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Antarctica's ice shelves modulate the grounded ice flow, and weakening of ice shelves due to climate forcing will decrease their ‘buttressing’ effect, causing a response in the grounded ice. While the processes governing ice-shelf weakening are complex, uncertainties in the response of the grounded ice sheet are also difficult to assess. The Antarctic BUttressing Model Intercomparison Project (ABUMIP) compares ice-sheet model responses to decrease in buttressing by investigating the ‘end-member’ scenario of total and sustained loss of ice shelves. Although unrealistic, this scenario enables gauging the sensitivity of an ensemble of 15 ice-sheet models to a total loss of buttressing, hence exhibiting the full potential of marine ice-sheet instability. All models predict that this scenario leads to multi-metre (1–12 m) sea-level rise over 500 years from present day. West Antarctic ice sheet collapse alone leads to a 1.91–5.08 m sea-level rise due to the marine ice-sheet instability. Mass loss rates are a strong function of the sliding/friction law, with plastic laws cause a further destabilization of the Aurora and Wilkes Subglacial Basins, East Antarctica. Improvements to marine ice-sheet models have greatly reduced variability between modelled ice-sheet responses to extreme ice-shelf loss, e.g. compared to the SeaRISE assessments.
We describe an ultra-wide-bandwidth, low-frequency receiver recently installed on the Parkes radio telescope. The receiver system provides continuous frequency coverage from 704 to 4032 MHz. For much of the band (
), the system temperature is approximately 22 K and the receiver system remains in a linear regime even in the presence of strong mobile phone transmissions. We discuss the scientific and technical aspects of the new receiver, including its astronomical objectives, as well as the feed, receiver, digitiser, and signal processor design. We describe the pipeline routines that form the archive-ready data products and how those data files can be accessed from the archives. The system performance is quantified, including the system noise and linearity, beam shape, antenna efficiency, polarisation calibration, and timing stability.
Remote monitoring of mood disorders may be an effective and low resource option for patient follow-up, but relevant evidence remains very limited. This study explores real-life compliance and health services impacts of mood monitoring among patients with bipolar disorder in the UK.
Patients with a diagnosis of bipolar disorder who were registered users of the True Colours monitoring system for at least 12 months at study assessment were included in this retrospective cohort study (n = 79). Compliance was measured as the proportion of valid depression and mania scale messages received in comparison to their expected numbers over the first 12 months of monitoring. Mental health service use data were extracted from case notes, costed using national unit costs, and compared 12 months before (pre-TC period) and 12 months after (TC period) patients’ engagement with monitoring. Associations with relevant patient factors were investigated in a multiple regression model.
Average compliance with monitoring was 82%. Significant increases in the annual use and costs of psychiatrist contacts and total mental health services were shown for patients newly referred to the clinic during the pre-TC period but not for long-term patients of the clinic. Psychiatric medication costs increased significantly between the pre-TC and TC periods (£ 235, P = 0.005) unrelated to patients’ referral status.
Remote mood monitoring has good compliance among consenting patients with bipolar disorder. We found no associations between observed changes in mental health service costs and the introduction of monitoring except for the increase in psychiatric medication costs.
Research in developmental neuropsychiatric conditions has revealed morphological and functional divergences in the brain. In some cases, the divergences occur due to one or two highly penetrant genomic mutations. In case such as autism, mutations in varied sets of genes may produce a convergent autism behavioral phenotype. It is thus likely that there may be other forms of non-genomic regulation of gene expression during development affecting behavioral outcome. Epigenetic gene regulation is one such mechanism that can permanently switch on or switch off gene expression, and these epigenetic changes can be inherited from one cell stage to another during differentiation, mimicking the effects of genomic mutations. Epigenetic gene regulation occurring during early developmental stages of cellular differentiation, which are highly sensitive to environmental cues, is the primary mechanism responsible for the phenomenon known as evolutionary development or “evo-devo.” This chapter discusses these mechanisms in the context of autism and the environmental factors that influence it.
Health data have enormous potential to transform healthcare, health service design, research, and individual health management. However, health data collected by institutions tend to remain siloed within those institutions limiting access by other services, individuals or researchers. Further, health data generated outside health services (e.g., from wearable devices) may not be easily accessible or useable by individuals or connected to other parts of the health system. There are ongoing tensions between data protection and the use of data for the public good (e.g., research). Concurrently, there are a number of data platforms that provide ways to disrupt these traditional health data siloes, giving greater control to individuals and communities. Through four case studies, this paper explores platforms providing new ways for health data to be used for personal data sharing, self-health management, research, and clinical care. The case-studies include data platforms: PatientsLikeMe, Open Humans, Health Record Banks, and unforgettable.me. These are explored with regard to what they mean for data access, data control, and data governance. The case studies provide insight into a shift from institutional to individual data stewardship. Looking at emerging data governance models, such as data trusts and data commons, points to collective control over health data as an emerging approach to issues of data control. These shifts pose challenges as to how “traditional” health services make use of data collected on these platforms. Further, it raises broader policy questions regarding how to decide what public good data should be put towards.
We present Phantom, a fast, parallel, modular, and low-memory smoothed particle hydrodynamics and magnetohydrodynamics code developed over the last decade for astrophysical applications in three dimensions. The code has been developed with a focus on stellar, galactic, planetary, and high energy astrophysics, and has already been used widely for studies of accretion discs and turbulence, from the birth of planets to how black holes accrete. Here we describe and test the core algorithms as well as modules for magnetohydrodynamics, self-gravity, sink particles, dust–gas mixtures, H2 chemistry, physical viscosity, external forces including numerous galactic potentials, Lense–Thirring precession, Poynting–Robertson drag, and stochastic turbulent driving. Phantom is hereby made publicly available.
Recent genetic, isotopic and linguistic research has dramatically changed our understanding of how the Corded Ware Culture in Europe was formed. Here the authors explain it in terms of local adaptations and interactions between migrant Yamnaya people from the Pontic-Caspian steppe and indigenous North European Neolithic cultures. The original herding economy of the Yamnaya migrants gradually gave way to new practices of crop cultivation, which led to the adoption of new words for those crops. The result of this hybridisation process was the formation of a new material culture, the Corded Ware Culture, and of a new dialect, Proto-Germanic. Despite a degree of hostility between expanding Corded Ware groups and indigenous Neolithic groups, stable isotope data suggest that exogamy provided a mechanism facilitating their integration. This article should be read in conjunction with that by Heyd (2017, in this issue).
Pragmatists have traditionally been enemies of representationalism but friends of naturalism, when naturalism is understood to pertain to human subjects, in the sense of Hume and Nietzsche. In this volume Huw Price presents his distinctive version of this traditional combination, as delivered in his René Descartes Lectures at Tilburg University in 2008. Price contrasts his view with other contemporary forms of philosophical naturalism, comparing it with other pragmatist and neo-pragmatist views such as those of Robert Brandom and Simon Blackburn. Linking their different 'expressivist' programmes, Price argues for a radical global expressivism that combines key elements from both. With Paul Horwich and Michael Williams, Brandom and Blackburn respond to Price in new essays. Price replies in the closing essay, emphasising links between his views and those of Wilfrid Sellars. The volume will be of great interest to advanced students of philosophy of language and metaphysics.
The origins of this volume lie in a kind invitation from the Tilburg Center for Logic and Philosophy of Science (TiLPS), to deliver their inaugural René Descartes Lectures in May 2008. I was delighted to accept, and presented the lectures under the title ‘Three Themes in Contemporary Pragmatism’ (the themes in question being naturalism, representationalism and pluralism). The lecture series was held in conjunction with a research workshop on pragmatism and naturalism, providing me with a remarkable opportunity to discuss some of my recent work with the best kind of philosophical audience – broadly sympathetic to a considerable extent, yet challenging on many points. I am very grateful indeed to Professor Stephan Hartmann and his colleagues at TiLPS for their hospitality, and for doing me the honour of inviting me in the first place. I am also greatly indebted to the workshop speakers and participants, for their part in making it such a memorable and educational experience, from my point of view.
With the promise of such an excellent audience, I tried to use the lectures to do two things: first, to present what I felt to be the most interesting ideas in my recent work at that time, and, second, to try to think through some succeeding steps (very much work in progress, at that stage). Accordingly, I used the first lecture to present some material that was then recently in print, on the role and significance of representationalist presuppositions in conventional forms of philosophical naturalism.
Some women with lower urinary tract symptoms will require more extensive investigation than that outlined in chapter 3. Additional assessment may require any or a combination of urodynamics, cystoscopy and urinary tract imaging. It is important that any clinician referring a patient for such tests has an understanding of what the tests entail and the indications for them.
Urodynamic studies include uroflowmetry, post-void residual measurement and cystometry.
CLINICAL INDICATIONS FOR URODYNAMIC ASSESSMENT
Complex mixed lower urinary tract symptoms
Some women present with such a complicated history that it is impossible to make any judgement as to whether they are suffering from urinary stress incontinence, detrusor overactivity or voiding dysfunction. Such women cannot be treated empirically and they should progress without delay to a urodynamic assessment so that treatment can be tailored appropriately.
Before surgery for urinary stress incontinence
Stress incontinence is the most common cause of urinary leakage in women. If pelvic floor physiotherapy fails, surgery is the definitive treatment. History alone may be an adequate preoperative assessment in women presenting with pure stress incontinence symptoms and the National Institute for Health and Clinical Excellence (NICE) recommends that such women have primary continence surgery without further urodynamic investigation.