An Analysis of Channel Bank Erosion and Development of a Catchment Sediment Budget Model

Increased sediment loads within river catchments have well-documented detrimental effects on water quality and catchment management plans are required to address reduction and mitigation of these problems. In order to do this it is essential that tools are available that deliver reliable sediment generation data at appropriate temporal and spatial scales. Currently, most sediment generation models do not include bank erosion individually as a sediment source. Therefore, to enable improved accuracy in predictions of future sediment pressures under environmental change, explicit modelling of the rates of sediment production by the bank erosion is required to provide a more complete representation of the catchment sediment budget. In this study, an existing prototype national bank erosion index has been refined. Using Geographical Information Systems (GIS) digitised overlays, channel migration rates were calculated for several UK catchments. Relationships between the rate of channel bank erosion and factors controlling the rates of channel migration were investigated, including channel sinuosity, slope, upstream catchment area, and restriction of migration due to valley width. Significant correlations between bank erosion and sinuosity, upstream area and channel confinement were observed. The non-linear influence of channel planform geometry (curvature and sinuosity) on migration rates was further investigated using an existing meander migration model. A new bank erosion model was developed to incorporate the influence of both channel confinement and sinuosity. As the model incorporates the key physical controls on bank erosion, hence it is expected that it will have wide applicability in catchment- to national-scale bank erosion assessment. A computationally efficient catchment routing model was developed. Data output from a newly developed catchment overland sediment and runoff estimation model (ADAS APT) was used as input to the routing model. The newly developed bank erosion model and an existing floodplain sedimentation model were incorporated within the routing methodology to provide a catchment sediment budget model. The model was applied to the Exe catchment, Devon, UK and validated against observational data. Model estimations of annual sediment generation through bank erosion, sediment deposition on floodplains, and sediment load at the catchment outlet were within the range of observed values. The catchment sediment budget model developed in this thesis provides a more comprehensive representation of catchment sediment processes than existing alternative methodologies.ADAS UK LtdUniversity of Exete

High Power Amplifier and Power Supply

A document discusses the creation of a high-voltage power supply (HVPS) that is able to contain voltages up to -20 kV, keep electrical field strengths to below 200 V/mil (approximately equal to 7.87 kV/mm), and can provide a 200-nanosecond rise/fall time focus modulator swinging between cathode potential of 16.3 kV and -19.3 kV. This HVPS can protect the 95-GHz, pulsed extended interaction klystron (EIK) from arcs/discharges from all sources, including those from within the EIK fs vacuum envelope. This innovation has a multi-winding pulse transformer design, which uses new winding techniques to provide the same delays and rise/fall times (less than 10 nanoseconds) at different potential levels ranging from -20 kV to -16 kV. Another feature involves a high-voltage printed-wiring board that was corona-free at -20 kV DC with a 3- kV AC swing. The corona-free multilayer high-voltage board is used to simulate fields of less than 200 V/mil (approximately equal to 7.87 kV/mm) at 20 kV DC. Drive techniques for the modulator FETs (field-effect transistors) (four to 10 in a series) were created to change states (3,000-V swing) without abrupt steps, while still maintaining required delays and transition times. The packing scheme includes a potting mold to house a ten-stage modulator in the space that, in the past, only housed a four-stage modulator. Problems keeping heat down were solved using aluminum oxide substrate in the high-voltage section to limit temperature rise to less than 10 while withstanding -20 kV DC voltage and remaining corona-free

Improving nursing care in a children’s hospital in rural India

Background: Nursing care quality in developing countries is an ongoing challenge leading to poor patient outcomes. The objective of this study is to evaluate changes in nursing performance providing routine cares following a training program in children’s hospital in Mota Fofalia, Gujarat, India. Methods: The main outcome measure was the proportion of newborns with vital signs and weights obtained by nursing staff before and after a training program. The training program consisted of an in-service reinforced by hands-on management of patient care for 2 weeks. Following the training, the nurses were observed for 2 months. Results: Observation of 138 newborn encounters demonstrated a 29.7% improvement in vital sign monitoring and 88.4% in weight monitoring from the 0% baseline. Conclusion: We observed a moderate improvement in measuring vital signs and a substantial improvement in measuring weights in newborns with the training intervention. For further improvement, continued training, and follow-up is indicated

Reliability and Validity of the HD-PRO-TriadTM, a Health-Related Quality of Life Measure Designed to Assess the Symptom Triad of Huntington\u27s Disease.

BACKGROUND: Huntington\u27s disease (HD), is a neurodegenerative disorder that is associated with cognitive, behavioral, and motor impairments that diminish health related quality of life (HRQOL). The HD-PRO-TRIADTM is a quality of life measure that assesses health concerns specific to individuals with HD. Preliminary psychometric characterization was limited to a convenience sample of HD participants who completed measures at home so clinician-ratings were unavailable. OBJECTIVES: The current study evaluates the reliability and validity of the HD-PRO-TRIADTM in a well-characterized sample of individuals with HD. METHODS: Four-hundred and eighty-two individuals with HD (n = 192 prodromal, n = 193 early, and n = 97 late) completed the HD-PRO-TRIADTM questionnaire. Clinician-rated assessments from the Unified Huntington Disease Rating Scales, the short Problem Behaviors Assessment, and three generic measures of HRQOL (WHODAS 2.0, RAND-12, and EQ-5D) were also examined. RESULTS: Internal reliability for all domains and the total HD-PRO-TRIADTM was excellent (all Cronbach\u27s α \u3e0.93). Convergent and discriminant validity were supported by significant associations between the HD-PRO-TRIADTM domains, and other patient reported outcome measures as well as clinician-rated measures. Known groups validity was supported as the HD-PRO-TRIADTM differentiated between stages of the disease. Floor and ceiling effects were generally within acceptable limits. There were small effect sizes for 12-month change over time and moderate effect sizes for 24-month change over time. CONCLUSIONS: Findings support excellent internal reliability, convergent and discriminant validity, known groups validity, and responsiveness to change over time. The current study supports the clinical efficacy of the HD-PRO-TRIADTM. Future research is needed to assess the test-retest reliability of this measure

Phase 3 Safety and Efficacy of AZD1222 (ChAdOx1 nCoV-19) Covid-19 Vaccine

BACKGROUND: The safety and efficacy of the AZD1222 (ChAdOx1 nCoV-19) vaccine in a large, diverse population at increased risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the United States, Chile, and Peru has not been known. METHODS: In this ongoing, double-blind, randomized, placebo-controlled, phase 3 clinical trial, we investigated the safety, vaccine efficacy, and immunogenicity of two doses of AZD1222 as compared with placebo in preventing the onset of symptomatic and severe coronavirus disease 2019 (Covid-19) 15 days or more after the second dose in adults, including older adults, in the United States, Chile, and Peru. RESULTS: A total of 32,451 participants underwent randomization, in a 2:1 ratio, to receive AZD1222 (21,635 participants) or placebo (10,816 participants). AZD1222 was safe, with low incidences of serious and medically attended adverse events and adverse events of special interest; the incidences were similar to those observed in the placebo group. Solicited local and systemic reactions were generally mild or moderate in both groups. Overall estimated vaccine efficacy was 74.0% (95% confidence interval [CI], 65.3 to 80.5; P CONCLUSIONS: AZD1222 was safe and efficacious in preventing symptomatic and severe Covid-19 across diverse populations that included older adults. (Funded by AstraZeneca and others; ClinicalTrials.gov number, NCT04516746.)

Single-cell multi-omics analysis of the immune response in COVID-19

Funder: Lister Institute of Preventive Medicine; doi: https://doi.org/10.13039/501100001255Funder: University College London, Birkbeck MRC Doctoral Training ProgrammeFunder: The Jikei University School of MedicineFunder: Action Medical Research (GN2779)Funder: NIHR Clinical Lectureship (CL-2017-01-004)Funder: NIHR (ACF-2018-01-004) and the BMA FoundationFunder: Chan Zuckerberg Initiative (grant 2017-174169) and from Wellcome (WT211276/Z/18/Z and Sanger core grant WT206194)Funder: UKRI Innovation/Rutherford Fund Fellowship allocated by the MRC and the UK Regenerative Medicine Platform (MR/5005579/1 to M.Z.N.). M.Z.N. and K.B.M. have been funded by the Rosetrees Trust (M944)Funder: Barbour FoundationFunder: ERC Consolidator and EU MRG-Grammar awardsFunder: Versus Arthritis Cure Challenge Research Grant (21777), and an NIHR Research Professorship (RP-2017-08-ST2-002)Funder: European Molecular Biology Laboratory (EMBL)Abstract: Analysis of human blood immune cells provides insights into the coordinated response to viral infections such as severe acute respiratory syndrome coronavirus 2, which causes coronavirus disease 2019 (COVID-19). We performed single-cell transcriptome, surface proteome and T and B lymphocyte antigen receptor analyses of over 780,000 peripheral blood mononuclear cells from a cross-sectional cohort of 130 patients with varying severities of COVID-19. We identified expansion of nonclassical monocytes expressing complement transcripts (CD16+C1QA/B/C+) that sequester platelets and were predicted to replenish the alveolar macrophage pool in COVID-19. Early, uncommitted CD34+ hematopoietic stem/progenitor cells were primed toward megakaryopoiesis, accompanied by expanded megakaryocyte-committed progenitors and increased platelet activation. Clonally expanded CD8+ T cells and an increased ratio of CD8+ effector T cells to effector memory T cells characterized severe disease, while circulating follicular helper T cells accompanied mild disease. We observed a relative loss of IgA2 in symptomatic disease despite an overall expansion of plasmablasts and plasma cells. Our study highlights the coordinated immune response that contributes to COVID-19 pathogenesis and reveals discrete cellular components that can be targeted for therapy

Fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin with gemtuzumab ozogamicin improves event-free survival in younger patients with newly diagnosed aml and overall survival in patients with npm1 and flt3 mutations

Purpose To determine the optimal induction chemotherapy regimen for younger adults with newly diagnosed AML without known adverse risk cytogenetics. Patients and Methods One thousand thirty-three patients were randomly assigned to intensified (fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin [FLAG-Ida]) or standard (daunorubicin and Ara-C [DA]) induction chemotherapy, with one or two doses of gemtuzumab ozogamicin (GO). The primary end point was overall survival (OS). Results There was no difference in remission rate after two courses between FLAG-Ida + GO and DA + GO (complete remission [CR] + CR with incomplete hematologic recovery 93% v 91%) or in day 60 mortality (4.3% v 4.6%). There was no difference in OS (66% v 63%; P = .41); however, the risk of relapse was lower with FLAG-Ida + GO (24% v 41%; P < .001) and 3-year event-free survival was higher (57% v 45%; P < .001). In patients with an NPM1 mutation (30%), 3-year OS was significantly higher with FLAG-Ida + GO (82% v 64%; P = .005). NPM1 measurable residual disease (MRD) clearance was also greater, with 88% versus 77% becoming MRD-negative in peripheral blood after cycle 2 (P = .02). Three-year OS was also higher in patients with a FLT3 mutation (64% v 54%; P = .047). Fewer transplants were performed in patients receiving FLAG-Ida + GO (238 v 278; P = .02). There was no difference in outcome according to the number of GO doses, although NPM1 MRD clearance was higher with two doses in the DA arm. Patients with core binding factor AML treated with DA and one dose of GO had a 3-year OS of 96% with no survival benefit from FLAG-Ida + GO. Conclusion Overall, FLAG-Ida + GO significantly reduced relapse without improving OS. However, exploratory analyses show that patients with NPM1 and FLT3 mutations had substantial improvements in OS. By contrast, in patients with core binding factor AML, outcomes were excellent with DA + GO with no FLAG-Ida benefit

Museum Activism

"Only a decade ago, the notion that museums, galleries and heritage organisations might engage in activist practice, with explicit intent to act upon inequalities, injustices and environmental crises, was met with scepticism and often derision. Seeking to purposefully bring about social change was viewed by many within and beyond the museum community as inappropriately political and antithetical to fundamental professional values. Today, although the idea remains controversial, the way we think about the roles and responsibilities of museums as knowledge based, social institutions is changing. Museum Activism examines the increasing significance of this activist trend in thinking and practice." -- Publisher's website