Surface water flood warnings in England: overview, Assessment and recommendations based on survey responses and workshops

Following extensive surface water flooding (SWF) in England in summer 2007, progress has been made in improving the management and prediction of this type of flooding. A rainfall threshold-based extreme rainfall alert (ERA) service was launched in 2009 and superseded in 2011 by the surface water flood risk assessment (SWFRA). Through survey responses from local authorities (LAs) and the outcome of workshops with a range of flood professionals, this paper examines the understanding, benefits, limitations and ways to improve the current SWF warning service. The current SWFRA alerts are perceived as useful by district and county LAs, although their understanding of them is limited. The majority of LAs take action upon receipt of SWFRA alerts, and their reactiveness to alerts appears to have increased over the years and as SWFRA superseded ERA. This is a positive development towards increased resilience to SWF. The main drawback of the current service is its broad spatial resolution. Alternatives for providing localised SWF forecast and warnings were analysed, and a two-tier national-local approach, with pre-simulated scenario-based local SWF forecasting and warning systems, was deemed most appropriate by flood professionals given current monetary, human and technological resources

A blood atlas of COVID-19 defines hallmarks of disease severity and specificity.

Treatment of severe COVID-19 is currently limited by clinical heterogeneity and incomplete description of specific immune biomarkers. We present here a comprehensive multi-omic blood atlas for patients with varying COVID-19 severity in an integrated comparison with influenza and sepsis patients versus healthy volunteers. We identify immune signatures and correlates of host response. Hallmarks of disease severity involved cells, their inflammatory mediators and networks, including progenitor cells and specific myeloid and lymphocyte subsets, features of the immune repertoire, acute phase response, metabolism, and coagulation. Persisting immune activation involving AP-1/p38MAPK was a specific feature of COVID-19. The plasma proteome enabled sub-phenotyping into patient clusters, predictive of severity and outcome. Systems-based integrative analyses including tensor and matrix decomposition of all modalities revealed feature groupings linked with severity and specificity compared to influenza and sepsis. Our approach and blood atlas will support future drug development, clinical trial design, and personalized medicine approaches for COVID-19

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Adversarial Queueing Model for Continuous Network Dynamics

In this paper we initiate the generalization of the Adversarial Queueing Theory (AQT) model to capture the dynamics of continuous scenarios in which th

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease