Landscape and the City: creating a sustainable development

This paper examines the potential of a holistic approach for urban and regional strategies in order to understand the way this might contribute more effectively to current global challenges. Part of a wider research strategy investigating the extent to which low carbon and spatial quality can be delivered at a regional level, it demonstrates benefits of adopting a range of processes to deliver integrated and sustainable urban development. The case studies examined include the Landscape Observatory (Spain), the Room for the River (the Netherlands) and HS2/HS2LV (UK). The Landscape Observatory has raised public awareness of the value of landscape to the extent to which there is now a public law protecting landscape in Catalonia. An investigation of projects dealing with climate adaptation in the Netherlands demonstrates the potential and significance of introducing low carbon and the quality of space in urban and regional infrastructure projects. An examination of the HS2 high-speed rail project in the UK illustrates how it might be possible to impact on the perception and development of a singular engineering project in order to convey a wider sustainable vision and the impact that this might have on future landscape in towns, cities and rural areas. The significance of development of procurement processes, policies and legislations as part of the administration phase of urban and regional landscape schemes are also considered necessary for future landscape strategies. Initial outcomes indicate that successful delivery requires the development of a landscape vision and the understanding of low carbon and spatial quality concepts through design in order to be better expressed in the infrastructure and create added value to our cities and regions

Focus Issue: Neck Dissection for Oropharyngeal Squamous Cell Carcinoma

The staging and prognosis of oropharyngeal squamous cell carcinoma is intimately tied to the status of the cervical lymph nodes. Due to the high risk for occult nodal disease, most clinicians recommend treating the neck for these primary tumors. While there are many modalities available, surgical resection of nodal disease offers both a therapeutic and a diagnostic intervention. We review the relevant anatomy, nodal drainage patterns, clinical workup, surgical management and common complications associated with neck dissection for oropharyngeal squamous cell carcinoma

Understanding landscape; the process to a quality and sustainable space

Part of a broader strategy to examine how a more holistic approach to landscape may significantly contribute the global challenges by re-establishing landscape at the forefront of development and as the context within which the development processes take place, this paper investigates the extent to which low carbon and spatial quality can be delivered in regional infrastructure projects. The paper looks at the outcomes of two case studies, one of the Landscape Observatory (Spain) and the second of the Room for the River/Dutch Waterline (Netherlands). The two case studies are complementary, the first examining the way the idea of landscape can change hearts and minds, the second showing how the idea of landscape is used to shape the implementation of national projects in the Netherlands. This research shows how the Landscape Observatory has changed public opinion through a series of catalogues, seminars, projects and public participation to such an extent that there is now a public law protecting landscape – a concept that would have been inconceivable 10 years ago. The two national programmes in the Netherlands known as the ‘Room for the River’ and the ‘Dutch Waterline’, devised in response to the problems of climate change and long term sustainability of the Netherlands, demonstrate the potential and significance of introducing the quality of space as a vital aspect of regional infrastructure. In their different ways, these case studies have shown how this idea of landscape can be used, through a range of specific tools and policies to achieve low carbon and sustainable outcomes as well as the extent to which both are dependent the various modes of visual and spatial representation of concepts, ideas and a sense of place to convey the powerful and profound value of the landscape. Finally, the potential of understanding landscape as the context for the process of development will be analysed by discussing the impact these case studies might have had for the regions

Sustainable landscape design; key ideas for effective implementation

This paper forms part of wider research looking at pioneer landscape strategies across Europe, examining the extent to which low carbon, sustainability and spatial quality can be delivered effectively on urban and strategic scale, and covers examples from the ‘Landscape Observatory’ (Spain), the ‘Room for the River’ and ‘New Dutch Waterline’ (Netherlands), and the ‘HS2/HS2LV’ project (UK). This paper presents the Netherlands and the UK case studies, illustrating effective ways where the key issues of low carbon and quality of space are integrated in the design framework and the impact this has on the decision making. The case studies have shown that effective implementation requires visual communication and an in-depth understanding of how the concepts of sustainability and spatial quality are expressed. Policies, and legislation are also considered significant for landscape based developments

Climate emergency adaption and sustainable management strategies

This paper discusses the way in which climate crisis-related strategies and the concepts of climate adaptation, sustainability and governance are being introduced into rural and agricultural landscapes. This forms part of a wider research focusing on pioneer landscape strategies across Europe, examining the extent to which low carbon can be delivered effectively and the ways in which policy guidance impacts on sustainable management strategies and implementation. This paper uses examples from the ‘LandscapeObservatory’ (Catalonia) and the ‘Room for the River’ (the Netherlands)

Gene transfer of RANTES elicits autoimmune renal injury in MRL-Faslpr mice

Infiltrating macrophages and T cells are instrumental in autoimmune kidney destruction of MRL-Faslpr mice. We report that the β-chemokine RANTES, a chemoattractant for macrophages and T cells, is up-regulated in the MRL-Faslpr kidney prior to injury, but not normal kidneys (MRL-++, C3H-++) and increases with progressive injury. Furthermore, we establish an association between RANTES expression in the kidney and renal damage using a gene transfer approach. Tubular epithelial cells genetically modified to secrete RANTES infused under the renal capsule incites interstitial nephritis in MRL-Faslpr, but not MRL-++ or C3H-++ mice. RANTES recruits predominantly macrophages (Mø) and CD4+ and CD8+ T cells. In contrast, gene transfer of CSF-1, another molecule up-regulated simultaneously with RANTES in MRL-Faslpr kidneys, promotes the influx of Mø, CD4+ T cells and the unique double-negative (DN) T cells (CD4-,CD8-), which are prominent in diseased MRL-Faslpr kidneys. Thus, RANTES and CSF-1 recruit distinct T cell populations into the MRL-Faslpr kidney. In addition, delivery of RANTES and CSF-1 into the kidney of MRL-Faslpr mice causes an additive increase in pathology. We suggest that the complementary recruitment of T cell populations by RANTES (CD4, CD8) and CSF-1 (CD4, DN) promotes autoimmune nephritis in MRL-Faslpr mice

Reverse cardio-oncology:Exploring the effects of cardiovascular disease on cancer pathogenesis

The field of cardio-oncology has emerged in response to the increased risk of cardiovascular disease (CVD) in patients with cancer. However, recent studies suggest a more complicated CVD-cancer relationship, wherein development of CVD, either prior to or following a cancer diagnosis, can also lead to increased risk of cancer and worse outcomes for patients. In this review, we describe the current evidence base, across epidemiological as well as preclinical studies, which supports the emerging concept of ‘reverse-cardio oncology’, or CVD-induced acceleration of cancer pathogenesis

Tidal Streams as Probes of the Galactic Potential

We explore the use of tidal streams from Galactic satellites to recover the potential of the Milky Way. Our study is motivated both by the discovery of the first lengthy stellar stream in the halo (\cite{it98}) and by the prospect of measuring proper motions of stars brighter than 20th magnitude in such a stream with an accuracy of $\sim 4\mu as/$yr, as will be possible with the Space Interferometry Mission (SIM). We assume that the heliocentric radial velocities of these stars can be determined from supporting ground-based spectroscopic surveys, and that the mass and phase-space coordinates of the Galactic satellite with which they are associated will also be known to SIM accuracy. Using results from numerical simulations as trial data sets, we find that, if we assume the correct form for the Galactic potential, we can predict the distances to the stars as a consequence of the narrow distribution of energy expected along the streams. We develop an algorithm to evaluate the accuracy of any adopted potential by requiring that the satellite and stars recombine within a Galactic lifetime when their current phase-space coordinates are integrated backwards. When applied to a four-dimensional grid of triaxial logarithmic potentials, with varying circular velocities, axis ratios and orientation of the major-axis in the disk plane, the algorithm can recover the parameters used for the Milky Way in a simulated data set to within a few percent using only 100 stars in a tidal stream.Comment: Revised version - original algorithm generalised to be applicable to any potential shape. LaTeX, 12 pages including 3 figures. To be published in ApJ Letter

Parents’ Pandemic NICU Experience in the United States: A Qualitative Study

Background Prior to the COVID-19 pandemic, parents of infants in the Neonatal Intensive Care Unit (NICU) frequently reported high levels of stress, uncertainty, and decreased parenting confidence. Early research has demonstrated that parents have had less access to their infants in the hospital due to restrictions on parental presence secondary to the pandemic. It is unknown how parents have perceived their experiences in the NICU since the beginning of the COVID-19 pandemic. The purpose of this study was to describe the lived experience of parents who had an infant in the NICU in the context of the COVID-19 pandemic to inform healthcare providers and policy makers for future development of policies and care planning. Methods The study design was a qualitative description of the impact of the COVID-19 pandemic on parents’ experiences of having an infant in the NICU. Free-text responses to open-ended questions were collected as part of a multi-method study of parents’ experiences of the NICU during the first six months of the pandemic. Participants from the United States were recruited using social media platforms between the months of May and July of 2020. Data were analyzed using a reflexive thematic approach. Findings Free-text responses came from 169 parents from 38 different states in the United States. Three broad themes emerged from the analysis: (1) parents’ NICU experiences during the COVID-19 pandemic were emotionally isolating and overwhelming, (2) policy changes restricting parental presence created disruptions to the family unit and limited family-centered care, and (3) interactions with NICU providers intensified or alleviated emotional distress felt by parents. A unifying theme of experiences of emotional distress attributed to COVID-19 circumstances ran through all three themes. Conclusions Parents of infants in the NICU during the first six months of the COVID-19 pandemic experienced emotional struggles, feelings of isolation, lack of family-centered care, and deep disappointment with system-level decisions. Moving forward, parents need to be considered essential partners in the development of policies concerning care of and access to their infants. Background The COVID-19 pandemic created unprecedented conditions for administrators and clinicians working in Neonatal Intensive Care Units (NICU) and greatly affected parents of infants requiring hospitalization. Prior to the COVID-19 pandemic, parents of infants admitted to a NICU reported high levels of stress, anxiety, uncertainty, and decreased parenting confidence when compared to parents of healthy full-term infants [1,2,3,4,5,6]. Approximately 28–40% of mothers of infants admitted to a NICU were diagnosed with a new mental illness, such as depression or perinatal post-traumatic stress disorder [7]. Fathers of infants requiring NICU hospitalization also reported significant stress and need for reassurance and support [8, 9]