Resocializing digital water transformations : outlining social science perspectives on the digital water journey

Funding information: National Cyber Security Centre; Scottish Government, Grant/Award Number: Hydro Nation Scholars; University of Manchester, Grant/Award Number: Presidential fellowship; University of Manchester, Grant/Award Number: SEED PGR scholarship (Amankwaa).Digital water transformation is often written about as though universally desirable and inevitable, capable of addressing the multifaceted socioecological challenges that water systems face. However, there is not widespread reflection on the complexities, tensions and unintended consequences of digital transformation, its social and political dimensions are often neglected. This article introduces case studies of digital water development, bringing examples of technological innovation into dialogue with literature and empirical research from across the social sciences. We examine how Big Data affects our observations of water in society to shape water management, how the Internet of Things becomes involved in reproducing unjust water politics, how digital platforms are entangled in the varied sociocultural landscape of everyday water use, and how opensource technologies provide new possibilities for participatory water governance. We also reflect on regulatory developments and the possible trajectories of innovation resulting from public‐private sector interactions. A socially and politically informed view of digital water is essential for just and sustainable development, and the gap between industry visions of digital water and research within the social sciences is inhibitive. Thus, the analysis presented in this article provides a novel, pluralistic perspective on digital water development and outlines what is required for more inclusive future scholarship, policy and practice.Publisher PDFPeer reviewe

Promoting natural regeneration for the restoration of Juniperus communis: a synthesis of knowledge and evidence for conservation practitioners

Questions: Natural regeneration is central to plant conservation strategies. Worldwide, many Juniperus species are threatened due to their failure to regenerate. We focus on Juniperus communis in areas of NW Europe where it is declining and ask: what advice is available to land managers on natural regeneration methods, and when applied, how effective has this been? Methods: We synthesize knowledge on the efficacy of management interventions and conditions associated with J. communis regeneration. In field trials, we test interventions where knowledge is lacking. We assess regeneration of J. communis, creation of regeneration microsites and germination of sown seed in response to the interventions. Results: Although J. communis occurs in different habitats, there is consistency in site conditions important for regeneration (unshaded/open, short ground vegetation, disturbed/bare ground, low herbivore pressure). In calcareous grasslands, areas with regeneration are stony/bare or vegetation is short or sparse; in upland acid grasslands and dry heathlands regeneration locations are disturbed areas sometimes with a moss cover. Several interventions (grazing, scarification, turf stripping) can create regeneration conditions. The synthesis identified cattle grazing and ground scarification for further testing on upland acid grasslands. In the resulting field trials, regeneration was rare and recorded on only one cattle-grazed site. An exposed moss layer characterized regeneration microsites but there was insufficient evidence that either intervention increased regeneration microsite frequency. Few sown seeds germinated. Conclusions: Different interventions or intensities of these appear to be required depending on habitat type. Broadly, on calcareous grassland intense scarification or soil stripping is needed, while on dry heathlands light scarification is suitable. On upland acid grassland, cattle grazing and ground scarification do not reliably result in regeneration. Creation of favourable mossy regeneration microsites is unlikely following intervention, unless soil fertility is low. Land-use change, increased climate warming and pollution are pressures acting on J. communis and may cause habitat loss and altered site conditions (e.g. soil fertility), making it difficult to create regeneration microsites at all J. communis sites. Other constraints on regeneration may operate (e.g. seed predation and low seed viability) and managers should assess population and site potential before undertaking management

Aerosol emission from the respiratory tract:an analysis of aerosol generation from oxygen delivery systems

INTRODUCTION: continuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) provide enhanced oxygen delivery and respiratory support for patients with severe COVID-19. CPAP and HFNO are currently designated as aerosol-generating procedures despite limited high-quality experimental data. We aimed to characterise aerosol emission from HFNO and CPAP and compare with breathing, speaking and coughing. MATERIALS AND METHODS: Healthy volunteers were recruited to breathe, speak and cough in ultra-clean, laminar flow theatres followed by using CPAP and HFNO. Aerosol emission was measured using two discrete methodologies, simultaneously. Hospitalised patients with COVID-19 had cough recorded using the same methodology on the infectious diseases ward. RESULTS: In healthy volunteers (n=25 subjects; 531 measures), CPAP (with exhalation port filter) produced less aerosol than breathing, speaking and coughing (even with large >50 L/min face mask leaks). Coughing was associated with the highest aerosol emissions of any recorded activity. HFNO was associated with aerosol emission, however, this was from the machine. Generated particles were small (<1 µm), passing from the machine through the patient and to the detector without coalescence with respiratory aerosol, thereby unlikely to carry viral particles. More aerosol was generated in cough from patients with COVID-19 (n=8) than volunteers. CONCLUSIONS: In healthy volunteers, standard non-humidified CPAP is associated with less aerosol emission than breathing, speaking or coughing. Aerosol emission from the respiratory tract does not appear to be increased by HFNO. Although direct comparisons are complex, cough appears to be the main aerosol-generating risk out of all measured activities

Identification of nutrition factors in the metabolic syndrome and its progression over time in older adults: analysis of the TUDA cohort

BACKGROUND: Nutrition is recognized as playing an important role in the metabolic syndrome (MetS), but the dietary components involved are unclear. We aimed to investigate nutrition factors in relation to MetS and its progression in older adults over a follow-up period of 5.4 years.METHODS: Community-dwelling adults (≥ 60y) from the Trinity-Ulster-Department-of-Agriculture study, sampled at baseline (2008-12) and follow-up (2014-18; n 953), were classified as 'with MetS' by having three or more of: waist circumference (≥ 102 cm, males; ≥ 88 cm, females); HDL-cholesterol (&lt; 1.0 mmol/L, males; &lt; 1.3 mmol/L, females); triglycerides (≥ 1.7 mmol/L); blood pressure (systolic ≥ 130 and/or diastolic ≥ 85 mmHg); and hemoglobin A1c (≥ 39 mmol/mol).RESULTS: MetS was identified in 67% of participants, increasing to 74% at follow-up. Predictors at baseline for the development of metabolic syndrome (MetS) at follow-up were higher waist circumference (odds ratio [95%CI]; 1.06 [1.01-1.11]), but not BMI, and increased triglyceride concentrations (2.01 [1.29-3.16]). In dietary analysis (at follow-up), higher protein (g/kg bodyweight/day) and monounsaturated fatty acid (g/day) intakes were each associated with lower risk of MetS (0.06 [0.02-0.20] and 0.88 [0.78-1.00], respectively), whilst higher protein was also associated with lower abdominal obesity (0.10 [0.02-0.51]) and hypertension (0.22 [0.00-0.80]). Furthermore, participants with, compared to without, MetS consumed less high-quality protein foods (P = 0.006) and more low-quality protein foods (P &lt; 0.001), as defined by the protein digestibility-corrected amino acid score.CONCLUSIONS: Dietary interventions targeting protein quantity and quality may have specific benefits in preventing or delaying the progression of MetS in at-risk older people, but this requires investigation in the form of randomized trials.</p

Flavan-3-ol-methylxanthine interactions: Modulation of flavan-3-ol bioavailability in volunteers with a functional colon and an ileostomy

Flavan-3-ols, including the flavan-3-ol monomer (-)-epicatechin, are dietary bioactives known to mediate beneficial cardiovascular effects in humans. Recent studies showed that flavan-3-ols could interact with methylxanthines, evidenced by an increase in flavan-3-ol bioavailability with a concomitant increase in flavan-3-ol intake-mediated vascular effects. This study aimed at elucidating flavan-3-ol-methylxanthine interactions in humans in vivo by evaluating the specific contributions of theobromine and caffeine on flavan-3-ol bioavailability. In ileostomists, the effect of methylxanthines on the efflux of flavan-3-ol metabolites in the small intestine was assessed, a parameter important to an understanding of the pharmacokinetics of flavan-3-ols in humans. In a randomized, controlled, triple cross-over study in volunteers with a functional colon (n = 10), co-ingestion of flavan-3-ols and cocoa methylxanthines, mainly represented by theobromine, increased peak circulatory levels (C ) of flavan-3-ols metabolites (+21 ± 8%; p &lt; 0.05). Conversely, caffeine did not mediate a statistically significant effect on flavan-3-ol bioavailability (C = +10 ± 8%, p = n.s.). In a subsequent randomized, controlled, double cross-over study in ileostomists (n = 10), cocoa methylxanthines did not affect circulatory levels of flavan-3-ol metabolites, suggesting potential differences in flavan-3-ol bioavailability compared to volunteers with a functional colon. The main metabolite in ileal fluid was (-)-epicatechin-3'-sulfate, however, no differences in flavan-3-ol metabolites in ileal fluid were observed after flavan-3-ol intake with and without cocoa methylxanthines. Taken together, these results demonstrate a differential effect of caffeine and theobromine in modulating flavan-3-ol bioavailability when these bioactives are co-ingested. These findings should be considered when comparing the effects mediated by the intake of flavan-3-ol-containing foods and beverages and the amount and type of methylxanthines present in the ingested matrixes. Ultimately, these insights will be of value to further optimize current dietary recommendations for flavan-3-ol intake. CLINICAL TRIAL REGISTRATION NUMBER: This work was registered at clinicaltrials.gov as NCT03526107 (study part 1, volunteers with functional colon) and NCT03765606 (study part 2, volunteers with an ileostomy). [Abstract copyright: Copyright © 2023 Elsevier Inc. All rights reserved.

Rates, causes and predictors of all-cause and avoidable mortality in 163 686 children and young people with and without intellectual disabilities:A record linkage national cohort study

Objectives: To investigate mortality rates and associated factors, and avoidable mortality in children/young people with intellectual disabilities. Design: Retrospective cohort; individual record-linked data between Scotland’s 2011 Census and 9.5 years of National Records for Scotland death certification data. Setting: General community. Participants: Children and young people with intellectual disabilities living in Scotland aged 5–24 years, and an age-matched comparison group. Main outcome measures: Deaths up to 2020: age of death, age-standardised mortality ratios (age-SMRs); causes of death including cause-specific age-SMRs/sex-SMRs; and avoidable deaths. Results: Death occurred in 260/7247 (3.6%) children/young people with intellectual disabilities (crude mortality rate=388/100 000 person-years) and 528/156 439 (0.3%) children/young people without intellectual disabilities (crude mortality rate=36/100 000 person-years). SMRs for children/young people with versus those without intellectual disabilities were 10.7 for all causes (95% CI 9.47 to 12.1), 5.17 for avoidable death (95% CI 4.19 to 6.37), 2.3 for preventable death (95% CI 1.6 to 3.2) and 16.1 for treatable death (95% CI 12.5 to 20.8). SMRs were highest for children (27.4, 95% CI 20.6 to 36.3) aged 5–9 years, and lowest for young people (6.6, 95% CI 5.1 to 8.6) aged 20–24 years. SMRs were higher in more affluent neighbourhoods. Crude mortality incidences were higher for the children/young people with intellectual disabilities for most International Statistical Classification of Diseases and Related Health Problems, 10th Revision chapters. The most common underlying avoidable causes of mortality for children/young people with intellectual disabilities were epilepsy, aspiration/reflux/choking and respiratory infection, and for children/young people without intellectual disabilities were suicide, accidental drug-related deaths and car accidents. Conclusion: Children with intellectual disabilities had significantly higher rates of all-cause, avoidable, treatable and preventable mortality than their peers. The largest differences were for treatable mortality, particularly at ages 5–9 years. Interventions to improve healthcare to reduce treatable mortality should be a priority for children/young people with intellectual disabilities. Examples include improved epilepsy management and risk assessments, and coordinated multidisciplinary actions to reduce aspiration/reflux/choking and respiratory infection. This is necessary across all neighbourhoods

Melt-processed PLA/HA platelet nanoparticle composites produced using tailored dispersants

Hydroxyapatite (HA) nanoparticles, similar to those seen in the structure of human bone, have been produced via hydrothermal synthesisand used to produce nanocomposite materials via melt blending with poly(lactic acid)(PLA). Both of these processes are scalable and commercially relevant. Tailored dispersants were developed and used to improve the dispersion of the HA. Modest improvements in flexural properties were observed (max increases 30% of dry modulus, 13% of wet strength). Rheometry is not suggestive of achieving percolation,so there is potential to improve mechanical properties further. It was established that very dry processing conditions are essential to maintaining the molecular weight of the PLA during processing and that the use of the tailored dispersants can also help to mitigateprocess-induced degradation.MicroCT has proved to be a useful quality control tool to support TEM analysis

SN 2021hpr and its two siblings in the Cepheid calibrator galaxy NGC 3147: A hierarchical BayeSN analysis of a Type Ia supernova trio, and a Hubble constant constraint

To improve Type Ia supernova (SN Ia) standardisability, the consistency of distance estimates to siblings -- SNe in the same host galaxy -- should be investigated. We present Young Supernova Experiment Pan-STARRS-1 $grizy$ photometry of SN 2021hpr, the third spectroscopically confirmed SN Ia in the high-stellar-mass Cepheid-calibrator galaxy NGC 3147. We analyse NGC 3147's trio of SN Ia siblings: SNe 1997bq, 2008fv and 2021hpr, using a new version of the BayeSN model of SN Ia spectral-energy distributions, retrained simultaneously using optical-NIR $BgVrizYJH$ (0.35--1.8 $\mu$m) data. The distance estimates to each sibling are consistent, with a sample standard deviation $\lesssim$0.01 mag, much smaller than the total intrinsic scatter in the training sample: $\sigma_0\approx0.09$ mag. Fitting normal SN Ia siblings in three additional galaxies, we estimate a $\approx$90% probability that the siblings' intrinsic scatter is smaller than $\sigma_0$. We build a new hierarchical model that fits light curves of siblings in a single galaxy simultaneously; this yields more precise estimates of the common distance and the dust parameters. Fitting the trio for a common dust law shape yields $R_V=2.69\pm0.52$. Our work motivates future hierarchical modelling of more siblings, to tightly constrain their intrinsic scatter, and better understand SN-host correlations. Finally, we estimate the Hubble constant, using a Cepheid distance to NGC 3147, the siblings trio, and 109 Hubble flow ($0.01 < z_{\rm{CMB}} < 0.08$) SNe Ia; marginalising over the siblings' and population's intrinsic scatters, and the peculiar velocity dispersion, yields $H_0=77.9\pm6.5 \text{ km s}^{-1}\text{Mpc}^{-1}$.Comment: Submitted to MNRAS; 30 pages, 22 figure

Effects of SlowMo, a blended digital therapy targeting reasoning, on paranoia among people with psychosis: a randomized clinical trial

Importance Persistent paranoia is common among patients with psychosis. Cognitive-behavioral therapy for psychosis can be effective. However, challenges in engagement and effectiveness remain. Objective To investigate the effects on paranoia and mechanisms of action of SlowMo, a digitally supported reasoning intervention, plus usual care compared with usual care only. Design, Setting, and Participants This parallel-arm, assessor-blinded, randomized clinical trial recruited participants at UK community health services from May 1, 2017, to May 14, 2019. Eligible participants consisted of a referral sample with schizophrenia-spectrum psychosis and distressing, persistent (≥3 months) paranoia. Interventions Individuals were randomized 1:1 to SlowMo, consisting of 8 digitally supported face-to-face sessions and a mobile app, plus usual care (n = 181) and usual care only (n = 181). Main Outcomes and Measures The primary outcome was paranoia, measured by the Green et al Paranoid Thoughts Scale (GPTS) total score at 24 weeks. Secondary outcomes included GPTS total score at 12 weeks and GPTS Part A (reference) and Part B (persecutory) scores, the Psychotic Symptom Rating Scales (PSYRATS Delusion subscale), reasoning (belief flexibility, possibility of being mistaken [Maudsley Assessment of Delusions, rated 0%-100%]), and jumping to conclusions (Beads Task). Results A total of 361 participants were included in intention-to-treat analysis, of whom 252 (69.8%) were male and 249 (69.0%) were White; the mean (SD) age was 42.6 (11.6) years. At 24 weeks, 332 participants (92.0%) provided primary outcome data. Of 181 participants in the SlowMo group, 145 (80.1%) completed therapy. SlowMo plus usual care was not associated with greater reductions than usual care in GPTS total score at 24 weeks (Cohen d, 0.20; 95% CI, −0.02 to 0.40; P = .06). There were significant effects on secondary paranoia outcomes at 12 weeks, including GPTS total score (Cohen d, 0.30; 95% CI, 0.09-0.51; P = .005), Part A score (Cohen d, 0.22; 95% CI, 0.06-0.39; P = .009), and Part B score (Cohen d, 0.32; 95% CI, 0.08-0.56; P = .009), and at 24 weeks, including Part B score (Cohen d, 0.25; 95% CI, 0.01-0.49; P = .04) but not Part A score (Cohen d, 0.12; 95% CI, −0.05 to 0.28; P = .18). Improvements were observed in an observer-rated measure of persecutory delusions (PSYRATS delusion) at 12 weeks (Cohen d, 0.47; 95% CI, 0.17-0.78; P = .002) and 24 weeks (Cohen d, 0.50; 95% CI, 0.20-0.80; P = .001) and belief flexibility at 12 weeks (Cohen d, 0.29; 95% CI, 0.09-0.49; P = .004) and 24 weeks (Cohen d, 0.28; 95% CI, 0.08-0.49; P = .005). There were no significant effects on jumping to conclusions. Improved belief flexibility and worry mediated paranoia change (range mediated, 36%-56%). Conclusions and Relevance SlowMo did not demonstrate significant improvements in the primary measure of paranoia at 24 weeks; however, a beneficial effect of SlowMo on paranoia was indicated by the results on the primary measure at an earlier point and on observer-rated paranoia and self-reported persecution at 12 and 24 weeks. Further work to optimize SlowMo’s effects is warranted

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy