The body as image: image as body

Pain consultations are often contested spaces where patient and clinician compete for the roles of speaker. Often patients are searching for mechanical explanations and clinicians for psychological ones - creating an impasse and causing distress to both parties. Meanwhile, as technology advances and we have increasing means of seeing inside a person’s body we seem to have less and less ability to see inside another’s world – to understand what it means to live with pain, the significance of that pain for that individual in their social context. In this paper we explore the potential for images of pain, co-created with patients, to intervene in this unproductive patient dynamic and bring the full experience of pain - social, emotional, physical - into focus. Narrative analysis is used on a series of transcripts of pain consultations

Prediction and Simulator Verification of Roll/Lateral Adverse Aeroservoelastic Rotorcraft–Pilot Couplings

The involuntary interaction of a pilot with an aircraft can be described as pilot-assisted oscillations. Such phenomena are usually only addressed late in the design process when they manifest themselves during ground/flight testing. Methods to be able to predict such phenomena as early as possible are therefore useful. This work describes a technique to predict the adverse aeroservoelastic rotorcraft–pilot couplings, specifically between a rotorcraft’s roll motion and the resultant involuntary pilot lateral cyclic motion. By coupling linear vehicle aeroservoelastic models and experimentally identified pilot biodynamic models, pilot-assisted oscillations and no-pilot-assisted oscillation conditions have been numerically predicted for a soft-in-plane hingeless helicopter with a lightly damped regressive lead–lag mode that strongly interacts with the roll modeat a frequency within the biodynamic band of the pilots. These predictions have then been verified using real-time flight-simulation experiments. The absence of any similar adverse couplings experienced while using only rigid-body models in the flight simulator verified that the observed phenomena were indeed aeroelastic in nature. The excellent agreement between the numerical predictions and the observed experimental results indicates that the techniques developed in this paper can be used to highlight the proneness of new or existing designs to pilot-assisted oscillation

Bridge distress caused by approach embankment settlement

Surtees Bridge, which carries the A66(T) over the River Tees near Thornaby-on-Tees in the UK, has been showing signs of distress that predate its opening in 1981. Subsequent investigations have shown that the bridge distress is related to unexpectedly large settlement of the eastern approach embankment. Recent ground investigations prompted by a proposed widening of the river crossing have produced many new data on the alluvial deposits underlying the site, and explain why embankment settlement was so much larger than originally anticipated. Comparison of the geotechnical parameters obtained from the original and more recent ground investigations suggests that the original investigation significantly underestimated the thickness of an alluvial clay layer underlying the site, and that its coefficient of consolidation was overestimated. Settlement analyses using geotechnical data from the original ground investigations predict moderate embankment settlements occurring principally during construction. Settlement analyses based on all the available data predict far larger embankment settlements occurring over extended time periods. The latter analyses predict an embankment settlement similar to that observed and of sufficient magnitude to cause the observed lateral displacement of the bridge due to lateral loading of its piled foundation

Time to negative throat culture following initiation of antibiotics for pharyngeal group A Streptococcus: a systematic review and meta-analysis up to October 2021 to inform public health control measures

Background: Public health guidance recommending isolation of individuals with group A streptococcal (GAS) infection or carriage for 12–24 h from antibiotic initiation to prevent onward transmission requires a strong evidence base. Aim: To estimate the pooled proportion of individuals who remain GAS culture-positive at set intervals after initiation of antibiotics through a systematic literature review (PROSPERO CRD42021290364) and meta-analysis. Methods: We searched Ovid MEDLINE (1946–), EMBASE (1974–) and Cochrane library. We included interventional or observational studies with ≥ 10 participants reporting rates of GAS throat culture positivity during antibiotic treatment for culture-confirmed GAS pharyngitis, scarlet fever and asymptomatic pharyngeal GAS carriage. We did not apply age, language or geographical restrictions. Results: Of 5,058 unique records, 43 were included (37 randomised controlled studies, three non-randomised controlled trials and three before-and-after studies). The proportion of individuals remaining culture-positive on day 1, day 2 and days 3–9 were 6.9% (95% CI: 2.7–16.8%), 5.4% (95% CI: 2.1–13.3%) and 2.6% (95% CI: 1.6–4.2%). For penicillins and cephalosporins, day 1 positivity was 6.5% (95% CI: 2.5–16.1%) and 1.6% (95% CI: 0.04–42.9%), respectively. Overall, for 9.1% (95% CI: 7.3–11.3), throat swabs collected after completion of therapy were GAS culture-positive. Only six studies had low risk of bias. Conclusions: Our review provides evidence that antibiotics for pharyngeal GAS achieve a high rate of culture conversion within 24 h but highlights the need for further research given methodological limitations of published studies and imprecision of pooled estimates. Further evidence is needed for non-beta-lactam antibiotics and asymptomatic individuals

Preliminary guidelines for a requirements-based approach to certification by simulation for rotorcraft

The paper presents an introduction to the preliminary guidelines for rotorcraft certification by simulation developed by the partners of the Clean Sky 2 project Rotorcraft Certification by Simulation – RoCS . The guidelines are primarily aimed at the application of (rotorcraft) flight modelling and simulation in support of certification for compliance with standards CS-27 and CS-29, PART B (Flight) and other Flight-related aspects (e.g. CS-29, Appendix B, Airworthiness Criteria for Helicopter Instrument Flight). However, the guidelines are also applicable, in principle, to the certification of other types of rotorcraft, including tilt-rotors and e-VTOL configurations. A requirements-based approach is advocated and outlined, acknowledging the profound importance of assembling preliminary requirements, as complete as possible, before embarking on simulation development processes. The proposed approach presents examples of metrics for quantifying the fidelity that is ‘sufficient’ for application to relevant Applicable Certification Requirements (ACRs). The concept of ‘adaptive fidelity’ is introduced in this Guidance to emphasise that what might be sufficient is task-specific, and therefore ACR-specific. The paper introduces the structure of the proposed Rotorcraft Certification by Simulation process, together with the main concepts that guide applicants to the development of simulations that can be effectively employed to reduce the cost, timescales, complexity and risks that may be associated with certification performed solely though flight tests

Bacterial colonisation dynamics of household plastics in a coastal environment

This is the final version. Available on open access from Elsevier via the DOI in this recordData availability: Scripts and final datasets are available on github (https://github.com/padpadpadpad/Lear_et_al_2022_stoten) and raw sequencing files (for the amplicon 16S) and genome assemblies (for the WGS) have been uploaded to the European Nucleotide Archive (Study accession number PRJEB5334).Accumulation of plastics in the marine environment has widespread detrimental consequences for ecosystems and wildlife. Marine plastics are rapidly colonised by a wide diversity of bacteria, including human pathogens, posing potential risks to health. Here, we investigate the effect of polymer type, residence time and estuarine location on bacterial colonisation of common household plastics, including pathogenic bacteria. We submerged five main household plastic types: low-density PE (LDPE), high-density PE (HDPE), polypropylene (PP), polyvinyl chloride (PVC) and polyethylene terephthalate (PET) at an estuarine site in Cornwall (U.K.) and tracked bacterial colonisation dynamics. Using both culture-dependent and culture-independent approaches, we found that bacteria rapidly colonised plastics irrespective of polymer type, reaching culturable densities of up to 1000 cells cm3 after 7 weeks. Community composition of the biofilms changed over time, but not among polymer types. The presence of pathogenic bacteria, quantified using the insect model Galleria mellonella, increased dramatically over a five-week period, with Galleria mortality increasing from 4% in week one to 65% in week five. No consistent differences in virulence were observed between polymer types. Pathogens isolated from plastic biofilms using Galleria enrichment included Serratia and Enterococcus species and they harboured a wide range of antimicrobial resistance genes. Our findings show that plastics in coastal waters are rapidly colonised by a wide diversity of bacteria independent of polymer type. Further, our results show that marine plastic biofilms become increasingly associated with virulent bacteria over time.Biotechnology & Biological Sciences Research Council (BBSRC)Natural Environment Research Council (NERC