Sensitivity of estuaries to compound flooding.

Fluvial and surge-tide extremes can occur synchronously resulting in compound flooding in estuaries, greatly intensifying the hazard. This flood risk has the potential to increase in the future as the frequency, phasing and/or intensity of these drivers change. Improved understanding of how extreme fluvial discharge and surge-tides interact will help inform future flood mitigation methodology. In this paper, therefore, we resolve for the first time intra-estuary sensitivities to fluvial and surge-tide extremes, for two contrasting UK estuaries (Humber and Dyfi). Model simulations at hyper-spatial resolution (< 50 m) using a 2D hydrodynamic model predicted compound flooding hazards based on: (1) present-day extreme events (worst on record); (2) present-day extreme events with shifted timings of the drivers to maximise flooding; and (3) modified drivers representing projected climate change. We found that in a small estuary with short-duration, high-intensity fluvial inputs (Dyfi), flood extent is sensitive to the relative timing of the fluvial and surge-tide drivers. In contrast, the relative timing of these drivers did not affect flooding in a larger estuary with a slower fluvial response to rainfall (Humber). In the Humber, extreme fluvial inputs during a compound hazard actually reduced maximum water depths in the outer estuary, compared with a surge-tide-only event. Projected future changes in these drivers by 2100 will increase compound flooding hazards: simulated sea-level rise scenarios predicted substantial and widespread flooding in both estuaries. However, projected increases in surge-tide behaved differently to sea-level rise of the same magnitude, resulting in a greater seawater influx and more flooding. Increased fluvial volumes were the weakest driver of estuarine flooding. In this paper we show how these interactions are complex and how the hydrodynamics vary considerably between different estuaries and sites within estuaries, making it difficult to generalise, use probabilistic or use 1D approaches for assessing compound flooding hazards. Hence, we contribute new knowledge and methods for catchment-to-coast impact modelling used for flood mitigation strategies

Sense about science - making sense of crime

Booklet 'Making Sense of Crime' published by registered charity 'Sense About Science'There’s always heated debate about crime in the media and a lot of political argument about how we should respond to it. But these arguments rarely provide insight into what actually causes crime, what lies behind trends over time and in different places, and how best to go about reducing it. Values inform how a society decides to deal with crime. We may decide that rehabilitation is a better principle than punishment, and this will influence how we decide what is most effective. However, we also expect these choices to be disciplined by sound evidence, because if crime policy ignores what works and what doesn’t, there are likely to be bad social consequences. And with over £10bn spent annually on tackling crime through the police, prisons, probation and courts, unless we look at evidence we can’t see how effective any of it is. Crime policy usually has twin aims – to prevent crime, and to seek justice by punishing those who commit offences. Research shows there’s only a loose link, if any, between the way offenders are punished and the number of offences committed. There is no reliable evidence for example, that capital punishment reduces serious crimes as its supporters claim. Yet politicians and commentators regularly claim that more punishments are a way to cut crime. Academic, government and community organisations have all said crime policies need to be based more on evidence, but much of the evidence available at the moment is poor or unclear. Debates about crime rarely reflect how strong the evidence behind opposing policies is, and even when politicians honestly believe they’re following the evidence, they tend to select evidence that supports their political views. This guide looks at some of the key things we do know and why it has been so difficult to make sense of crime policy. An important point throughout is that policymakers sometimes have to make decisions when things are not clear-cut. They have a better chance of making effective policies if they admit to this uncertainty – and conduct robust research to find out more. In the following pages we have shared insights from experts in violent crime, policing, crime science, psychology and the media’s influence on the crime debate. They don’t have all the answers, but we hope they leave you better-placed to hold policymakers and commentators to account and promote a more useful discussion about crime

Diverging trends in smoking behaviours according to mental health status

Introduction: People with mental health disorders are much more likely to smoke compared to those who do not. This study investigates recent trends in smoking behaviors among both these populations in England. Methods: We used survey responses from adults (aged 16 years and older) living in households in England who participated in the Health Survey for England from 1993 to 2011 (n = 11,300 per year on average). Linear regression was used to quantify annual changes over the time period in smoking prevalence, daily cigarette consumption, and desire to quit among respondents with and without 2 indicators of mental disorder (self-reported longstanding mental illness and recent use of psychoactive medication). Results: Among survey respondents who did not report a longstanding mental illness, there were long-term declines in smoking prevalence (−0.48% per year, 95% confidence interval [CI] = −0.56 to −0.40) and daily cigarette consumption (−0.14% per year, 95% CI = −0.17 to −0.11). Similar declines were also seen among respondents not taking psychoactive medications. However, there were no long-term changes in smoking prevalence and cigarette consumption among respondents who reported these indicators of mental disorder, although smoking prevalence among those taking psychoactive medications may have declined during the later part of the study period. Smokers both with and without the 2 indicators of mental disorder showed similar levels of desire to quit smoking. Conclusions: Smoking is largely unchanged since 1993 among those with indicators of longstanding mental disorders or recent psychoactive medication usage, although declines have been observed among those without such indicators of mental disorder

UK Parliament Environment, Food and Rural Affairs Select Committee Flooding Inquiry: Written Evidence from Dr Kate Smith et al. (FLO0043)

This submission presents the research conducted within the Energy and Environment Institute at the University of Hull. Our work demonstrates that hazards represented by flooding have multiple dimensions, and that solutions to them need to take these complex inter-relationships into account. The research described below covers both the physical and social impacts of flooding; the recommendations that follow from our work are based on our understanding that flood risk management needs to expand across land-water boundaries at the full range of spatial, temporal and societal scales. Responding to each of the terms of reference in turn, our data shows that the response to flooding needs to start changing now in order to ensure the resilience of our communities, businesses and infrastructure in the future

Effects of Parkinson’s disease and dopamine on digit span measures of working memory

Rationale Parkinson’s disease (PD) impairs working memory (WM)—the ability to maintain items in memory for short periods of time and manipulate them. There is conflicting evidence on the nature of the deficits caused by the disease, and the potential beneficial and detrimental effects of dopaminergic medication on different WM processes. Objectives We hypothesised that PD impairs both maintenance and manipulation of items in WM and dopaminergic medications improve this in PD patients but impair it in healthy older adults. Methods We tested 68 PD patients ON and OFF their dopaminergic medication, 83 healthy age-matched controls, and 30 healthy older adults after placebo and levodopa administration. We used the digit span, a WM test with three components (forwards, backwards, and sequence recall) that differ in the amount of manipulation required. We analysed the maximum spans and the percentage of lists correctly recalled, which probe capacity of WM and the accuracy of the memory processes within this capacity, respectively. Results PD patients had lower WM capacity across all three digit span components, but only showed reduced percentage accuracy on the components requiring manipulation (backwards and sequence spans). Dopaminergic medication did not affect performance in PD patients. In healthy older adults, levodopa did not affect capacity, but did impair accuracy on one of the manipulation components (sequence), without affecting the other (backwards). Conclusions This suggests that the deficit of maintenance capacity and manipulation accuracy in PD patients is not primarily a dopaminergic one and supports a potential “overdosing” of intact manipulation mechanisms in healthy older adults by levodopa

Geographical and seasonal variation in Iodine content of cow’s milk in the UK and consequences for the consumer´s supply

Background. Dairy products provide a crucial source of dietary iodine for the majority of the UK population, contributing approximately 30-40 % of daily intake. Fluctuations in the iodine content of purchased milk both seasonally and annually implies potential fragility of iodine supply likely through fluctuating supplementation practices in cow herds. We set out to establish the level of national variation in herds and identify factors which might impact milk iodine content. Methods. Milk samples were obtained from 98 herds across the UK via the National Milk Laboratories in August and December 2016. Iodine concentration of samples was measured using ICP-MS. Milk samples and feed intake data were additionally taken from 22 cows from the University of Nottingham (UON) dairy herd. Results. There was considerable variation in milk iodine content from < 0.012 (Limit of Detection) to 1558 µg L-1, with a summer median of 197 µg L-1 and winter median 297 µg L-1. Overall, winter values were higher than summer counterparts (

Pharmacogenetic allele nomenclature: International workgroup recommendations for test result reporting

This manuscript provides nomenclature recommendations developed by an international workgroup to increase transparency and standardization of pharmacogenetic (PGx) result reporting. Presently, sequence variants identified by PGx tests are described using different nomenclature systems. In addition, PGx analysis may detect different sets of variants for each gene, which can affect interpretation of results. This practice has caused confusion and may thereby impede the adoption of clinical PGx testing. Standardization is critical to move PGx forward

Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation