Direct bilirubin levels observed in prolonged neonatal jaundice: a retrospective cohort study

OBJECTIVE: Prolonged neonatal jaundice is common and usually benign; however, assessment of bilirubin fractions is recommended to determine the need for further assessment for congenital liver disease, particularly biliary atresia. The direct (conjugated) bilirubin thresholds currently used are variable and poorly evidenced. Hence, we aimed to delineate direct bilirubin levels in disease-free neonates with prolonged jaundice. METHODS: We performed a retrospective cohort analysis of split bilirubin levels, and subsequent follow-up, for all neonates initially assessed in our prolonged neonatal jaundice clinic over 2 years. We plotted centile charts for total, direct and direct-total bilirubin ratio levels against age at sampling. The association was assessed using linear regression analysis. RESULTS: Data were collected for 420 neonates (501 blood samples) across an age range of 10-70 days. No significant liver disease was found. For each day of older age, total bilirubin fell by 3.72 µmol/L (95% CI 2.46 to 5.00) and direct bilirubin fell by 0.39 µmol/L (0.18 to 0.59). The ratio between the two did not change significantly (-0.0006 to +0.0034). The 95th centile for direct bilirubin was stable at ~25 µmol/L. Direct-total bilirubin ratio was very variable with some 95th centiles >30%. CONCLUSIONS: In a clinically relevant population of disease-free neonates with prolonged jaundice both the total and the direct bilirubin decreased with age. The absolute direct bilirubin is more useful clinically than the direct-total bilirubin ratio. Our results support National Institute for Health and Care Excellence guidance that conjugated bilirubin >25 µmol/L, or even more stringent criteria, constitutes an appropriate threshold for further investigation for neonatal liver disease

Seed bank dynamics govern persistence of Brassica hybrids in crop and natural habitats

This is the final version. Available on open access from Oxford University Press via the DOI in this record• Background and Aims: Gene flow from crops to their wild relatives has the potential to alter population growth rates and demography of hybrid populations, especially when a new crop has been genetically modified (GM). This study introduces a comprehensive approach to assess this potential for altered population fitness, and uses a combination of demographic data in two habitat types and mathematical (matrix) models that include crop rotations and outcrossing between parental species. • Methods: Full life-cycle demographic rates, including seed bank survival, of non-GM Brassica rapa x B. napus F1 hybrids and their parent species were estimated from experiments in both agricultural and semi-natural habitats. Altered fitness potential was modelled using periodic matrices including crop rotations and outcrossing between parent species. • Key Results: The demographic vital rates (i.e. For major stage transitions) of the hybrid population were intermediate between or lower than both parental species. The population growth rate (λ) of hybrids indicated decreases in both habitat types, and in a semi-natural habitat hybrids became extinct at two sites. Elasticity analyses indicated that seed bank survival was the greatest contributor to λ. In agricultural habitats, hybrid populations were projected to decline, but with persistence times up to 20 years. The seed bank survival rate was the main driver determining persistence. It was found that λ of the hybrids was largely determined by parental seed bank survival and subsequent replenishment of the hybrid population through outcrossing of B. Rapa with B. napus. • Conclusions: Hybrid persistence was found to be highly dependent on the seed bank, suggesting that targeting hybrid seed survival could be an important management option in controlling hybrid persistence. For local risk mitigation, an increased focus on the wild parent is suggested. Management actions, such as control of B. Rapa, could indirectly reduce hybrid populations by blocking hybrid replenishment.Biotechnology and Biological Sciences Research Council (BBSRC)Natural Environment Research Council (NERC

Prediction of the environmental impact and sustainability of large-scale irrigation with gypsiferous mine-water on groundwater resources

Irrigation of agricultural crops is one of the most cost-effective options for the utilisation of gypsiferous mine wastewater. In addition, it creates the opportunity to produce crops during the dry season. Gypsum is a slightly soluble salt and concentrating the gypsiferous soil solution through crop evapotranspiration precipitates gypsum in the soil profile, removing it from the water system and reducing the potential for groundwater pollution. In previous research, it was found that crops can be commercially produced under irrigation with gypsiferous mine- water with no obvious impact on groundwater in the short term (3 years). It was, however, recommended that monitoring should continue to confirm findings over a longer period and for different conditions. A research project was therefore initiated in 2001 to determine the impact of  irrigation with several gypsiferous water/soil combinations on crop performance, soil properties and groundwater quality. Field trials were carried out in South Africa on three mines: Kleinkopjé and New Vaal Collieries (Anglo Coal), and at Syferfontein (Sasol). Different crop and pasture species were grown on different soil types under centre-pivot irrigation with different mine-water qualities. Intensive monitoring systems were established in each irrigated field to determine the components of the soil-water and salt balance. Boreholes were also installed to monitor groundwater level and quality. Field water and salt balance data were used for calibration and validation of the mechanistic, generic crop, Soil-Water Balance (SWB) Model. The results of the field trials indicated that high crop and pasture yields can be obtained, provided site selection, land preparation, fertilisation and irrigation water management are appropriate. The results of the soil-water and salt balance studies indicated that considerable volumes of mine-water can be used and substantial amounts of salts can be removed from the water system through precipitation of gypsum in the soil profile. The groundwater impact was limited based on borehole measurements, indicating the presence of a zone of attenuation between the cropped soil profile and groundwater, but this should be monitored over a longer period. With appropriate management, water and salt runoff, and under specific conditions, drainage and salts leached can be intercepted, thereby minimising unwanted impacts on groundwater. Thirty-year scenario simulations were run with SWB and the generated salt loads from this model were used as input into a separate groundwater model in order to predict the likely long-term effects of irrigation with gypsiferous mine-water on groundwater. The results of these simulations showed that while salts reached the groundwater, there was a drop in concentration of the plume as it moved away from the irrigated area. This was due largely to dilution by infiltration from rainfall recharge and the dispersive characteristics of the aquifer. The simulations also showed the importance of matching the amount of drainage from an irrigated site with the transmissivity and storage properties of the aquifer below. These results suggest that large-scale irrigation with gypsiferous water could be viable if irrigated fields are carefully sited to prevent waterlogging and are well managed. A site-specific approach is essential. Water SA Vol 32(1)pp:21-2

Factors associated with alcohol reduction in harmful and hazardous drinkers following alcohol brief intervention in Scotland: a qualitative enquiry

Background: Alcohol Brief Intervention (ABI) uses a motivational counselling approach to support individuals to reduce excessive alcohol consumption. There is growing evidence on ABI’s use within various health care settings, although how they work and which components enhance success is largely unknown. This paper reports on the qualitative part of a mixed methods study. It explores enablers and barriers associated with alcohol reduction following an ABI. It focuses on alcohol’s place within participants’ lives and their personal perspectives on reducing consumption. There are a number of randomised controlled trials in this field though few ABI studies have addressed the experiences of hazardous/harmful drinkers. This study examines factors associated with alcohol reduction in harmful/hazardous drinkers following ABI. Methods: This qualitative study was underpinned by a realist evaluation approach and involved semistructured interviews with ten harmful or hazardous alcohol drinkers. Participants (n = 10) were from the intervention arm of a randomised controlled trial (n = 124). All had received ABI, a 20 min motivational counselling interview, six months previously, and had reduced their alcohol consumption. Interviews were recorded, transcribed verbatim and thematically analysed. Results: Participants described their views on alcohol, its’ place in their lives, their personal perspectives on reducing their consumption and future aspirations. Conclusions: The findings provide an insight into participants’ views on alcohol, ABI, and the barriers and enablers to change. Participants described a cost benefit analysis, with some conscious consideration of the advantages and disadvantages of reducing intake or abstaining from alcohol. Findings suggest that, whilst hospital admission can act as a catalyst, encouraging individuals to reflect on their alcohol consumption through ABI may consolidate this, turning this reflective moment into action. Sustainability may be enhanced by the presence of a ‘significant other’ who encourages and experiences benefit. In addition having a purpose or structure with activities linked to employment and/or social and leisure pursuits offers the potential to enhance and sustain reduced alcohol consumption. Trial registration: Trial registration number TRN NCT00982306 September 22nd 200

Saddle point localization of molecular wavefunctions

The quantum mechanical description of isomerization is based on bound eigenstates of the molecular potential energy surface. For the near-minimum regions there is a textbook-based relationship between the potential and eigenenergies. Here we show how the saddle point region that connects the two minima is encoded in the eigenstates of the model quartic potential and in the energy levels of the [H, C, N] potential energy surface. We model the spacing of the eigenenergies with the energy dependent classical oscillation frequency decreasing to zero at the saddle point. The eigenstates with the smallest spacing are localized at the saddle point. The analysis of the HCN???HNC isomerization states shows that the eigenstates with small energy spacing relative to the effective (v1, v3, l) bending potentials are highly localized in the bending coordinate at the transition state. These spectroscopically detectable states represent a chemical marker of the transition state in the eigenenergy spectrum. The method developed here provides a basis for modeling characteristic patterns in the eigenenergy spectrum of bound states

Exploring the experiences of having Guillain‐Barré Syndrome: A qualitative interview study

Background: Guillain-Barré syndrome (GBS) is a rare inflammatory disorder affecting the peripheral nerves. Although typically there is full neurological recovery, some people continue to experience residual physical, psychological or social problems longer term. Evidence describing the experiences of people with GBS is limited. Objective: We aimed to explore the experiences of people with GBS in the UK. Design: We used qualitative (face-to-face and telephone) interviews to explore experiences of people with GBS. Audio-recorded data were transcribed verbatim and analysed using the Framework Method supported by NVivo 11. Setting and Participants: We purposively recruited a sample of 16 volunteers with a prior diagnosis of GBS of varying age, sex, ethnicity, location, marital status, time since diagnosis and length of hospital stay to maximize differences in experience. Interviewees were required to have been discharged from hospital, able to give informed consent, able to speak and understand English and currently resident in the United Kingdom. Results: The key themes arising from the analysis were as follows: the importance of early diagnosis; the experiences of inpatient care; the importance of active support for recovery; the need for communication throughout the course of the illness; the need for greater awareness, knowledge and provision of information by health-care staff; and path to achieving function. Conclusion: This is the first qualitative study exploring experiences of people with GBS in the UK through their whole illness journey from onset to recovery. The findings contribute to our understanding of the experiences and support needs of people recovering from GBS

Near-field emission profiling of tropical forest and Cerrado fires in Brazil during SAMBBA 2012

This is the final version. Available from European Geosciences Union (EGU) / Copernicus Publications via the DOI in this record. Data availability: All raw time series data used to derive the emission ratios and factors from the FAAM research aircraft are publicly available from the Centre for Environmental Data Analysis website (http://www.ceda.ac.uk/, last access: 12 March 2018). Direct links to the flight data records are given in the reference list (Facility for Airborne Atmospheric Measurements, Natural Environment Research Council, and Met Office, 2014a, b).We profile trace gas and particulate emissions from near-field airborne measurements of discrete smoke plumes in Brazil during the 2012 biomass burning season. The South American Biomass Burning Analysis (SAMBBA) Project conducted during September and October 2012 sampled across two distinct fire regimes prevalent in the Amazon Basin. Combined measurements from a Compact Time-of-Flight Aerosol Mass Spectrometer (C-ToF-AMS) and a Single Particle Soot Photometer (SP2) are reported for the first time in a tropical biomass burning environment. Emissions from a mostly smouldering tropical forest wildfire in Rondônia state and numerous smaller flaming Cerrado fires in Tocantins state are presented. While the Cerrado fires appear to be representative of typical fire conditions in the existing literature, the tropical forest wildfire likely represents a more extreme example of biomass burning with a bias towards mostly smouldering emissions. We determined fire-integrated modified combustion efficiencies, emission ratios and emission factors for trace gas and particulate components for these two fire types, alongside aerosol microphysical properties. Seven times more black carbon was emitted from the Cerrado fires per unit of fuel combustion (EFBC of 0.13±0.04ĝ€†gĝ€†kg-1) compared to the tropical forest fire (EFBC of 0.019±0.006gĝ€†kg-1), and more than 6 times the amount of organic aerosol was emitted from the tropical forest fire per unit of fuel combustion (EFOM of 8.00±2.53gĝ€†kg-1, EFOC of 5.00±1.58gĝ€†kg-1) compared to the Cerrado fires (EFOM of 1.31±0.42gĝ€†kg-1, EFOC of 0.82±0.26gĝ€†kg-1). Particulate-phase species emitted from the fires sampled are generally lower than those reported in previous studies and in emission inventories, which is likely a combination of differences in fire combustion efficiency and fuel mixture, along with different measurement techniques. Previous modelling studies focussed on the biomass burning season in tropical South America have required significant scaling up of emissions to reproduce in situ and satellite aerosol concentrations over the region. Our results do not indicate that emission factors used in inventories are biased low, which could be one potential cause of the reported underestimates in modelling studies. This study supplements and updates trace gas and particulate emission factors for fire-type-specific biomass burning in Brazil for use in weather and climate models. The study illustrates that initial fire conditions can result in substantial differences in terms of their emitted chemical components, which can potentially perturb the Earth system.NERCMet Offic

Phytoestrogens

Collectively, plants contain several different families of natural products among which are compounds with weak estrogenic or antiestrogenic activity toward mammals. These compounds, termed phytoestrogens, include certain isoflavonoids, flavonoids, stilbenes, and lignans. The best-studied dietary phytoestrogens are the soy isoflavones and the flaxseed lignans. Their perceived health beneficial properties extend beyond hormone-dependent breast and prostate cancers and osteoporosis to include cognitive function, cardiovascular disease, immunity and inflammation, and reproduction and fertility. In the future, metabolic engineering of plants could generate novel and exquisitely controlled dietary sources with which to better assess the potential health beneficial effects of phytoestrogens

Making Projects Real in a Higher Education Context

Challenging educators to rethink projects and see them as a practice rather than as a model of management the authors explore the possibilities for using live projects to enhance real world learning in higher education. Drawing on the work of the ‘critical projects movement’ the chapter outlines a theoretical underpinning for reconceptualising projects as a practice and proposes a new pedagogic model that of ‘agile learning’. Framing the use of live projects is a mode of real world learning that generates encounters with industry professionals and provides real-value outputs for clients. The chapter explores the challenges that face educators who wish to foreground ‘social learning’ and engagement with communities of practice as a means of easing the transition for students from education to the world of work