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Purpose: In April 2020, the UK Government implemented NHS Test and Trace to provide SARS-CoV-2 quantitative reverse transcription polymerase chain reaction (qRT-PCR) testing for the public, with nose-and-throat swabbing for samples performed by trained staff. Self-swabbing (SS) would allow rapid scale-up of testing capacity and access. Six studies were undertaken to determine whether SS was as effective for detecting SARS-CoV-2 as swabbing performed by trained staff. Methods: Six prospective studies were conducted between April–October 2020, using six swab/media combinations. Differences between assisted swabbing (AS) and SS were evaluated for concordance, positivity, sensitivity, cycle threshold (Ct) values and void rates. Statistical analysis was performed using 95% confidence intervals (CIs), paired t-tests and model-based methods. Results: Overall, 3,253 individuals were recruited (median age 37 years, 49% female), with 2,933 having valid paired qRT-PCR results. Pooled concordance rate was 98% (95% CI: 96%, 99%). Positivity rate differences for SS (8.1%) and AS (8.4%) and differences in pooled sensitivities between SS (86%; 95% CI: 78%, 92%) and AS (91%; 95% CI: 78%, 96%) were nonsignificant. Both types of swabbing led to pooled void rates below 2% and strongly correlated Ct values. Age, sex and previous swabbing experience did not have a significant impact on concordance or sensitivity. Conclusion: The UK adopted a policy to promote self-testing for SARS-CoV-2 based on data demonstrating equivalence of SS versus AS. Positive outcomes with SS are likely generalisable to testing for other respiratory pathogens, and we consider self-sampling and self-testing essential for future pandemic preparedness. [ABSTRACT FROM AUTHOR]

Distributed optical fibre sensing (DOFS)-based strain measurement systems are now routinely deployed across infrastructure health monitoring applications. However, there are still practical performance and measurement issues associated with the fibre's attachment method, particularly with thermoplastic pipeline materials (e.g., high-density polyethylene, HDPE) and adhesive affixment methods. In this paper, we introduce a new optical fibre installation method that utilises a hot-weld encapsulation approach that fully embeds the fibre onto the pipeline's plastic surface. We describe the development, application and benefits of the new embedment approach (as compared to adhesive methods) and illustrate its practical performance via a full-scale, real-world, dynamic loading trial undertaken on a 1.8 m diameter, 6.4 m long stormwater pipeline structure constructed from composite spiral-wound, steel-reinforced, HDPE pipe. The optical frequency domain reflectometry (OFDR)-based strain results show how the new method improves strain transference and dynamic measurement performance and how the data can be easily interpreted, in a practical context, without the need for complex strain transfer functions. Through the different performance tests, based on UK rail-road network transport loading conditions, we also show how centimetre- to metre-scale strain variations can be clearly resolved at the frequencies and levels consistent with transport- and construction-based, buried infrastructure loading scenarios. [ABSTRACT FROM AUTHOR]

Wireless sensor networks (WSN) have emerged as a robust and cost-effective solution for buried pipeline monitoring due to the low cost (a maximum of a few tens of UK pounds (GBP)), low power supply capacity (in the order of 1 watt/hour) and small size (centimetre scale) requirements of the wireless sensor nodes. One of the main challenges for WSN deployment, however, is the limited range of underground data communication between the wireless sensor nodes of less than 3 m, which subsequently increases deployment costs for a utility owner for buried pipeline monitoring. A promising alternative to overcome this limitation is using low-frequency (<1 kHz) acoustic signal propagation along the pipe. This paper examines the feasibility of using low-frequency acoustic signal propagation along exposed and buried medium-density polyethylene (MDPE) pipes and makes predictions of the potential distances at which reliable data communication can be achieved. Quantification of the acoustic attenuation was performed using both analytical and numerical models in addition to laboratory and field experiments. The predicted acoustic data communication distance ranged between approximately 18 m for an exposed and approximately 11 m for a buried MDPE pipe. These results demonstrate the feasibility of using low-frequency acoustic signal propagation for achieving reliable wireless underground communication. [ABSTRACT FROM AUTHOR]

Introduction: The increasing prevalence of type 2 diabetes (T2DM) in the UK imposes a significant burden on the National Health Service (NHS). Despite the availability of effective treatments, the loss of glycaemic control over time results in significant comorbidities, including nephropathy, neuropathy and retinopathy. The cost of treating these microvascular complications has not been well documented, and this study aimed to provide an accurate assessment of the healthcare resource utilisation (HCRU) associated with managing T2DM and its complications. Methods: This retrospective cohort study utilised electronic medical records from patients with T2DM from the Heart of England Foundation Trust (HEFT), which captures data from patients using secondary care services. Patients were diagnosed with microvascular complications based on ICD-10 or OPCS codes. HCRU over a 2-year period was based on NHS Tariffs for healthcare services for inpatient, accident and emergency, and dialysis clinic usage. Results: The study cohort comprised 26,629 patients with T2DM who used HEFT services during the study period, 22.6%, 20.8% and 3.1% of whom had comorbid nephropathy, retinopathy or neuropathy, respectively. While the prevalence of diabetes in the overall HEFT population was reported to be 7% in 2012, diabetes and its associated complications accounted for more than 30% of secondary care costs. Furthermore, while patients with diabetes represent only 17% of HEFT inpatients, they account for more than 20% of service usage. The economic burden of microvascular complications increased substantially with the severity of the condition, with the overall cost exceeding £70 million over the 2-year period. Conclusion: This study of patients with T2DM in a typical secondary care provider in the UK showed that avoiding the progression of microvascular complications could provide substantial cost savings through targeted interventions that improve outcomes and lower resource use. Funding: Merck Sharp & Dohme Limited. [ABSTRACT FROM AUTHOR]

Microgravity measurements are a useful tool for detecting subsurface features, especially deep targets or those in conductive ground which lie outside the capabilities of other methods based on electromagnetic signal transmission. However, the method is limited by a range of noise sources including vibrational noise from the environment, one source of which being the microseism noise due to ocean waves. This noise travels through the bedrock and manifests itself in the data. It varies as a function of time and location. The effect of the wave noise on microgravity measurements in the United Kingdom was assessed for the first time using a field gravimeter (Scintrex CG5) and a link was demonstrated between the noise from microgravity measurements and those from a broadband seismometer. As a result, a new method for assessing the impact of this noise on microgravity measurements in the United Kingdom is proposed using readily available data from the continuously monitoring seismic network run by the British Geological Survey to create an accurate nowcast. Knowledge of this noise on the day of survey in conjunction with an approximate signal strength of the expected targets can be used to significantly improve survey planning in terms of the optimal observation time at which surveys for particular targets should be conducted, saving time and money on failed microgravity surveys. [ABSTRACT FROM AUTHOR]

Asset monitoring, specifically infrastructure monitoring such as water distribution pipelines, is becoming increasingly critical for utility owners who face new challenges due to an aging network. In the UK alone, during the period of 2009-2010, approximately 3281 mega litres (106) of water were wasted due to failure or leaks in water pipelines. Various techniques can be used for the monitoring of water distribution networks. This paper presents the design, development and testing of a smart wireless sensor network for leak detection in water pipelines, based on the measurement of relative indirect pressure changes in plastic pipes. Power consumption of the sensor nodes is minimised to 2.2 µW based on one measurement every 6 h in order to prolong the lifetime of the network and increase the sensor nodes' compatibility with current levels of power available by energy harvesting methods and long life batteries. A novel pressure sensing method is investigated for its performance and capabilities by both laboratory and field trials. The sensors were capable of measuring pressure changes due to leaks. These pressure profiles can also be used to locate the leaks. [ABSTRACT FROM AUTHOR]

An essay discussing English prison reformer John Howard is presented. He was educated at the Dissenters' schools of Tower School and the Congregational Fund Academy. After serving an apprenticeship as a grocer, he was made independently wealthy upon the death of his father in 1742. In 1772, he was appointed High Sheriff of Bedford, England, which prompted his visits to local and foreign prisons, consequently resulting in his 1777 book "The State of the Prisons." The book "The Curious Mr Howard," by Tessa West, is considered.

The value of well-designed and people-friendly places is well recognized and there are many exemplars. However, often the qualities of quite ordinary but pleasant places are being gradually diminished, not as a result of deliberate intent but from a progressive erosion or degradation arising from many small acts or omissions. This does not seem to be because there is no shared perception of what qualities are desirable, but more from the difficulty of integrating actions in practice. In this paper the challenges of integration between the diverse interests at work at different spatial and temporal scales are discussed and these are related to the quite different instruments and approaches that are used in practice. It is concluded that more effective processes of analysis and appraisal, through public engagement and multi-disciplinary work, could provide a knowledge base which would foster more integrated strategic development planning and place-making inherently. The renewed focus upon Localism, not just in the UK, presents an opportunity for further innovation and initiative in urban design and the paper reflects upon key opportunities that are emerging for this. [ABSTRACT FROM AUTHOR]

Several millions of kilometres of pipes and cables are buried beneath our streets in the UK. As they are not visible and easily accessible, the monitoring of their integrity as well as the quality of their contents is a challenge. Any information of these properties aids the utility owners in their planning and management of their maintenance regime. Traditionally, expensive and very localised sensors are used to provide irregular measurements of these properties. In order to have a complete picture of the utility network, cheaper sensors need to be investigated which would allow large numbers of small sensors to be incorporated into (or near to) the pipe leading to so-called smart pipes. This paper focuses on a novel trial where a short section of a prototype smart pipe was buried using mainly off-the-shelf sensors and communication elements. The challenges of such a burial are presented together with the limitations of the sensor system. Results from the sensors were obtained during and after burial indicating that off-the-shelf sensors can be used in a smart pipes system although further refinements are necessary in order to miniaturise these sensors. The key challenges identified were the powering of these sensors and the communication of the data to the operator using a range of different methods. [ABSTRACT FROM AUTHOR]

Presents a study which explored the issues of quality in urban design through an evaluation of the Department of the Environment's Quality in Town and Country (QTC) initiative in Great Britain. Quality of life issues; Factors in London's environmental quality; Information on some of the successful urban development projects in London; Cost and value of urban design and development briefing.

• Self-testing by LFD is only marginally less sensitive than professional LFD testing. • LFD self-testing tends to be associated with a higher void rate. • LFD exhibits consistent performance across different age groups and sex. • Sensitivity of LFDs significantly increases when symptoms are present. The advent of lateral flow devices (LFDs) for SARS-CoV-2 detection enabled widespread use of rapid self-tests during the pandemic. While self-testing using LFDs is now common, whether self-testing provides comparable performance to professional testing was a key question that remained important for pandemic planning. Three prospective multi-centre studies were conducted to compare the performance of self- and professional testing using LFDs. Participants tested themselves or were tested by trained (professional) testers at community testing sites in the UK. Corresponding qRT-PCR test results served as reference standard. The performance of Innova, Orient Gene and SureScreen LFDs by users (self) and professional testers was assessed in terms of sensitivity, specificity, and kit failure (void) rates. Impact of age, sex and symptom status was analysed using logistic regression modelling. 16,617 participants provided paired tests, of which 15,418 were included in the analysis. Self-testing with Innova, Orient Gene or SureScreen LFDs achieved sensitivities of 50 %, 53 % or 72 %, respectively, compared to qRT-PCR. Self and professional LFD testing showed no statistically different sensitivity with respect to corresponding qRT-PCR testing. Specificity was consistently equal to or higher than 99 %. Sex and age had no or only marginal impact on LFD performance while sensitivity was significantly higher for symptomatic individuals. Sensitivity of LFDs increased strongly to up to 90 % with higher levels of viral RNA measured by qRT-PCR. Our results support SARS-CoV-2 self-testing with LFDs, especially for the detection of individuals whose qRT-PCR tests showed high viral concentrations. [ABSTRACT FROM AUTHOR]

Recent research has shown that there is a discernible relationship between trackbed stiffness and track quality deterioration. Even though correlations between maintenance, track geometry deterioration and subgrade condition have been identified, the trackbed is rarely considered in the design and implementation of maintenance and renewals works proposals. Often track components are maintained or replaced with little regard for subgrade properties and their subsequent effects on continued total asset life. Consequently, a need has arisen for a more consistent, detailed trackbed investigation that can be carried out under the physical working and access restrictions applicable in the UK railway network. Level 1 evaluation refers to the assessment of large track lengths, and is concerned mainly with the initial identification of poor subgrade sites. Level 2 evaluation focuses on the causes of track geometry deterioration at identified poor subgrade sites. This paper presents a critical analysis of test devices for identification and assessment of existing and potential subgrade problems, and of their application in a railways environment. Devices deemed potentially applicable were tested on a site on the existing railway network, and the results are presented in part II of this series of papers. [ABSTRACT FROM AUTHOR]

Background/objectives: We investigated if performing two lateral flow device (LFD) tests, LFD2 immediately after LFD1, could improve diagnostic sensitivity or specificity for detecting severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) antigen., Study Design: Individuals aged ≥16 years attending UK community testing sites (February-May 2021) performed two successive LFD tests and provided a nose-and-throat sample for a polymerase chain reaction (PCR) test. Using the PCR result as the reference diagnosis, we assessed whether improvements could be achieved in sensitivity (by counting a positive result in either LFD as a positive overall test result) or specificity (by using LFD2 as confirmatory test)., Results: Overall, 2231 participants were included with 159 (7 %) having a positive PCR test. Of 2223 participants who completed both LFD tests, LFD results were highly concordant both with each other and with PCR tests (>97 %). The proportion of discord LFD results decreased significantly over the study period. Combined LFD usage achieved a sensitivity of 68.6 %, versus 67.1 % for either LFD individually. The specificity increased from 99.5 % to 99.8 % when using LFD2 as confirmatory test. Observed increases in sensitivity and specificity were not statistically significant. Void results were recorded for 31 (1.4 %) LFD1s, 19 (0.9 %) LFD2s and 6 (0.3 %) combined LFD tests., Conclusions: LFD tests were highly reproducible even when they were performed by untrained users following only written instructions and without supervision. While performing two LFD tests of the same type in quick succession marginally increased sensitivity or specificity, statistically significant improvements were not detected in our study., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2024. Published by Elsevier B.V. All rights reserved.)