In situ analysis of solvent/nonsolvent exchange and phase separation processes during the membrane formation of polylactides

Membrane formation of polylactides has been studied using in situ analysis techniques. An experimental method based on the use of dark ground optics and reflected light illumination is used to monitor the mass transfer and phase separation dynamics during for mation. Additionally, the phase separation and structure formation has been studied using optical microscopy. The results of the dark ground optics technique for the polymer/solvent/nonsolvent systems poly-L-lactide/chloroform/methanol and poly-DL-lactide/chloroform/methanol showed that the diffusion kinetics were similar for the semicrystalline poly-L-lactide (PLLA) and the amorphous poly-DL-lactide. The influence of the molecular weight of the polymers on the diffusion kinetics was found to be negligible. Increasing the polymer concentration of the casting solution decreased the rate of diffusion. The phase separation of poly-DL-lactide was studied with optical microscopy and found to proceed via liquid-liquid demixing. For poly-L-lactide solutions of relatively low concentration (5-6% w/w), phase separation proceeded via liquid-liquid demixing followed by crystallization. For more concentrated PLLA solutions, phase separation proceeded directly via solid-liquid demixing processes. Additionally, for 6% w/w solutions of poly-L-lactide in dioxane immersed in methanol, precipitation also occurred solely via solid-liquid demixing

How much heat can we grow in our cities? Modelling UK urban biofuel production potential

Biofuel provides a globally significant opportunity to reduce fossil fuel dependence; however its sustainability can only be meaningfully explored for individual cases. It depends on multiple considerations including: life‐cycle GHG emissions, air quality impacts, food versus fuel trade‐offs, biodiversity impacts of land use change, and socio‐economic impacts of energy transitions. One solution that may address many of these issues is local production of biofuel on non‐agricultural land. Urban areas drive global change, for example they are responsible for 70% of global energy use, but are largely ignored in their resource production potential; however under‐used urban greenspaces could be utilised for biofuel production near the point of consumption. This could avoid food versus fuel land conflicts in agricultural land and long‐distance transport costs, provide ecosystem service benefits to urban dwellers, and increase the sustainability and resilience of cities and towns. Here, we use a GIS to identify urban greenspaces suitable for biofuel production, using exclusion criteria, in ten UK cities. We then model production potential of three different biofuels: Miscanthus grass, short rotation coppice willow and short rotation coppice poplar, within the greenspaces identified and extrapolate up to a UK‐scale. We demonstrate that approximately 10% of urban greenspace (3% of built‐up land) is potentially suitable for biofuel production. We estimate the potential of this to meet energy demand through heat generation, electricity, and combined heat and power (CHP) operations. Our findings show that, if fully utilised, urban biofuel production could meet nearly a fifth of demand for biomass in CHP systems in the UK’s climate‐compatible energy scenarios by 2030, with potentially similar implications for other comparable countries and regions

Exploring the relative value of end of life QALYs: are the comparators important?

In the UK, life extending, end-of-life (EoL) treatments are an exception to standard cost-per-quality-adjusted life year (QALY) thresholds. This implies that greater value is placed on gaining these QALYs, than QALYs gained by the majority of other patient groups treated for anything else in the health system, even for other EoL contexts (such as quality of life (QoL) improvements alone). This paper reports a Person Trade-Off (PTO) study to test whether studies that find societal support for prioritising EoL life extensions can be explained by the severity, in terms of prospective QALYs loss, of the non-terminal comparator scenarios. Eight health scenarios were designed depicting i) QoL improvements for non-EoL temporary (T-QoL) and chronic (C-QoL) health problems and ii) QoL improvements and life extensions (LEs) for EoL health problems. Preferences were elicited from a quota sample of 901 Scottish respondents in 2016 using PTO techniques via Computer Assisted Personal Interview (CAPI). Our results indicate that there is little evidence to suggest that the severity of non-EoL comparator scenarios influence preferences for EoL treatments. Respondents do not appear to have a preference for EoL over non-EoL health gains; instead there is some indication that non-EoL health gains are preferred, particularly when compared to EoL-LE health gains. Comparing between QoL and life extending EoL scenarios, our results suggest QoL improvements are preferred to life extensions. Overall, results challenge current UK EoL policy which gives additional weight to EoL health gains, particularly EoL life extensions in the case of the National Institute for Health and Care Excellence (NICE)

Urban Tree Effects on Soil Organic Carbon

Urban trees sequester carbon into biomass and provide many ecosystem service benefits aboveground leading to worldwide tree planting schemes. Since soils hold ~75% of ecosystem organic carbon, understanding the effect of urban trees on soil organic carbon (SOC) and soil properties that underpin belowground ecosystem services is vital. We use an observational study to investigate effects of three important tree genera and mixed-species woodlands on soil properties (to 1 m depth) compared to adjacent urban grasslands. Aboveground biomass and belowground ecosystem service provision by urban trees are found not to be directly coupled. Indeed, SOC enhancement relative to urban grasslands is genus-specific being highest under Fraxinus excelsior and Acer spp., but similar to grasslands under Quercus robur and mixed woodland. Tree cover type does not influence soil bulk density or C:N ratio, properties which indicate the ability of soils to provide regulating ecosystem services such as nutrient cycling and flood mitigation. The trends observed in this study suggest that genus selection is important to maximise long-term SOC storage under urban trees, but emerging threats from genus-specific pathogens must also be considered

Measurement and analysis of household carbon: the case of a UK city

There is currently a lack of data recording the carbon and emissions inventory at household level. This paper presents a multi-disciplinary, bottom-up approach for estimation and analysis of the carbon emissions, and the organic carbon (OC) stored in gardens, using a sample of 575 households across a UK city. The annual emission of carbon dioxide emissions from energy used in the homes was measured, personal transport emissions were assessed through a household survey and OC stores estimated from soil sampling and vegetation surveys. The results showed that overall carbon patterns were skewed with highest emitting third of the households being responsible for more than 50% of the emissions and around 50% of garden OC storage. There was diversity in the relative contribution that gas, electricity and personal transport made to each household’s total and different patterns were observed for high, medium and low emitting households. Targeting households with high carbon emissions from one source would not reliably identify them as high emitters overall. While carbon emissions could not be offset by growing trees in gardens, there were considerable amounts of stored OC in gardens which ought to be protected. Exploratory analysis of the multiple drivers of emissions was conducted using a combination of primary and secondary data. These findings will be relevant in devising effective policy instruments for combatting city scale green-house gas emissions from domestic end-use energy demand

Association of Prognostic Understanding with Health Care Use among Older Adults with Advanced Cancer: A Secondary Analysis of a Cluster Randomized Clinical Trial

Importance: A poor prognostic understanding regarding curability is associated with lower odds of hospice use among patients with cancer. However, the association between poor prognostic understanding or prognostic discordance and health care use among older adults with advanced incurable cancers is not well characterized. Objective: To evaluate the association of poor prognostic understanding and patient-oncologist prognostic discordance with hospitalization and hospice use among older adults with advanced cancers. Design, Setting, and Participants: This was a post hoc secondary analysis of a cluster randomized clinical trial that recruited patients from October 29, 2014, to April 28, 2017. Data were collected from community oncology practices affiliated with the University of Rochester Cancer Center National Cancer Institute Community Oncology Research Program. The parent trial enrolled 541 patients who were aged 70 years or older and were receiving or considering any line of cancer treatment for incurable solid tumors or lymphomas; the patients' oncologists and caregivers (if available) were also enrolled. Patients were followed up for at least 1 year. Data were analyzed from January 3 to 16, 2021. Main Outcomes and Measures: At enrollment, patients and oncologists were asked about their beliefs regarding cancer curability (100%, >50%, 50%, 5 years; answers of >5 years reflected poor prognostic understanding). Any difference between oncologist and patient in response options was considered discordant. Outcomes were any hospitalization and hospice use at 6 months captured by the clinical research associates. Results: Among the 541 patients, the mean (SD) age was 76.6 (5.2) years, 264 of 540 (49%) were female, and 486 of 540 (90%) were White. Poor prognostic understanding regarding curability was reported for 59% (206 of 348) of patients, and poor prognostic understanding regarding life expectancy estimates was reported for 41% (205 of 496) of patients. Approximately 60% (202 of 336) of patient-oncologist dyads were discordant regarding curability, and 72% (356 of 492) of patient-oncologist dyads were discordant regarding life expectancy estimates. Poor prognostic understanding regarding life expectancy estimates was associated with lower odds of hospice use (adjusted odds ratio, 0.30; 95% CI, 0.16-0.59). Discordance regarding life expectancy estimates was associated with greater odds of hospitalization (adjusted odds ratio, 1.64; 95% CI, 1.01-2.66). Conclusions and Relevance: This study highlights different constructs of prognostic understanding and the need to better understand the association between prognostic understanding and health care use among older adult patients with advanced cancer. Trial Registration: ClinicalTrials.gov Identifier: NCT02107443

Diabetic gastroparesis: Therapeutic options

Gastroparesis is a condition characterized by delayed gastric emptying and the most common known underlying cause is diabetes mellitus. Symptoms include nausea, vomiting, abdominal fullness, and early satiety, which impact to varying degrees on the patient’s quality of life. Symptoms and deficits do not necessarily relate to each other, hence despite significant abnormalities in gastric emptying, some individuals have only minimal symptoms and, conversely, severe symptoms do not always relate to measures of gastric emptying. Prokinetic agents such as metoclopramide, domperidone, and erythromycin enhance gastric motility and have remained the mainstay of treatment for several decades, despite unwanted side effects and numerous drug interactions. Mechanical therapies such as endoscopic pyloric botulinum toxin injection, gastric electrical stimulation, and gastrostomy or jejunostomy are used in intractable diabetic gastroparesis (DG), refractory to prokinetic therapies. Mitemcinal and TZP-101 are novel investigational motilin receptor and ghrelin agonists, respectively, and show promise in the treatment of DG. The aim of this review is to provide an update on prokinetic and mechanical therapies in the treatment of DG

Recovered memories, satanic abuse, Dissociative Identity Disorder and false memories in the UK: a survey of Clinical Psychologists and Hypnotherapists

An online survey was conducted to examine psychological therapists’ experiences of, and beliefs about, cases of recovered memory, satanic / ritualistic abuse, Multiple Personality Disorder / Dissociative Identity Disorder, and false memory. Chartered Clinical Psychologists (n=183) and Hypnotherapists (n=119) responded. In terms of their experiences, Chartered Clinical Psychologists reported seeing more cases of satanic / ritualistic abuse compared to Hypnotherapists who, in turn, reported encountering more cases of childhood sexual abuse recovered for the first time in therapy, and more cases of suspected false memory. Chartered Clinical Psychologists were more likely to rate the essential accuracy of reports of satanic / ritualistic abuse as higher than Hypnotherapists. Belief in the accuracy of satanic / ritualistic abuse and Multiple Personality Disorder / Dissociative Identity Disorder reports correlated negatively with the belief that false memories were possible