Definition of an indicator assessing the impact of a dam on the downstream river landscape

The increasing number of water withdrawals in Alpine regions represents a significant threat to aquatic ecosystems and river landscape (riverscape). To assess their sustainability, the impacts on river ecological status and landscape features need to be quantified with appropriate indicators. However, assessment of landscape attributes is a complex challenge, due to the lack of standardized methods. Moreover, few metrics quantifying the impacts of water withdrawal on downstream riverscape perception are available in the scientific literature. In this paper, a new indicator, named Landscape Protection Level (LPL), aimed at assessing the effects of water withdrawals on the river landscape, is presented. The indicator has been developed in Aosta Valley (NW Italian Alps), where the river network is heavily exploited by hundreds of withdrawals for hydropower production and irrigation, and it has been included in a multi-criteria analysis (MCA) procedure to assess the sustainability of water withdrawal licenses in relation to different flow release scenarios. The LPL indicator is based on three parameters, Constraint Factor, Release Factor, and Visual Elements Factor, quantifying the presence of landscape protection constraints, the ratio of flow released downstream of the dam to the available river discharge, and the impact on the visual perception of the bypassed stretch, respectively. Its application in four real case studies of existing hydropower plants is presented and discussed in the paper, demonstrating the indicator applicability to assess both specific release values and flow release scenarios varying over the year. Results are analyzed by highlighting the main strengths and weaknesses of the indicator and proposing some suggestions for future improvements. In particular, the reactiveness of the indicator, the representativeness of the stakeholders’ interests, the transparency of the indicator calculation procedure, and the time required for data collection and processing are discussed. Finally, future activities aimed at further improving the indicator applicability and transferability to different river contexts are proposed

The TANDEM trial: protocol for the process evaluation of a randomised trial of a complex intervention for anxiety and/or depression in people living with chronic obstructive pulmonary disease (COPD)

Background: TANDEM is a randomised controlled trial of a complex healthcare intervention to improve the psychological and physical health of people living with chronic obstructive pulmonary disease (COPD) and anxiety and/or depression. Based on health psychology theory set out in a logic model, respiratory health professionals were recruited and trained to deliver a cognitive behavioural approach intervention (The TANDEM intervention) under the supervision of senior cognitive behavioural practitioners. Here, we describe the protocol for the process evaluation commissioned alongside the trial. A realist approach that includes attention to describing contexts and mechanisms has been adopted. Methods: We set up a multi-disciplinary team to develop and deliver the process evaluation. The mixed-methods design incorporates quantitative process data; monitoring of intervention fidelity; qualitative interviews with patients, carers, health professionals (facilitators) and clinical supervisors about their perspectives on acceptability of the intervention; and exploration with all stakeholders (including management/policy-makers) on future implementation. Normalisation process theory (NPT) will inform data collection and interpretation with a focus on implementation. Quantitative process data will be analysed descriptively. Qualitative interview data will be analysed before the trial outcomes are known using analytic induction and constant comparison to develop themes. Findings from the different elements will be reported separately and then integrated. Conclusion: Detailed description and analysis of study processes in a research trial such as TANDEM enables research teams to describe study contexts and mechanisms and to examine the relationship with outcomes. In this way, learning from the trial goes beyond the randomised control trial (RCT) model where effectiveness is prioritised and makes it possible to explore issues arising for post-trial study implementation. Trial registration: ISRCTN ISRCTN59537391. Registered on 20 March 2017. Trial protocol version 6.0, 22 April 2018. Process evaluation protocol version 4.0, 1 November 2020

Limits on light-speed anisotropies from Compton scattering of high-energy electrons

The possibility of anisotropies in the speed of light relative to the limiting speed of electrons is considered. The absence of sidereal variations in the energy of Compton-edge photons at the ESRF's GRAAL facility constrains such anisotropies representing the first non-threshold collision-kinematics study of Lorentz violation. When interpreted within the minimal Standard-Model Extension, this result yields the two-sided limit of 1.6 x 10^{-14} at 95% confidence level on a combination of the parity-violating photon and electron coefficients kappa_{o+} and c. This new constraint provides an improvement over previous bounds by one order of magnitude.Comment: 4 pages, 4 figure

A new limit on the light speed isotropy from the GRAAL experiment at the ESRF

When the electrons stored in the ring of the European Synchrotron Radiation Facility (ESRF, Grenoble) scatter on a laser beam (Compton scattering in flight) the lower energy of the scattered electron spectra, the Compton Edge (CE), is given by the two body photon-electron relativistic kinematics and depends on the velocity of light. A precision measurement of the position of this CE as a function of the daily variations of the direction of the electron beam in an absolute reference frame provides a one-way test of Relativistic Kinematics and the isotropy of the velocity of light. The results of GRAAL-ESRF measurements improve the previously existing one-way limits, thus showing the efficiency of this method and the interest of further studies in this direction.Comment: Proceed. MG12 meeting, Paris, July, 200

Donor Lymphocyte Infusions After Allogeneic Stem Cell Transplantation in Acute Leukemia: A Survey From the Gruppo Italiano Trapianto Midollo Osseo (GITMO)

We conducted a retrospective multicenter study including pediatric and adult patients with acute leukemia (AL) who received donor lymphocyte infusions (DLIs) after allogeneic hematopoietic stem cell transplantation (HCT) between January 1, 2010 and December 31, 2015, in order to determine the efficacy and toxicity of the immune treatment. Two hundred fifty-two patients, median age 45.1 years (1.6\u201373.4), were enrolled from 34 Italian transplant centers. The underlying disease was acute myeloid leukemia in 180 cases (71%). Donors were HLA identical or 1 locus mismatched sibling (40%), unrelated (40%), or haploidentical (20%). The first DLI was administered at a median time of 258 days (55\u20133,784) after HCT. The main indication for DLI was leukemia relapse (73%), followed by mixed chimerism (17%), and pre-emptive/prophylactic use (10%). Ninety-six patients (38%) received one single infusion, whereas 65 (26%), 42 (17%), and 49 patients (19%) received 2, 3, or 654 infusions, respectively, with a median of 31 days between two subsequent DLIs. Forty percent of evaluable patients received no treatment before the first DLI, whereas radiotherapy, conventional chemotherapy or targeted treatments were administered in 3, 39, and 18%, respectively. In informative patients, a few severe adverse events were reported: grade III\u2013IV graft versus host disease (GVHD) (3%), grade III\u2013IV hematological toxicity (11%), and DLI-related mortality (9%). Forty-six patients (18%) received a second HCT after a median of 232 days (32\u20131,390) from the first DLI. With a median follow-up of 461 days (2\u20133,255) after the first DLI, 1-, 3-, and 5- year overall survival (OS) of the whole group from start of DLI treatment was 55, 39, and 33%, respectively. In multivariate analysis, older recipient age, and transplants from haploidentical donors significantly reduced OS, whereas DLI for mixed chimerism or as pre-emptive/prophylactic treatment compared to DLI for AL relapse and a schedule including more than one DLI significantly prolonged OS. This GITMO survey confirms that DLI administration in absence of overt hematological relapse and multiple infusions are associated with a favorable outcome in AL patients. DLI from haploidentical donors had a poor outcome and may represent an area of further investigation

Measurement of eta photoproduction on the proton from threshold to 1500 MeV

Beam asymmetry and differential cross section for the reaction gamma+p->eta+p were measured from production threshold to 1500 MeV photon laboratory energy. The two dominant neutral decay modes of the eta meson, eta->2g and eta->3pi0, were analyzed. The full set of measurements is in good agreement with previously published results. Our data were compared with three models. They all fit satisfactorily the results but their respective resonance contributions are quite different. The possible photoexcitation of a narrow state N(1670) was investigated and no evidence was found.Comment: 18 pages, 14 figures, 4 tables Submitted to EPJ

Measurement of the Neutron Radius of 208Pb Through Parity-Violation in Electron Scattering

We report the first measurement of the parity-violating asymmetry A_PV in the elastic scattering of polarized electrons from 208Pb. A_PV is sensitive to the radius of the neutron distribution (Rn). The result A_PV = 0.656 \pm 0.060 (stat) \pm 0.014 (syst) ppm corresponds to a difference between the radii of the neutron and proton distributions Rn - Rp = 0.33 +0.16 -0.18 fm and provides the first electroweak observation of the neutron skin which is expected in a heavy, neutron-rich nucleus.Comment: 6 pages, 1 figur

A tailored psychological intervention for anxiety and depression management in people with chronic obstructive pulmonary disease: TANDEM RCT and process evaluation

Background: People with chronic obstructive pulmonary disease have high levels of anxiety and depression, which is associated with increased morbidity and poor uptake of effective treatments, such as pulmonary rehabilitation. Cognitive-behavioural therapy improves mental health of people with long-term conditions and could potentially increase uptake of pulmonary rehabilitation, enabling synergies that could enhance the mental health of people with chronic obstructive pulmonary disease. Aim: Our aim was to develop and evaluate the clinical effectiveness and cost effectiveness of a tailored cognitive-behavioural approach intervention, which links into, and optimises the benefits of, routine pulmonary rehabilitation. Design: We carried out a pragmatic multicentre randomised controlled trial using a 1.25 : 1 ratio (intervention : control) with a parallel process evaluation, including assessment of fidelity. Setting: Twelve NHS trusts and five Clinical Commissioning Groups in England were recruited into the study. The intervention was delivered in participant\u27s own home or at a local NHS facility, and by telephone. Participants: Between July 2017 and March 2020 we recruited adults with moderate/very severe chronic obstructive pulmonary disease and mild/moderate anxiety and/or depression, meeting eligibility criteria for assessment for pulmonary rehabilitation. Carers of participants were invited to participate. Intervention: The cognitive-behavioural approach intervention (i.e. six to eight 40- to 60-minute sessions plus telephone support throughout pulmonary rehabilitation) was delivered by 31 trained respiratory healthcare professionals to participants prior to commencing pulmonary rehabilitation. Usual care included routine pulmonary rehabilitation referral. Main outcome measures: Co-primary outcomes were Hospital Anxiety and Depression Scale - anxiety and Hospital Anxiety and Depression Scale - depression at 6 months post randomisation. Secondary outcomes at 6 and 12 months included health-related quality of life, smoking status, uptake of pulmonary rehabilitation and healthcare use. Results: We analysed results from 423 randomised participants (intervention, n = 242; control, n = 181). Forty-three carers participated. Follow-up at 6 and 12 months was 93% and 82%, respectively. Despite good fidelity for intervention delivery, mean between-group differences in Hospital Anxiety and Depression Scale at 6 months ruled out clinically important effects (Hospital Anxiety and Depression Scale - anxiety mean difference -0.60, 95% confidence interval -1.40 to 0.21; Hospital Anxiety and Depression Scale - depression mean difference -0.66, 95% confidence interval -1.39 to 0.07), with similar results at 12 months. There were no between-group differences in any of the secondary outcomes. Sensitivity analyses did not alter these conclusions. More adverse events were reported for intervention participants than for control participants, but none related to the trial. The intervention did not generate quality-of-life improvements to justify the additional cost (adjusted mean difference \ua3770.24, 95% confidence interval -\ua327.91 to \ua31568.39) to the NHS. The intervention was well received and many participants described positive affects on their quality of life. Facilitators highlighted the complexity of participants\u27 lives and considered the intervention to be of potential valuable; however, the intervention would be difficult to integrate within routine clinical services. Our well-powered trial delivered a theoretically designed intervention with good fidelity. The respiratory-experienced facilitators were trained to deliver a low-intensity cognitive-behavioural approach intervention, but high-intensity cognitive-behavioural therapy might have been more effective. Our broad inclusion criteria specified objectively assessed anxiety and/or depression, but participants were likely to favour talking therapies. Randomisation was concealed and blinding of outcome assessment was breached in only 15 participants. Conclusions: The tailored cognitive-behavioural approach intervention delivered with fidelity by trained respiratory healthcare professionals to people with chronic obstructive pulmonary disease was neither clinically effective nor cost-effective. Alternative approaches that are integrated with routine long-term condition care are needed to address the unmet, complex clinical and psychosocial needs of this group of patients. Trial registration: This trial is registered as ISRCTN59537391. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 13/146/02) and is published in full in Health Technology Assessment; Vol. 28, No. 1. See the NIHR Funding and Awards website for further award information.People with long-standing lung problems, such as chronic obstructive pulmonary disease, often also have anxiety and depression, which further reduces their quality of life. Two existing treatments could help. Pulmonary rehabilitation (a programme of exercise and education) improves both the physical and mental health of people with chronic obstructive pulmonary disease. Cognitive–behavioural therapy (a talking therapy) may reduce anxiety and depression. The TANDEM [Tailored intervention for Anxiety and Depression Management in chronic obstructive pulmonary disease (COPD)] intervention linked these two treatments by providing talking therapy based on cognitive–behavioural therapy during the waiting time following referral for pulmonary rehabilitation. The TANDEM treatment was delivered by respiratory healthcare professionals (e.g. nurses or physiotherapists) trained to deliver the talking therapy in six to eight weekly sessions. The sessions were conducted in the participant’s home (or another convenient location), with brief telephone support during the pulmonary rehabilitation. Of 423 participants recruited to the study, 242 participants received TANDEM talking therapy and 181 participants received usual care (including a referral to pulmonary rehabilitation). We measured mental health, quality of life, social life, attendance at pulmonary rehabilitation and healthcare use in both groups at 6 and 12 months. Forty-three carers joined the study and we assessed their mental well-being. We interviewed patients, carers and health professionals to find out their views and experience of the TANDEM treatment. We also examined whether or not the TANDEM treatment was good value for money. The TANDEM treatment did not improve the mental or the physical health of people with chronic obstructive pulmonary disease. In addition, the TANDEM treatment cost the NHS an extra \ua3770 per patient, which was not good value for money. The TANDEM treatment was well received, and many participants told us how it had helped them. Heath-care professionals noted how participants did not just have chronic obstructive pulmonary disease, but were coping with many physical, mental and social problems. The TANDEM intervention was not effective and, therefore, other strategies will be needed to help people with chronic obstructive pulmonary disease and mental health problems live with their condition

Dark matter search in a Beam-Dump eXperiment (BDX) at Jefferson Lab

MeV-GeV dark matter (DM) is theoretically well motivated but remarkably unexplored. This Letter of Intent presents the MeV-GeV DM discovery potential for a 1 m$^3$ segmented plastic scintillator detector placed downstream of the beam-dump at one of the high intensity JLab experimental Halls, receiving up to 10$^{22}$ electrons-on-target (EOT) in a one-year period. This experiment (Beam-Dump eXperiment or BDX) is sensitive to DM-nucleon elastic scattering at the level of a thousand counts per year, with very low threshold recoil energies ($\sim$1 MeV), and limited only by reducible cosmogenic backgrounds. Sensitivity to DM-electron elastic scattering and/or inelastic DM would be below 10 counts per year after requiring all electromagnetic showers in the detector to exceed a few-hundred MeV, which dramatically reduces or altogether eliminates all backgrounds. Detailed Monte Carlo simulations are in progress to finalize the detector design and experimental set up. An existing 0.036 m$^3$ prototype based on the same technology will be used to validate simulations with background rate estimates, driving the necessary R$\&$D towards an optimized detector. The final detector design and experimental set up will be presented in a full proposal to be submitted to the next JLab PAC. A fully realized experiment would be sensitive to large regions of DM parameter space, exceeding the discovery potential of existing and planned experiments by two orders of magnitude in the MeV-GeV DM mass range.Comment: 28 pages, 17 figures, submitted to JLab PAC 4