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The potential detrimental environmental impact of ports is vast, and port-cities bear the brunt of this. It is essential that future port-city development proceeds in such a way as to reduce the environmental impact that port activity creates for the city and local area. This global study of port authorities in 26 countries and city authorities in 13 countries investigated the current views on pollution, levels of adoption of mitigation measures, future plans, levels of interest in adoption and barriers to key measures for reducing a port’s environmental impact. This reveals consensus on key areas between port and city authorities for the first time. Water pollution was found to be the number one environmental concern of port authorities globally. Air, noise and waste were also found to be important forms of pollution in ports, both from the perspective of port and city authorities and in terms of complaints received. Ports largely have facilities for recycling, although the majority have no set recycling plans, with 62% of ports having none in place. Targets should be encouraged, as well as circular economy approaches, if this is to be addressed. Renewable energy, electric port equipment, building efficiency improvements, electric port and harbour vessels and shore-to-ship power all have high levels of support from port and city authorities, although costs provide the largest barriers to implementation. Greater cooperation between port-city stakeholders is necessary to overcome the large financial barriers that appear to be preventing ports from pursuing the environmental improvements they are interested in.

Fluorescent imaging, a key technique in life science research, frequently utilizes fluorogenic probes for precise imaging in living systems. Tetrazine is an effective emission quencher in the design of fluorogenic probes, which can be selectively damaged upon bioorthogonal click reactions, leading to considerable emission enhancement. Despite significant efforts to increase the emission enhancement ratio (IAC/IBC) of tetrazine-functionalized fluorogenic probes, the influence of molecular aggregation on the emission properties has been largely overlooked in the design of these probes. In this study, we reveal that an ultrahigh IAC/IBC can be realized in the aggregate system when tetrazine is paired with aggregation-induced emission luminogens (AIEgens). Tetrazine can increase its quenching efficiency upon aggregation and drastically reduce background emissions. Subsequent click reactions damage tetrazine and trigger significant AIE, leading to considerably enhanced IAC/IBC. We further showcase the capability of these ultra-fluorogenic systems in selective imaging of multiple organelles in living cells. We propose the term "Matthew Effect in Aggregate Emission" to describe the unique fluorogenicity of these probes, potentially providing a universal approach to attain ultrahigh emission enhancements in diverse fluorogenic aggregate systems.

An ability to extract detailed spirometry-like breath-ing waveforms from wearable sensors promises to greatly improve respiratory health monitoring. Photoplethysmography (PPG) has been researched in depth for estimation of respiration rate, given that it varies with respiration through overall intensity, pulse amplitude and pulse interval. We compare and contrast the extraction of these three respiratory modes from both the ear canal and finger and show a marked improvement in the respiratory power for respiration induced intensity variations and pulse amplitude variations when recording from the ear canal. We next employ a data driven multi-scale method, noise assisted multivariate empirical mode decomposition (NA-MEMD), which allows for simultaneous analysis of all three respiratory modes to extract detailed respiratory waveforms from in-ear PPG. For rigour, we considered in-ear PPG recordings from healthy subjects, both older and young, patients with chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) and healthy subjects with artificially obstructed breathing. Specific in-ear PPG waveform changes are observed for COPD, such as a decreased inspiratory duty cycle and an increased inspiratory magnitude, when compared with expiratory magnitude. These differences are used to classify COPD from healthy and IPF waveforms with a sensitivity of 87% and an overall accuracy of 92%. Our findings indicate the promise of in-ear PPG for COPD screening and unobtrusive respiratory monitoring in ambulatory scenarios and in consumer wearables.

Purpose Previous research has indicated that university students experienced substantial mental health issues during the global COVID-19 pandemic, but few studies have considered changes relative to pre-pandemic levels across population groups. Hence, the aim of this study was to compare changes in mental health and associated stressors across the pandemic for international and local university students studying in Australia. Methods In a cohort of 4407 university students, we assessed depression (Patient Health Questionnaire 2), anxiety (Generalized Anxiety Disorder-2), social support (Medical Outcomes Study—Social Support Survey), inability to afford food, fear of partner, and experiences of discrimination, both pre-pandemic (April–May 2019) and during the pandemic (September–October 2020). Change in prevalence between local and international students were estimated with logistic regression, adjusting for baseline factors. Results Compared to local students, international students experienced an increase in probable major depression (odds ratio (OR) 1.43, 95% Confidence Interval (CI) 1.23, 1.66), low social support (OR 2.63, 95% CI 2.23, 3.11), inability to afford food (OR 5.21, 95% CI 3.97, 6.83) race-based discrimination (OR 2.21, 95% CI 1.82, 2.68) and fear of partner (OR 3.46, 95% CI 2.26, 5.13). Interaction analyses indicated that these issues were more likely to be experienced by students living outside their country of origin, inclusive of international students based in Australia (depression p value interaction term 0.02). Conclusion The pandemic had a substantial negative impact on international students, particularly those living outside of their country of origin during the pandemic. The inequalities exacerbated by the pandemic were present prior to the pandemic and are likely to continue post-pandemic without action. Interventions to build the supports for international students need to be urgently explored.

Introduction: As people living with HIV age, the increasing burden of multimorbidity poses a significant health challenge. The aims of this study were to identify common patterns of multimorbidity and examine changes in their burden, as well as their associations with risk factors, over a 3–5 year period in people with HIV, enrolled in the Pharmacokinetic and clinical Observations in PeoPle over fiftY (POPPY) study.Methods: Common multimorbidity patterns were identified in POPPY participants with HIV using principal component analysis, based on Somers’ D statistic. Multimorbidity burden scores were calculated for each participant/pattern at study entry/follow-up and were standardised relative to the mean in the sample at baseline (scores >0 thus reflect a greater number of comorbidities relative to the mean). Two multivariable linear regression models were fitted to examine the associations between risk factors and burden z-scores at baseline and change in z-scores over a 3–5 year period.Results: Five patterns were identified among the 1073 POPPY participants with HIV {median age [interquartile range (IQR)], 52 (47–59) years; 85% male and 84% white}: Cardiovascular diseases (CVDs), Sexually transmitted diseases (STDs), Neurometabolic, Cancer and Mental-gastro-joint. The multivariable linear regression showed that older age, behavioural factors (i.e., body mass index (BMI), history of injection drug use, current recreational drug use and sex between men), and HIV-specific factors (i.e., duration since HIV diagnosis and a prior AIDS diagnosis) were associated with higher multimorbidity burden at baseline. However, only three of the factors (age, BMI and duration since HIV diagnosis) were significantly associated with an increase in burden across specific patterns over time.Discussion: Key modifiable and non-modifiable factors contributing to an increase in burden of multimorbidity were identified. Our findings may inform the development of more targeted interventions and guidelines to effectively prevent and manage the rising burden of multimorbidity in people with HIV.

Background: Uncomplicated type B aortic dissection (un-TBAD) has been managed conservatively with medical therapy in order to control the heart rate and blood pressure to limit disease progression, in addition to radiological follow-up. However, several trials and observational studies have investigated the use of thoracic endovascular aortic repair (TEVAR) in un-TBAD and suggested that TEVAR provides a survival benefit over medical therapy. Outcomes of TEVAR have also been linked with the timing of intervention. Aims: The scope of this review is to collate and summarise all the evidence in the literature on the mid- and long-term outcomes of TEVAR in un-TBAD, confirming its superiority. We also aimed to investigate the relationship between timing of TEVAR intervention and results. Methods: We carried out a comprehensive literature search on multiple electronic databases including PubMed, Scopus and EMBASE in order to collate and summarise all research evidence on the mid- and long-term outcomes of TEVAR in un-TBAD, as well as its relationship with intervention timing. Results: TEVAR has proven to be a safe and effective tool in un-TBAD, offering superior mid- and long-term outcomes including all-cause and aorta-related mortality, aortic-specific adverse events, aortic remodelling, and need for reintervention. Additionally, performing TEVAR during the subacute phase of dissection seems to yield optimal results. Conclusion: The evidence demonstrating a survival advantage in favour TEVAR over medical therapy in un-TBAD means that with further research, particular trials and observational studies, TEVAR could become the gold-standard treatment option for un-TBAD patients.

Nitrogen (N) leaching is a major source of groundwater contamination. We used a series of lysimeters and suction cups to measure total N leaching losses in a high N maize crop system on a long-term maize paddock in the Waikato. The goal of the study was to 1) quantify N leaching losses under maize silage, 2) determine the effectiveness of a cut-and-carry annual ryegrass catch crop (RG) in mitigating N leaching losses and 3) determine an appropriate depth for measuring N leaching losses under maize. At least 200 kg/ha more fertiliser N than calculated plant requirements was applied to the maize crop to ensure surplus soil N after maize. Nitrogen leaching losses were measured in a maize-RG and maize-fallow rotation over two seasons (October 2018 - September 2020). Less than 10 % of N leaching losses occurred during the maize growing season. This is likely due to evapotranspiration exceeding rainfall in summer. The greatest leaching losses were observed in the maize-fallow rotation, averaging 60 kg N/ha and 88 kg N/ha for the 2018/19 and 2019/20 seasons. This was despite 2020 winter being drier than 2019. The greater 2019/20 leaching losses can be attributed to a greater soil N concentration (+15 mg N/L) in 2020. The importance of catch crops as a N leaching mitigation tool after maize was evident over the two years, resulting in leaching reductions >85% in the maize-RG than the maize–fallow plots. The catch crop removed >200 kg N/ha from the soil, significantly reducing the soil N concentration, which appear to be the main driver of leaching losses in our study. Additionally, RG also increased gravimetric soil water content by 7.3 % in the top 30 cm. When N leaching was measured at 70 cm, losses in fallow plots were almost three times higher than the 41.6 kg N/ha recorded at the 120 cm soil depth, our default maize rooting depth. A similar amount of isotopic 15N (1.2 %) was observed in maize grain at maturity when 15N was inserted to 60 cm or 120 cm soil depth. This was greater than the background values obtained when standard urea was applied to the plots (0.37 %), indicating 15N interception at depth. It is speculated that provided fertiliser rates match crop N demand and catch crops are used, N leaching losses in maize crops should be much lower than values reported here, irrespective of soil type and season.

Biosolids are the solid by-product of the wastewater treatment system. They are regularly applied to agricultural land in the UK to fertilize and increase crop yields, but they have been shown to contain high concentrations of microplastics. Here we sampled a selection of agricultural soils in the Southeast of England which had received or never received biosolid treatment. Sites were sampled on two occasions in the summer and winter. Microplastic (MP) numbers were high in both the biosolid treated fields (874 MP/kg) and the untreated fields (664 MP/kg) and a wide variety of polymers were found across sites. However, there was a lack of significant difference between treated and untreated soils. This suggests the influence of other microplastic sources e.g. agricultural plastic and general littering, and external conditions e.g. farm management and rainfall. Microplastic concentrations were higher in the summer suggesting that erosion, runoff, and wind transport may be removing microplastics from these systems. The dynamic nature of the agricultural soils may result in them becoming a vector for microplastics into the wider environment. The high variability in results seen here highlights the complexity of microplastic concentrations in heterogeneous agricultural soils. This study suggests that biosolids, whilst are likely a contributor, are not the sole source of microplastics in agricultural soils. Further research is required to determine source and sink dynamics in these systems. Understanding the sources of microplastic contamination in soils is imperative for future mitigation strategies to be effective.

This article uses the work of brand theorists and New Zealand–based cultural critics to examine the circumstances that created the “Hobbit Law,” a New Zealand law aimed at busting local film industry unions. Branding logics created a struggle for authenticity around the importance of Middle-earth to New Zealand's national identity in the twenty-first century. This hybrid identity was then articulated as something that stood against labor actions by film industry workers, culminating in citizen marches against local labor. It closes by exploring ways that the importance of the brand as sense-making tool under neoliberalism might be reconfigured as something that might bridge the gap between media consumer and creative industry worker.

Background Universities are increasingly recognised as institutions where health and wellbeing can be promoted to maximise academic outcomes, career transitions, and lifelong positive health behaviours. There is concern about the mental health of university students and other factors which affect academic outcomes particularly for subgroups such as international students. There are few cohort studies of the breadth of issues that can impact on mental health and academic outcomes for both local and international students. We conducted a baseline prevalence survey of students at a large Australian university covering health, academic, and social determinants of wellbeing. The purpose was to inform the university’s new student health and wellbeing framework with a view to follow-up to determine predictors of mental ill-health and academic outcomes in the subsequent year. In this paper we present the baseline prevalence data and report on selected mental health and health care access issues for local and international students. Methods The entire university population as of April 2019 of over 56,375 students aged 18 or above were invited to complete the online survey. Questions explored eight domains: demographic characteristics, general health and wellbeing, mental health, risk taking behaviours, psychosocial stressors, learning and academic factors, social and cultural environment, and awareness of and access to health and wellbeing services. Records of academic results were also accessed and matched with survey data for a large subset of students providing consent. Results Fourteen thousand eight hundred eighty (26.4%) students commenced our survey and were representative of the entire student population on demographic characteristics. Three quarters were aged between 18 to 25 years and one third were international students. Eighty-five percent consented to access of their academic records. Similar proportions of local and international students experienced symptoms of a depression or anxiety disorder, however international students were less aware of and less likely to access available health services both inside and external to the university. We also reported on the prevalence of: general lifestyle factors (diet, exercise, amount of daily sleep); risk-taking behaviours (including alcohol, tobacco and other drug use; unprotected sexual activity); psychosocial stressors (financial, intimate partner violence, discrimination, academic stressors, acculturative stress); subjects failed; resilience; social supports; social media use; and health services accessed online. Conclusions This rigorous and comprehensive examination of the health status of local and international students in an Australian university student population establishes the prevalence of mental health issues and other psychosocial determinants of health and wellbeing, along with academic performance. This study will inform a university-wide student wellbeing framework to guide health and wellbeing promotion and is a baseline for a 12-month follow-up of the cohort in 2020 during the COVID-19 pandemic.

People living with HIV (PLWH) on suppressive antiretroviral therapy (ART) can have residual immune dysfunction and often display poorer responses to vaccination. We assessed in a cohort of PLWH (n=110) and HIV negative controls (n=64) the humoral and spike-specific B-cell responses following 1, 2 or 3 SARS-CoV-2 vaccine doses. PLWH had significantly lower neutralizing antibody (nAb) titers than HIV-negative controls at all studied timepoints. Moreover, their neutralization breadth was reduced with fewer individuals developing a neutralizing response against the Omicron variant (BA.1) relative to controls. We also observed a delayed development of neutralization in PLWH that was underpinned by a reduced frequency of spike-specific memory B cells (MBCs) and pronounced B cell dysfunction. Improved neutralization breadth was seen after the third vaccine dose in PLWH but lower nAb responses persisted and were associated with global, but not spike-specific, MBC dysfunction. In contrast to the inferior antibody responses, SARS-CoV-2 vaccination induced robust T cell responses that cross-recognized variants in PLWH. Strikingly, a subset of PLWH with low or absent neutralization had detectable functional T cell responses. These individuals had reduced numbers of circulating T follicular helper cells and an enriched population of CXCR3+CD127+CD8+T cells after two doses of SARS-CoV-2 vaccination, which may compensate for sub-optimal serological responses in the event of infection. Therefore, normalisation of B cell homeostasis could improve serological responses to vaccines in PLWH and evaluating T cell immunity could provide a more comprehensive immune status profile in these individuals and others with B cell imbalances.

We assessed a cohort of people living with human immunodeficiency virus (PLWH) (n = 110) and HIV negative controls (n = 64) after 1, 2 or 3 SARS-CoV-2 vaccine doses. At all timepoints, PLWH had significantly lower neutralizing antibody (nAb) titers than HIV-negative controls. We also observed a delayed development of neutralization in PLWH that was underpinned by a reduced frequency of spike-specific memory B cells (MBCs). Improved neutralization breadth was seen against the Omicron variant (BA.1) after the third vaccine dose in PLWH but lower nAb responses persisted and were associated with global MBC dysfunction. In contrast, SARS-CoV-2 vaccination induced robust T cell responses that cross-recognized variants in PLWH. Strikingly, individuals with low or absent neutralization had detectable functional T cell responses. These PLWH had reduced numbers of circulating T follicular helper cells and an enriched population of CXCR3+CD127+CD8+T cells after two doses of SARS-CoV-2 vaccination.

Background: Partial anomalous pulmonary venous connection (PAPVC) occurs when at least one pulmonary vein drains into the right atrium or its tributaries rather than the left atrium, most commonly connecting with the superior vena cava (SVC). The Warden procedure involves transecting the SVC proximal to the uppermost connection of the pulmonary vein followed by proximal SVC reattachment to the right atrial appendage. However, descending thoracic aortic homograft replacement for SVC translocation has recently been introduced as a modified technique. Aims: This commentary aims to discuss the recent study by Said and colleagues who reported their experiences with 6 PAPVC cases undergoing a modified Warden procedure using thoracic aortic homograft SVC translocation. Methods: A comprehensive literature search was performed using multiple electronic databases in order to collate the relevant research evidence. Results: The Warden procedure is associated with a 10% incidence of SVC obstruction with many requiring reintervention. Meanwhile, using the aortic homograft for SVC translocation, Said et al. observed no SVC obstructions. In addition, this modified technique does not require anticoagulation and has demonstrated an improvement in long-term SVC patency. Nevertheless, it can be considered an expensive procedure. Moreover, since the thoracic aortic homograft utilised is biological tissue, only long-term follow-up will determine whether calcification and graft degeneration is an issue. Conclusion: It can be concluded that the modified Warden procedure is a safe and effective method to reconstruct the systemic venous drainage into the right atrium when a direct anastomosis under tension might be prone to re-stenosis.

The feasibility of using in-ear [Formula: see text] to track cognitive workload induced by gaming is investigated. This is achieved by examining temporal variations in cognitive workload through the game Geometry Dash, with 250 trials across 7 subjects. The relationship between performance and cognitive load in Dark Souls III boss fights is also investigated followed by a comparison of the cognitive workload responses across three different genres of game. A robust decrease in in-ear [Formula: see text] is observed in response to cognitive workload induced by gaming, which is consistent with existing results from memory tasks. The results tentatively suggest that in-ear [Formula: see text] may be able to distinguish cognitive workload alone, whereas heart rate and breathing rate respond similarly to both cognitive workload and stress. This study demonstrates the feasibility of low cost wearable cognitive workload tracking in gaming with in-ear [Formula: see text], with applications to the play testing of games and biofeedback in games of the future.

Background While open surgical repair continues to be the mainstay option for aortic arch reconstruction, the associated mortality, morbidity, and high turn-down rates have led to a need for the development of minimally invasive options for aortic arch repair. Though RELAY™ Branched (Terumo Aortic, Inchinnan, UK) represents a promising option for complex endovascular aortic arch repair, neurological complications remain a pertinent risk. Herein we seek to present multi-centre data from Europe documenting the neurological outcomes associated with RELAY™ Branched. Methods Prospective data collected between January 2019 and January 2022 associated with patients treated with RELAY™ single-, double-, and triple-branched endoprostheses from centres across Europe was retrospectively analysed with descriptive and distributive analysis. Follow up data from 30 days and 6-, 12-, and 24 months postoperatively was included. Patients follow up was evaluated for the onset of disabling stroke (DS) and non-disabling stroke (NDS). Results Technical success was achieved in 147 (99.3%) cases. Over 24 months period, in total, 6 (4.1%) patients suffered DS and 8 (5.4%) patients suffered NDS after undergoing aortic arch repair with RELAY™. All patients that developed postoperative DS had been treated with the double-branched RELAY™ endoprosthesis. Discussion The data presented herein demonstrates that RELAY™ Branched is associated with favourable neurological outcomes and excellent technical success rates. Key design features of the endoprosthesis and good perioperative management can contribute greatly to mitigating neurological complications following endovascular aortic arch repair.

Classification of cognitive workload promises immense benefit in diverse areas ranging from driver safety to augmenting human capability through closed loop brain computer interface. The brain is the most metabolically active organ in the body and increases its metabolic activity and thus oxygen consumption with increasing cognitive demand. In this study, we explore the feasibility of in-ear SpO2 cognitive workload tracking. To this end, we preform cognitive workload assessment in 8 subjects, based on an N-back task, whereby the subjects are asked to count and remember the number of odd numbers displayed on a screen in 5 second windows. The 2 and 3-back tasks lead to either the lowest median absolute SpO2 or largest median decrease in SpO2 in all of the subjects, indicating a robust and measurable decrease in blood oxygen in response to increased cognitive workload. Using features derived from in-ear pulse oximetry, including SpO2, pulse rate and respiration rate, we were able to classify the 4 N-back task categories, over 5 second epochs, with a mean accuracy of 94.2%. Moreover, out of 21 total features, the 9 most important features for classification accuracy were all SpO2 related features. The findings suggest that in-ear SpO2 measurements provide valuable information for classification of cognitive workload over short time windows, which together with the small form factor promises a new avenue for real time cognitive workload tracking., 8 pages, 9 figures

At the heart of the circular economy model is the reorientation of consumer behaviours away from disposing of items before they reach end of their functional life as a step towards resource efficiency and reduction of environmental impacts. One way to facilitate this change is to enable proactive redistribution of electrical and electronic equipment (EEE) with reuse value from urban spaces followed by high quality recycling at end-of-life. We have conducted the first assessment and critical evaluation of a model for the recovery of reusable EEE from a distinct urban mine (DUM) - in this case, a university. The Infrastructure, Service and Behaviour (ISB) model was used as a guide for interventions. EEE recovered from two Halls of Residence at the University of Southampton were characterised and sorted. From the items inspected, 97% was reusable and were donated to participating charities for redistribution via reuse/sale. The results show that an ISB Model system designed using choice architecture to recover reusable EEE from a DUM contributes strongly to extending products’ lifetimes and promotes circular economy ambitions. The study provides strong evidence of a viable reuse-based recovery system for small EEE in a university DUM and with a potential for replicability at global scale. It is recommended that a carefully planned and tailored system based on the ISB model should be put in place in universities for the recovery and redistribution of reusable EEE (ReEEE) and that recycling is implemented only after practical options for reuse have been exhausted.

This essay seeks to historicize Lettrist activity in France and to situate Lettrist aesthetic productions and destructions in relation to the memory of German Occupation of France during World War II, and to the violent outbursts and acting out of the Lettrists’ contemporaries. Isidore Isou and others belonged to a rather unique generation in the history of France—a generation that caused adults a great deal of concern as young men and women committed crimes and acts of violence at unprecedented rates. Attending to the cultural historical specificities of the Lettrists and other young troublemakers in postwar France, I argue that Lettrism, as an aesthetic idea, could never have gained or sustained momentum without the mid-century fait divers, a specific genre of miscellaneous news story. In the years immediately following the end of World War II, the raison d’être of the young Lettrists in France could perhaps be defined as the construction of situations that would generate banal news items of a very specific nature. Reframing Lettrist activity as essentially compatible with the raw material for faits divers, as defined by Roland Barthes, helps us to appreciate the somewhat-surprising interest the group generated at a historic moment when France had never been more concerned with the gratuitous misdeeds of young men.

Inequality in achievement in Scottish schools is argued to be caused in part by the process through which learning may take place, for example the medium of the Curriculum for Excellence (CfE) Literacy Outcomes. In practice, and perhaps by implication, standard, sequenced middle-class discourse, be it Scots or English, may be presumed to be the assessed process of learning and thus provide a barrier. Alternatives are considered: radical, extra-curricular political groupings, supplemented by social media dialects; direct instruction of information as a stage sequence towards open, group discourse; subversion of standard language through consciousness of a continuum between radical dialect and standard form.

BackgroundSurgical intervention remains the mainstay treatment for aortic arch aneurysm and dissection, but the high mortality and morbidity rates have led to a need for the development of minimally invasive alternatives to arch reconstruction. RELAY™ Branched (Terumo Aortic, Inchinnan, UK) represents a viable option for complex endovascular aortic arch repair. We present multi-center data from Europe documenting the efficacy of the endograft in terms of its target vessel patency and reintervention rates.MethodsProspective data collected between January 2019 and January 2022 associated with patients treated with RELAY™ single-, double-, and triple-branched endoprostheses from centers across Europe was retrospectively analyzed with descriptive and distributive analysis. Follow up data from 30 days and 6-, 12-, and 24 months postoperatively was included. Patient follow up was evaluated in terms of target vessel patency and reintervention rates.ResultsTechnical success was achieved in 147 (99.3%) cases. Over 24 months period, target vessel patency was maintained in 80.2% (n = 118) of patients. Target vessel cannulation was achieved in 146 (99.3%) cases. Over the 24-month follow-up period, 30 reintervention procedures were required, of which 29 (97%) took place within the South Europe region which accounted for 19.6% (n = 29) of total cases. Zero reinterventions were required in patients that were treated with single- or triple-branched endoprostheses.DiscussionThe data presented herein demonstrates that RELAY™ Branched is a technically efficacious device for endovascular aortic arch repair and is associated with favorable target vessel patency and reintervention rates. Key design features of the endoprosthesis and good perioperative management can contribute greatly to mitigating reintervention and loss of vessel patency following endovascular aortic arch repair.

Surgical intervention remains the mainstay treatment for aortic arch aneurysm and dissection, but the high mortality and morbidity rates have led to a need for the development of minimally invasive alternatives to arch reconstruction. RELAY™ Branched (Terumo Aortic, Inchinnan, UK) represents a viable option for complex endovascular aortic arch repair. We present multi-center data from Europe documenting the efficacy of the endograft in terms of its target vessel patency and reintervention rates.Prospective data collected between January 2019 and January 2022 associated with patients treated with RELAY™ single-, double-, and triple-branched endoprostheses from centers across Europe was retrospectively analyzed with descriptive and distributive analysis. Follow up data from 30 days and 6-, 12-, and 24 months postoperatively was included. Patient follow up was evaluated in terms of target vessel patency and reintervention rates.Technical success was achieved in 147 (99.3%) cases. Over 24 months period, target vessel patency was maintained in 80.2% (The data presented herein demonstrates that RELAY™ Branched is a technically efficacious device for endovascular aortic arch repair and is associated with favorable target vessel patency and reintervention rates. Key design features of the endoprosthesis and good perioperative management can contribute greatly to mitigating reintervention and loss of vessel patency following endovascular aortic arch repair.

The current paradigm of brain protection in aortic surgery falls short of delivering good outcomes with minimal complications. A renewed understanding of neuroprotective methods and biomarkers to predict brain injury and aortic disease are crucial towards the development of more effective clinical management strategies. A review of current literature was carried out to identify current flaws in our approach to neuroprotection in aortic surgery. Emerging evidence surrounding neuroprotective strategies, biomarkers for brain injury, and biomarkers for predicting aortic disease are evaluated in terms of their impact for future therapeutic approaches. Current literature suggests that the prevailing methods of neuroprotection need renewal. Clinical outcomes associated with deep hypothermic circulatory arrest remain varied. Branch-first and endovascular approaches to aortic repair are particularly promising alternatives. The use of biomarkers to identify and manage brain injury, as well as to diagnose aortic disease in the nonacute and acute settings, would further help to improve our overall paradigm of neuroprotection in aortic surgery. Though much prospective research is still required, the outlook for neuroprotection in aortic surgery is promising. Adopting alternative surgical techniques and exploiting predictive novel biomarkers will help us to gradually eliminate the risk of brain damage in aortic surgery.

Colloids may be treated as `big atoms' so that they are good models for atomic and molecular systems. Colloidal hard disks are therefore good models for 2d materials and although their phase behavior is well characterized, rheology has received relatively little attention. Here we exploit a novel, particle-resolved, experimental set-up and complementary computer simulations to measure the shear rheology of quasi-hard-disc colloids in extreme confinement. In particular, we confine quasi-2d hard discs in a circular `corral' comprised of 27 particles held in optical traps. Confinement and shear suppress hexagonal ordering that would occur in the bulk and create a layered fluid. We measure the rheology of our system by balancing drag and driving forces on each layer. Given the extreme confinement, it is remarkable that our system exhibits rheological behavior very similar to unconfined 2d and 3d hard particle systems, characterized by a dynamic yield stress and shear-thinning of comparable magnitude. By quantifying particle motion perpendicular to shear, we show that particles become more tightly confined to their layers with no concomitant increase in density upon increasing shear rate. Shear thinning is therefore a consequence of a reduction in dissipation due to a weakening in interactions between layers as the shear rate increases. We reproduce our experiments with Brownian Dynamics simulations with Hydrodynamic Interactions (HI) included at the level of the Rotne-Prager tensor. That the inclusion of HI is necessary to reproduce our experiments is evidence of their importance in transmission of momentum through the system., Comment: accepted in J. Chem. Phys. special issue on Slow Dynamics, 15 pages

Introduction: This review aims to summarise the current trend and practice for management of type B aortic dissection (TBAD) across the UK. We also aim to highlight the service specification and configuration as well as the current portrayed outcomes published from different sources within the UK. Methods: We carried out a comprehensive literature search on multiple electronic databases including PUBMED, Scopus and EMBASE in order to collate all research evidence on TBAD service line in the UK. We also navigated through official reports published from different sources within the UK specifically highlighting aortic dissection. Results: The UK’s research into TBAD falls short when compared to international counterparts due to a lack of evidence related to TBAD incidence and outcomes. Some TBAD patients are managed at unspecialised centres and others are lost to follow-up. The UK’s vascular surgery workforce is expanding at a very slow rate and the specialised aortic units are consistently failing to meet the waiting time standards for treatment. Conclusions: Restructuring and service reconfiguration are imperative for outcome reporting for TBAD affected population cohort. TBAD should be centralised towards hospital with concentrated level of experience and expertise.

Background Uncomplicated type B aortic dissection (unTBAD) comprises the estimated majority of type B aortic dissection (TBAD), presenting without any of the complications associated with complicated TBAD (coTBAD). Although first-line treatment for coTBAD is thoracic endovascular aortic repair (TEVAR), and despite the fact that TEVAR has proven its safety and effectiveness in the treatment of unTBAD, unTBAD is still being predominantly managed conservatively with medical therapy, with a small proportion of patients being offered TEVAR. Aims The main scope of this review is to highlight the evidence in the literature of the demographic characteristics and associated co-morbidities of unTBAD patients undergoing TEVAR in order to produce a risk stratification system to achieve favourable outcomes. Methods A comprehensive literature search was conducted using multiple electronic databases including PubMed, Ovid, Scopus, and EMBASE. Results Multiple demographic characteristics and associated co-morbidities of unTBAD patients affecting TEVAR outcomes were identified, assessed, and investigated, including age, gender, race, genetics, medical conditions, such as hypertension and diabetes, and lifestyle factors such as smoking. Most factors were associated with increased risks of mortality and morbidity, while others, such as race, were identified as being protective against those when it comes to TEVAR. Conclusion Despite the favourable results yielded by TEVAR in unTBAD, there remains a grey area concerning its management. Thus, it is important to incorporate the demographics and co-morbidities of unTBAD patients’ when into clinical judgement when assessing indications for TEVAR intervention to ensure optimum results can be achieved.

From an urban mining perspective stockpiles of Waste of Electronic and Electrical Equipment (WEEE) by individuals represent anthropogenic stocks that could be exploited for precious and critical resources. The current challenge resides in minimising these stocks generation, as well as accessing the resources they represent. Behavioural models such as the Theory of Planned Behaviour (TPB) have been used in waste and resources management studies to understand WEEE end-of-use intentions and behaviours. But the results have been uneven and the very presence of these anthropogenic stocks is the acknowledgement that these models need to be adapted. Based on a review from the waste and resources management literature we found that TPB models incorporating emotions tended to have higher variance explained for intention, but the intention-behaviour gap remained strong. To explain this gap for small WEEE we propose using variables associating emotions with decision-making biases and tendencies that affect individual behaviours. This study is a theoretical elaboration supporting future empirical testing. A TPB extended with behavioural economics could better model small WEEE end-of-use decisions. Improved understanding of small WEEE urban mines generation could, in turn, inform policy and incentives design to transform these anthropogenic stocks into flows of resources within a circular economy.

Adolescence is often a time when risk-taking behaviours emerge and attendance at primary health care is low. School-based health services can serve to improve access to health care. Clinicians play a key role in improving adolescents’ health literacy and capacity to make informed care decisions. Australia’s national digital health record, My Health Record (MHR), has posed significant challenges for both clinicians and adolescents in understanding impacts on patient privacy. Guidance is required on how best to communicate about MHR to adolescents. This exploratory qualitative study aims to examine adolescents’ understanding of MHR, clinicians’ knowledge of MHR and their use of MHR with adolescents. Focus groups with students, school health and well-being staff and semistructured interviews with GPs and nurses were undertaken in one regional and one urban secondary school-based health service in Victoria. Transcripts from audio recorded sessions were examined using thematic analysis. Resulting themes include minimal understanding and use of MHR, privacy and security concerns, possible benefits of MHR and convenience. The results suggest opportunities to address gaps in understanding and to learn from adolescents’ preferences for digital health literacy education. This will support primary care clinicians to provide best-practice health care for adolescents.

A critical factor in fisheries management is the protection of spawning sites for ecologically and economically important fish species. DNA barcoding (i.e., amplification and sequencing of the mitochondrial cytochrome c oxidase I (COI) gene) of fish eggs has emerged as a powerful technique for identifying spawning sites. However, DNA barcoding of individual fish eggs is time-consuming and expensive. In an attempt to reduce costs and effort for long-term fisheries monitoring programs, here we used DNA metabarcoding, in which DNA is extracted and amplified from a composited sample containing all the fish eggs collected at a given site, to identify fish eggs from 49 stations on the West Florida Shelf. A total of 37 taxa were recovered from 4,719 fish eggs. Egg distributions on the West Florida Shelf corresponded with the known habitat types occupied by these taxa, which included burrower, coastal pelagic, epipelagic, mesopelagic, demersal, deep demersal, commensal, and reef-associated taxa. Metabarcoding of fish eggs was faster and far less expensive than barcoding individual eggs; however, this method cannot provide absolute taxon proportions due to variable copy numbers of mitochondrial DNA in different taxa, different numbers of cells within eggs depending on developmental stage, and PCR amplification biases. In addition, some samples yielded sequences from more taxa than the number of eggs present, demonstrating the presence of contaminating DNA and requiring the application of a threshold proportion of sequences required for counting a taxon as present. Finally, we review the advantages and disadvantages of using metabarcoding vs. individual fish egg barcoding for long-term monitoring programs.

In The Devil Finds Work (1976), James Baldwin presents a remarkably generous review of Boris Vian's controversial novel, J’irai cracher sur vos tombes (1946). Vian's book was exceptionally sensitive to the “rage and pain” of African Americans, Baldwin thought. Baldwin's words seem surprising today: Vian, a white Frenchman, published the work as a protest novel under the false identity of a fictional African American, whom he called Vernon Sullivan. The novel was a hoax, a prank. J’irai cracher sur vos tombes tends to be viewed today in North America, rightly, as an egregious instance of cultural appropriation. The present study argues, however, that the French pastiche of a Black American protest novel baited the reading public into a debate that ignored racism, colonialism, and protest. We argue to view J’irai cracher sur vos tombes and the ensuing scandal it provoked, as an historical archive that allows us to chart a certain ideological climate in France. The public reception of the novel makes abundantly clear that, on the subject of J’irai cracher, Paris wanted to talk about sex, youth morality, and the threats of American cultural hegemony—not racism. Read as an historical affaire, the scandal exposes an extended moment of collective blindness in France. When examined as an historical incident, “the J’irai cracher Affair” reads like a dramatic ironic pronouncement, as if Vian were making a joke only he and a select audience—Baldwin, for one—would understand.

In the 10 months since the first confirmed case of coronavirus disease 2019 (COVID-19) was reported in the United States on January 20, 2020 (1), approximately 13.8 million cases and 272,525 deaths have been reported in the United States. On October 30, the number of new cases reported in the United States in a single day exceeded 100,000 for the first time, and by December 2 had reached a daily high of 196,227.* With colder weather, more time spent indoors, the ongoing U.S. holiday season, and silent spread of disease, with approximately 50% of transmission from asymptomatic persons (2), the United States has entered a phase of high-level transmission where a multipronged approach to implementing all evidence-based public health strategies at both the individual and community levels is essential. This summary guidance highlights critical evidence-based CDC recommendations and sustainable strategies to reduce COVID-19 transmission. These strategies include 1) universal face mask use, 2) maintaining physical distance from other persons and limiting in-person contacts, 3) avoiding nonessential indoor spaces and crowded outdoor spaces, 4) increasing testing to rapidly identify and isolate infected persons, 5) promptly identifying, quarantining, and testing close contacts of persons with known COVID-19, 6) safeguarding persons most at risk for severe illness or death from infection with SARS-CoV-2, the virus that causes COVID-19, 7) protecting essential workers with provision of adequate personal protective equipment and safe work practices, 8) postponing travel, 9) increasing room air ventilation and enhancing hand hygiene and environmental disinfection, and 10) achieving widespread availability and high community coverage with effective COVID-19 vaccines. In combination, these strategies can reduce SARS-CoV-2 transmission, long-term sequelae or disability, and death, and mitigate the pandemic's economic impact. Consistent implementation of these strategies improves health equity, preserves health care capacity, maintains the function of essential businesses, and supports the availability of in-person instruction for kindergarten through grade 12 schools and preschool. Individual persons, households, and communities should take these actions now to reduce SARS-CoV-2 transmission from its current high level. These actions will provide a bridge to a future with wide availability and high community coverage of effective vaccines, when safe return to more everyday activities in a range of settings will be possible.

Background: There is emerging evidence to support pre-emptive thoracic endovascular aortic repair (TEVAR) intervention for uncomplicated type B aortic dissection (unTBAD). Pre-emptive intervention would be particularly beneficial in patients that have a higher baseline risk of progressing to complicated TBAD (coTBAD). There remains debate on the optimal clinical, laboratory, morphological and radiological parameters which would identify the highest-risk patients that would benefit most from pre-emptive TEVAR. Aim: This review summarises evidence on the clinical, laboratory, and morphological parameters that increase the risk profiles of unTBAD patients. Methods: A comprehensive literature search was carried out on multiple electronic databases including PubMed, EMBASE, Ovid and Scopus in order to collate all research evidence on the the clinical, laboratory, and morphological parameters that increase the risk profiles of unTBAD patients Results: At present, there are no clear clinical guidelines using risk-stratification to inform the selection of unTBAD patients for TEVAR. However, there are noticeable literature trends that can assist with the identification of the most at-risk unTBAD patients. Patients are at particular risk when they have refractory pain and/or hypertension, elevated C-reactive protein (CRP), larger aortic diameter and larger entry tears. These risks should be considered alongside factors that increase the procedural risk of TEVAR to create a well-balanced approach. Advances in biomarkers and imaging are likely to identify more pertinent parameters in future to optimise the development of balanced, risk-stratified treatment protocols. Conclusion: There are a variety of risk profiling parameters that can be used to identify the high-risk unTBAD patient, with novel biomarkers and imaging parameter emerging. Longer-term evidence verifying these parameters would be ideal. Further randomized controlled trials and multicentre registry analyses are also warranted to guide risk-stratified selection protocols.

There is emerging evidence to support pre-emptive thoracic endovascular aortic repair (TEVAR) intervention for uncomplicated type B aortic dissection (unTBAD). Pre-emptive intervention would be particularly beneficial in patients that have a higher baseline risk of progressing to complicated TBAD (coTBAD). There remain debate on the optimal clinical, laboratory, morphological, and radiological parameters, which would identify the highest-risk patients that would benefit most from pre-emptive TEVAR.This review summarizes evidence on the clinical, laboratory, and morphological parameters that increase the risk profiles of unTBAD patients.A comprehensive literature search was carried out on multiple electronic databases including PubMed, EMBASE, Ovid, and Scopus to collate all research evidence on the clinical, laboratory, and morphological parameters that increase the risk profiles of unTBAD patients RESULTS: At present, there are no clear clinical guidelines using risk-stratification to inform the selection of unTBAD patients for TEVAR. However, there are noticeable literature trends that can assist with the identification of the most at-risk unTBAD patients. Patients are at particular risk when they have refractory pain and/or hypertension, elevated C-reactive protein (CRP), larger aortic diameter, and larger entry tears. These risks should be considered alongside factors that increase the procedural risk of TEVAR to create a well-balanced approach. Advances in biomarkers and imaging are likely to identify more pertinent parameters in the future to optimize the development of balanced, risk-stratified treatment protocols.There are a variety of risk profiling parameters that can be used to identify the high-risk unTBAD patient, with novel biomarkers and imaging parameters emerging. Longer-term evidence verifying these parameters would be ideal. Further randomized controlled trials and multicentre registry analyses are also warranted to guide risk-stratified selection protocols.

Background: Acute type B aortic dissection (TBAD) is a rare condition that can be divided into complicated (CoTBAD) and uncomplicated (UnCoTBAD) based on certain presenting clinical and radiological features, with UnCoTBAD constituting the majority of TBAD cases. The classification of TBAD directly affects the treatment pathway taken, however, there remains confusion as to exactly what differentiates complicated from uncomplicated TBAD. Aims: The scope of this review is to delineate the literature defining the intervention parameters for UnCoTBAD. Methods: A comprehensive literature search was conducted using multiple electronic databases including PubMed, Scopus, and EMBASE to collate and summarize all research evidence on intervention parameters and protocols for UnCoTBAD. Results: A TBAD without evidence of malperfusion or rupture might be classified as uncomplicated but there remains a subgroup who might exhibit high-risk features. Two clinical features representative of “high risk” are refractory pain and persistent hypertension. First line treatment for CoTBAD is TEVAR, and whilst this has also proven its safety and effectiveness in UnCoTBAD, it is still being managed conservatively. However, TBAD is a dynamic pathology and a significant proportion of UnCoTBADs can progress to become complicated, thus necessitating more complex intervention. While the “high risk” UnCoTBAD do benefit the most from TEVAR, yet, the defining parameters are still debatable as this benefit can be extended to a wider UnCoTBAD population. Conclusion: Uncomplicated TBAD remains a misnomer as it is frequently representative of a complex ongoing disease process requiring very close monitoring in a critical care setting. A clear diagnostic pathway may improve decision making following a diagnosis of UnCoTBAD. Choice of treatment still predominantly depends on when an equilibrium might be reached where the risks of TEVAR outweigh the natural history of the dissection in both the short- and long-term.