Guidelines on fibrinogen assays

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Does sticky blood predict a sticky end? Associations of blood viscosity, haematocrit and fibrinogen with mortality in the West of Scotland

There is increasing evidence that blood viscosity and its major determinants (haematocrit, plasma viscosity and fibrinogen) are associated with an increased risk of incident cardiovascular events; however, their associations with mortality are not established. We therefore studied the associations of these variables with cardiovascular events and total mortality in 1238 men and women aged 25-64 years, followed for 13 years in the first North Glasgow MONICA (MONItoring CArdiovascular disease) survey and West of Scotland centres in the Scottish Heart Health Study. After adjustment for age and sex, increasing whole blood viscosity, plasma viscosity, haematocrit and fibrinogen (analysed by both von Clauss and heat precipitation assays) were significantly associated with mortality. Only the association for fibrinogen (von Clauss assay) remained significant after adjustment for major cardiovascular risk factors. We conclude that clottable fibrinogen may be independently associated with mortality. However, the significance of this association, and the extent to which viscosity is associated with mortality, remain to be established in larger studies and meta-analyses

Systematically missing confounders in individual participant data meta-analysis of observational cohort studies.

One difficulty in performing meta-analyses of observational cohort studies is that the availability of confounders may vary between cohorts, so that some cohorts provide fully adjusted analyses while others only provide partially adjusted analyses. Commonly, analyses of the association between an exposure and disease either are restricted to cohorts with full confounder information, or use all cohorts but do not fully adjust for confounding. We propose using a bivariate random-effects meta-analysis model to use information from all available cohorts while still adjusting for all the potential confounders. Our method uses both the fully adjusted and the partially adjusted estimated effects in the cohorts with full confounder information, together with an estimate of their within-cohort correlation. The method is applied to estimate the association between fibrinogen level and coronary heart disease incidence using data from 154,012 participants in 31 cohort

Contributions of green infrastructure to enhancing urban resilience

© 2018, The Author(s). After briefly reviewing key resilience engineering perspectives and summarising some green infrastructure (GI) tools, we present the contributions that GI can make to enhancing urban resilience and maintaining critical system functionality across complex integrated social–ecological and technical systems. We then examine five key challenges for the effective implementation of GI that include (1) standards; (2) regulation; (3) socio-economic factors; (4) financeability; and (5) innovation. We highlight ways in which these challenges are being dealt with around the world, particularly through the use of approaches that are both context appropriate and socially inclusive. Although progress surmounting these challenges has been made, more needs to be done to ensure that GI approaches are inclusive and appropriate and feature equally alongside more traditional ‘grey’ infrastructure in the future of urban resilience planning. This research was undertaken for the Resilience Shift initiative to shift the approach to resilience in practice for critical infrastructure sectors. The programme aims to help practitioners involved in critical infrastructure to make decisions differently, contributing to a safer and better world

Impact of the iWHELD digital person-centered care program on quality of life, agitation and psychotropic medications in people with dementia living in nursing homes during the COVID-19 pandemic: A randomized controlled trial

This is the final version. Available on open access from Wiley via the DOI in this recordINTRODUCTION: iWHELD is a digital person-centered care program for people with dementia in nursing homes adapted for remote delivery during the COVID-19 pandemic. METHODS: A 16-week two-arm cluster-randomized controlled trial in 149 UK nursing homes compared iWHELD with treatment as usual (TAU). Primary outcome was the overall quality of life with secondary outcomes of agitation and psychotropic use. RESULTS: iWHELD conferred benefit to quality of life on the primary (F = 4.3, p = 0.04) and secondary measures of quality of life (F = 6.45, p = 0.01) and reduced psychotropic medication use (χ2  = 4.08, p = 0.04) with no worsening of agitation. Benefit was seen in participants who contracted COVID-19, those with agitation at baseline, and those taking psychotropic medications. DISCUSSION: iWHELD confers benefits to quality of life and key measures of well-being, can be delivered during the challenging conditions of a pandemic, and should be considered for use alongside any emerging pharmacological treatment for neuropsychiatric symptoms. HIGHLIGHTS: iWHELD is the only remote, digital delivery nursing home training programme for dementia care iWHELD improved quality of life in people with dementia and reduced antipsychotic use without worsening of agitation Residents who contracted Covid-19 during the study also experienced benefits from iWHELD iWHELD offers a valuable, pandemic-safe tool for improving dementia care.Medical Research Council (MRC)National Institute for Health and Care Research (NIHR

ASKAP HI imaging of the galaxy group IC 1459

© 2015 The Authors. Published by Oxford University Press on behalf of the Royal Astronomical Society. We present HI imaging of the galaxy group IC 1459 carried out with six antennas of the Australian Square Kilometre Array Pathfinder equipped with phased-array feeds. We detect and resolve HI in 11 galaxies down to a column density of ~1020 cm-2 inside a ~6 deg2 field and with a resolution of ~1 arcmin on the sky and ~8 kms-1 in velocity. We present HI images, velocity fields and integrated spectra of all detections, and highlight the discovery of three HI clouds - two in the proximity of the galaxy IC 5270 and one close to NGC 7418. Each cloud has an HI mass of ~109 M? and accounts for ~15 per cent of the HI associated with its host galaxy. Available images at ultraviolet, optical and infrared wavelengths do not reveal any clear stellar counterpart of any of the clouds, suggesting that they are not gas-rich dwarf neighbours of IC 5270 and NGC 7418. Using Parkes data, we find evidence of additional extended, low-column-density HI emission around IC 5270, indicating that the clouds are the tip of the iceberg of a larger system of gas surrounding this galaxy. This result adds to the body of evidence on the presence of intragroup gas within the IC 1459 group. Altogether, the HI found outside galaxies in this group amounts to several times 109 M?, at least 10 per cent of the HI contained inside galaxies. This suggests a substantial flow of gas in and out of galaxies during the several billion years of the group's evolution

Discovery of HI gas in a young radio galaxy at z = 0.44 using the Australian Square Kilometre Array Pathfinder

We report the discovery of a new 21-cm H i absorption system using commissioning data from the Boolardy Engineering Test Array of the Australian Square Kilometre Array Pathfinder (ASKAP). Using the 711.5–1015.5 MHz band of ASKAP we were able to conduct a blind search for the 21-cm line in a continuous redshift range between z = 0.4 and 1.0, which has, until now, remained largely unexplored. The absorption line is detected at z = 0.44 towards the GHz-peaked spectrum radio source PKS B1740−517 and demonstrates ASKAP's excellent capability for performing a future wide-field survey for H i absorption at these redshifts. Optical spectroscopy and imaging using the Gemini-South telescope indicates that the H i gas is intrinsic to the host galaxy of the radio source. The narrow [O iii] emission lines show clear double-peaked structure, indicating either large-scale outflow or rotation of the ionized gas. Archival data from the XMM–Newton satellite exhibit an absorbed X-ray spectrum that is consistent with a high column density obscuring medium around the active galactic nucleus. The H i absorption profile is complex, with four distinct components ranging in width from 5 to 300 km s−1 and fractional depths from 0.2 to 20 per cent. In addition to systemic H i gas, in a circumnuclear disc or ring structure aligned with the radio jet, we find evidence for a possible broad outflow of neutral gas moving at a radial velocity of v ~ 300 km s−1. We infer that the expanding young radio source (tage ≈ 2500 yr) is cocooned within a dense medium and may be driving circumnuclear neutral gas in an outflow of ~1 M⊙ yr−1