The use of videofluoroscopy (VFS) and fibreoptic endoscopic evaluation of swallowing (FEES) in the investigation of oropharyngeal dysphagia in stroke patients: A narrative review.

ObjectivesPatients with suspected acute stroke require rapid assessment of swallowing on admission. If aspiration is suspected, this takes the form of specialist assessment, using either videofluoroscopy (VFS) or fibreoptic endoscopic evaluation of swallowing (FEES). The review aim was to evaluate and compare the effectiveness of each method in stroke patients. Literature was collected from the databases Scopus, Web of Science and Medline, and articles included in the review were published within the last 10 years, in the English language.Key findingsSensitivity and specificity ranged from 0.29-0.33 and 0.96-1.0 for VFS, respectively, and 0.37-1.0 and 0.65-0.87 for FEES, respectively, depending on the type of bolus utilised. VFS is the current gold-standard for the investigation of oropharyngeal dysphagia (OD), however, radiation dose and patient transport implications mean FEES may be preferred. FEES has limitations including 'whiteout' and the invasive nature of the endoscope. The NICE guidelines do not recommend a definitive protocol specifically in stroke patients. This suggests further research may be required to determine the most effective method.ConclusionFEES is a beneficial first line examination, providing limited invasiveness, and administering a high level of patient suitability, without using ionising radiation. VFS could potentially be useful following FEES to secure full visualisation, ensuring an aspiration event is not missed during FEES.Implications for practiceUse of FEES as the first line test rather than VFS, ensures radiation dose is as low as reasonably practicable (ALARP). Ongoing research to ensure protocols follow current best practice can help ensure accurate management of oropharyngeal dysphagia in stroke patients

Greenhouse gas measurements from a UK network of tall towers: technical description and first results

A network of three tall tower measurement stations was set up in 2012 across the United Kingdom to expand measurements made at the long-term background northern hemispheric site, Mace Head, Ireland. Reliable and precise in situ greenhouse gas (GHG) analysis systems were developed and deployed at three sites in the UK with automated instrumentation measuring a suite of GHGs. The UK Deriving Emissions linked to Climate Change (UK DECC) network uses tall (165–230 m) open-lattice telecommunications towers, which provide a convenient platform for boundary layer trace gas sampling. In this paper we describe the automated measurement system and first results from the UK DECC network for CO2, CH4, N2O, SF6, CO and H2. CO2 and CH4 are measured at all of the UK DECC sites by cavity ring-down spectroscopy (CRDS) with multiple inlet heights at two of the three tall tower sites to assess for boundary layer stratification. The short-term precisions (1σ on 1 min means) of CRDS measurements at background mole fractions for January 2012 to September 2015 is < 0.05 µmol mol−1 for CO2 and < 0.3 nmol mol−1 for CH4. Repeatability of standard injections (1σ) is < 0.03 µmol mol−1 for CO2 and < 0.3 nmol mol−1 for CH4 for the same time period. N2O and SF6 are measured at three of the sites, and CO and H2 measurements are made at two of the sites, from a single inlet height using gas chromatography (GC) with an electron capture detector (ECD), flame ionisation detector (FID) or reduction gas analyser (RGA). Repeatability of individual injections (1σ) on GC and RGA instruments between January 2012 and September 2015 for CH4, N2O, SF6, CO and H2 measurements were < 2.8 nmol mol−1, < 0.4 nmol mol−1, < 0.07 pmol mol−1, < 2 nmol mol−1 and < 3 nmol mol−1, respectively. Instrumentation in the network is fully automated and includes sensors for measuring a variety of instrumental parameters such as flow, pressures, and sampling temperatures. Automated alerts are generated and emailed to site operators when instrumental parameters are not within defined set ranges. Automated instrument shutdowns occur for critical errors such as carrier gas flow rate deviations. Results from the network give good spatial and temporal coverage of atmospheric mixing ratios within the UK since early 2012. Results also show that all measured GHGs are increasing in mole fraction over the selected reporting period and, except for SF6, exhibit a seasonal trend. CO2 and CH4 also show strong diurnal cycles, with night-time maxima and daytime minima in mole fractions

A novel retinoblastoma therapy from genomic and epigenetic analyses.

Retinoblastoma is an aggressive childhood cancer of the developing retina that is initiated by the biallelic loss of RB1. Tumours progress very quickly following RB1 inactivation but the underlying mechanism is not known. Here we show that the retinoblastoma genome is stable, but that multiple cancer pathways can be epigenetically deregulated. To identify the mutations that cooperate with RB1 loss, we performed whole-genome sequencing of retinoblastomas. The overall mutational rate was very low; RB1 was the only known cancer gene mutated. We then evaluated the role of RB1 in genome stability and considered non-genetic mechanisms of cancer pathway deregulation. For example, the proto-oncogene SYK is upregulated in retinoblastoma and is required for tumour cell survival. Targeting SYK with a small-molecule inhibitor induced retinoblastoma tumour cell death in vitro and in vivo. Thus, retinoblastomas may develop quickly as a result of the epigenetic deregulation of key cancer pathways as a direct or indirect result of RB1 loss

Atmospheric observations consistent with reported decline in the UK’s methane emissions, 2013 – 2020

Atmospheric measurements can be used as a tool to evaluate national greenhouse gas inventories through inverse modelling. Using 8 years of continuous methane (CH4) concentration data, this work assesses the United Kingdom's (UK) CH4 emissions over the period 2013–2020. Using two different inversion methods, we find mean emissions of 2.10 ± 0.09 and 2.12 ± 0.26 Tg yr−1 between 2013 and 2020, an overall trend of −0.05 ± 0.01 and −0.06 ± 0.04 Tg yr−2 and a 2 %–3 % decrease each year. This compares with the mean emissions of 2.23 Tg yr−1 and the trend of −0.03 Tg yr−2 (1 % annual decrease) reported in the UK's 2021 inventory between 2013 and 2019. We examine how sensitive these estimates are to various components of the inversion set-up, such as the measurement network configuration, the prior emissions estimate, the inversion method and the atmospheric transport model used. We find the decreasing trend to be due, primarily, to a reduction in emissions from England, which accounts for 70 % of the UK CH4 emissions. Comparisons during 2015 demonstrate consistency when different atmospheric transport models are used to map the relationship between sources and atmospheric observations at the aggregation level of the UK. The posterior annual national means and negative trend are found to be consistent across changes in network configuration. We show, using only two monitoring sites, that the same conclusions on mean UK emissions and negative trend would be reached as using the full six-site network, albeit with larger posterior uncertainties. However, emissions estimates from Scotland fail to converge on the same posterior under different inversion set-ups, highlighting a shortcoming of the current observation network in monitoring all of the UK. Although CH4 emissions in 2020 are estimated to have declined relative to previous years, this decrease is in line with the longer-term emissions trend and is not necessarily a response to national lockdowns

First validation of high-resolution satellite-derived methane emissions from an active gas leak in the UK

Atmospheric methane (CH4) is the second-most-important anthropogenic greenhouse gas and has a 20-year global warming potential 82 times greater than carbon dioxide (CO2). Anthropogenic sources account for g1/4g% of global CH4 emissions, of which 20g% come from oil and gas exploration, production and distribution. High-resolution satellite-based imaging spectrometers are becoming important tools for detecting and monitoring CH4 point source emissions, aiding mitigation. However, validation of these satellite measurements, such as those from the commercial GHGSat satellite constellation, has so far not been documented for active leaks. Here we present the monitoring and quantification, by GHGSat's satellites, of the CH4 emissions from an active gas leak from a downstream natural gas distribution pipeline near Cheltenham, UK, in the spring and summer of 2023 and provide the first validation of the satellite-derived emission estimates using surface-based mobile greenhouse gas surveys. We also use a Lagrangian transport model, the UK Met Office's Numerical Atmospheric-dispersion Modelling Environment (NAME), to estimate the flux from both satellite-and ground-based observation methods and assess the leak's contribution to observed concentrations at a local tall tower site (30gkm away). We find GHGSat's emission estimates to be in broad agreement with those made from the in situ measurements. During the study period (March-June 2023) GHGSat's emission estimates are 236-1357gkggCH4gh-1, whereas the mobile surface measurements are 634-846gkggCH4gh-1. The large variability is likely down to variations in flow through the pipe and engineering works across the 11-week period. Modelled flux estimates in NAME are 181-1243gkggCH4gh-1, which are lower than the satellite-and mobile-survey-derived fluxes but are within the uncertainty. After detecting the leak in March 2023, the local utility company was contacted, and the leak was fixed by mid-June 2023. Our results demonstrate that GHGSat's observations can produce flux estimates that broadly agree with surface-based mobile measurements. Validating the accuracy of the information provided by targeted, high-resolution satellite monitoring shows how it can play an important role in identifying emission sources, including unplanned fugitive releases that are inherently challenging to identify, track, and estimate their impact and duration. Rapid, widespread access to such data to inform local action to address fugitive emission sources across the oil and gas supply chain could play a significant role in reducing anthropogenic contributions to climate change.</p

Evidence of a recent decline in UK emissions of hydrofluorocarbons determined by the InTEM inverse model and atmospheric measurements

National greenhouse gas inventories (GHGIs) are submitted annually to the United Nations Framework Convention on Climate Change (UNFCCC). They are estimated in compliance with Intergovernmental Panel on Climate Change (IPCC) methodological guidance using activity data, emission factors and facility-level measurements. For some sources, the outputs from these calculations are very uncertain. Inverse modelling techniques that use high-quality, long-term measurements of atmospheric gases have been developed to provide independent verification of national GHGIs. This is considered good practice by the IPCC as it helps national inventory compilers to verify reported emissions and to reduce emission uncertainty. Emission estimates from the InTEM (Inversion Technique for Emission Modelling) model are presented for the UK for the hydrofluorocarbons (HFCs) reported to the UNFCCC (HFC-125, HFC-134a, HFC-143a, HFC-152a, HFC-23, HFC-32, HFC-227ea, HFC-245fa, HFC-43-10mee and HFC-365mfc). These HFCs have high global warming potentials (GWPs), and the global background mole fractions of all but two are increasing, thus highlighting their relevance to the climate and a need for increasing the accuracy of emission estimation for regulatory purposes. This study presents evidence that the long-term annual increase in growth of HFC-134a has stopped and is now decreasing. For HFC-32 there is an early indication, its rapid global growth period has ended, and there is evidence that the annual increase in global growth for HFC-125 has slowed from 2018. The inverse modelling results indicate that the UK implementation of European Union regulation of HFC emissions has been successful in initiating a decline in UK emissions from 2018. Comparison of the total InTEM UK HFC emissions in 2020 with the average from 2009–2012 shows a drop of 35 %, indicating progress toward the target of a 79 % decrease in sales by 2030. The total InTEM HFC emission estimates (2008–2018) are on average 73 (62–83) % of, or 4.3 (2.7–5.9) Tg CO2-eq yr−1 lower than, the total HFC emission estimates from the UK GHGI. There are also significant discrepancies between the two estimates for the individual HFCs.</p

Hear my screams: An auto-ethnographic account of the police

Other writers, notably police researchers, infrequently discuss the problems and difficulties that they encounter in and outside of fieldwork when doing research on the police. In this article, I piece together some critical and personal reflections of researching the police to provide nuanced information that can help other writers to learn from my own experiences of researching the police and also help them to navigate their own experiences of working with the police for research purposes. These reflections of mine emanate from fieldwork notes and my research diary. I use Ahmed’s The Promise of Happiness as a lens to theorise and make sense of such experiences, understanding how my presence gets in the way of the happiness of others because of my affiliation to sexual violence work. By naming a problem, rape as a problem, I became the problem. The article outlines some of the chief ethical, personal and pragmatic issues that can surface when researching the police. For example, I frequently encountered interrogative questions whereby officers questioned my sexuality, asking ‘are you gay?’ I became a nuisance for the police, a problem by highlighting the issue of male rape as a problem given that it challenges the status quo of normative heterosexuality. I argue that, doing research on the police, which can involve sensitive and challenging work that affects one emotionally, socially and physically, impacts not only the officers being interviewed, but also the researchers themselves. The latter group should be identified much more readily than seems to be the case in the social sciences

Combining Top‐Down and Bottom‐Up Approaches to Evaluate Recent Trends and Seasonal Patterns in UK N2O Emissions

Atmospheric trace gas measurements can be used to independently assess national greenhouse gas inventories through inverse modeling. Atmospheric nitrous oxide (N2O) measurements made in the United Kingdom (UK) and Republic of Ireland are used to derive monthly N2O emissions for 2013–2022 using two different inverse methods. We find mean UK emissions of 90.5 ± 23.0 (1σ) and 111.7 ± 32.1 (1σ) Gg N2O yr− 1 for 2013–2022, and corresponding trends of − 0.68 ± 0.48 (1σ) Gg N2O yr− 2 and − 2.10 ± 0.72 (1σ) Gg N2O yr− 2 , respectively, for the two inverse methods. The UK National Atmospheric Emissions Inventory (NAEI) reported mean N2O emissions of 73.9 ± 1.7 (1σ) Gg N2O yr− 1 across this period, which is 22%–51% smaller than the emissions derived from atmospheric data. We infer a pronounced seasonal cycle in N2O emissions, with a peak occurring in the spring and a second smaller peak in the late summer for certain years. The springtime peak has a long seasonal decline that contrasts with the sharp rise and fall of N2O emissions estimated from the bottom‐up UK Emissions Model (UKEM). Bayesian inference is used to minimize the seasonal cycle mismatch between the average top‐down (atmospheric data‐based) and bottom‐up (process model and inventory‐based) seasonal emissions at a sub‐sector level. Increasing agricultural manure management and decreasing synthetic fertilizer N2O emissions reduces some of the discrepancy between the average top‐down and bottom‐up seasonal cycles. Other possibilities could also explain these discrepancies, such as missing emissions from NH3 deposition, but these require further investigation

A renewed rise in global HCFC-141b emissions between 2017???2021

Global emissions of the ozone-depleting gas HCFC-141b (1,1-dichloro-1-fluoroethane, CH3CCl2F) derived from measurements of atmospheric mole fractions increased between 2017 and 2021 despite a fall in reported production and consumption of HCFC-141b for dispersive uses. HCFC-141b is a controlled substance under the Montreal Protocol, and its phase-out is currently underway, after a peak in reported consumption and production in developing (Article 5) countries in 2013. If reported production and consumption are correct, our study suggests that the 2017–2021 rise is due to an increase in emissions from the bank when appliances containing HCFC-141b reach the end of their life, or from production of HCFC-141b not reported for dispersive uses. Regional emissions have been estimated between 2017–2020 for all regions where measurements have sufficient sensitivity to emissions. This includes the regions of northwestern Europe, east Asia, the United States and Australia, where emissions decreased by a total of 2.3 ± 4.6 Gg yr−1, compared to a mean global increase of 3.0 ± 1.2 Gg yr−1 over the same period. Collectively these regions only account for around 30 % of global emissions in 2020. We are not able to pinpoint the source regions or specific activities responsible for the recent global emission rise