Controls on the spatial distribution of natural pipe outlets in heavily degraded blanket peat

Natural soil pipes are recognised as a common geomorphological feature in many peatlands, and they can discharge large quantities of water and sediment. However, little is known about their morphological characteristics in heavily degraded peat systems. This paper presents a survey of pipe outlets in which the frequency and extent of natural soil pipes are measured across a heavily gullied blanket peat catchment in the Peak District of northern England. Over a stream length of 7.71 km we determined the occurrence and size of 346 pipe outlets, and found a mean frequency of 22.8 km−1 gully bank. Topographic position was an important control on the size and depth of pipe outlets. Aspect had a large influence on pipe outlet frequency, with southwest and west- facing gully banks hosting more than 43% of identified pipe outlets. Pipe outlets on streambanks with signs of headward retreat were significantly larger and closer to the peat surface compared to pipe outlets that issued onto uniform streambank edges. We suggest that larger pipe frequencies are observed on gully banks that are more susceptible to desiccation cracking, and propose that future peatland restoration works could prioritise mitigating against pipe formation by revegetating and reprofiling south and west facing gully banks

Soil macroaggregation drives sequestration of organic carbon and nitrogen with three-year grass-clover leys in arable rotations

Conventional arable cropping with annual crops established by ploughing and harrowing degrades larger soil aggregates that contribute to storing soil organic carbon (SOC). The urgent need to increase SOC content of arable soils to improve their functioning and sequester atmospheric CO2 has motivated studies into the effects of reintroducing leys into long-term conventional arable fields. However, effects of short-term leys on total SOC accumulation have been equivocal. As soil aggregation may be important for carbon storage, we investigated the effects of arable-to-ley conversion on cambisol soil after three years of ley, on concentrations and stocks of SOC, nitrogen and their distributions in different sized water-stable aggregates. These values were benchmarked against soil from beneath hedgerow margins. SOC stocks (0–7 cm depth) rose from 20.3 to 22.6 Mg ha−1 in the arable-to-ley conversion, compared to 30 Mg ha−1 in hedgerows, but this 2.3 Mg ha−1 difference (or 0.77 Mg C ha−1 yr−1) was not significant). However, the proportion of large macroaggregates (> 2000 μm) increased 5.4-fold in the arable-to-ley conversion, recovering to similar abundance as hedgerow soils, driving near parallel increases in SOC and nitrogen within large macroaggregates (5.1 and 5.7-fold respectively). The total SOC (0–7 cm depth) stored in large macroaggregates increased from 2.0 to 9.6 Mg ha−1 in the arable-to-ley conversion, which no longer differed significantly from the 12.1 Mg ha−1 under hedgerows. The carbon therefore accumulated three times faster, at 2.53 Mg C ha−1 yr−1, in the large macroaggregates compared to the bulk soil. These findings highlight the value of monitoring large macroaggregate-bound SOC as a key early indicator of shifts in soil quality in response to change in field management, and the benefits of leys in soil aggregation, carbon accumulation, and soil functioning, providing justification for fiscal incentives that encourage wider use of leys in arable rotations

Fluoroquinolones and isoniazid-resistant tuberculosis: implications for the 2018 WHO guidance.

INTRODUCTION: 2018 World Health Organization (WHO) guidelines for the treatment of isoniazid (H)-resistant (Hr) tuberculosis recommend a four-drug regimen: rifampicin (R), ethambutol (E), pyrazinamide (Z) and levofloxacin (Lfx), with or without H ([H]RZE-Lfx). This is used once Hr is known, such that patients complete 6 months of Lfx (≥6[H]RZE-6Lfx). This cohort study assessed the impact of fluoroquinolones (Fq) on treatment effectiveness, accounting for Hr mutations and degree of phenotypic resistance. METHODS: This was a retrospective cohort study of 626 Hr tuberculosis patients notified in London, 2009-2013. Regimens were described and logistic regression undertaken of the association between regimen and negative regimen-specific outcomes (broadly, death due to tuberculosis, treatment failure or disease recurrence). RESULTS: Of 594 individuals with regimen information, 330 (55.6%) were treated with (H)RfZE (Rf=rifamycins) and 211 (35.5%) with (H)RfZE-Fq. The median overall treatment period was 11.9 months and median Z duration 2.1 months. In a univariable logistic regression model comparing (H)RfZE with and without Fqs, there was no difference in the odds of a negative regimen-specific outcome (baseline (H)RfZE, cluster-specific odds ratio 1.05 (95% CI 0.60-1.82), p=0.87; cluster NHS trust). Results varied minimally in a multivariable model. This odds ratio dropped (0.57, 95% CI 0.14-2.28) when Hr genotype was included, but this analysis lacked power (p=0.42). CONCLUSIONS: In a high-income setting, we found a 12-month (H)RfZE regimen with a short Z duration to be similarly effective for Hr tuberculosis with or without a Fq. This regimen may result in fewer adverse events than the WHO recommendations

Pattern of reading eye movements during monovision contact lens wear in presbyopes

Monovision can be used as a method to correct presbyopia with contact lenses (CL) but its effect on reading behavior is still poorly understood. In this study eye movements (EM) were recorded in fifteen presbyopic participants, naïve to monovision, whilst they read arrays of words, non-words, and text passages to assess whether monovision affected their reading. Three conditions were compared, using daily disposable CLs: baseline (near correction in both eyes), conventional monovision (distance correction in the dominant eye, near correction in the non-dominant eye), and crossed monovision (the reversal of conventional monovision). Behavioral measures (reading speed and accuracy) and EM parameters (single fixation duration, number of fixations, dwell time per item, percentage of regressions, and percentage of skipped items) were analyzed. When reading passages, no differences in behavioral and EM measures were seen in any comparison of the three conditions. The number of fixations and dwell time significantly increased for both monovision and crossed monovision with respect to baseline only with word and non-word arrays. It appears that monovision did not appreciably alter visual processing when reading meaningful texts but some limited stress of the EM pattern was observed only with arrays of unrelated or meaningless items under monovision, which require the reader to have more in-depth controlled visual processing

Prospective validation of the 4C prognostic models for adults hospitalised with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol

Purpose: To prospectively validate two risk scores to predict mortality (4C Mortality) and in-hospital deterioration (4C Deterioration) among adults hospitalised with COVID-19. // Methods: Prospective observational cohort study of adults (age ≥18 years) with confirmed or highly suspected COVID-19 recruited into the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) WHO Clinical Characterisation Protocol UK (CCP-UK) study in 306 hospitals across England, Scotland and Wales. Patients were recruited between 27 August 2020 and 17 February 2021, with at least 4 weeks follow-up before final data extraction. The main outcome measures were discrimination and calibration of models for in-hospital deterioration (defined as any requirement of ventilatory support or critical care, or death) and mortality, incorporating predefined subgroups. // Results: 76 588 participants were included, of whom 27 352 (37.4%) deteriorated and 12 581 (17.4%) died. Both the 4C Mortality (0.78 (0.77 to 0.78)) and 4C Deterioration scores (pooled C-statistic 0.76 (95% CI 0.75 to 0.77)) demonstrated consistent discrimination across all nine National Health Service regions, with similar performance metrics to the original validation cohorts. Calibration remained stable (4C Mortality: pooled slope 1.09, pooled calibration-in-the-large 0.12; 4C Deterioration: 1.00, –0.04), with no need for temporal recalibration during the second UK pandemic wave of hospital admissions. // Conclusion: Both 4C risk stratification models demonstrate consistent performance to predict clinical deterioration and mortality in a large prospective second wave validation cohort of UK patients. Despite recent advances in the treatment and management of adults hospitalised with COVID-19, both scores can continue to inform clinical decision making

Development and validation of the ISARIC 4C Deterioration model for adults hospitalised with COVID-19: a prospective cohort study

BACKGROUND: Prognostic models to predict the risk of clinical deterioration in acute COVID-19 cases are urgently required to inform clinical management decisions. METHODS: We developed and validated a multivariable logistic regression model for in-hospital clinical deterioration (defined as any requirement of ventilatory support or critical care, or death) among consecutively hospitalised adults with highly suspected or confirmed COVID-19 who were prospectively recruited to the International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) study across 260 hospitals in England, Scotland, and Wales. Candidate predictors that were specified a priori were considered for inclusion in the model on the basis of previous prognostic scores and emerging literature describing routinely measured biomarkers associated with COVID-19 prognosis. We used internal-external cross-validation to evaluate discrimination, calibration, and clinical utility across eight National Health Service (NHS) regions in the development cohort. We further validated the final model in held-out data from an additional NHS region (London). FINDINGS: 74 944 participants (recruited between Feb 6 and Aug 26, 2020) were included, of whom 31 924 (43·2%) of 73 948 with available outcomes met the composite clinical deterioration outcome. In internal-external cross-validation in the development cohort of 66 705 participants, the selected model (comprising 11 predictors routinely measured at the point of hospital admission) showed consistent discrimination, calibration, and clinical utility across all eight NHS regions. In held-out data from London (n=8239), the model showed a similarly consistent performance (C-statistic 0·77 [95% CI 0·76 to 0·78]; calibration-in-the-large 0·00 [-0·05 to 0·05]); calibration slope 0·96 [0·91 to 1·01]), and greater net benefit than any other reproducible prognostic model. INTERPRETATION: The 4C Deterioration model has strong potential for clinical utility and generalisability to predict clinical deterioration and inform decision making among adults hospitalised with COVID-19. FUNDING: National Institute for Health Research (NIHR), UK Medical Research Council, Wellcome Trust, Department for International Development, Bill & Melinda Gates Foundation, EU Platform for European Preparedness Against (Re-)emerging Epidemics, NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool, NIHR HPRU in Respiratory Infections at Imperial College London

The influence of the accessory genome on bacterial pathogen evolution

Bacterial pathogens exhibit significant variation in their genomic content of virulence factors. This reflects the abundance of strategies pathogens evolved to infect host organisms by suppressing host immunity. Molecular arms-races have been a strong driving force for the evolution of pathogenicity, with pathogens often encoding overlapping or redundant functions, such as type III protein secretion effectors and hosts encoding ever more sophisticated immune systems. The pathogens’ frequent exposure to other microbes, either in their host or in the environment, provides opportunities for the acquisition or interchange of mobile genetic elements. These DNA elements accessorise the core genome and can play major roles in shaping genome structure and altering the complement of virulence factors. Here, we review the different mobile genetic elements focusing on the more recent discoveries and highlighting their role in shaping bacterial pathogen evolution

Quantitative 3D Mapping of the Human Skeletal Muscle Mitochondrial Network

Genetic and biochemical defects of mitochondrial function are a major cause of human disease, but their link to mitochondrial morphology in situ has not been defined. Here, we develop a quantitative three-dimensional approach to map mitochondrial network organization in human muscle at electron microscopy resolution. We establish morphological differences between human and mouse and among patients with mitochondrial DNA (mtDNA) diseases compared to healthy controls. We also define the ultrastructure and prevalence of mitochondrial nanotunnels, which exist as either free-ended or connecting membrane protrusions across non-adjacent mitochondria. A multivariate model integrating mitochondrial volume, morphological complexity, and branching anisotropy computed across individual mitochondria and mitochondrial populations identifies increased proportion of simple mitochondria and nanotunnels as a discriminant signature of mitochondrial stress. Overall, these data define the nature of the mitochondrial network in human muscle, quantify human-mouse differences, and suggest potential morphological markers of mitochondrial dysfunction in human tissues

Prediction of the release process of the nitrogen-extinguishant binary mixture considering surface tension

© 2020 Springer-Verlag. The final publication is available at Springer via https://doi.org/10.1007/s10973-020-10040-2.Nitrogen used for pressurization in the extinguisher can be partially dissolved in the fire extinguishing agent. Consequently, the evolution of the dissolved nitrogen has a significant effect on the release behavior of the fire extinguishing agent in a rapid process. In this article, a new model was developed to predict the critical pressure of the nitrogen evolution and the release process of the fire extinguishing agent was described in detail. According to the Peng-Robinson (PR) equation of state and van der Waals mixing rule, the effect of the dissolved nitrogen on the surface tension of the fire extinguishant was analyzed by considering surface phase and fugacity coefficient. A method to calculate the surface tension of the liquid agent dissolved with nitrogen was proposed. The results showed that the proposed model can determine the accurate critical pressure of the evolution of the dissolved nitrogen and further evaluated whether nitrogen escapes. At different initial filling pressure, in addition, the release process of the nitrogen-extinguishant such as CF3I, FC218 (C3F8), HFC125 (C2HF5), and Halon1301 (CF3Br) was well predicted by the fluid release model when taking the surface tension and adiabatic index of the mixture into account. Compared with the previously obtained experimental data, the predictions obtained indicated that the present model can adequately describe the liquid and the gas mixture release stage in the release process of the nitrogen-extinguishant.Peer reviewe

Prevalence of challenging behaviour in adults with intellectual disabilities, correlates, and association with mental health

Purpose of Review To summarise findings about the prevalence and correlates of challenging behaviour in adults with intellectual disabilities from robust research. We also describe findings on the interplay between challenging behaviour and mental health. Recent Findings Recent studies that have utilised psychometrically evaluated tools, with clear operational definitions, show similar findings on the prevalence of challenging behaviour of about 1 in every 5–6 adults known to services. We describe common correlates identified such as communication impairments, severity of intellectual disability, and living in institutional settings or congregate care. We also describe the complex and multifaceted relationship between challenging behaviour and mental health. Summary Based on recent studies, we propose a revised framework model to help understand challenging behaviour. We propose a number of areas where more research is required, particularly the development of risk tools clinicians can utilise in practice