London Sites Research Articles

Development and Validation of a Mortality Risk Score for Repaired Tetralogy of Fallot.

Robust risk assessment is crucial for the growing repaired tetralogy of Fallot population at risk of major adverse clinical outcomes; however, current tools are hindered by lack of validation. This study aims to develop and validate a risk prediction model for death in the repaired tetralogy of Fallot population. Patients with repaired tetralogy of Fallot enrolled in the INDICATOR (International Multicenter Tetralogy of Fallot Registry) cohort with clinical, arrhythmia, cardiac magnetic resonance, and outcome data were included. Patients from London, Amsterdam, and Boston sites were placed in the development cohort; patients from the Toronto site were used for external validation. Multivariable Cox regression was used to evaluate factors associated with time from cardiac magnetic resonance until the primary outcome: all-cause death. Of 1552 eligible patients (n=1221 in development, n=331 in validation; median age at cardiac magnetic resonance 23.4 [interquartile range, 15.6-35.6] years; median follow up 9.5 years), 102 (6.6%) experienced the primary outcome. The multivariable Cox model performed similarly during development (concordance index, 0.83 [95% CI, 0.78-0.88]) and external validation (concordance index, 0.80 [95% CI, 0.71-0.90]) and identified older age at cardiac magnetic resonance, obesity, type of tetralogy of Fallot repair, higher right ventricular end-systolic volume index, and lower biventricular global function index as independent predictors of death. A risk-scoring algorithm dividing patients into low-risk (score ≤4) versus high-risk (score >4) groups was validated to effectively discriminate risk of death (15-year survival of 95% versus 74%, respectively; P<0.001). This externally validated mortality risk prediction algorithm can help identify vulnerable patients with repaired tetralogy of Fallot who may benefit from targeted interventions.

Impact of exposure to urban air pollution on grey squirrel (Sciurus carolinensis) lung health

The increased rate of global urbanisation has recently exacerbated the significant public health problem of traffic related air pollution. Despite the known significant impact on human health, little is known about the effects of air pollution on wildlife health. The lung is the primary target organ for the effects of exposure to air pollution, leading to lung inflammation, altering the lung epigenome, culminating in respiratory disease. In this study, we aimed to assess lung health and DNA methylation profiles in Eastern grey squirrel (Sciurus carolinensis) populations living across an urban-rural air pollution gradient. Squirrel lung health was assessed in four populations situated across the most polluted inner-city boroughs to the less polluted edges of Greater London. We also assessed lung DNA methylation across three London sites and a further two rural sites in Sussex and North Wales. Lung and tracheal diseases were present in 28% and 13% of the squirrels respectively. Specifically, focal inflammation (13%), focal macrophages with vacuolated cytoplasm (3%) and endogenous lipid pneumonia (3%). There was no significant difference in prevalence of lung, tracheal diseases, anthracosis (carbon presence) or lung DNA methylation levels between urban sites and urban and rural sites respectively or NO2 levels. BALT (Bronchus-Associated Lymphoid Tissue) was significantly smaller in the site with highest NO2 and contained the highest carbon loading compared to sites with lower NO2, however differences in carbon loading in between sites were not significant. High pollution site individuals also had significantly higher numbers of alveolar macrophages which suggests that grey squirrels are exposed to and respond to traffic-related air pollution and further research is needed to understand the impact of traffic-related air pollutants on wildlife health.

The Flowers of Extinction: An Ecocritical Flâneur in London, April 2019 to April 2020

ABSTRACT How does one do ‘ecocritical Walter Benjamin’ in the city of London? As a professional flâneur between April 2019 and April 2020, I enlisted the support of Benjamin’s 1940 writings ‘Some Motifs in Baudelaire’ and ‘On the Concept of History’, and four poems from Charles Baudelaire’s Les Fleurs du Mal. These lyrics explore entangled spaces between the human and nonhuman world. Benjamin developed two concepts – ‘shock’ and ‘shock experience’ (Chockerlebnis), the latter through his engagement with Baudelaire’s work. Therefore, ecopoetic analyses of Baudelaire’s ‘Correspondances’, ‘Obsession’ (1857), ‘Le Soleil’ and ‘Le Squelette Laboureur’ (1861) aided my analysis of four London sites: Lewisham’s train tracks, Sky Garden, Oxford Circus, and the Charterhouse Museum. Reading the four sites with the aid of Baudelaire’s lyrics allowed an unearthing and creation of dialectical images as they relate to the climate emergency.

The Triumphs of Repetition: Living Places in Early Modern Mayoral Shows

This article expands on previous studies of repetition in mayoral shows by examining the manner by which the genre regularly brings London sites to life. As forms of environmental theatre that fashion civic sites into dramatic participants, the shows repeatedly represent London and its places as recurring characters, or actants, in the civic dramatic events. London locations take on a protean quality by addressing changing and topical circumstances in relation to their functions and topography, despite their seemingly fixed nature. The later shows of Thomas Middleton in particular are explored for the ways in which they blend person and place by merging space and speech through an anonymous speaker in a specific locale. In these instances, place — and by extension the city of London fully — becomes a living part of the drama that speaks and participates in the environmental theatre of the day and year ahead.

Design method for the ‘impression pile’

Urban development in congested cities requires a better exploitation of the available surface, leading to taller structures. These buildings are usually founded on piles that have to be increased in dimension to accommodate the larger loads, resulting in increases in both the cost and the carbon dioxide footprint of the pile foundation. An alternative option is to improve pile performance by enhancing the shaft capacity, which is commonly the most important factor in determining the ultimate capacity of a pile constructed in a clay soil subjected to axial load. For piles in stiff clays such as London Clay, the soil–pile friction may be increased by profiling the side walls of a bored cast in situ pile with small discrete ‘impressions’ such that the latter form nodules on the shaft of the concreted pile. Centrifuge tests carried out at City, University of London, and field trials undertaken by Keltbray Piling across different London sites showed an increase in the shaft capacity of around 40%. In this work, a simple design method based on experimental evidence and an existing plastic failure mechanism was derived for ‘impression’ piles. The proposed method shows good agreement with data and enables a direct prediction of the increase in capacity for future designs.

Is Heathrow airport really a localised hot spot?

Location of observing sites mentioned in the text. The extent of London's built-up area is also shown. Base map obtained from OpenStreetMap (www.openstreetmap.org) and Open Street Map Foundation, licensed as CC BY-SA. (© OpenStreetMap contributors.) Daily maximum temperatures observed at London's Heathrow airport are compared with those of other official observing sites around the west and southwest of London to explore how representative Heathrow's temperatures are of the local environment. The frequency with which Heathrow is the warmest place in the UK is found to peak sharply between June and September. However, daily maximum temperatures at all of the London sites are usually similar, particularly at other times of the year.

Marion Steven and the Logie Collection

Marion Kerr Steven (1912–1999), founder of the James Logie Memorial Collection at the University of Canterbury, has been a significant and yet elusive figure in the university’s history. A recent oral history project in the Department of Classics has built up a vivid impression of Steven’s character and personal influence on her students. Prior to this, Steven’s travel diary from 30 November 1958 to 13 July 1959 was donated to the Logie Collection and transcribed in 2017. This article, resulting from research in relation to the transcription, situates Steven in context as a woman in the then male-dominated academic world, and explores her role in reshaping classics as a discipline at the University of Canterbury. The diary records her journeys to London, Rome, and various sites across Greece as she conducted research for teaching purposes, scouted out new objects for the Collection, and participated in meetings of academic organisations. While the period was perceived by many in the field as a time of crisis for classics, Steven appears to have instead seized the opportunity to extend the potential of the discipline.

Cetacean exploitation in Roman and medieval London: Reconstructing whaling activities by applying zooarchaeological, historical, and biomolecular analysis

Cetacean (whale, dolphin, and porpoise) remains are occasionally encountered at Roman and medieval sites in London and are regularly the topic of medieval historical sources. These sources are often concerned with whale strandings and the subsequent claims on the carcass by the king, queen, or other members of the nobility or clergy with jurisdiction over the coastline that the whale stranded upon. The meat stripped from the carcasses was regularly transported to London and cetaceans have therefore been ascribed as a “high-status food source”. Besides, strandings, several historical sources also suggest that active whaling was undertaken, and that meat was sold at several London markets. Based on these historical sources it however remains unclear to what extent active whaling was undertaken, and which species were exploited.Zooarchaeological studies address whales and their role in Roman and medieval society more directly through the study of animal bones. This study combines historical sources and the identification of zooarchaeological cetacean remains from the London sites of Bermondsey Abbey, Westminster Abbey (cellarium), Winchester Palace, Vintry, St Peter’s Hill, and Trig Lane through Zooarchaeology by Mass Spectrometry (ZooMS) and morphological analysis. The historical and zooarchaeological evidence from London indicates that cetacean meat was indeed associated with a high-status diet, in particular the ecclesiastical diet, though some form of commercialization of cetacean meat also took place. On occasion, whale bone was used for the creation of bone artefacts or tools, primarily during the Middle Saxon period. Additionally, it is suggested that active whaling might occasionally have been undertaken, potentially already from the Middle Saxon period onwards. However, the majority of the remains were probably acquired through opportunistic scavenging of stranded individuals.

Analysis from the NeoOBS Global Neonatal Sepsis Prospective Observational Cohort Study Across 19 Hospitals in 11 Countries; Clinical Presentation, Treatment, Mortality Outcomes and Development of the NeoSEP Sepsis Severity Score

Background: Neonatal sepsis is associated with high mortality, but there is limited clinical data on outcomes in hospital facilities in low and middle income countries (LMIC). The NeoOBS study aimed to determine the clinical features, pathogens and clinical outcomes of infants presenting with neonatal sepsis in hospitals globally. Methods: Infants <60 days of age, fulfilling at least 2 sepsis criteria were enrolled across 19 sites in 11 countries, with prospective data collection to 28 days. A multivariable Cox regression model was built to predict mortality and develop a sepsis severity score in 85% of infants (randomly selected) and validated in 15%. Findings: 3204 infants were enrolled between 2018-2020; median (IQR) postnatal age was 5 (2-15) days, birth weight 2500g (1400-3000g), with 4 (2-5) clinical and 1 (0-2) laboratory sepsis criteria, and 69% hospitalised since birth. Overall mortality was 11.3% (95%CI 10.2-12.5%; n=350), but higher in infants with culture positive blood stream infection at baseline (17.7%, 95%CI 14.7-21.1%, n=564) than culture negative (n=2631, 9.9%, 95%CI 8.8-11.2%). Among 309 infection-related deaths, 59% (n=183) occurred in healthcare-associated infections (HAI). Klebsiella pneumoniae was the most common pathogen identified (n=132, 23.4% of baseline cultures). A wide variety of antibiotic regimens were prescribed, with frequent use of carbapenems. A sepsis severity score was developed using infants’ characteristics, supportive care, and clinical signs. In the validation sample, mortality (95%CI) was 1% (0-5%), 6% (4-10%), and 28% (19-39%) in low (score 0-3), medium (4-6) and high (7-14) risk groups, respectively. Interpretation: High rates of HAI, mortality and carbapenem use were observed in neonatal units globally. Novel strategic treatment and prevention trials are urgently required, where the NeoSEP score may have utility. Funding Information: The study was sponsored by the Global Antibiotic Research and Development Partnership (GARDP) with additional funding from: Bill and Melinda Gates Foundation, German Federal Ministry of Education and Research (BMBF), South African Medical Research Council, UK Department of Health and Social Care, Monaco and in-kind contribution from Indian Council for Medical Research. Declaration of Interests: None to declare. Ethics Approval Statement: Ethical approval was obtained both from St. George’s, University of London Research Ethics Committee and sites’ local, central or national ethics committees and other relevant local bodies, where required.

Investigating the background and local contribution of the oxidants in London and Bangkok.

The contribution of NOx emissions and background O3 to the sources and partitioning of the oxidants [OX (= O3 + NO2)] at the Marylebone Road site in London during the 2000s and 2010s has been investigated to see the impact of the control measures or technology changes inline with the London Mayor's Air Quality Strategy. The abatement of the pollution emissions has an impact on the trends of local and background oxidants, [OX]L and [OX]B, decreasing by 1.4% per year and 0.4% per year, respectively from 2000 to 2019. We also extend our study to three roadside sites (Din Daeng, Thonburi and Chokchai) in another megacity, Bangkok, to compare [OX]L and [OX]B and their behavioural changes with respect to the Marylebone Road site. [OX]L and [OX]B at the Marylebone Road site (0.21[NOx] and 32 ppbv) are comparable with the roadside sites of Thailand (0.12[NOx] to 0.26[NOx] and 29 to 32 ppbv). The seasonal variation of [OX]B levels displays a spring maximum for London, which is due to the higher northern hemispheric ozone baseline, but a maximum during the dry season is found for Bangkok which is likely due to regional-scale long-range transport from the Asian continent. The diurnal variations of [OX]L for both London and Bangkok roadside sites confirm the dominance of the oxidants from road transport emissions, which are found to be higher throughout the daytime. WRF-Chem-CRI model simulations of the distribution of [OX] showed that the model performed well for London background sites when predicting [OX] levels compared with the measured [OX] levels suggesting that the model is treating the chemistry of the oxidants correctly. However, there are large discrepancies for the model-measurement [OX] levels at the traffic site because of the difficulties in the modelling of [OX] at large road networks in megacities for the complex sub grid-scale dynamics that are taking place, both in terms of atmospheric processes and time-varying sources, such as traffic volumes. For roadside sites in Bangkok, the trend in changes of [OX] is predicted by the model correctly but overestimated in absolute magnitude. We suggest that this large deviation is likely to be due to discrepancies in the EDGAR emission inventory (emission overestimates) beyond the resolution of the model.

The Community Navigator Study: Results from a feasibility randomised controlled trial of a programme to reduce loneliness for people with complex anxiety or depression.

BackgroundLoneliness is common among people with mental health problems and predicts poorer recovery from depression and anxiety. Needs for support with loneliness and social relationships are often under-addressed in mental health services.The Community Navigator programme was designed to reduce loneliness for adults (aged 18 and above) with complex depression or anxiety who were using secondary mental health services. Acceptability and feasibility of the programme and a trial evaluation were tested in a feasibility randomised controlled trial with qualitative evaluation.MethodsForty participants with depression or anxiety using secondary mental health services were recruited from mental health services in two London sites and randomised to receive: the Community Navigator programme over six months in addition to routine care (n = 30); or routine care (n = 10). Measures of loneliness, depression, other clinical and social outcomes and service use were collected at baseline and six-months follow-up. Levels of engagement in the programme and rates of trial recruitment and retention were assessed. Programme delivery was assessed through session logs completed by Community Navigators. The acceptability of the programme was explored through qualitative interviews (n = 32) with intervention group participants, their family and friends, programme providers and other involved staff.ResultsForty participants were recruited in four months from 65 eligible potential participants asked. No one withdrew from the trial. Follow-up interviews were completed with 35 participants (88%). Process records indicated the programme was delivered as intended: there was a median of seven meetings with their Community Navigator (of a maximum ten) per treatment group participant. Qualitative interviews indicated good acceptability of the programme to stakeholders, and potential utility in reducing loneliness and depression and anxiety.ConclusionsA definitive, multi-site randomised controlled trial is recommended to evaluate the effectiveness and cost-effectiveness of the Community Navigator programme for people with complex anxiety and depression in secondary mental health services.

HIV positive and treated for cancer: The convergence of pressures "invisible" in HIV and "visible" in cancer.

ObjectiveAn increasing number of people living with HIV are living longer and experiencing a dual diagnosis of HIV and cancer. Little is known of their experience and quality of care. This paper presents the findings of a study exploring experiences of cancer care, from the perspectives of both patients and healthcare professionals.MethodsThematic analysis of participant narratives provided in longitudinal, semi‐structured interviews with 17 people, recruited from three London sites between 2015 and 2017. Focused ethnography comprising 27 hr of participant observation and seven semi‐structured interviews with healthcare professionals.ResultsBoth HIV and cancer have a powerful, combined impact; in cancer, the impact is visible; in HIV, it is generally hidden. Patients and staff experienced particular challenges in the cancer setting. Patients felt responsible for their HIV management and described being excluded from clinical trials. Both staff and patients encountered difficulties around the management of information relating to HIV.ConclusionThis dual diagnosis has a profound and negative effect on patients' experiences and potential outcomes. Improvement depends on interventions that acknowledge the shared social narrative and impact of HIV‐related stigma so that this burden is not carried by the patient alone.

CN46 - HIV positive and treated for cancer: A qualitative study exploring the experiences of HIV related stigma in the cancer clinical setting

BackgroundAn increasing number of people living with HIV are living longer and experiencing a dual diagnosis of HIV and cancer. Little is known of their experience and quality of care. Here we present the findings of a study exploring patient experiences of cancer care, with a focus on the impact of HIV related stigma in the cancer clinical setting. MethodsAn interpretive approach, utilising qualitative research methods was adopted to explore the complexity of experiences. Thematic analysis of participant narratives provided in longitudinal, semi-structured interviews with 17 people, recruited from three London sites between 2015 and 2017. Focused ethnography comprising 27hours of participant observation and seven semi-structured interviews with healthcare professionals. ResultsBoth HIV and cancer have a powerful, combined impact on individuals with a dual diagnosis; in cancer the impact is visible; in HIV it is generally hidden. Patients reported feeling a sense of difference within cancer services. The combination of marginalising features such as age, ethnicity and sexuality with reported experiences such as exclusion from clinical trials, extra infection control precautions and tensions about the involvement of the GP led to a powerful felt stigma. Inadequate knowledge about HIV amongst healthcare staff who were unfamiliar with the latest changes in the HIV field led to patients feeling isolated and dependent on their own resources to navigate care. The management of information relating to HIV status was experienced as an additional emotional burden on top of a physically debilitating and disruptive cancer diagnosis. Issues around disclosure were often framed by healthcare professionals as inconvenient and potentially unsafe, but they did not always demonstrate empathy for the potentially devastating implications for those patients for whom secrecy was integral to continued social support. ConclusionsDual diagnosis of cancer and HIV can have a profound and negative effect on patients’ experiences and potentially outcomes. Improvement depends on interventions that acknowledge the shared social narrative and impact of HIV-related stigma so that this burden is not carried by the patient alone. Legal entity responsible for the studyUCL. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Improving Health Literacy about Tuberculosis among Drug Users. A Pilot Randomised Controlled Trial

Introduction: Despite effective treatment, tuberculosis remains among the top-10 causes of death causing ~1.3 million deaths in 2017. Furthermore, tuberculosis infection rates have increased amongst excluded populations such as people misusing substances. Objectives and design: We conducted a two London sites pilot randomized controlled trial to test interventions, recruitment, attrition rates and assessment procedures of a parallel, three-arms controlled trial to assess the effectiveness of tuberculosis health literacy interventions among drug dependent (heroin, crack cocaine or heroin and crack cocaine) population in treatment. Results: Forty-two subjects were recruited to the pilot trial (response rate = 26%) and randomized to three interventions (1st: Information booklet; 2nd: Interactive seminar; 3rd: Interactive seminar + contingency management targeting tuberculosis-health-related action). Baseline and post-intervention tuberculosis knowledge scores were obtained and re-assessed at 2-months follow up. The overall attrition rate was 43%. The knowledge scale had good internal reliability (Cronbach’s α = 0.7). Statistically significant increases in knowledge scores (baseline to post-intervention = 5.9 points, baseline to follow-up = 4.3) were recorded for the whole sample (CI = 99%; p < 0.001 for both analysis), but no statistically significant differences between-groups were observed (p = 0.7). Half of participants in the contingency management group achieved their health-action targets. Conclusion: Health literacy interventions to increase knowledge about tuberculosis among drug users are feasible and achieve promising increases in knowledge and health-related actions but measures to prevent a high attrition rate in a large-scale trial must be introduced. The absence of difference between trial-group outcomes suggests low-intensity interventions may achieve knowledge gain too. Further investigation of contingency management to promote tuberculosis-related health behaviours is needed.

Exploring Michèle Roberts’ Imagined Voices in The Walworth Beauty

The Walworth Beauty (2017) is Michèle Roberts’s haunting new novel, which links historical facts with imaginative fiction. Set in central London, the Anglo-French feminist writer’s novel explores certain Victorian women’s lives, lives which are simultaneously connected with those of twenty-first century men and women. A researcher from the nineteenth century, Joseph Benson, and a retired lecturer and writer from today, Madeleine, develop their stories in different times but in similar locations around a Walworth cul-de-sac and other London sites. Past and present, north and south London link to uncover the enigmatic accounts pictured by the protagonists of this sensuous work of fiction. Inspired by Henry Mayhew’s fourth volume dedicated to the villains, the poor and the prostitutes of the Victorian era, Michèle Roberts narrates the story that emerges from their unrecorded words, putting these women’s voices and personal testimonies on paper. Walking the streets of London will connect Joseph and Madeleine, two flâneurs who are witnessing and feeling the different pathways they encounter. The inner and the outer voices of the protagonists establish a dialogue between the man and the woman that celebrates human connection.

Interpretation of particle number size distributions measured across an urban area during the FASTER campaign

Abstract. Particle number size distributions have been measured simultaneously by scanning mobility particle sizers (SMPSs) at five sites in central London for a 1 month campaign in January–February 2017. These measurements were accompanied by condensation particle counters (CPCs) to measure total particle number count at four of the sites and Aethalometers measuring black carbon (BC) at five sites. The spatial distribution and inter-relationships of the particle size distribution and SMPS total number counts with CPC total number counts and black carbon measurements have been analysed in detail as well as variations in the size distributions. One site (Marylebone Road) was in a street canyon with heavy traffic, one site (Westminster University) was on a rooftop adjacent to the Marylebone Road sampler, and a further sampler was located at Regent's University within a major park to the north of Marylebone Road. A fourth sampler was located nearby at 160 m above ground level on the BT tower and a fifth sampler was located 4 km to the west of the main sampling region at North Kensington. Consistent with earlier studies it was found that the mode in the size distribution had shifted to smaller sizes at the Regent's University (park) site, the mean particle shrinkage rate being 0.04 nm s−1 with slightly lower values at low wind speeds and some larger values at higher wind speeds. There was evidence of complete evaporation of the semi-volatile nucleation mode under certain conditions at the elevated BT Tower site. While the SMPS total count and black carbon showed typical traffic-dominated diurnal profiles, the CPC count data typically peaked during night-time as did CPC∕SMPS and CPC∕BC ratios. This is thought to be due to the presence of high concentrations of small particles (2.5–15 nm diameter) probably arising from condensational growth from traffic emissions during the cooler night-time conditions. Such behaviour was most marked at the Regent's University and Westminster University sites and less so at Marylebone Road, while at the elevated BT Tower site the ratio of particle number (CPC) to black carbon peaked during the morning rush hour and not at night-time, unlike the other sites. An elevation in nucleation mode particles associated with winds from the west and WSW sector was concluded to result from emissions from London Heathrow Airport, despite a distance of 22 km from the central London sites.

Modelling carbonaceous aerosol from residential solid fuel burning with different assumptions for emissions

Abstract. Evidence is accumulating that emissions of primary particulate matter (PM) from residential wood and coal combustion in the UK may be underestimated and/or spatially misclassified. In this study, different assumptions for the spatial distribution and total emission of PM from solid fuel (wood and coal) burning in the UK were tested using an atmospheric chemical transport model. Modelled concentrations of the PM components were compared with measurements from aerosol mass spectrometers at four sites in central and Greater London (ClearfLo campaign, 2012), as well as with measurements from the UK black carbon network.The two main alternative emission scenarios modelled were Base4x and combRedist. For Base4x, officially reported PM2.5 from the residential and other non-industrial combustion source sector were increased by a factor of four. For the combRedist experiment, half of the baseline emissions from this same source were redistributed by residential population density to simulate the effect of allocating some emissions to the smoke control areas (that are assumed in the national inventory to have no emissions from this source). The Base4x scenario yielded better daily and hourly correlations with measurements than the combRedist scenario for year-long comparisons of the solid fuel organic aerosol (SFOA) component at the two London sites. However, the latter scenario better captured mean measured concentrations across all four sites. A third experiment, Redist – all emissions redistributed linearly to population density, is also presented as an indicator of the maximum concentrations an assumption like this could yield.The modelled elemental carbon (EC) concentrations derived from the combRedist experiments also compared well with seasonal average concentrations of black carbon observed across the network of UK sites. Together, the two model scenario simulations of SFOA and EC suggest both that residential solid fuel emissions may be higher than inventory estimates and that the spatial distribution of residential solid fuel burning emissions, particularly in smoke control areas, needs re-evaluation. The model results also suggest the assumed temporal profiles for residential emissions may require review to place greater emphasis on evening (including discretionary) solid fuel burning.

Functional Neuroimaging Predictors of Self-Reported Psychotic Symptoms in Adolescents.

This study investigated the neural correlates of psychotic-like experiences in youths during tasks involving inhibitory control, reward anticipation, and emotion processing. A secondary aim was to test whether these neurofunctional correlates of risk were predictive of psychotic symptoms 2 years later. Functional imaging responses to three paradigms-the stop-signal, monetary incentive delay, and faces tasks-were collected in youths at age 14, as part of the IMAGEN study. At baseline, youths from London and Dublin sites were assessed on psychotic-like experiences, and those reporting significant experiences were compared with matched control subjects. Significant brain activity differences between the groups were used to predict, with cross-validation, the presence of psychotic symptoms in the context of mood fluctuation at age 16, assessed in the full sample. These prediction analyses were conducted with the London-Dublin subsample (N=246) and the full sample (N=1,196). Relative to control subjects, youths reporting psychotic-like experiences showed increased hippocampus/amygdala activity during processing of neutral faces and reduced dorsolateral prefrontal activity during failed inhibition. The most prominent regional difference for classifying 16-year-olds with mood fluctuation and psychotic symptoms relative to the control groups (those with mood fluctuations but no psychotic symptoms and those with no mood symptoms) was hyperactivation of the hippocampus/amygdala, when controlling for baseline psychotic-like experiences and cannabis use. The results stress the importance of the limbic network's increased response to neutral facial stimuli as a marker of the extended psychosis phenotype. These findings might help to guide early intervention strategies for at-risk youths.

Cocaine and cannabinoids in the atmosphere of Northern Europe cities, comparison with Southern Europe and wastewater analysis

This study reports the first investigation of atmospheric illicit drug concentrations in Northern Europe using measurements of cocaine and cannabinoids in Amsterdam, London and Stockholm. Further, these measurements were compared to those made in Rome to explore the geographical and inter-city variability. Co-located measurements of atmospheric particulate mass and PAHs were used to help describe and interpret the illicit drug measurements with respect to atmospheric dispersion. Cocaine concentrations ranged from 0.03 to 0.14ng/m3 in Amsterdam, from 0.02 to 0.33ng/m3 in London and were below quantification limit (3pg/m3) in Stockholm. Cannabinol was the only cannabinoid molecule detected in the three cities. During this campaign, London reported the highest concentrations of cocaine and meaningful differences were detected between the urban background and city centre London sites. Mean cocaine concentrations measured in Amsterdam during March 2011 were also compared with those measured simultaneously in eight Italian cities. The cocaine concentration in Amsterdam was comparable to that measured at an urban background in Milan and at a densely populated site in Florence. Although correlating atmospheric concentrations directly with drug prevalence is not possible using current data, links between concentrations of cocaine and estimates of abuse prevalence assessed by the more routinely used wastewater analysis were also examined. A statistically significant correlation was found between the two sets of data (R2=0.66; p=0.00131). Results confirmed that meteorology, population rate and habits of consumption influence the atmospheric concentrations of drugs. If these confounding factors were better controlled for, the techniques described here could became an easy and cost effective tool to index the impact of cocaine abuse in the area; especially where local hot spots need to be identified.

Comparison of methods for evaluation of wood smoke and estimation of UK ambient concentrations

Abstract. Airborne concentrations of the wood smoke tracers, levoglucosan and fine potassium have been measured at urban and rural sites in the United Kingdom alongside measurements with a multi-wavelength aethalometer. The UK sites, and especially those in cities, show low ratios of levoglucosan to potassium in comparison to the majority of published data. It is concluded that there may be two distinct source types, one from wood stoves and fireplaces with a high organic carbon content, best represented by levoglucosan, the other from larger, modern appliances with a very high burn-out efficiency, best represented by potassium. Based upon levoglucosan concentrations and a conversion factor of 11.2 from levoglucosan to wood smoke mass, average concentrations of wood smoke including winter and summer sampling periods are 0.23 μg m−3 in Birmingham and 0.33 μg m−3 in London, well below concentrations typical of other northern European urban areas. There may be a further contribution from sources of potassium-rich emissions amounting to an estimated 0.08 μg m−3 in Birmingham and 0.30 μg m−3 in London. Concentrations were highly correlated between two London sites separated by 4 km suggesting that a regional source is responsible. Data from the aethalometer are either supportive of these conclusions or suggest higher concentrations, depending upon the way in which the data are analysed.