Resource Implications Research Articles

Geochemistry of Pelites at Chengmen Area: Implications for Sediments Resource and Tectonic Environment.

The pelite samples were collected from drillholes from the Chengmen area of the Fuzhou Basin of Fujian, China to reveal the sediments resource and tectonic environment of these pelites via an analysis of its lithology and geochemistry. The rare earth element distribution pattern of the pelites exhibited a high degree of fractionation between light and heavy rare earth elements, moderate negative Eu anomalies, and positive Ce anomalies, which are consistent with the rare earth element distribution pattern of Minjiang sediments and Fujian soils. Moreover, the variations in trace elements are also generally consistent, indicating a common provenance. The extremely high chemical index of alteration (CIA) and index of chemical variability (ICV) values of the pelites suggest that the source area experienced intense weathering, indicating a subtropical hot and humid climate environment in the source area and the Fuzhou Basin at that time. The source rock attribute discrimination diagrams show that the main source of pelites is felsic igneous rocks. The ratios of REDOX parameters show that during the sedimentary period, the water body in the study area was predominantly in an oxidizing environment. Furthermore, the tectonic background diagrams reveal that the source area underwent geological tectonic evolution processes of active and passive continental margins, marking the transition from the continental margin above the subduction of the ancient Pacific plate to the continental margin extension after subduction cessation.

Changes over a decade of fitness within a Scottish soccer academy and the impact of first team relegation on academy physical profiles

Introduction: academy soccer practitioners have a responsibility to prepare youth players for the demands of first team. The development of physical capabilities to sustain the high intensity locomotor activities that have been reported in elite soccer is essential. Challenges exist monitoring locomotor targets as resource limitations mean that often academies will not have locomotor data, instead relying on physiological testing to assess whether a player is ready for first team transition. Physiological testing results have a direct relationship with locomotor activity. Physical development has been shown over various longitudinal periods with established progression in speed, change of direction, lower body power and endurance in elite Austrian youths, increases in VO2max in an elite regional French academy and in the interval shuttle run test of over 50% in elite Dutch academy. The success of a club’s academy can lead to increased resource allocation however some organisational challenges such as relegation can have a severe financial impact. The initial aim of the present study was to establish whether previously observed changes in physical capacity were observed in a professional Scottish soccer academy over a ten-year period. A further aim was to assess the impact of first team relegation on academy physical profiles considering the resource implications of relegation. Methodology: a retrospective analysis was completed where Linear Mixed Effect (LME) Models were fitted to explain variation across each measure of physical capacity. Model selection was undertaken with Likelihood Ratio Tests where initial complex models were compared to simpler nested models to arrive at the final model by maximum likelihood. The impact of relegation was assessed by LME models to assess whether physical capacity measures changed post relegation. Ethical approval was granted. Results: 5 m best time reduced by 0.0055 s per year (t = −11.8, p < 0.001), 10 m best time reduced by 0.008 s per year (t = −9.2, p < 0.001), 20 m best time reduced by 0.011 s per year (t = −7.8, p < 0.001). CMJ increased each year depended on age group with the older cohorts showing greater improvement and the YYIR1 distance increased each year varying across age group. Performance of aforementioned physical capacity measures significantly reduced with relegation, except 20 m best time (t = −1.4, p = 0.16). Application: reference values within clubs that establish first team requirements will contribute to appropriate transition strategies. By conducting analyses related to uncontrollable challenges, practitioners can use these results to protect against criticism and withdrawal of resource when physical progression is negatively impacted.

The negative spillover effect of sandwich-generation caregiving on employees’ job satisfaction: does work time matter?

PurposeThis study aims to investigate the effect of sandwich-generation caregiving (caregiving for elders and children simultaneously) on employed caregivers’ job satisfaction when compared with non-sandwich caregiving patterns of no caregiving, children-only caregiving and elders-only caregiving. This study also aims to explore whether depression mediates this effect and whether three types of caregivers-friendly work time (less work-time length, less nonstandard work-time schedule and more work-time autonomy) buffer these direct and indirect effects.Design/methodology/approachA sample of 7,571 Chinese employees is chosen from the 2020 China Family Panel Studies through a multistage stratified sampling design.FindingsAfter controlling for employees’ sociodemographic, work and other caregiving characteristics, this study finds that sandwich-generation caregiving is indeed more likely to negatively affect employees’ job satisfaction when compared with no caregiving and elders-only caregiving, but to the same extent as children-only caregiving. This study also suggests that the effect of sandwich-generation caregiving on job satisfaction is mediated by employees’ depression and that three types of caregiver-friendly work time help to weaken the negative effects on employees’ depression and job satisfaction.Originality/valueTo the best of the authors’ knowledge, this is the first study to explore the negative spillover effect and its mechanisms of caregiving on employees’ job satisfaction through focusing on a special caregivers group: employed sandwich-generation caregivers. These results shed light on the importance of extending caregiver studies to the workplace and provide implications for organization managers and human resources practitioners to design caregiver-friendly workplace policies to maintain employed caregivers’ work-family balance.

Lung volume reduction surgery: a micro-costing analysis from a national tertiary referral Centre.

Lung volume reduction surgery (LVRS) is a clinically effective palliation procedure for patients with chronic obstructive pulmonary disease (COPD). LVRS has recently been commissioned by the NHS England. In this study, a costing model was developed to analyse cost and resource implications of different LVRS procedures. Three pathways were defined by their surgical procedures: bronchoscopic endobronchial valve insertion (EBV-LVRS), video assisted (VATS-LVRS), and robotic assisted LVRS (RATS-LVRS). The costing model considered use of hospital resources from the LVRS decision until 90-days after hospital admission. The model was calibrated with data obtained from an observational study, electronic health records, and expert opinion. Unit costs were obtained from the hospital finance department and reported in 2021-Euros. VATS-LVRS was associated with the lowest cost at €12,896 per patient. This compares to the costs of EBV-LVRS at €15,598 per patient and €13,305 per patient for RATS-LVRS. A large component of EBV-LVRS costs were accrued secondary to complications, including revision EBV-LVRS. This study presents a comprehensive model framework for the analysis of hospital-related resource use and costs for the three surgical modalities. In the future, service commissioning agencies, hospital management, and clinicians can use this framework to determine their modifiable resource use (composition of surgical teams, use of staff and consumables, planned length of stay, and revision rates for EBV-LVRS) and to assess the potential cost implications of changes in these parameters.

The predictive role of Ki67 in pathological complete response (pCR) and invasive disease-free survival (IDFS) in HER2-positive breast cancer: A retrospective study of 246 cases.

e12610 Background: While Ki67 is a routine diagnostic measure for early hormone receptor positive breast cancer, it is not integrated into the standard procedure for patients with Human Epidermal Growth Factor Receptor 2 (HER2)-positive breast cancer patients, given the substantial risk linked to HER2 expression alone. Consequently, the predictive significance of Ki67 in achieving pathological complete response (pCR) or invasive disease-free survival (IDFS) in this subgroup remains uncertain. Methods: This retrospective, bi-centric analysis focused on HER2-positive early breast cancer patients undergoing neoadjuvant chemotherapy from 2015 to 2023. We assessed the correlation between Ki67 values and the achievement of pathological complete response (pCR, defined as ypT0/is, pN0). Multivariable logistic regression analyzed the independent association of various clinical parameters, including Ki67, with pCR. Ki67 values were categorized into risk groups (low <15%, intermediate 15.1-35%, high >35%) following the GepardTrio data [1]. Kaplan-Meier estimator calculated differences in overall and invasive disease-free survival. Results: The study included 246 HER2-positive early breast cancer patients with known Ki67 expression, followed for a median of 42 months. The median age was 52 years. Final nodal status was pN0 in 80.5%, pN1 in 15%, and pN2 in 3.3%. Hormone receptor positivity was observed in 66% of patients. 147 patients (60%) achieved pCR. Median Ki67 was 30. When categorized, 13% were low, 41.5% intermediate, and 45.5% high risk. No correlation between Ki67 and pCR was observed (p=0.25). HER2 IHC score 3+ significantly increased pCR compared to IHC 2+ (62.2% vs. 44.6%, p=0.023). Hormone receptor-positive tumors had a lower pCR rate (52.7% vs. 72.4%, p=0.0016. 5-year overall survival was 96.5% for pCR and 83.8% for non-pCR (p=0.008). 5-year invasive disease-free survival showed no difference between low Ki67 (89.5%), intermediate Ki67 (79.9%), and high Ki67 (80.9%) groups (p=0.77). Conclusions: In this study, Ki67 did not predict pCR in HER2-positive breast cancer, providing no additional clinical value. HER2 IHC score and hormone receptor status were predictive indicators for pCR. Ki67 expression appears to lack additional value in HER2-positive breast cancer, considering resource implications. 1. Denkert C et al: Ann Oncol. 2013 Nov;24(11):2786-93. doi: 10.1093/annonc/mdt350. Epub 2013 Aug 22. PMID: 23970015.

Dementia care coordinators in primary care: a realist evaluation.

A dementia care coordinator (DCC) service has recently been implemented across Kent and Medway Integrated Care Board (ICB). DCCs are provided at the primary care network (PCN) level and work closely with GP practice teams. The service is intended to help service users navigate the care system and provide proactive support to mitigate crisis points. However, the value of this service from key stakeholder perspectives is not yet known. To understand: 1) how the DCC service works, for whom, and in what circumstances; and 2) identify outcomes, resource implications, and costs. The study uses mixed-methods realist evaluation with an embedded economic component. Data collection includes: questionnaires, service provider metrics, and qualitative interviews with healthcare practitioners and service users. Interpretive comparative analysis and narrative synthesis including evaluation of service costs against outcomes will produce a refined final programme theory. Patient and public involvement have been consulted throughout. Preliminary results indicate that when embedded in a local practice, healthcare practitioners including GPs welcome DCC involvement. DCCs act as community lynchpins, bridging service users to appropriate care pathways. The service may be capable of increasing diagnosis rates and reducing crisis points. However, caseloads are currently untamed. Therefore, the service and its workforce are becoming over-stretched. This evaluation describes preliminary findings from a recently implemented DCC service in Kent and Medway ICB. There is a crucial need to enhance the support of this workforce in order to ensure sustainability of this service. These findings will inform service development and future investment decisions.

Single centre observational study evaluating the impact of introducing High Flow Nasal Cannula outside of Paediatric Critical Care Unit.

To evaluate the impact of High Flow Nasal Cannula (HFNC) introduction outside of Paediatric Critical Care Units (PCCU), on PCCU admissions and intubation rates. Secondarily, to identify escalation predictors. Retrospective observational study with matched PCCU admissions and intubation rates, 2-years before (Group 1) and 2-years after (Group 2) HFNC introduction outside of PCCU. Within Group 2, we compared those admitted to PCCU (escalation) and those who did not (non-escalation). Observations, change in observations and time to starting HFNC were analysed. Pre- and post-introduction comparison: Of 980 admissions in Group 1, 55 were admitted to PCCU, whereas of 1209 admission in Group 2, there were 85 admissions, P = 0.188. Group 1 had 25 intubations compared to 23 in Group 2, P = 0.309. Over twice as many children had some form of respiratory support in Group 2. Post-introduction: 104 children commenced HFNC, 72% for bronchiolitis. Median age was 4 months in the non-escalation group and 6.5 months in the escalation group, P = 0.663. Thirty-eight children escalated to PCCU: 33 required CPAP/BiPAP, 4 were intubated with 1 remaining on HFNC. Comparisons of age, gender, comorbidities, observations, change in observations and time to starting HFNC showed no significant escalation predictors. This study identified no statistically significant predictors of escalation. There was an observed increase in PCCU admissions with decreased intubations. The resource implications of this therapy are significant and further studies should examine cost effectiveness of HFNC use outside of PCCU.

Defense Resources Implications of the Conflict in Ukraine on European Countries

Abstract The conflict in Ukraine has determined significant shifts in European defence and security paradigms. This paper focuses on the European Union (EU) has reacted to the crisis on its borders, examining the evolution of EU defence spending, procurement policies, and cooperation agreements in the wake of the conflict, analysing the impact on both individual member states and collective EU initiatives. The aim of this paper is to examine how the conflict in Ukraine influenced the European Union countries in terms of defence spending and defence policies. The objectives of the paper consist in identifying the main changes in the defence expenditures of the European Union Countries, overall and in terms of destination of expenditures and highlighting the main changes on terms of procurement policies and cooperation agreements generated by the events in Ukraine.

Exploratory study of frequent attenders in general practice to better understand why patients seek help.

Frequent attenders (defined as the top 10% of health care users or those making ≥10 visits per year) account for 30-50% of GP consultations. This has significant resource implications. To understand the characteristics of frequent attenders (≥18-years) at an outer London general practice (list 5,876; deprivation index 5th decile) and reasons for attending. A retrospective case note review was conducted using SystmOne of people attending on ≥10 occasions to see a health professional between March 2022 and February 2023. Data were extracted by hand: age, gender, reason and type of consultation, diagnoses, referrals, Charlson Comorbidity Index (CCI), mortality at one year. Patient notes for ≥30 contacts were reviewed by a senior GP. 544 people (9.3%) attended ≥10 appointments. Of these, five interacted with a GP ≥50 occasions (Group 1;mean age:74.6yrs/female: 4 /CCI:5.0), eight ≥40 occasions (Group 2; 69.6yrs/6.0/5.5) and 35 ≥30 occasions (Group 3;70yrs/27/4.7). Forty-eight people accounted for 882 appointments, 29% face to face and 71% by telephone. Frequency increased with age and CCI. Patients in group 3 underwent more investigations (6.0/6.0/10.0). There was no difference in mean numbers of clinicians seen (6.4/7.1/7.4) or referrals (5.0/4.0/5.0) between the three groups. Frequent attenders tended to fall into two groups: people with chronic diseases, typically associated with anxiety and complex needs, and people with ongoing mental health conditions. Coding was challenging due to complexity. Frequent attenders presented due to their medical complexity or mental health disorders rather than medically unexplained symptoms. Most interactions with a GP are understandable.

Measuring the Gains and Losses of Virtual Water Flows in China’s Coastal Areas

The virtual water flow behind product trade provides researchers with ideas to alleviate water problems in China’s coastal areas, with accompanying resource and economic implications. This paper adopts a multi-region input–output model to calculate virtual water flows in coastal areas and analyses resource benefits and economic benefits, by combining the water stress index and shadow price, to measure gains and losses of virtual water flow. This study shows that (1) China’s coastal areas depends on external water supplies; (2) virtual water flows between coastal and inland areas generated 38.26 billion m3 of net scarce water savings and CNY 31,751 billion of net economic benefits, indicating that coastal areas benefited from virtual water flows from both resource and economic perspectives; (3) virtual water flows among coastal provinces and cities caused 11.10 billion m3 of net scarce water losses, but generated CNY 9784 billion of net economic gains, indicating that a further intensification of water stress in coastal areas, but such a virtual water flow pattern was beneficial from an economic perspective. This paper reveals the resource and economic impacts of virtual water flow at the national scale and among coastal provinces and cities and further proposes suggestions for promoting the beneficial flow of virtual water in coastal areas.

Predicting atrial fibrillation risk following embolic stroke of unknown source using cardiac magnetic resonance imaging

Abstract Background Approximately 25% of embolic strokes of unknown source (ESUS) are attributed to undiagnosed atrial fibrillation (AF).1 The European Stroke Organisation (ESO) recommends implantable loop recorder (ILR) monitoring to identify ESUS patients with AF, permit the initiation of anticoagulation and reduce risk of recurrent stroke.2 However, this approach delays treatment and carries significant cost and resource implications. An alternative approach, where early anticoagulation is initiated in the absence of AF has failed to reduce recurrent stroke in four randomised controlled trials (NAVIGATE ESUS, RE-SPECT ESUS, ATTICUS and ARCADIA).3-6 An urgent need exists for new strategies to identify ESUS patients with undiagnosed AF that are at high risk of future thromboembolism. Purpose The primary objective of this study was to produce a substrate-based predictive model for AF in ESUS patients using atrial cardiac magnetic resonance imaging (CMRi). Method The Atrial CARdiac Magnetic resonance imaging in patients with embolic stroke of unknown source without documented AF (CARM-AF) Study is a prospective, multi-centre, observational study. All patients underwent CMRi and ILR insertion for AF detection within 3 months of ESUS. The main inclusion criteria were expected survival >12 months, CHA2DS2VASc≥3 and eGFR >30ml/min. Patients were allocated to the study group if AF >30 seconds was detected by ILR during the first year of follow-up and control group if no AF detected (Figure 1). Univariable analysis was used to identify clinical, echocardiographic and CMR parameters associated with AF diagnosis. Parameters with p<0.2 and no co-linearity were used to develop multivariable logistic regression models for AF prediction. Results From September 2020 to September 2022, 102 patients were enrolled and 91 were included in the final analysis. AF was detected in 17 patients during the first year of follow-up (18.6%). In univariable analysis, patients with AF were more likely to be female (p=0.02), but there were no significant differences in age, race, body mass index (BMI) or CHA2DS2VASc score (p=0.06, 0.272, 0.195, 0.211) between groups. Increased left atrial (LA) volume, surface area and reduced LA ejection fraction were associated with increased risk of AF detection at 1 year (p=0.006, 0.044, 0.008). LA fibrosis and sphericity were not associated with AF (p=0.84, 0.98). Logistic regression models for AF risk prediction were developed using patient, echocardiographic and CMR parameters. A combined model of patient and CMR parameters outperformed assessment of patient characteristics alone, achieving an AUC of 0.85 for predicting AF occurrence (p<0.005). Pseudo R2 of 0.30 (McFadden) indicated excellent model fit (Figure 2). Conclusion CARM-AF is the first study to demonstrate feasibility and utility of CMR imaging to predict AF risk following ESUS. A randomised controlled trial initiating anticoagulation using the developed model is recommended.Study DesignModel Comparison (ROC Curves)

Chemical Perspectives on the Impact of Climate Change in Afghanistan: A Comprehensive Review

: Climate change is a global phenomenon that has significant impacts on various aspects of human life, including the environment, economy, and social well-being. Afghanistan, one of the least developed and most vulnerable countries to climate change, is facing alarming effects due to its high dependence on agricultural livelihoods, fragile environment, poor socio-economic development, high frequency of natural hazards, and over four decades of conflict. This comprehensive review aims to provide an overview of the current state of knowledge on the impact of climate change on Afghanistan's environment, economy, and society, and to highlight the vulnerability of Afghanistan to climate change. The review also explores the chemical composition of air pollutants in Afghan cities, the impact of air and water pollution on human health and the environment, the influence of climate change on soil composition and nutrient availability, and the implications for water resources, including groundwater quality and availability. Finally, the review discusses the chemical aspects of climate change adaptation and mitigation efforts in Afghanistan, focusing on innovative technologies and practices to address climate-related challenges in the country.

Thermochronological constraints on the tectonic history of the Polda Basin

The Polda Basin is a narrow, east–west striking intracontinental basin that extends ~400 km from the onshore Eyre Peninsula in South Australia to the offshore Great Australian Bight and contains up to 5 km of strata, with a thick sequence of Neoproterozoic rocks overlain by unconformably-bound sequences of Carboniferous-Permian, Jurassic and Cenozoic strata. Though the Polda Basin has witnessed limited exploration for hydrocarbons, it is attracting renewed interest due to the potential for underground hydrogen storage in Neoproterozoic halites, whilst surrounding regions of the Gawler Craton are considered prospective for natural hydrogen. To date however, knowledge of the tectonic history of the Polda Basin, which is critical to assessing its potential role in the energy transition, is limited. Here we present results from a regional apatite fission track analysis study of the Eyre Peninsula, focussing on data from the onshore Kilroo-1A borehole, which provide insights into the burial and exhumation history of the Polda Basin. Results indicate that the preserved Upper Jurassic sequence was thicker prior to Late Cretaceous exhumation, which may have supplied sediment to the adjacent Ceduna Sub-basin. Our results highlight a complex history of Phanerozoic vertical motions in this region, which have implications for both resource and energy storage potential.

The association of comorbid dementia with length of stay, cost and mortality among older adults in US acute hospitals: An observational study

BackgroundAlthough overall health and social care expenditures among persons with dementia are larger than for other diseases, the resource and cost implications of a comorbid diagnosis of dementia in acute hospitals in the U.S. are largely unknown. We estimate the difference in inpatient outcomes between similar hospital admissions for patients with and without comorbid dementia (CD). MethodsInpatient admissions, from the U.S. National Inpatient Sample (2016–2019), were stratified according to hospital characteristics and primary diagnosis (using ICD-10-CM codes), and entropy balanced within strata according to patient and hospital characteristics to create two comparable groups of admissions for patients (aged 65 years or older) with and without CD (a non-primary diagnosis of dementia). Generalized linear regression modeling was then used to estimate differences in length of stay (LOS), cost, absolute mortality risk and number of procedures between these two groups. ResultsThe final sample consisted of 8,776,417 admissions, comprised of 1,013,879 admissions with and 7,762,538 without CD. CD was associated with on average 0.25 (95 % CI: 0.24–0.25) days longer LOS, 0.4 percentage points (CI: 0.37–0.42) higher absolute mortality risk, $1187 (CI: −1202 to −1171) lower inpatient costs and 0.21 (CI: −0.214 to −0.210) fewer procedures compared to similar patients without CD. ConclusionComorbid dementia is associated with longer LOS and higher mortality in acute hospitals but lower inpatient costs and fewer procedures. This highlights potential communication issues between dementia patients and hospital staff, with patients struggling to express their needs and staff lacking sufficient dementia training to address communication challenges.

Curie point depth, thermal gradient and heat flow along the Ethiopia Rift System and adjacent plateaus using spectral evaluation approach: implications for geothermal resources

The Ethiopia Rift System (ERS) is a section of the East African Rift System within Ethiopia extending from the Afar in the northeast to the Kenya border in the southwest. It is apparent that magmatism and magmatic intrusions influence the crustal shape in the ERS resulting in its thinning and the shallowing of magmatic sources at various locations within it. As a consequence, more than 31 volcanoes hosting hydrothermal structures with a conceivable potential to generate massive quantities of geothermal energy have been identified along the ERS. In this study, we map the Curie Point Depth (CDP) over the ERS based on the analysis of aeromagnetic data extracted from the World Digital Magnetic Anomaly Map. Spectral evaluation method was used to estimate the boundaries (top and bottom) of the magnetized crust. Reduced-to-pole (RTP) aeromagnetic records have been divided into 105 (50% overlap) square blocks of 200 × 200 km size. The Curie temperature (580 °C) of magnetite was used to determine the thermal gradient and the heat drift in the area. The depths obtained for the bottom of the magnetized crust are assumed to correspond to the Curie Depths, where the magnetic layer loses all its magnetization. The determined values of Curie Point Depth, geothermal gradient and heat flow for the 50% overlapped 105 blocks, respectively, range from 8.85 to 55.85 km, 10.38 to 65.54 °C/km and 25.96 to 163.84 mW/m2. Lower CPD (< 20 km) in the ERS was obtained between Mille and Gewane (southwest Afar), between Adama (Nazret) and Yerer (NMER) and between Wendo Genet and Koti (SMER) localities. These areas, showing low CPD, exhibit excessive geothermal gradient and high heat flow all of which indicate the presence of significant geothermal potential.

3228: Analysing healthcare benefits and resource implications of lung cancer CT screening in Jordan

3228: Analysing healthcare benefits and resource implications of lung cancer CT screening in Jordan

Updates on pharmacological treatment for Alzheimer's disease.

Alzheimer's disease (AD) is the most common cause of dementia, and its rising prevalence is constantly increasing the global health burden. There are currently no curative therapies for AD, and current treatment options provide only modest clinical benefit. Despite numerous clinical trials, there have been no major additions to the AD treatment armamentarium this century. The prevailing pathomechanistic hypothesis for AD begins with abnormal accumulation of amyloid β (Aβ) leading to plaque development, and disease-modifying candidate therapies have largely aimed to disrupt this process. Numerous clinical trials of monoclonal antibodies directed at various stages of Aβ plaque development have yielded mostly negative results; however, recent results suggest that a breakthrough may be on the horizon. The past two years have yielded positive results for three monoclonal antibodies (aducanumab, lecanemab, and donanemab) although questions remain regarding their clinical effectiveness. Additional clarity is needed to determine whether the clinical benefits are great enough to offset the treatment risks and the resource implications for healthcare systems. This review provides a foundational context and update on recent disease-modifying therapies for AD that have reached Phase III clinical trials. Up-to-date information on these therapies will help clinicians better inform their clinical decision-making and the counselling they can offer patients and their carers.

Nano-Food Farming Approaches to Mitigate Heat Stress under Ongoing Climate Change: A Review

Increased heat stress is a common feature of global climate change and can cause adverse impacts on crops from germination through maturation and harvest. This review focuses on the impacts of extreme heat (&gt;35 °C) on plants and their physiology and how they affect food and water security. The emphasis is on what can be done to minimize the negative effects of heat stress, which includes the application of various materials and approaches. Nano-farming is highlighted as one promising approach. Heat is often combined with drought, salinity, and other stresses, which together affect the whole agroecosystem, including soil, plants, water, and farm animals, leading to serious implications for food and water resources. Indeed, there is no single remedy or approach that can overcome such grand issues. However, nano-farming can be part of an adaptation strategy. More studies are needed to verify the potential benefits of nanomaterials but also to investigate any negative side-effects, particularly under the intensive application of nanomaterials, and what problems this might create, including potential nanotoxicity.

Trans-radial cerebral angiography for stereotactic radiosurgery treatment of arteriovenous malformations

The popularity of trans-radial access (TRA) for cerebral angiography is growing. Potential benefits of TRA over traditional trans-femoral access (TFA) are multitude. This study aimed to evaluate discharge outcomes and patient opinion of TRA compared to TFA in patients undergoing cerebral angiography prior to stereotactic radiosurgery (SRS) treatment for cerebral arteriovenous malformations. Consecutive patients treated at the National Centre for Stereotactic Radiosurgery (Sheffield, United Kingdom) over a 22-month period were included. All patients underwent cerebral angiography with either TRA or TFA as part of treatment planning prior to SRS. TRA patients who had previously undergone TFA in other centres were surveyed for their experience of cerebral angiography using a questionnaire. SRS staff at our centre was approached for their opinion. 492 patients were included (median age=43 years, 57.5% male, median lesions treated=1). More patients underwent angiography with TFA (75.2%) than TRA (24.8%). No difference was found in accumulated dose for angiography between the groups (p>0.05). There was 17.6% reduction in overnight stay between TRA and TRF, the proportion of patients requiring overnight admission was higher for the TFA (35.2%) than TRA (17.6%, p<0.05). 101 patients were surveyed, with a response rate of 47%. Most respondents (79%) indicated preference for TRA over TFA. Use of TRA in pre-SRS cerebral angiography is feasible and improves both patient and staff experience. The adoption of TRA could have important implications for department resources and costs by reducing the proportion of overnight admissions.

Multi-criteria decision analysis framework for engaging stakeholders in river pollution risk management

Water pollution presents a substantial environmental challenge with extensive implications for water resources, ecosystem sustainability, and human health. Using a South African catchment, this study aimed to provide watershed managers with a framework for selecting best management practices (BMPs) to reduce pollution and the related risk to river users, while also including the perspectives of key catchment stakeholders. The framework encompassed the identification of and consultation with key stakeholders within the catchment. A Multi-Criteria Decision Analysis (MCDA) methodology using the Simple Multi-Attribute Rating Technique for Enhanced Stakeholder Take-up (SMARTEST) was used to identify and prioritise suitable BMPs in a case study. Decision alternatives and assessment criteria as well as their weights were derived based on stakeholder responses to a two-stage survey. Stakeholders included those utilising the river for domestic and recreational purposes, municipal representatives, scientists, NGOs, and engineers. The assessment of decision alternatives considered environmental, economic, and social criteria. The aggregated scores for decision alternatives highlighted the significance of involving stakeholders throughout the decision process. This study recommends the pairing of structural and non-structural BMPs. The findings provide valuable insights for catchment managers, policymakers, and environmental stakeholders seeking inclusive and effective pollution mitigation strategies in a catchment.