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We present the first analysis of the atomic and molecular processes at play during detachment in the MAST-U Super-X divertor using divertor spectroscopy data. Our analysis indicates detachment in the MAST-U Super-X divertor can be separated into four sequential phases: first, the ionisation region detaches from the target at detachment onset leaving a region of increased molecular densities downstream. The plasma interacts with these molecules, resulting in molecular ions ( D 2 + and/or D 2 − → D + D − ) that further react with the plasma leading to molecular activated recombination and dissociation (MAR and MAD), which results in excited atoms and significant Balmer line emission. Second, the MAR region detaches from the target leaving a sub-eV temperature region downstream. Third, an onset of strong emission from electron-ion recombination (EIR) ensues. Finally, the electron density decays near the target, resulting in the bulk of the electron density moving upstream. The analysis in this paper indicates that plasma-molecule interactions have a larger impact than previously reported and play a critical role in the intensity and interpretation of hydrogen atomic line emission characteristics on MAST-U. Furthermore, we find that the Fulcher band emission profile in the divertor can be used as a proxy for the ionisation region and may also be employed as a plasma temperature diagnostic for improving the separation of hydrogenic emission arising from electron-impact excitation and that from plasma-molecular interactions. We provide evidences for the presence of low electron temperatures (≪0.5 eV) during detachment phases III-IV based on quantitative spectroscopy analysis, a Boltzmann relation of the high-n Balmer line transitions together with an analysis of the brightness of high-n Balmer lines.

24 augustus 2022, Contains fulltext : 253265.pdf (Publisher’s version ) (Open Access), Listening to music can have a calming effect on people, but the natural “consumption” of music is generally not used in a goal-oriented way to reduce physiological arousal (i.e., heart rate and skin conductance) and tension, and to enhance mood. X-System is designed to predict the innate neurophysiological response to pieces of music and influence the arousal levels of users. We hypothesized that listening to a preferred genre of music has beneficial physiological and psychological effects and that X-System had an effect over and above the use of preferred music genres. A small-scale study (N = 38) was conducted in a medium secure forensic psychiatric facility to investigate the effects of passive music therapy on the arousal, tension, and mood of patients and their caregivers. Participants listened to a selection of songs of their preferred music genre for 2 days. On one of the 2 days, the music selection was played in an order established by X-System, with the aim to maximally reduce arousal, whereas on the other day the music selection was played in random order. In both conditions, physiological indices and self-reported tension decreased after listening to the preferred music. The hypothesized accelerated reduction in skin conductance for the X-System playlist was evident on visual inspection of the data, but the trend was non-significant (p = .065). The use of personalized music in forensic psychiatry might be a relatively effective, inexpensive way to benefit patients and staff members, especially patients that are hesitant to engage in the more traditional therapies.

Abstract Background Exposure to pesticides has been linked to many health outcomes. More recently, chronic kidney disease not related to diabetes or hypertension (CKDu) has been postulated to be related to rural occupational exposures in agricultural workers in several Low to Middle Income Country (LMIC) regions such as Mesoamerica and the Subcontinent. Our study wished to examine the relationship between pesticide exposure and kidney function. Methods We used the resources of pooled population from NHANES 2001-2004, 2007-2010 (n = 29,053). We examined pesticide exposure (logged, continuous) with kidney function as measured by glomerular filtration rate (derived from urinary creatinine) with and without presence of hypertension and diabetes. Logistic regression was adjusted for a range of cofactors such as age, sex, SES, tobacco, and heavy metals. Cadmium was used as a positive control. Results Pesticides 2,4-D, chlorpyrifos, malathion and 3-phenoxybenzoic acid (the major metabolite of deltamethrin) were associated with the increasing risk of kidney dysfunction (not with hypertension or diabetes) after adjusting for a range of known risk factors (OR 1.80 (1.47-2.21); 2.16 (1.57-2.98); 1.20 (0.94-1.54) and 1.40 (1.19-1.64), respectively). Cd was not associated with kidney dysfunction (OR 0.99 (0.81-1.21)), or acephate (OR 0.43 (0.13-1.48)). Conclusions Chronic or acute pesticide exposure may increase the risk of kidney dysfunction, which is not related to hypertension or diabetes in particular. It may have a different pathological pathway from heavy metal exposures and CKD. This has repercussions for interventions in LMIC agricultural practices. Key messages

Chronic kidney disease (CKD) not associated with known risk factors has been reported from parts of India and presumed to be similar to CKD of unknown etiology (CKDu) described from Central America. The reports from India have been fragmented, without clear description of the disease phenotype or its determinants. This paper summarises the current state of knowledge around CKDu in India based on a review of literature, multistakeholder consultation, and a survey of the membership of the Indian nephrologists. We also contacted individual research groups to solicit data. Our findings suggests that that CKDu is reported from most regions in India but is different from the phenotype described from Central America and Sri Lanka. The differences include lack of a clear demographic or occupation group, older age of affected participants and presence of mild hypertension and low-grade proteinuria. Well-designed prospective field studies with appropriate diagnostic workup are needed to establish the disease burden and identify etiologies, along with socioeconomic and health consequences, the intersection with the environment, and the public health response. Community-based research should phenotype the entire CKD population rather than be restricted to cases with presumed CKDu based on predefined criteria. Guidelines are needed for clinical evaluation, referral and management, and harmonization of clinical documentation and health records. More data are needed to support the existence of a unique CKDu phenotype in India.

Chronic kidney disease (CKD) not associated with known risk factors has been reported from parts of India and is presumed to be similar to CKD of unknown etiology (CKDu) that has been described from Central America. The reports from India have been fragmented without clear description of the disease phenotype or its determinants. This paper summarizes the current state of knowledge around CKDu in India based on a review of literature, multi-stakeholder consultation, and a survey of Indian nephrologists. We also contacted individual research groups to solicit data. Our findings suggest that that CKDu is reported from most regions in India; however, it is interpreted differently from the phenotype described from Central America and Sri Lanka. The differences include lack of a clear demographic or occupation group, older age of affected participants, and presence of mild hypertension and low-grade proteinuria. Well-designed prospective field studies with appropriate diagnostic workup are needed to establish the disease burden and identify etiologies, along with socioeconomic and health consequences, the intersection with the environment, and the public health response. Community-based research should phenotype the entire CKD population rather than be restricted to cases with presumed CKDu based on predefined criteria. Guidelines are needed for clinical evaluation, referral, management, and harmonization of clinical documentation and health records. More data are needed to support the existence of a unique CKDu phenotype in India.

This critical commentary reflects on a rapidly mobilised international podcast project, in which 25 urban scholars from around the world provided audio recordings about their cities during COVID-19. New digital tools are increasing the speeds, formats and breadth of the research and communication mediums available to researchers. Voice recorders on mobile phones and digital audio editing on laptops allows researchers to collaborate in new ways, and this podcast project pushed at the boundaries of what a research method and community might be. Many of those who provided short audio 'reports from the field' recorded on their mobile phones were struggling to make sense of their experience in their city during COVID-19. The substantive sections of this commentary discuss the digital methodology opportunities that podcasting affords geographical scholarship. In this case the methodology includes the curated production of the podcast and critical reflection on the podcast process through collaborative writing. Then putting this methodology into action some limited reflections on cities under COVID-19 lockdown and social distancing initiatives around the world are provided to demonstrate the utility and limitations of this method.

Objective. Loss of disc height is commonly associated with chronic low back pain (CLBP). Isolated lumbar extension (ILEX) exercise for the lumbar extensors is recommended to treat CLBP and is suggested such exercise might promote disc healing and regeneration. This study examined a 12-week ILEX intervention on indirect determination of disc height and shrinkage through seated stadiometry, strength, pain, and disability. Design. A quasi-experimental wait-list controlled design was used. Nine participants underwent pretesting (T1), a 12-week control period, retesting (T2), a 12-week intervention period, and finally posttesting (T3). Seated stadiometry, ILEX strength, pain, and disability were measured at each time point. Results. No significant repeated-measures effects for any seated stadiometry variables occurred. Significant improvement across the intervention period (T2 to T3) was found for strength (P <0.0001; effect size [ES] = 2.42). Change in pain was not significant for repeated effects (P = 0.064); however, ES for the intervention period (T2 to T3) was moderate (ES = −0.77). Change in disability was significant between time point T1 and T3 (P = 0.037) and ES for the intervention period (T2 to T3) was large (ES = −0.92). Pain and disability achieved minimal clinically important changes. Conclusions. This is apparently the first study to examine disc change in vivo after exercise in CLBP. Results of the present study, though supporting ILEX resistance training to improve strength, pain, and disability, did not find any effect on spinal height.

© 2019, The Author(s). Environmental exposure to phthalates may contribute to an increased risk of asthma in children and adults. We aimed to assess the direction and strength of the association between urinary phthalates metabolites and current asthma in children and adults that participated in the National Health and Nutrition Examination Survey (NHANES) 2007–2012. Data on ten urinary phthalate metabolites, self-reported questionnaires, spirometry measures, and covariates were obtained from 7765 participants (28.1% were children aged 6–17 years) taking part in the NHANES 2007–2012. Asthma was assessed using self-reported questionnaires for children and adults, and via spirometry measures for adults alone. We used crude and adjusted logistic regression models to estimate the odds ratios (ORs) and 95% confidence interval (CI) per one log10 unit change in the concentration of phthalate metabolites. We further modeled the effect modification by sex. Out of 10 metabolites, only mono-benzyl phthalate (MBzP) was positively associated with the prevalence of self-reported asthma in children, after adjusting for a range of potential confounders (odds ratio 1.54; 95% confidence interval 1.05–2.27). No significant relationship was observed for adults. The association of mono-ethyl phthalate (MEP) was modified by sex, with significantly increased odds of asthma among males [boys (2.00; 1.14–3.51); adult males (1.32; 1.04–1.69)]. While no other phthalates showed a positive relationship with current asthma in males, mono-(carboxynonyl) phthalate (MCNP) and mono-(3-carboxylpropyl) phthalate (MCPP) were inversely associated with spirometrically defined asthma in adult females. A sex-specific relationship in adults was evident when spirometry, but not self-reported measures were used to define asthma. We found no clear association between exposure to phthalates and current asthma, except for a significant relationship between MBzP metabolites and self-reported asthma in children. A

Background/Aim: Grass (Poaceae) pollen is the most significant outdoor aeroallergen, and is linked to asthma exacerbations and respiratory allergic response. Understanding of the relative contributions of different grass taxa to respiratory health outcomes is currently unknown. We investigate associations between a range of grass genera and proxies of both asthma exacerbation (hospital admissions) and respiratory allergic response (prescribing rates). A better understanding of allergenic exposures will allow better disease management by patients and healthcare providers. This work forms part of the PollerGEN Project. Methods: Combining metagenomics and pollen count data, we produced semi-quantitative estimates of concentrations of the pollen of 14 grass genera and undifferentiated (i.e. unidentified) Poaceae, at six sites across the UK during the pollen season (May to September) of 2016. Using a series of generalised additive models (GAMs), these data are being combined with hospital admissions and prescribing datasets (and various confounding datasets) to assess associations between different types of grass pollen with serious asthma exacerbations and respiratory allergic response at a population level. Results: Preliminary GAMs, adjusted for weather, air pollution, rural-urban status, deprivation, health organisation and time period, explain >95% of variation in health outcome variables (adjusted R2 = 0.912). Notably, they suggest a potential positive relationship between respiratory antihistamines and concentrations of Holcus pollen during the 2016 UK pollen season (F = 25.9, P = 2.41 x 10^-8), whereas overall grass pollen concentrations (i.e. standard pollen ‘counts’), did not provide significant correlation. Conclusions: Our preliminary results suggest that certain grass taxa may contribute more than others to respiratory health outcomes in the UK, including contributing more than overall grass pollen concentrations. This

Contains fulltext : 193378.pdf (publisher's version ) (Closed access)

Objective. Loss of disc height is commonly associated with chronic low back pain (CLBP). Isolated lumbar extension (ILEX) exercise for the lumbar extensors is recommended to treat CLBP and is suggested such exercise might promote disc healing and regeneration. This study examined a 12-week ILEX intervention on indirect determination of disc height and shrinkage through seated stadiometry, strength, pain, and disability. Design. A quasi-experimental wait-list controlled design was used. Nine participants underwent pretesting (T1), a 12-week control period, retesting (T2), a 12-week intervention period, and finally posttesting (T3). Seated stadiometry, ILEX strength, pain, and disability were measured at each time point. Results. No significant repeated-measures effects for any seated stadiometry variables occurred. Significant improvement across the intervention period (T2 to T3) was found for strength (P <0.0001; effect size [ES] = 2.42). Change in pain was not significant for repeated effects (P = 0.064); however, ES for the intervention period (T2 to T3) was moderate (ES = −0.77). Change in disability was significant between time point T1 and T3 (P = 0.037) and ES for the intervention period (T2 to T3) was large (ES = −0.92). Pain and disability achieved minimal clinically important changes. Conclusions. This is apparently the first study to examine disc change in vivo after exercise in CLBP. Results of the present study, though supporting ILEX resistance training to improve strength, pain, and disability, did not find any effect on spinal height.

Strengthening the lumbar extensor musculature is a common recommendation for chronic low back pain (CLBP). Although reported as effective, variability in response in CLBP populations is not well investigated. This study investigated variability in responsiveness to isolated lumbar extension (ILEX) resistance training in CLBP participants by retrospective analysis of three previous randomized controlled trials. Data from 77 participants were available for the intervention arms (males = 43, females = 34) 37 participants data (males = 20, females = 17) from the control arms. Intervention participants had all undergone 12 weeks of ILEX resistance training and changes in ILEX strength, pain (visual analogue scale; VAS), and disability (Oswestry disability index; ODI) measured. True inter-individual (i.e., between participants) variability in response was examined through calculation of difference in the standard deviation of change scores for both control and intervention arms. Intervention participants were classified into responder status using k-means cluster analysis for ILEX strength changes and using minimal clinically important change cut-offs for VAS and ODI. Change in average ILEX strength ranged 7.6 Nm (1.9%) to 192.1 Nm (335.7%). Change in peak ILEX strength ranged -12.2 Nm (-17.5%) to 276.6 Nm (169.6%). Participants were classified for strength changes as low (n = 31), medium (n = 36), and high responders (n = 10). Change in VAS ranged 12.0 mm to -84.0 mm. Participants were classified for VAS changes as negative (n = 3), non-responders (n = 34), responders (n = 15), and high responders (n = 19). Change in ODI ranged 18 pts to -45 pts. Participants were classified for ODI changes as negative (n = 2), non-responders (n = 21), responders (n = 29), and high responders (n = 25). Considerable variation exists in response to ILEX resistance training in CLBP. Clinicians should be aware of this and future work should identify factors prognostic of successful outcomes.

Background and Aim: Women who are homozygous for the p.C282Y mutation in the HFE gene are at much lower risk of iron overload-related disease than p.C282Y homozygous men, presumably because of the iron-depleting effects of menstruation and pregnancy. We used data from a population cohort study to model the impact of menstruation cessation at menopause on serum ferritin (SF) levels in female p.C282Y homozygotes, with p.C282Y/p.H63D simple or compound heterozygotes and those with neither p.C282Y nor p.H63D mutations (HFE wild types) as comparison groups. Methods: A sample of the Melbourne Collaborative Cohort Study was selected for the “HealthIron” study (n = 1438) including all HFE p.C282Y homozygotes plus a random sample stratified by HFE-genotype (p.C282Y and p.H63D). The relationship between the natural logarithm of SF and time since menopause was examined using linear mixed models incorporating spline smoothing. Results: For p.C282Y homozygotes, SF increased by a factor of 3.6 (95% CI (1.8, 7.0), P < 0.001) during the first 10 years postmenopause, after which SF continued to increase but at less than half the previous rate. In contrast, SF profiles for other HFE genotype groups increase more gradually and did not show a distinction between premenopausal and postmenopausal SF levels. Only p.C282Y homozygotes had predicted SF exceeding 200 µg/L postmenopause, but the projected SF did not increase the risk of iron overload-related disease. Conclusions: These data provide the first documented evidence that physiological blood loss is a major factor in determining the marked gender difference in expression of p.C282Y homozygosity.

Indirect measurement of disc hydration can be obtained through measures of spinal height using stadiometry. However, specialised stadiometers for this are often custom-built and expensive. Generic wall-mounted stadiometers alternatively are common in clinics and laboratories. This study examined the reliability of a custom set-up utilising a wall-mounted stadiometer for measurement of spinal height using custom built wall mounted postural rods. Twelve participants with non-specific chronic low back pain (CLBP; females n = 5, males n = 7) underwent measurement of spinal height on three separate consecutive days at the same time of day where 10 measurements were taken at 20 s intervals. Comparisons were made using repeated measures analysis of variance for 'trial' and 'gender'. There were no significant effects by trial or interaction effects of trial x gender. Intra-individual absolute standard error of measurement (SEM) was calculated for spinal height using the first of the 10 measures, the average of 10 measures, the total shrinkage, and the rate of shrinkage across the 10 measures examined as the slope of the curve when a linear regression was fitted. SEMs were 3.1 mm, 2.8 mm, 2.6 mm and 0.212, respectively. Absence of significant differences between trials and the reported SEMs suggests this custom set-up for measuring spinal height changes is suitable use as an outcome measure in either research or clinical practice in participants with CLBP.

Low back pain (LBP) is highly prevalent and presents an enormous cost both through direct health care and indirectly through significant work and production loss. Low back pain is acknowledged widely to be a multifactorial pathology with a variety of symptoms, dysfunctions, and a number of possible sources of pain. One source that has been suspected and evidenced for some time is the intervertebral disc. Some degree of disc degeneration is a physiologic process associated with aging, however, more severe degeneration and/or structural abnormality may be indicative of a pathologic process or injury and is more commonly present in those suffering from LBP. Much like other tissues (ie, muscle, bone, etc.), it has been suspected that there exists an optimal loading strategy to promote the health of the disc. Exercise is often prescribed for LBP and effectively reduces pain and disability. However, whether specific loading through exercise might plausibly heal or regenerate the intervertebral discs is unknown.

Background Chronic low back pain is a multifactorial condition with many dysfunctions including gait variability. The lumbar spine and its musculature are involved during gait and in chronic low back pain the lumbar extensors are often deconditioned. It was therefore of interest to examine relationships between lumbar kinematic variability during gait, with pain, disability and isolated lumbar extension strength in participants with chronic low back pain. Methods Twenty four participants with chronic low back pain were assessed for lumbar kinematics during gait, isolated lumbar extension strength, pain, and disability. Angular displacement and kinematic waveform pattern and offset variability were examined. Findings Angular displacement and kinematic waveform pattern and offset variability differed across movement planes; displacement was highest and similar in frontal and transverse planes, and pattern variability and offset variability higher in the sagittal plane compared to frontal and transverse planes which were similar. Spearman's correlations showed significant correlations between transverse plane pattern variability and isolated lumbar extension strength (r = −.411) and disability (r = .401). However, pain was not correlated with pattern variability in any plane. The r2 values suggested 80.5% to 86.3% of variance was accounted for by other variables. Interpretation Considering the lumbar extensors role in gait, the relationship between both isolated lumbar extension strength and disability with transverse plane pattern variability suggests that gait variability may result in consequence of lumbar extensor deconditioning or disability accompanying chronic low back pain. However, further study should examine the temporality of these relationships and other variables might account for the unexplained variance.

The apparent rapid increase in IgE-mediated food allergy and its implications are now widely recognized, but little is known about the relationship between family history (an indirect measure of genetic risk) and the risk of food allergy. In a population-based study of 5,276 one year old infants (HealthNuts), the prevalence of oral food challenge-confirmed food allergy was measured. Associations between family history of allergic disease and food allergy in infants were examined using multiple logistic regression. Food allergy was diagnosed in 534 infants. Compared to those with no family history of allergic disease, children meeting the current definition of "high risk" for allergic disease (one immediate family member with a history of any allergic disease) showed only a modest increase (OR 1.4, 95% CI 1.1-1.7) in food allergy, while having two or more allergic family members was more strongly predictive of food allergy in the child (OR 1.8, 95% CI 1.5-2.3). There were also differences in the associations between family history and egg and peanut allergy in the child. Re-defining "high risk" as two or more allergic family members may be more useful for identification of groups with a significantly increased risk of food allergy both clinically and within research studies. © 2013 by the authors; licensee MDPI, Basel, Switzerland.

Background: Questionnaire-based studies investigating blood donation history rely on the accurate recall of information from participants for results to be valid. This study aimed to retrieve electronic records from a national blood donation service and link them to self-reported history of donation to assess agreement between the two sources. Study design and methods: Between 2004 and 2006, a sample of participants of northern European descent was selected from the Melbourne Collaborative Cohort Study (n = 31,192) to participate in the “HealthIron” study (n = 1438). A total of 1052 participants completed questionnaires that included questions about blood donation history. In 2009, consenting participants' records were linked to the Australian Red Cross Blood Service (ARCBS) to provide information on blood donations made between 1980 and follow-up (2004-2006). Those who commenced blood donation before 1980 were excluded. Results: A total of 718 participants were available for analysis. Of these, 394 (55%) provided signed consent, including 182 (82%) of the 227 participants who self-reported ever donating blood. The two data sources were concordant for 331 (87%) of participants, with a κ statistic of 0.74 (SE, 0.05) indicating a high level of agreement. Participants tended to overstate by a factor of 2.0 (95% confidence interval, 1.7-2.2) the number of donations they had made when compared with ARCBS records. Conclusion: Participants in studies assessing self-reported blood donation history are likely to correctly indicate whether or not they have ever donated blood. Quantitative estimates are potentially inaccurate and could benefit from validating a sample of records to quantify the bias.

HFE-associated hereditary hemochromatosis (HH) is a genetic predisposition to iron overload and subsequent signs and symptoms of disease potentially affecting around 80,000 in Australia and almost one million people in the USA. Most clinical cases are homozygous for the C282Y mutation in the HFE gene, with serum ferritin (SF) concentration >1000 μg/L the strongest predictor of cirrhosis. The optimal treatment regimen for those with SF concentrations above the normal range but <1000 μg/L is unknown. We assessed HFE mutations in a prospective cohort of 31,192 participants of northern European descent, aged 40–69 years. An HFE-stratified random sample of 1438 participants including all C282Y homozygotes with iron studies 12 years apart were examined by physicians blinded to HFE genotype. All previously undiagnosed C282Y homozygotes (35 male, 67 female) and all HFE wild-types (131 male, 160 female) with baseline and follow-up SF concentrations <1000 μg/L were assessed for HH-associated signs and symptoms including abnormal second/third metacarpophalangeal joints (MCP 2/3), raised liver enzymes, hepatomegaly, and self-reported liver disease, fatigue, diabetes mellitus, and use of arthritis medication. The prevalence of HH-associated signs and symptoms was similar for C282Y homozygotes and HFE wild-types for both normal and moderately elevated SF concentrations. The maximum prevalence difference between HFE genotype groups with moderately elevated SF was 11% (MCP 2/3 95% CI (−6%, 29%), p=0.22) and for normal SF was 6% (arthritis medicine use, 95% CI (−3, 16), p=0.11).

Leber Hereditary Optic Neuropathy (LHON) is a maternally inherited form of visual loss, due to selective degeneration of retinal ganglion cells. Despite the established aetiological association between LHON and mitochondrial DNA mutations affecting complex I of the electron transport chain, the pathophysiology of this disorder remains obscure. Primary rat retinal cultures were exposed to increasing concentrations of rotenone to titrate complex I inhibition. Neural cells were more sensitive than Mfiller glial cells to rotenone toxicity. Rotenone induced an increase in mitochondrial-derived free radicals and lipid peroxidation. Sodium -dependent glutamate uptake, which is mostly mediated by the glutamate transporter GLAST expressed by Mfiller glial cells, was reduced dose-dependently by rotenone with no changes in GLAST expression. Our findings suggest that complex 1-derived free radicals and disruption of glutamate transport might represent key elements for explaining the selective retinal ganglion cell death in LHON. (c) 2006 Elsevier Inc. All rights reserved.

The construction risks associated with the complex, shallow, large diameter, close proximity layout of the tunnels, in the London Underground, were increased by the potential impact of compensation grouting. The contract required this method of ground treatment to minimise the effects of settlement on the overlying main-line station structures. The potential adverse impact of the grouting needed to be evaluated and design assumptions had to be updated systematically during construction using an observational approach. The systems used were highly effective in ensuring stability and keeping to acceptable settlement and tunnel convergence tolerances. These were achieved by excavating for and installing optimal temporary supports and configuring efficient compensation grout injection patterns. Anticipated mechanisms controlling the impact of compensation grouting are discussed and monitoring data for ground movements, tunnel deflections and temporary works loading presented., The construction risks associated with the complex, shallow, large diameter, close proximity layout of the tunnels, in the London Underground, were increased by the potential impact of compensation grouting. The contract required this method of ground treatment to minimise the effects of settlement on the overlying main-line station structures. The potential adverse impact of the grouting needed to be evaluated and design assumptions had to be updated systematically during construction using an observational approach. The systems used were highly effective in ensuring stability and keeping to acceptable settlement and tunnel convergence tolerances. These were achieved by excavating for and installing optimal temporary supports and configuring efficient compensation grout injection patterns. Anticipated mechanisms controlling the impact of compensation grouting are discussed and monitoring data for ground movements, tunnel deflections and temporary works loading presented.

Scrutinising the volume of spoil from the tunnel face is the first line of defence against major ground loss in tunnels under urban areas such as Singapore. On two Circle Line mass transit contracts, different techniques used to calculate the amount of excavated material per ring include counting the number of disposal skips, using a conveyor-belt weighing device and monitoring spoil with a laser scanner on the belt. An analysis of the data produced is used to evaluate belt weighing and laser scanning for a Hitachi Zosen and a Herrenknecht tunnel boring machine excavating marine clays and alluvium. The results suggest that automated spoil monitoring can be used to avoid large volume losses and collapse at surface, through early identification and mitigation of over-excavation. Nearly all volumes recorded automatically fell within 10% of those obtained by counting muck skips and most within 5%, while a closely observed trial over 10 rings provided even better correlation. A number of anomalies in the weighing and scanning systems are noted and refinements suggested., Scrutinising the volume of spoil from the tunnel face is the first line of defence against major ground loss in tunnels under urban areas such as Singapore. On two Circle Line mass transit contracts, different techniques used to calculate the amount of excavated material per ring include counting the number of disposal skips, using a conveyor-belt weighing device and monitoring spoil with a laser scanner on the belt. An analysis of the data produced is used to evaluate belt weighing and laser scanning for a Hitachi Zosen and a Herrenknecht tunnel boring machine excavating marine clays and alluvium. The results suggest that automated spoil monitoring can be used to avoid large volume losses and collapse at surface, through early identification and mitigation of over-excavation. Nearly all volumes recorded automatically fell within 10% of those obtained by counting muck skips and most within 5%, while a closely observed trial over 10 rings provided even better correlation. A number of anomalies in the weighing and scanning systems are noted and refinements suggested.

There has been almost no use of sprayed concrete linings or the New Austrian Tunnelling Method in Singapore, apart from excavations less than 6 m long in boulder clay and decomposed granite. For the North East line of the mass rapid system, sprayed linings were used on Contract 710 for twin cross-over tunnels of 8.4 m inside diameter, constructed less than 1 m apart in Jurong Formation sandstones. Sprayed concrete was also used to line an advance tunnel for the future deep tunnel sewage system, constructed through Old Alluvium sands and gravels as part of the North East line's Contract 705. The geotechnical characteristics of both rock formations were important both in the selection of temporary support methods and in determining ground behaviour during tunnelling. Planning and design were concentrated on ensuring the overall integrity and stability of both projects. A variety of construction techniques were successfully used., There has been almost no use of sprayed concrete linings or the New Austrian Tunnelling Method in Singapore, apart from excavations less than 6 m long in boulder clay and decomposed granite. For the North East line of the mass rapid system, sprayed linings were used on Contract 710 for twin cross-over tunnels of 8.4 m inside diameter, constructed less than 1 m apart in Jurong Formation sandstones. Sprayed concrete was also used to line an advance tunnel for the future deep tunnel sewage system, constructed through Old Alluvium sands and gravels as part of the North East line's Contract 705. The geotechnical characteristics of both rock formations were important both in the selection of temporary support methods and in determining ground behaviour during tunnelling. Planning and design were concentrated on ensuring the overall integrity and stability of both projects. A variety of construction techniques were successfully used.

Tactile acuity, body schema and motor control and clinical outcome measures – A comparison study of adults with chronic low back pain and matched controls Chronic low back pain (CLBP) is common, often lacks discernible aetiology and contributes to morbidity and low quality of life. Treatments often focus on pain relief and improving motor function but outcomes remain moderate and many experience ongoing pain. In Complex Regional Pain Syndrome and Phantom Limb Pain, the cortical neurophysiology and specific sensory outputs are altered. Interventions to reverse these impairments coincide with a reduction in pain intensity. Sharing similar neurophysiological characteristics, it’s plausible that similar approaches may improve CLBP outcomes so identification of similar features in this group is needed. We conducted a systematic review regarding the questions: Are two-point discrimination threshold (TPDT) and body schema (BS) altered in adults with CLBP and do they relate to impaired lumbopelvic motor control (LMC)? This review initiated stage two; data collection to investigate TPDT, BS, LMC, back-perception, disability, kinesiophobia and clinical outcome measures in adults with CLBP and matched controls. Following a systematic review to guide our study, we aimed to identify differences in tactile acuity, body schema, lumbopelvic motor function and association with clinical outcome measures when measured in adults with chronic low back pain and matched controls. Using a systematic search strategy, a literature search of 12 bibliographic databases, grey literature, Google Scholar and the reference lists of included articles was undertaken over 5 months to Feb 2016. Studies involving adults aged 18 or older with CLBP longer than 3 months duration were included. Pregnancy, 6 months post-partum, central neurological conditions and nerve root pathologies were exclusion criteria. Two independent reviewers’ assessed for quality using an adapted Downs and Black Quality Index Sco

It has regularly been stated that consumer demand for CSR is larger than ever, but do consumers really want to be informed about the ethical behaviour of brands? Does digital media have an impact on meaningful CSR communication? A research analysing consumer reaction to social media posts about CSR is limited. Using mixed method, this study examined the UK consumer attitudes towards CSR and its communication in digital media plus its consequent effect on purchasing intentions. Results indicate that consumers are more likely to evaluate a brand higher if made aware of CSR activity, which in turn affects purchase intention. Consumers have fairly positive attitudes about CSR communicated on digital media, but may react negatively if the message contradicts prior behaviour of the brand. Overall, the study show support for the communication of digital media but brands looking to enhance a damaged reputation must take great consideration over the message at hand.

Background Lumbar segmental instability is often considered to be a cause of chronic low back pain. However, defining its measurement has been largely limited to laboratory studies. These have characterised segmental stability as the intrinsic resistance of spine specimens to initial bending moments by quantifying the dynamic neutral zone. However these measurements have been impossible to obtain in vivo without invasive procedures, preventing the assessment of intervertebral stability in patients. Quantitative fluoroscopy (QF), measures the initial velocity of the attainment of intervertebral rotational motion in patients, which may to some extent be representative of the dynamic neutral zone. This study sought to explore the possible relationship between the dynamic neutral zone and intervertebral rotational attainment rate as measured with (QF) in an in vitro preparation. The purpose was to find out if further work into this concept is worth pursuing. Method This study used passive recumbent QF in a multi-segmental porcine model. This assessed the intrinsic intervertebral responses to a minimal coronal plane bending moment as measured with a digital force guage. Bending moments about each intervertebral joint were calculated and correlated with the rate at which global motion was attained at each intervertebral segment in the first 10° of global motion where the intervertebral joint was rotating. Results Unlike previous studies of single segment specimens, a neutral zone was found to exist during lateral bending. The initial attainment rates for left and right lateral flexion were comparable to previously published in vivo values for healthy controls. Substantial and highly significant levels of correlation between initial attainment rate and neutral zone were found for left (Rho = 0.75, P = 0.0002) and combined left-right bending (Rho = 0.72, P = 0.0001) and moderate ones for right alone (Rho = 0.55, P = 0.0012). Conclusions This study found good correlation bet