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The 5G RuralDorset project (https://5gruraldorset.org/) was a large (£9M; 2020-2022), multi-disciplinary project funded by the UK Department for Culture, Media and Sport that aimed to understand how 5G mobile network technologies could address some specific challenges in rural communities in Dorset, UK: public safety, economic growth, food production and environmental. Work Package X aimed to develop and trial a novel landslide monitoring system for coastal cliffs using 5G/NB-IoT (Narrow Band - Internet of Things) technologies. The system comprised a set of small, fully autonomous, highly integrated and power efficient sensing devices that were able to collect sensory data to identify landslide activity and landslide movement. These data were transmitted wirelessly using 5G/NB-IoT to a cloud-based Data Management Platform, where they were presented to the end user over a web interface for processing by Machine Learning algorithms. It is important to note that the term ‘Internet of Things’ has been used widely in recent years in application to landslide monitoring to in fact describe real-time telemetry of data. However, the true added value of IoT-enabled systems lies in their ability to extract knowledge from collected data, make decisions and take actions based on ambient conditions and evolution of physical processes. This talk will describe the lessons learned from this work and highlight some of the obstacles to overcome when attempting to develop and commission such a system.

Objectives Altered awareness of motor symptoms is reported in people with Parkinson's disease and Dementia with Lewy Bodies, and may adversely affect quality of life and medication concordance. How symptom awareness is influenced by motor and cognitive disease severity, age and medication use is not fully understood. We carried out a systematic review of the literature on motor symptom awareness in Parkinson's disease and Dementia with Lewy Bodies. Methods Pubmed and Wed of Science were searched for relevant articles published in or prior to March 2019. Data regarding participant demographics, diagnosis, cognitive status, method of assessing awareness and study findings were extracted from relevant publications. Results Sixteen relevant publications were identified. Motor symptom awareness appears to decline over the course of Parkinson's disease. Imaging studies implicate the prefrontal cortex, with different mechanisms involved in hypokinesia and dyskinesia awareness. The hypothesis that people with right hemisphere based disease would have more severely reduced awareness is only weakly supported. Most studies focused on cognitively intact individuals, and on awareness of dyskinesia rather than hypokinesia. Conclusions Whilst reduced awareness of dyskinesia and to a lesser extent hypokinesia is common, there is a lack of longitudinal data on how awareness changes over time, and how it interacts with global cognitive changes. Motor symptom awareness in Dementia with Lewy Bodies is understudied. Future studies of symptom awareness should include robust assessment of overall cognitive functioning, and use a longitudinal design to elucidate how awareness changes over time. J Am Geriatr Soc 68:-, 2020.

This research has developed a system that monitors social media continuously for landslide-related content, using a landslide classification model to identify and retain the most relevant information. The system harvests photographs in real-time and interprets each image as landslide or not-landslide. To achieve this, a training model was developed and tested through independent and collaborative working to establish a large image dataset that has then been applied to the live Twitter data stream. This paper presents results from interdisciplinary research carried out by computer scientists at the Qatar Computing Research Institute (QCRI), earthquakes and social media specialists at the European-Mediterranean Seismological Centre (EMSC) and landslide hazard expertise from the British Geological Survey (BGS).

Background The impact of COVID-19 on physical and mental health and employment after hospitalisation with acute disease is not well understood. The aim of this study was to determine the effects of COVID-19-related hospitalisation on health and employment, to identify factors associated with recovery, and to describe recovery phenotypes. Methods The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a multicentre, long-term follow-up study of adults (aged ≥18 years) discharged from hospital in the UK with a clinical diagnosis of COVID-19, involving an assessment between 2 and 7 months after discharge, including detailed recording of symptoms, and physiological and biochemical testing. Multivariable logistic regression was done for the primary outcome of patient-perceived recovery, with age, sex, ethnicity, body-mass index, comorbidities, and severity of acute illness as covariates. A post-hoc cluster analysis of outcomes for breathlessness, fatigue, mental health, cognitive impairment, and physical performance was done using the clustering large applications k-medoids approach. The study is registered on the ISRCTN Registry (ISRCTN10980107). Findings We report findings for 1077 patients discharged from hospital between March 5 and Nov 30, 2020, who underwent assessment at a median of 5·9 months (IQR 4·9–6·5) after discharge. Participants had a mean age of 58 years (SD 13); 384 (36%) were female, 710 (69%) were of white ethnicity, 288 (27%) had received mechanical ventilation, and 540 (50%) had at least two comorbidities. At follow-up, only 239 (29%) of 830 participants felt fully recovered, 158 (20%) of 806 had a new disability (assessed by the Washington Group Short Set on Functioning), and 124 (19%) of 641 experienced a health-related change in occupation. Factors associated with not recovering were female sex, middle age (40–59 years), two or more comorbidities, and more severe acute illness. The magnitude of the persistent health burden was substantial but only weakly associated with the severity of acute illness. Four clusters were identified with different severities of mental and physical health impairment (n=767): very severe (131 patients, 17%), severe (159, 21%), moderate along with cognitive impairment (127, 17%), and mild (350, 46%). Of the outcomes used in the cluster analysis, all were closely related except for cognitive impairment. Three (3%) of 113 patients in the very severe cluster, nine (7%) of 129 in the severe cluster, 36 (36%) of 99 in the moderate cluster, and 114 (43%) of 267 in the mild cluster reported feeling fully recovered. Persistently elevated serum C-reactive protein was positively associated with cluster severity. Interpretation We identified factors related to not recovering after hospital admission with COVID-19 at 6 months after discharge (eg, female sex, middle age, two or more comorbidities, and more acute severe illness), and four different recovery phenotypes. The severity of physical and mental health impairments were closely related, whereas cognitive health impairments were independent. In clinical care, a proactive approach is needed across the acute severity spectrum, with interdisciplinary working, wide access to COVID-19 holistic clinical services, and the potential to stratify care. Funding UK Research and Innovation and National Institute for Health Research.

The paper describes results to date of an ongoing monitoring study of coastal ‘soft cliff’ recession at the British Geological Survey (BGS)’s ‘Coastal Landslide Observatory’ (CLO) on the east coast of England at Aldbrough, East Riding of Yorkshire, UK. The cliffed site, part of the 50 km long Holderness coast, consists of glacial deposits, and is one of the most rapidly eroding coastlines in Europe. This rapid rate of erosion provides an ideal opportunity for observation and process understanding because it facilitates the collection of data over periods of time encompassing significant new landslide events at the same location. The results of two approaches are reported: firstly terrestrial LiDAR surveying (TLS) and secondly the installation of instrumented boreholes. The aim of the research is to combine these to investigate the role of landslides and their pre-conditioning factors and the influence of geology, geotechnics, topography and environmental factors on cliff recession. To date, an average recession rate of 1.8 m per year and a maximum rate of 3.4 m per year have been recorded for the site. The establishment of the CLO and its conceptual geological / geotechnical model are described in a related article (Hobbs et al. 2019a).

The paper describes the establishment of the British Geological Survey (BGS)’s field-based ‘Coastal Landslide Observatory’, designed for the study of coastal ‘soft cliff’ recession on the east coast of England at Aldbrough, East Riding of Yorkshire. The cliffed site is part of the 50 km long Holderness coast which is one of the most rapidly eroding coastlines in Europe. The site features a 16–17 m high sea-cliff formed by Late Devensian (18–13 ka) glacial deposits dominated by tills. The aim of the research is to investigate the role of landslides and their pre-conditioning factors, including geology, geotechnics and topography, in cliff recession with a view to developing coastal landslide forecasting capability. Two research approaches are encompassed in the observatory: firstly, terrestrial LiDAR surveying, from 2001 to present, to create digital elevation models of the cliff and, secondly, installation of instrumented boreholes from 2012. The design, methods, conceptual ground model, implementation of the observatory and geotechnical laboratory test results are described in this article. The interpretation of results and the final ground model are presented in a related article in this volume.

Functional cognitive disorder (FCD) is a relatively common cause of cognitive symptoms, characterised by inconsistency between symptoms and observed or self-reported cognitive functioning. We aimed to improve the clinical characterisation of FCD, in particular its differentiation from early neurodegeneration. Two patient cohorts were recruited from a UK-based tertiary cognitive clinic, diagnosed following clinical assessment, investigation and expert multidisciplinary team review: FCD, (n = 21), and neurodegenerative Mild Cognitive Impairment (nMCI, n = 17). We separately recruited a healthy control group (n = 25). All participants completed an assessment battery including: Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test Part B (TMT-B), Depression Anxiety and Stress Scale (DASS) and Minnesota Multiphasic Personality Inventory (MMPI-2RF). In comparison to healthy controls, the FCD and nMCI groups were equally impaired on trail making, immediate recall, and recognition tasks, had equally elevated mood symptoms, showed similar aberration on a range of personality measures, and had similar difficulties on inbuilt performance validity tests. However, participants with FCD performed significantly better than nMCI on HVLT-R delayed free recall and retention (regression coefficient −10.34, p = 0.01). Mood, personality and certain cognitive abilities were similarly altered across nMCI and FCD groups. However, those with FCD displayed spared delayed recall and retention, in comparison to impaired immediate recall and recognition. This pattern, which is distinct from that seen in prodromal neurodegeneration, is a marker of internal inconsistency. Differentiating FCD from nMCI is challenging, and the identification of positive neuropsychometric features of FCD is an important contribution to this emerging area of cognitive neurology.

An increasing proportion of cognitive difficulties are recognized to have a functional cause, the chief clinical indicator of which is internal inconsistency. When these symptoms are impairing or distressing, and not better explained by other disorders, this can be conceptualized as a cognitive variant of functional neurological disorder, termed functional cognitive disorder (FCD). FCD is likely very common in clinical practice but may be under-diagnosed. Clinicians in many settings make liberal use of the descriptive term mild cognitive impairment (MCI) for those with cognitive difficulties not impairing enough to qualify as dementia. However, MCI is an aetiology-neutral description, which therefore includes patients with a wide range of underlying causes. Consequently, a proportion of MCI cases are due to non-neurodegenerative processes, including FCD. Indeed, significant numbers of patients diagnosed with MCI do not ‘convert’ to dementia. The lack of diagnostic specificity for MCI ‘non-progressors’ is a weakness inherent in framing MCI primarily within a deterministic neurodegenerative pathway. It is recognized that depression, anxiety and behavioural changes can represent a prodrome to neurodegeneration; empirical data are required to explore whether the same might hold for subsets of individuals with FCD. Clinicians and researchers can improve study efficacy and patient outcomes by viewing MCI as a descriptive term with a wide differential diagnosis, including potentially reversible components such as FCD. We present a preliminary definition of functional neurological disorder–cognitive subtype, explain its position in relation to other cognitive diagnoses and emerging biomarkers, highlight clinical features that can lead to positive diagnosis (as opposed to a diagnosis of exclusion), and red flags that should prompt consideration of alternative diagnoses. In the research setting, positive identifiers of FCD will enhance our recognition of individuals who are not in a neurodegenerative prodrome, while greater use of this diagnosis in clinical practice will facilitate personalized interventions.

Behavioural studies investigating the preservation of semantic memory in healthy ageing have reported mixed findings. One suggested reason for this discrepancy is that the processes underpinning lexical access to semantic knowledge may be sensitive to ageing. It is therefore necessary to assess semantic memory utilising tasks that are not explicitly linguistic. In this study, a fast periodic visual stimulation (FPVS) paradigm coupled with EEG was used to assess the ability of younger and older adults to automatically distinguish between images by their semantic category. Participants were presented with a 6 Hz stream of images drawn from one semantic category except every fifth image (occurring at a rate of 1.2 Hz) which was drawn from an alternate semantic category. For both younger and older adults, results demonstrate successful and comparable semantic categorisation. This was detectable at the individual level for 71% and 72% of older and younger adults, respectively. Given the rapid presentation rate and absence of explicit instruction to categorise images, the task is unlikely to utilise linguistic strategies and suggests the maintenance of semantic memory in healthy ageing. Moreover, this study utilised mobile EEG equipment and short presentation times that would be suitable for practical application outside a research setting.

BACKGROUND Patients undergoing re-transplantation often receive high doses of immunosuppression, which may lead to an immunocompromised status of the recipient. This study investigates the outcomes after intestine/multivisceral re-transplantation. MATERIAL AND METHODS Clinical outcomes of 23 patients undergoing 24 re-transplantations at a single intestine transplant center were reviewed. Bone marrow suppression was used as a surrogate marker of immunocompromised status, and was defined as platelet count

Aim: Frontotemporal lobar degeneration (FTLD) is a significant cause of dementia in mid-life and older adults. The extent of interactions between FTLD and other neurodegenerative pathologies is unclear. We reviewed the occurrences of mixed pathology in cases of neuropathologically diagnosed FTLD from the UK Brain Bank Network. Materials and methods: Clinicopathological details of cases of FTLD were extracted from the UK Brain Bank Network database. Results: Of 515 cases, 30.10% had mixed neuropathology. Concordance between clinical and neuropathological diagnosis was lower in these cases (38.71% vs. 59.17%). Alzheimer's spectrum pathology was the commonest additional finding. Age at death was higher in mixed neuropathology cases (mean 76.7 years vs. 72.59.0 years, p

Objectives Altered awareness of cognitive and neuropsychiatric symptoms is a common feature of neurodegeneration, which can significantly impact on quality of life, medication concordance and personal safety. Elucidating how awareness is affected by common alpha-synucleinopathies therefore has significant clinical relevance. We performed a systematic review of the literature on awareness of cognitive and neuropsychiatric symptoms in Parkinson's disease and Dementia with Lewy Bodies. Methods Searches of PubMed and Web of Science were carried out, using keywords and MeSH subheadings, limited to papers in English dealing with humans. The terms "Parkinson's" or "Lewy body" were used to denote the disease of interest, combined with either "agnosia", "anosognosia", "insight", "metacognition", or "neuropsychology" to denote the neuropsychological area of interest. Results 21 publications investigating awareness of cognitive symptoms, and 18 publications on awareness of neuropsychiatric symptoms were identified. The large majority focused on Parkinson's disease rather than Dementia with Lewy Bodies. Cognitively intact people with Parkinson's disease may over-report cognitive symptoms, whilst those with cognitive impairment under-report symptoms. Awareness of neuropsychiatric symptoms is likely to decline over time, particularly in those with progressive cognitive impairment. Conclusions Altered awareness of cognitive and neuropsychiatric symptoms is common in Parkinson's disease. Symptom awareness varies significantly between individuals, and appears to be influenced by mood and global cognitive functioning, with executive functioning specifically implicated. There are gaps in our understanding of how dopaminergic medications influence symptom awareness, and a need for longitudinal studies of how awareness changes over time in Parkinson's disease and Dementia with Lewy Bodies.

H.A.B. is funded by a National Institute for Health Research (NIHR) Clinical Lectureship. R.B. is supported by a NIHR Academic Clinical Fellowship. D.J.B. is funded by Alzheimer's Research UK & Rosetrees. D.J.B., M.R. and A.V. acknowledge the support of the National Institute for Health Research Sheffield Biomedical Research Centre (Translational Neuroscience). M.J.E. is funded by NIHR and the Medical Research Council. S.M.F. is funded by the Wellcome Trust & the Royal Society. J.H. is funded by a Wellcome Clinical Research Career Development Fellowship. R.H., N.C.F., J.M.S. and M.N.R. acknowledge the support of the National Institute for Health Research University College London Hospitals Biomedical Research Centre. L.M. receives philanthropic funding from Baillie Gifford. T.R.N. is funded by an NIHR Clinician Scientist Award. C.P. is funded by the Innovative Medicines Initiative, BRACE, and the David Telling Charitable Trust. J.S. is supported by a National Research Scotland Career Researcher Fellowship. This publication presents independent research; the views expressed are those of the authors and not necessarily those of the specified funding bodies.

Background Antimicrobial stewardship programs (ASPs) allow for infectious diseases (ID)-trained practitioners to focus on timely and appropriate antimicrobial use. In December 2016, the ASP at Indiana University (IU) Health expanded from one ID pharmacist to three. The purpose of this study was to assess the impact of an expanding ASP on broad-spectrum antimicrobial use within post-liver transplant patients. Methods This was a retrospective, cross-sectional study. Data were collected from patients aged at least 18 years old that received a liver transplant either before or after the ASP expansion. Patients were excluded if they survived less than 72 hours after transplant, if they received a multivisceral transplant, or if there was an active infection prior to transplantation. The hypothesis of this study was that an expanded ASP leads to a reduction in days of therapy (DOT) per 1000 patient-days for a composite of broad-spectrum antimicrobial agents within this patient population. Results A total of 268 patients were included in this study. Of the patients that received at least one dose of the studied antimicrobial agents, the median (IQR) DOT per 1000 patient-days in the pre- and post-ASP expansion cohort was 174.4 (117.6 – 333.3) and 142.9 (62.5 – 257.5), respectively. This was statistically significant (difference 48.6, 95% CI 7.5 – 83.3). Specifically, the post-ASP expansion cohort used less meropenem (difference 197.8, 95% CI 66.3 – 451.6) and vancomycin (difference 57.6, 95% CI 2.2 – 132.2). The post-ASP expansion cohort also consulted ID for more patients (2 vs. 12 consults in the pre- and post-expansion group, respectively; p=0.011). Patient and graft survival one year after transplantation were similar between the two cohorts (p=0.540 and p=0.255, respectively). Conclusion An expanded ASP contributed to a reduction in broad-spectrum antimicrobial use in post-liver transplant patients without negatively impacting patient and graft survival one year post-transplantation. These data provide further evidence of ASP benefits within immunocompromised populations. Disclosures All Authors: No reported disclosures

Objectives/AimsFunctional Cognitive Disorder (FCD) describes distressing or disabling cognitive symptoms that can be positively identified as internally inconsistent with recognised brain or systemic disease processes. FCD is common amongst attendees to cognitive or memory clinics. We aimed to improve the clinical characterisation of such patients, and identify means to differentiate them from patients with early neurodegeneration.MethodsWe identified two samples of patients recruited from a specialist cognitive clinic, classified on the basis of consensus expert clinical opinion following relevant investigations: FCD, (n=21), and neurodegenerative Mild Cognitive Impairment ‘MCI’, (n=17). We also recruited healthy control participants (n=25). All participants completed a cognitive battery: Montreal Cognitive Assessment (MoCA), Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test part B (TMT-B); and the Minnesota Multiphasic Personality Inventory (MMPI-2RF). Analyses included regression models controlling for age and gender. Analysis of the personality data focused on specific hypotheses generated from previous work on functional disorders.ResultsAs expected, the FCD participants were younger than the MCI participants (mean age 58 vs 72), and were more likely to be occupationally active (35% vs 6%).As described previously in this sample*, subjective cognitive symptoms were equally elevated in FCD and MCI compared to controls. Both the FCD and MCI groups were impaired in comparison to controls on MoCA, TMT-B and the initial recall component of HVLT-R. However, FCD participants demonstrated a dip in scores from free recall to recognition on HVLT-R, which was not seen in MCI (pConclusionsCognitive symptoms, basic bedside cognitive testing, personality analysis, and mood symptoms are all similar across both early neurodegenerative and FCD groups, making them hard to disentangle clinically. We hope that by highlighting certain testing modalities that can illustrate internal inconsistency (such as delayed recall spared relative to recognition, as opposed to consistently poor delayed recall and recognition that is more typical of Alzheimer’s neurodegeneration), we can improve diagnosis and thereby management strategies. It is unclear why both mood and non-cognitive somatic symptoms are elevated in both FCD and MCI; this could reflect an epiphenomenon of distress surrounding the cognitive symptoms, despite diverse origins of the cognitive symptoms.ReferencePennington C, Ball HA, Swirski M. Functional cognitive disorder: diagnostic challenges and future directions.Diagnostics 2019; 9: 131.

Debris flows in Great Britain have caused damage to transport infrastructure, buildings, and disruption to businesses and communities. This study describes a GIS-based heuristic model developed by the British Geological Survey (BGS) to produce a national scale spatial assessment of debris flow susceptibility for Great Britain. The model provides information on the potential for debris flow occurrence using properties and characteristics of geological materials (permeability, material availability and characteristics when weathered), slope angle and proximity to stream channels as indicators of susceptibility. Building on existing knowledge, the model takes into account the presence or absence of glacial scouring. As determined by the team of geologists and geomorphologists, the model ranks the availability of debris material and slope as the two dominant factors important for potential debris flow initiation, however it also considers other factors such as geological controls on infiltration. The resultant model shows that over 90 % of the mapped debris flows in the BGS inventory occurred in areas with the highest potential for instability and approximately 6 % were attributed to areas where the model suggested that debris flows are unlikely or not thought to occur. Model validation in the Cairngorm Mountains indicated a better performance, with 93.50 % in the former and less than 3 % in the latter category. Although the quality of the input datasets and selected methodological approach bear limitations and introduce a number of uncertainties, overall, the proposed susceptibility model performs better than previous attempts, representing a useful tool in the hands of policy-makers, developers and engineers to support regional or national scale development action plans and disaster risk reduction strategies.

IntroductionWidespread white matter damage and cognitive impairment have been demonstrated in chronic obstructive pulmonary disease (COPD). However, it remains unclear if brain atrophy is a global phenomenon or if specific subregions are differentially affected. The aims of this study are, first, to test a simple, validated visual analogue grading technique. Second, we hypothesised that frontal regions of the brains of patients with COPD will show greater signs of atrophy compared with control subjects. Third, any localised regions of atrophy would correlate with components of cognitive performance. Finally, the severity of cerebral atrophy would be associated with measures of respiratory disease severity.MethodsWe used a simple, validated visual analogue grading technique to assess the degree of regional atrophy in multiple brain regions from cerebral MR images in patients with stable non-hypoxaemic COPD (n=25) and age-matched control subjects (n=25). We also explored correlations between regional brain atrophy with demographics, cognitive performance measures and disease severity. Measures of cognitive performance focused on executive function, working memory, verbal memory, overall memory and processing speed. Measures of disease severity include lung function, gas exchange, health status and breathlessness questionnaires.ResultsThe visual grading scale found that patients with COPD had significantly greater frontal atrophy than control subjects (p=0.02), independent of smoking history, comorbid depression or anxiety. Cognitive function was significantly worse in the COPD group for executive function (pConclusionFurther work is needed to identify causative mechanisms behind unexplained structural brain changes in COPD.

There have been a number of high profile reports of landslides on the national rail network of Great Britain (comprising England, Scotland and Wales) over recent years. Events range in size from small wash out failures (St. Bees, Cumbria) to well publicised large failures causing major longer term disruption (Hatfield Colliery, South Yorkshire). In conjunction with negative media attention, derailment and damage to railway infrastructure, failures along the rail network have the potential to cause injury and loss of life. The national rail network comprises ten strategic routes that cover a variety of terrains and geologies. The British Geological Survey (BGS) have produced, for Network Rail, a high level susceptibility model of landslide hazard from Outside Party Slopes adjacent to the strategic rail network. This assessment was compiled based on Geographic Information System (GIS) techniques and historical landslide records (landslide inventory). The model was designed to give a high level overview of potential landslide hazard to Network Rail senior management and individual Route Asset Managers. The national study adopted a fixed buffer style analysis of each 5 chain section (∼100 m length) of the entire railway network. It included event data from the BGS National Landslide Database superimposed on mapped data from the BGS GeoSure land instability susceptibility model and geologically mapped landslide polygons. The National Landslide Database is the most comprehensive inventory of landslide events in Great Britain. The BGS GeoSure slope instability layer provides a scientifically based 1:50 000 scale assessment of national susceptibility to natural slope failure. The results of this study have been provided as a spatially attributed dataset with total hazard susceptibility scores A (low)–E (high). Maximum hazard scores are attributed for both up and down- track and 5 chain length for the full network. A high score indicates where conditions imply a significant potential for future landslide hazard. Further refinement of the hazard layers are being developed by BGS to include specific landslide processes such as Rockfall, Earthflow and Debris Flow hazards.

The Jurassic Escarpment in the North York Moors in Northern Britain has a high density of deep-seated relict landslides but their regional hazard is poorly understood due to a lack of detailed case studies. Investigation of a typical relict landslide at Great Fryup Dale suggests that the crop of the Whitby Mudstone Formation is highly susceptible to landslide hazards. The mudstone lithologies along the Escarpment form large multiple rotational failures which break down at an accelerated rate during wetter climates and degrade into extensive frontal mudflows. Geomorphological mapping, high resolution LiDAR imagery, boreholes, and geophysical ERT surveys are deployed in a combined approach to delimit internal architecture of the landslide. Cross-sections developed from these data indicate that the main movement displaced a bedrock volume of c. 1 × 107 m3 with a maximum depth of rupture of c. 50 m. The mode of failure is strongly controlled by lithology, bedding, joint pattern, and rate of lateral unloading. Dating of buried peats using the AMS method suggests that the 10 m thick frontal mudflow complex was last active in the Late Holocene, after c. 2270 ± 30 calendar years BP. Geomorphic mapping and dating work indicates that the landslide is dormant, but slope stability modelling suggests that the slope is less stable than previously assumed; implying that this and other similar landslides in Britain may become more susceptible to reactivation or extension during future wetter climatic phases. This study shows the value of a multi-technique approach for landslide hazard assessment and to enhance national landslide inventories.

Background dementia is a common cause of altered decision-making capacity. Determining whether an individual has the ability to make a specific decision can be very challenging for both clinicians and researchers. The UK legislation requires that we both promote residual capacity where possible, and protect vulnerable adults who cannot make independent decisions. We evaluated published instruments designed to aid in the assessment of capacity, focussing on those meeting the UK legal requirements. We also consider further disease and culture-specific factors which may influence decision making. Methods a search of electronic databases was made for articles published between 2000 and 2017 detailing structured tools for the assessment of mental capacity. These were evaluated against the UK legal requirements. Results nine tools were identified which fulfilled the UK legal requirements. Their design and structure varied, as did the level of reliability and validity data available. Some instruments can be tailored for a specific decisional scenario, whilst others are designed for use by particular patient groups. Discussion a wide range of mental capacity assessment instruments is available, but not all fulfil the UK legal requirements. Healthcare professionals and researchers should be mindful of personal, cultural and disease-specific factors when assessing capacity. No gold standard for capacity assessment exists, which hampers the evaluation of different approaches. A combination of the opinion of a healthcare professional or researcher trained in capacity evaluation, plus the use of a structured assessment tool is the most robust approach.

Both recognition of familiar objects and pattern separation, a process that orthogonalises overlapping events, are critical for effective memory. Evidence is emerging that human pattern separation requires dentate gyrus. Dentate gyrus is intimately connected to CA3 where, in animals, an autoassociative network enables recall of complete memories to underpin object/event recognition. Despite huge motivation to treat age-related human memory disorders, interaction between human CA3 and dentate subfields is difficult to investigate due to small size and proximity. We tested the hypothesis that human dentate gyrus is critical for pattern separation, whereas, CA3 underpins identical object recognition. Using 3 T MR hippocampal subfield volumetry combined with a behavioural pattern separation task, we demonstrate that dentate gyrus volume predicts accuracy and response time during behavioural pattern separation whereas CA3 predicts performance in object recognition memory. Critically, human dentate gyrus volume decreases with age whereas CA3 volume is age-independent. Further, decreased dentate gyrus volume, and no other subfield volume, mediates adverse effects of aging on memory. Thus, we demonstrate distinct roles for CA3 and dentate gyrus in human memory and uncover the variegated effects of human ageing across hippocampal regions. Accurate pinpointing of focal memory-related deficits will allow future targeted treatment for memory loss.

The need to develop a national map that characterises landslides across Great Britain has long been recognised by the British Geological Survey as part of its strategic role providing hazard information to stakeholders. Hierarchical landslide domains represent areas of similar physiographic, meteorological, climatic and geological characteristics that shaped the style of landsliding. Developed to underpin current research into how different types of landslides and terrains will be affected by changing environmental conditions, the map further assists development of a national landslide susceptibility map with conditioning factors tailored to a specific domain. This paper considers the role of national-scale land systems mapping to create a Landslide Domain Map, the refinement of a national model using landslide inventories to better reflect the spatial extent and characteristics of landslides within domains. The distribution of landsliding in Great Britain is a product of the complex range of lithologies and geomorphological processes active under a range of climatic conditions. The domains represent landslides across a series of unstable slopes ranging from very large, ancient landslides formed under periglacial climate conditions to small, modern failures, particularly along transport infrastructure corridors. Although analysis of the National Landslide Database broadly informed the nature of landsliding within a specific domain, expert knowledge was needed to supplement it especially in areas where recent mapping had not taken place. Targeted data collection is planned in data-poor domains to supplement the database. Further domain-specific research is ongoing and includes development of semi-empirical process-specific models involving the weighting of critical factors in order to refine the current national landslide susceptibility map, GeoSure. As an example of this refinement, this paper discusses an improved debris flow model for the Scottish Highlands.

The British Geological Survey (BGS) has developed a multi-stage methodology for landslide mapping by augmenting traditional mapping techniques with new geospatial technologies. This allows better characterisation and understanding of the country’s landslides: an essential requirement for landslide susceptibility modelling, risk assessment and resilient infrastructure planning. The BGS methodology has most recently been applied to the North York Moors National Park in northern England, UK: an area with steep slopes, landslide-prone lithologies and an exposed coastal section but few recorded landslide events. Over 550 landslides have now been identified and data on the characteristics and mechanisms of these have been used to inform hazard assessments and susceptibility modelling research including the National Landslide Database, the National Landslide Domains Map and the National Geohazard Assessment.

The UK is a country with limited direct experience of natural disasters. Whilst landslide losses are not negligible and fatalities are rare, accounts are under-reported. Financial losses from landslides are poorly understood but likely to be considerably in excess of £10 million per year. As a result, a strategic management framework has evolved based upon small, low-impact events punctuated by occasional larger events or larger landslides affecting urban areas. We present an overview of the different landslide management mechanisms in the UK and discuss them in context of cases studies to explore their effectiveness. We conclude with three issues that may have implications for landslide management in the UK and other ‘low-risk’ countries. Firstly, the evidence base by which landslide hazards and risks are measured is insufficient and limitations in existing information need to be better understood. Secondly, existing guidance on strategic and responsive management needs to be assessed for its fitness for purpose. Thirdly, we encourage debate about the importance of near misses.

A geoelectrical investigation of a slow moving earth slide–earth flow in Lower Jurassic Lias Group rocks of the Cleveland Basin, UK, is described. These mudrock slopes are particularly prone to failure and are a major source of lowland landslides in the UK, but few attempts have been made to spatially or volumetrically characterise the subsurface form of these slides. The primary aim of this study was to consider the efficacy of fully three-dimensional geoelectrical imaging for landslide investigation with reference to a geological setting typical of Lias Group escarpments. The approach described here included a reconnaissance survey phase using two-dimensional electrical resistivity tomography (ERT), resistivity mapping, self-potential (SP) profiling and mapping, followed by a detailed investigation of an area of the landslide using three-dimensional (3D) ERT and self-potential tomography (SPT). Interpretation of the geophysical data sets was supported by surface observations (aerial LiDAR and differential GPS geomorphological surveys) and intrusive investigations (boreholes and auger holes). The initial phase of the study revealed the existence of a strong SP signature at the site consistent with a streaming potential source and established the relationships between the main geological units, the geomorphologic expression of the landslide, and the resistivity of the materials in and around the study area. The 3D SPT model generated during the second phase of the study indicated drainage patterns across the landslide and preferential flow from the low permeability mud rocks into the underlying more permeable sandstone formation. Because of favourable resistivity contrasts between the clay-rich Whitby Mudstone Formation landslide material and the underlying Staithes Sandstone Formation, the volumetric 3D ERT image allowed a number of surface and subsurface landslide features to be identified and spatially located. These included the lateral extent of slipped material and zones of depletion and accumulation; the surface of separation and the thickness of individual earth flow lobes; and the dipping in situ geological boundary between the Whitby Mudstone and Staithes Sandstone bedrock formations.

The paper describes recent applications by the British Geological Survey (BGS) of the technique of mobile terrestrial Light Detection And Ranging (LiDAR) surveying to monitor various geomorphological changes on English coasts and estuaries. These include cliff recession, landslides and flood defences, and are usually sited at remote locations undergoing dynamic processes with no fixed reference points. Advantages, disadvantages and some practical problems are discussed. The role of GPS in laser scanning is described.

Landslide research at the British Geological Survey (BGS) is carried out through a number of activities, including surveying, database development and real-time monitoring of landslides. Landslide mapping across the UK has been carried out since BGS started geological mapping in 1835. Today, BGS geologists use a combination of remote sensing and ground-based investigations to survey landslides. The development of waterproof tablet computers (BGS·SIGMAmobile), with inbuilt GPS and GIS for field data capture provides an accurate and rapid mapping methodology for field surveys. Regional and national mapping of landslides is carried out in conjunction with site-specific monitoring, using terrestrial LiDAR and differential GPS technologies, which BGS has successfully developed for this application. In addition to surface monitoring, BGS is currently developing geophysical ground-imaging systems for landslide monitoring, which provide real-time information on subsurface changes prior to failure events. BGS's mapping and monitoring activities directly feed into the BGS National Landslide Database, the most extensive source of information on landslides in Great Britain. It currently holds over 14 000 records of landslide events. By combining BGS's corporate datasets with expert knowledge, BGS has developed a landslide hazard assessment tool, GeoSure, which provides information on the relative landslide hazard susceptibility at national scale.

Genes with homology to the transduction-like gene transfer agent (GTA) were observed in genome sequences of three cultured members of the marine Roseobacter clade. A broader search for homologs for this host-controlled virus-like gene transfer system identified likely GTA systems in cultured Alphaproteobacteria , and particularly in marine bacterioplankton representatives. Expression of GTA genes and extracellular release of GTA particles (∼50 to 70 nm) was demonstrated experimentally for the Roseobacter clade member Silicibacter pomeroyi DSS-3, and intraspecific gene transfer was documented. GTA homologs are surprisingly infrequent in marine metagenomic sequence data, however, and the role of this lateral gene transfer mechanism in ocean bacterioplankton communities remains unclear.

Patients frequently present to the memory clinic with self-reported cognitive symptoms that cannot be attributed to structural, toxic, or metabolic causes, and are out of keeping with their performance on neuropsychological assessment. This can be considered to be Functional (psychosomatic) Cognitive Disorder, which results in significant patient distress and often has a major impact on social functioning and employment. We performed a retrospective analysis of the Bristol ReMemBr group cognitive clinic database to ascertain the prevalence of Functional Cognitive Disorder, review the patient characteristics, and develop new guidelines for diagnosis and management. 196 patients were screened of whom 23 were diagnosed with Functional Cognitive Disorder; the oldest patient with this diagnosis was aged 60 years at symptom onset. When considering only those presenting below the age of 60 years (total no. held on database = 69), a third were diagnosed with Functional Cognitive Disorder. On neuropsychological testing, 47% had an atypical (invalid) pattern of results, or failed tests of performance validity. Of those with valid neuropsychological results, 80% scored in the normal range. Depression and anxiety were common but did not appear to be the primary cause of cognitive symptoms. Particular characteristics seen were excessively low self-rating of memory ability, and discrepancies between perceived and actual cognitive performance. The rate of unemployment was high, often due to the cognitive symptomatology. This is an important disorder to address, being common in working adults, and carrying a risk of misdiagnosis as early neurodegeneration, with subsequent inappropriate treatment and inclusion in clinical trials.

To err is human, and it is normal to make minor cognitive errors from time to time. Some people experience persistent subjective cognitive difficulties that cause distress and functional impairment, with no underlying structural, neurodegenerative, toxic or metabolic cause. This is considered a form of functional disorder. In this article, we review functional cognitive disorder and outline its core clinical features. Patients with this are typically of working age and have a source of psychological distress, such as chronic pain, work stress or family difficulties. Its distinction from incipient dementia is difficult and usually requires interval follow-up. Pointers towards possible dementia include abnormal neuroimaging or loss of insight. Many patients accept a functional cognitive disorder diagnosis and willingly engage with psychological therapies but there is no defined optimal treatment. Functional cognitive disorder is common but under-studied; future research priorities include the development of clear diagnostic criteria and robust trials of therapeutic strategies.

The accumulation of fat cells (adipocytes) in bone marrow is now thought to be a factor contributing to age-related bone loss. Women with osteoporosis have higher numbers of marrow adipocytes than women with healthy bone, and bone formation rate is inversely correlated with adipocyte number in bone tissue biopsies from both men and women. Adipogenic differentiation of bone marrow stromal cells increases with age, but the factors regulating populations of mature adipocytes are not well understood. Leptin is thought to regulate adipose tissue mass via its receptors in the ventromedial hypothalamus (VMH). We have therefore tested the hypothesis that stimulation of leptin receptors in the VMH regulates adipocyte number in bone marrow. Results indicate that unilateral twice-daily injections of leptin into the rat VMH for only 4 or 5 days cause a significant reduction in the number of adipocytes in peripheral fat pads and bone marrow and indeed eliminate adipocytes almost entirely from bone marrow of the proximal tibia. Osteoblast surface is not affected with leptin treatment. Apoptosis assays performed on bone marrow samples from control and treated rats have revealed a significant increase in protein concentration of the apoptosis marker caspase-3 with leptin treatment. We conclude that stimulation of leptin receptors in the VMH significantly decreases the adipocyte population in bone marrow, primarily through apoptosis of marrow adipocytes. Elimination of marrow adipocytes via this central pathway may represent a useful strategy for the treatment and prevention of osteoporosis.

We have investigated muscle-bone interactions using two mouse mutants that are known to differ from normal mice in skeletal muscle growth and development: mice lacking myostatin (GDF8) and mice lacking dystrophin (mdx). Myostatin-deficient mice show increased muscle size and strength compared to normal mice, whereas the mdx mouse is a well-established animal model for Duchenne muscular dystrophy. The mdx mice have significantly larger hindlimb muscles than controls, and histological sections of the quadriceps muscles show dystrophic changes with extensive fibrosis. Femoral bone mineral density (BMD) and fracture strength (Fu) are significantly greater in mdx mice than controls, and these variables are more strongly correlated with quadriceps muscle mass than with body mass. In contrast, mdx mice do not shower high bone mineral density in the spine relative to controls, whereas myostatin-deficient mice have significantly increased BMD in the lumbar spine compared to normal mice. Both mdx mice and myostatin-deficient mice have expanded femoral trochanters for attachment of large hindlimb muscles, and both mutant strains show increased cross-sectional area moments of inertia mediolaterally (Iyy) but not anteroposteriorly (Ixx) compared to normal mice. These data suggest that lean (muscle) mass is a significant determinant of bone mineral density and strength in the limb skeleton, even when accompanied by a dystrophic phenotype. Likewise, increased muscle mass produces a marked increase in the external dimensions of muscle attachment sites, even when increased muscle size is accompanied by extensive fibrosis and muscle weakness.

GDF-8, also known as myostatin, is a member of the transforming growth factor-beta superfamily of secreted growth and differentiation factors that is expressed in vertebrate skeletal muscle. Myostatin functions as a negative regulator of skeletal muscle growth and myostatin null mice show a doubling of muscle mass compared to normal mice. We describe here morphology of the lumbar spine in myostatin knockout (Mstn(-/-)) mice using histological and densitometric techniques. The Mstn(-/-) mice examined in this study weigh approximately 10% more than controls (p

The British Geological Survey (BGS) is the national geological agency for Great Britain that provides geoscientific information to government, other institutions and the public. The National Landslide Database has been developed by the BGS and is the focus for national geohazard research for landslides in Great Britain. The history and structure of the geospatial database and associated Geographical Information System (GIS) are explained, along with the future developments of the database and its applications. The database is the most extensive source of information on landslides in Great Britain with over 17,000 records of landslide events to date, each documented as fully as possible for inland, coastal and artificial slopes. Data are gathered through a range of procedures, including: incorporation of other databases; automated trawling of current and historical scientific literature and media reports; new field- and desk-based mapping technologies with digital data capture, and using citizen science through social media and other online resources. This information is invaluable for directing the investigation, prevention and mitigation of areas of unstable ground in accordance with Government planning policy guidelines. The national landslide susceptibility map (GeoSure) and a national landslide domains map currently under development, as well as regional mapping campaigns, rely heavily on the information contained within the landslide database. Assessing susceptibility to landsliding requires knowledge of the distribution of failures, an understanding of causative factors, their spatial distribution and likely impacts, whilst understanding the frequency and types of landsliding present is integral to modelling how rainfall will influence the stability of a region. Communication of landslide data through the Natural Hazard Partnership (NHP) and Hazard Impact Model contributes to national hazard mitigation and disaster risk reduction with respect to weather and climate. Daily reports of landslide potential are published by BGS through the NHP partnership and data collected for the National Landslide Database are used widely for the creation of these assessments. The National Landslide Database is freely available via an online GIS and is used by a variety of stakeholders for research purposes.

The influence of dietary ferric iron on the intestinal microbiota of mice was investigated with a view to promoting benign lactic acid bacteria (which have minimal iron requirements) in order to enhance colonization-resistance potential. Three groups of eight mice received a diet differing only in iron content, for a period of 12 weeks. Dietary iron deprivation resulted in overall increased small intestinal bacterial populations, including lactic acid bacteria, but these differences were generally not significant (p > 0.05). With the exception of coliforms, all examined bacterial groups (anaerobes, micro-aerophiles, lactobacilli, and enterococci) were significantly (p < 0.05) elevated in the colons of iron-deprived mice. The relatively low numbers of total anaerobes in the colons of iron-replete and iron-overloaded mice suggested that, as well as promotion of bacteria under iron-deprived condition, provision of ferric iron suppressed bacteria, probably by oxidation of normally reduced environments.