The Influence Of Particle Size And Frictional/Cohesional Shear Strength Components On UK Salt Marsh Substrate Stability

Salt marshes and tidal flats contribute valuable ecosystem services, by providing habitats, storing pollutants and reducing flood and erosion risk in the coastal hinterland. However, salt marsh areal extent is decreasing both globally and regionally (e.g. in Northwest Europe). While we know that salt marshes are retreating, this could be occurring due to biological, geochemical and geotechnical properties of the marsh and tidal flat, and/or due to changes in hydrodynamic forcing. Until now, very few studies have assessed how substrate geotechnical properties influence both the erosion processes and the erodibility of the marsh edge and tidal flat surface. Here, we compare frictional and cohesional strength components at two hydrodynamically-similar but sedimentologically-different salt marshes and tidal flats in the UK. As such, we assess how sediment composition and behavior may influence marsh resistance to hydrodynamic forcing.This work was funded by a NERC PhD studentship (LCAG/329; 2016-2020), and a Collaborative Award in Science and Engineering with the British Geological Survey (LCAG/352)

Privacy Aware On-Demand Resource Provisioning for IoT Data Processing

International audienceEdge processing in IoT networks offers the ability to enforce privacy at the point of data collection. However, such enforcement requires extra processing in terms of data filtering and the ability to configure the device with knowledge of policy. Supporting this processing with Cloud resources can reduce the burden this extra processing places on edge processing nodes and provide a route to enable user defined policy. To enable this work from the PaaSage project [12] into the Cloud modelling language is applied to IoT networks to enable standardised management of IoT and Cloud integration and enable edge processing to effectively use the Cloud in a privacy protecting way

Risk driven Smart Home resource management using cloud services

In order to fully exploit the concept of Smart Home, challenges associated with multiple device management in consumer facing applications have to be addressed. Specific to this is the management of resource usage in the home via the improved utilization of devices, this is achieved by integration with the wider environment they operate in. The traditional model of the isolated device no longer applies, the future home will be connected with services provided by third parties ranging from supermarkets to domestic appliance manufacturers. In order to achieve this risk based integrated device management and contextualization is explored in this paper based on the cloud computing model. We produce an architecture and evaluate risk models to assist in this management of devices from a security, privacy and resource management perspective. We later propose an expansion on the risk based approach to wider data sharing between the home and external services using the key indicators of TREC (Trust, Risk, Eco-efficiency and Cost). The paper contributes to Smart Home research by defining how Cloud service management principles of risk and contextualization for virtual machines can produce solutions to emerging challenges facing a new generation of Smart Home devices

Magnetic Resonance Imaging Follow-up of Targeted Biopsy-negative Prostate Lesions

BACKGROUND: The optimal radiological follow-up of prostate lesions negative on magnetic resonance imaging (MRI)-targeted biopsy (MRI-TB) is yet to be optimised. OBJECTIVE: To present medium-term radiological and clinical follow-up of biopsy-negative lesions. DESIGN, SETTING, AND PARTICIPANTS: The records for men who underwent multiparametric MRI at the UCLH one-stop clinic for suspected prostate cancer between September 2017 and March 2020 were reviewed (n = 1199). Patients with Likert 4 or 5 lesions were considered (n = 495), and those with a subsequent negative MRI-TB comprised the final study population (n = 91). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Baseline and follow-up MRI and biopsy data (including prostate-specific antigen [PSA], prostate volume, radiological scores, and presence of any noncancerous pathology) were extracted from reports. The last follow-up date was the date of the last test or review in clinic. RESULTS AND LIMITATIONS: Median follow-up was 1.8 yr (656 d, interquartile range [IQR] 359-1008). At baseline, the median age was 65.4 yr (IQR 60.7-70.0), median PSA was 7.1 ng/ml (IQR 4.7-10.0), median prostate volume was 54 ml (IQR 39.5-75.0), and median PSA density (PSAD) was 0.13 ng/ml2 (IQR 0.09-0.18). Eighty-six men (95%) had Likert 4 lesions, while the remaining five (5%) had Likert 5 lesions. Only 21 men (23%) had a single lesion; most had at least two. Atrophy was the most prevalent pathology on MRI-TB, present in 64 men (74%), and followed by acute inflammation in 42 (46%), prostatic intraepithelial neoplasia in 33 (36%), chronic inflammation in 18 (20%), atypia in 13 (14%), and granulomatous inflammation in three (3%). Fifty-eight men had a second MRI study (median 376 d, IQR 361-412). At the second MRI, median PSAD decreased to 0.11 ng/ml2 (IQR 0.08-0.18). A Likert 4 or 5 score persisted only in five men (9%); 40 men (69%) were scored Likert 3, while the remaining 13 (22%) were scored Likert 2 (no lesion). Of 45 men with a Likert ≥3 score, most only had one lesion at the second MRI (28 men; 62%). Of six men with repeat MRI-TB during the study period, two were subsequently diagnosed with prostate cancer and both had persistent Likert 4 scores (at baseline and at least one follow-up MRI). CONCLUSIONS: Most biopsy-negative MRI lesions in the prostate resolve over time, but any persistent lesions should be closely monitored. PATIENT SUMMARY: Lesions in the prostate detected via magnetic resonance imaging (MRI) scans that are negative for cancer on biopsy usually resolve. Repeat MRI can indicate persistent lesions that might need a second biopsy

Establishment of a core outcome set for burn care research: development and international consensus

Objective: To develop a core outcome set for international burn research.Design: Development and international consensus, from April 2017 to November 2019.Methods: Candidate outcomes were identified from systematic reviews and stakeholder interviews. Through a Delphi survey, international clinicians, researchers, and UK patients prioritised outcomes. Anonymised feedback aimed to achieve consensus. Pre-defined criteria for retaining outcomes were agreed. A consensus meeting with voting was held to finalise the core outcome set.Results: Data source examination identified 1021 unique outcomes grouped into 88 candidate outcomes. Stakeholders in round 1 of the survey, included 668 health professionals from 77 countries (18% from low or low middle income countries) and 126 UK patients or carers. After round 1, one outcome was discarded, and 13 new outcomes added. After round 2, 69 items were discarded, leaving 31 outcomes for the consensus meeting. Outcome merging and voting, in two rounds, with prespecified thresholds agreed seven core outcomes: death, specified complications, ability to do daily tasks, wound healing, neuropathic pain and itch, psychological wellbeing, and return to school or work.Conclusions: This core outcome set caters for global burn research, and future trials are recommended to include measures of these outcomes

Dementia: beyond disorders of mood

This editorial will present the growing argument in the research literature that mood disorders, as defined by psychiatric diagnostic criteria, do not well serve individuals with dementia. This is important because anxiety and depression are our most used and most influential ways of understanding a highly prevalent and personally important experience in dementia: emotion. As such, there is a need to review how the disorders are currently conceptualised since they may have limited applicability for individuals with dementia, and consider what alternatives there might be. Agitation is offered as a lesson in how imprecise descriptions of behaviour can exclude the internal world of people with dementia. In our research to explore how the emotional experiences of individuals with dementia are understood, we consider what might lie beyond disorders of mood

Ectopic Lymphoid Structures Support Ongoing Production of Class-Switched Autoantibodies in Rheumatoid Synovium

Costantino Pitzalis and colleagues show that lymphoid structures in synovial tissue of patients with rheumatoid arthritis support production of anti-citrullinated peptide antibodies, which continues following transplantation into SCID mice

Rheumatoid arthritis - clinical aspects: 134. Predictors of Joint Damage in South Africans with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) causes progressive joint damage and functional disability. Studies on factors affecting joint damage as clinical outcome are lacking in Africa. The aim of the present study was to identify predictors of joint damage in adult South Africans with established RA. Methods: A cross-sectional study of 100 black patients with RA of >5 years were assessed for joint damage using a validated clinical method, the RA articular damage (RAAD) score. Potential predictors of joint damage that were documented included socio-demographics, smoking, body mass index (BMI), disease duration, delay in disease modifying antirheumatic drug (DMARD) initiation, global disease activity as measured by the disease activity score (DAS28), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and autoantibody status. The predictive value of variables was assessed by univariate and stepwise multivariate regression analyses. A p value <0.05 was considered significant. Results: The mean (SD) age was 56 (9.8) years, disease duration 17.5 (8.5) years, educational level 7.5 (3.5) years and DMARD lag was 9 (8.8) years. Female to male ratio was 10:1. The mean (SD) DAS28 was 4.9 (1.5) and total RAAD score was 28.3 (12.8). The mean (SD) BMI was 27.2 kg/m2 (6.2) and 93% of patients were rheumatoid factor (RF) positive. More than 90% of patients received between 2 to 3 DMARDs. Significant univariate predictors of a poor RAAD score were increasing age (p = 0.001), lower education level (p = 0.019), longer disease duration (p < 0.001), longer DMARD lag (p = 0.014), lower BMI (p = 0.025), high RF titre (p < 0.001) and high ESR (p = 0.008). The multivariate regression analysis showed that the only independent significant predictors of a higher mean RAAD score were older age at disease onset (p = 0.04), disease duration (p < 0.001) and RF titre (p < 0.001). There was also a negative association between BMI and the mean total RAAD score (p = 0.049). Conclusions: Patients with longstanding established RA have more severe irreversible joint damage as measured by the clinical RAAD score, contrary to other studies in Africa. This is largely reflected by a delay in the initiation of early effective treatment. Independent of disease duration, older age at disease onset and a higher RF titre are strongly associated with more joint damage. The inverse association between BMI and articular damage in RA has been observed in several studies using radiographic damage scores. The mechanisms underlying this paradoxical association are still widely unknown but adipokines have recently been suggested to play a role. Disclosure statement: C.I. has received a research grant from the Connective Tissue Diseases Research Fund, University of the Witwatersrand. All other authors have declared no conflicts of interes