RECENT FINDINGS: Here, as a group of paediatric and adult CF specialists, we review the evidence base for sensitive physiological testing based on multibreath washout, lung imaging, exercise and activity monitoring, assessment of infection and quality of life measures. SUMMARY: We seek to emphasise the importance of further work in these areas, as outcome measures become widely applicable to a growing CF population

A Qualitative Evaluation of an NHS Weight Management Programme for Obese Patients in Liverpool

Purpose – The increasing prevalence of obesity in the UK has been of concern for some time. This is particularly true in Liverpool and in response the Liverpool Weight Management Programme (LWMP) was devised. It offers a service involving dietitians and other expert agencies working towards facilitating dietary and lifestyle changes in obese NHS patients in Liverpool via a 12-week education programme. This qualitative study aims to investigate patients' experiences of the LWMP. Design/methodology/approach – Informed volunteers participated in focus groups exploring their experiences following the programme. Focus groups were audio recorded and transcribed verbatim, then analysed following a thematic approach utilising constant comparison analysis to allow a qualitative view of the LWMP to be formed. Findings – Participants described an increase in immediate self-confidence during the LWMP, as opposed to coercion and pressure experienced elsewhere. The results also show the implementation of dietary changes by participants and favourable opinions towards both the group settings and patient-centred care. Participants also positively described the LWMP regarding the programmes social approach and aspects of programme content; however, there were issues with over-dependence on healthcare professionals. Healthcare professionals also need to recognise that long-term empowerment may still be lacking and that follow-up support and the effectiveness of some areas of programme content need to be considered to ensure patients benefit from sustainable weight management. Originality/value – This paper addresses an identified need for qualitative research in the area of health service weight management programmes and highlights the importance of long-term support in empowering patients by exploring their lived experience of the LWMP

The "drive to eat" hypothesis: energy expenditure and fat-free mass but not adiposity are associated with milk intake and energy intake in 12 week infants

BACKGROUND: Recent work has challenged the long-held assumption that appetite functions to maintain stable body mass and fat mass (FM), suggesting instead that appetite matches food intake to energy expenditure and its correlate, fat-free mass (FFM). Whether this scenario applies to young infants, in chronic positive energy balance, remains unknown. OBJECTIVES: To test associations of components of energy expenditure and body composition with milk intake (MI) and energy intake (EI) in 12-week infants, by reanalyzing published cross-sectional data. METHODS: Data were available for 48 infants. In addition to anthropometric measurements, we assessed MI and EI by test-weighing, sleeping metabolic rate (SMR) by indirect calorimetry, and FFM, FM, and total energy expenditure (TEE) by doubly labeled water. Mean parental height was calculated as a marker of infant growth drive. Correlation and multiple regression analyses were applied. RESULTS: MI and EI correlated with FFM (r = 0.47 and 0.57, respectively; P  0.6). MI and EI correlated with SMR (r = 0.42 and 0.53, respectively; P  0.2). In a multiple regression analysis, MI was independently associated with TEE (partial r = 0.39) and FFM (partial r = 0.35). EI showed similar associations. Mean parental height was correlated with weight gain, MI, and EI. CONCLUSIONS: As in adults, MI and EI in young infants were strongly associated with FFM and with total and sleeping components of energy expenditure, but not with fatness. The infant's growth drive contributed to these associations. This suggests that appetite is regulated by the rate of energy expenditure, the size of energy-using tissues, and tissue deposition rate, and that the high levels of body fat characteristic of infants may not constrain weight gain

Curvilinearity provides additional information to lung clearance index only in a minority of children with early cystic fibrosis lung disease

Curvilinearity, as calculated from multiple-breath washout, is abnormal in a small number of children with cystic fibrosis when other tests are still normal https://bit.ly/3p9QAV4

A new role for pond management in farmland bird conservation

Biodiversity declines in agricultural landscapes represent a major conservation challenge. In the UK, some agricultural landscapes contain high pond densities, but many farmland ponds have become terrestrialised since the 1960s, with input of organic material resulting in a decrease in the size and depth of ponds that eventually transform into wet woodland habitats. Pond management, including removal of overhanging scrub and sediment, has proven highly effective in enhancing freshwater biodiversity. However, the implications of this management for farmland bird assemblages are unknown. Bird surveys were undertaken at recently managed, open, macrophyte-dominated and at highly terrestrialised, macrophyte-free ponds in the intensively cultivated farmland of North Norfolk, UK. The diversity, abundance and composition of bird assemblages visiting these ponds were compared to determine responses to pond management by tree and mud removal. Avian species richness, abundance and bird-visit frequencies were all higher at open farmland ponds. The observed patterns of bird occurrence were best explained by management-induced reductions in tree shading that resulted in aquatic macrophyte-dominance likely associated with high emergent invertebrate prey abundance. Moreover, we predict that open-canopy ponds offer greater habitat heterogeneity than overgrown ponds, allowing diversified bird use. Overgrown, terrestrialised ponds were preferred by some woodland bird species. Gamma diversity across the entire pondscape exceeded all individual pond alpha diversity measures by an order of magnitude, suggesting distinct variation in the bird assemblages visiting farmland ponds during different successional stages. Pond management that generates a mosaic of pond successional stages, including open-canopy, macrophyte-dominated ponds, could help to address the long-term decline of farmland birds. We strongly advocate increased agro-ecological research in this field, combined with greater emphasis on ponds and pond management options in agri-environment schemes

A biological pathway linking inflammation and depression: activation of indoleamine 2,3-dioxygenase

This article highlights the evidence linking depression to increased inflammatory drive and explores putative mechanisms for the association by reviewing both preclinical and clinical literature. The enzyme indoleamine 2,3-dioxygenase is induced by proinflammatory cytokines and may form a link between immune functioning and altered neurotransmission, which results in depression. Increased indoleamine 2,3-dioxygenase activity may cause both tryptophan depletion and increased neurotoxic metabolites of the kynurenine pathway, two alterations which have been hypothesized to cause depression. The tryptophan-kynurenine pathway is comprehensively described with a focus on the evidence linking metabolite alterations to depression. The use of immune-activated groups at high risk of depression have been used to explore these hypotheses; we focus on the studies involving chronic hepatitis C patients receiving interferon-alpha, an immune activating cytokine. Findings from this work have led to novel strategies for the future development of antidepressants including inhibition of indoleamine 2,3-dioxygenase, moderating the cytokines which activate it, or addressing other targets in the kynurenine pathway

Clinical pharmacokinetics and dose recommendations for posaconazole gastroresistant tablets in children with cystic fibrosis.

Objectives: To investigate the population pharmacokinetics of posaconazole gastroresistant tablets in children with cystic fibrosis (CF) and perform simulations to recommend optimal doses. Patients and methods: Children from a paediatric CF centre who had received posaconazole tablets and underwent therapeutic drug monitoring were identified from pharmacy records. Relevant clinical data were collated from case notes and electronic patient records and used to develop an allometrically scaled population pharmacokinetic model. A stepwise covariate model-building exercise evaluated the influence of interacting medicines and liver function. Results: One hundred posaconazole serum concentrations were collected from 37 children with a median age of 14 years (range 7–17). Posaconazole pharmacokinetics were adequately described by a one-compartment model with inter-individual variability on clearance. Dose simulations demonstrated a 77%–83% probability of attaining a trough target of 1 mg/L with a dose of 300 mg every 12 h for two doses then 300 mg once daily (OD) in children aged 6–11 years; and 86%–88% with a dose of 400 mg every 12 h for two doses then 400 mg OD in adolescents aged 12–17 years. This dose scheme also yielded a 90% probability of achieving an AUC of 30 mg·h/L. AUC and trough concentration were highly correlated (r2 = 0.98). Simulations showed that trough concentrations of >0.75 mg/L would exceed an AUC of 30 mg·h/L in 90% of patients. Conclusions: A starting dose of 300 mg OD in those aged 6–11 years and 400 mg OD in those aged 12–17 years (following loading doses) yields a 90% probability of attaining an AUC of 30 mg·h/L