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Early development of the microbiome has been shown to affect general health and physical development of the infant and, although some studies have been undertaken in high-income countries, there are few studies from low- and middle-income countries. As part of the BARNARDS study, we examined the rectal microbiota of 2,931 neonates (term used up to 60 d) with clinical signs of sepsis and of 15,217 mothers screening for bla CTX-M-15 , bla NDM , bla KPC and bla OXA-48 -like genes, which were detected in 56.1%, 18.5%, 0% and 4.1% of neonates’ rectal swabs and 47.1%, 4.6%, 0% and 1.6% of mothers’ rectal swabs, respectively. Carbapenemase-positive bacteria were identified by MALDI-TOF MS and showed a high diversity of bacterial species (57 distinct species/genera) which exhibited resistance to most of the antibiotics tested. Escherichia coli , Klebsiella pneumoniae and Enterobacter cloacae / E. cloacae complex, the most commonly found isolates, were subjected to whole-genome sequencing analysis and revealed close relationships between isolates from different samples, suggesting transmission of bacteria between neonates, and between neonates and mothers. Associations between the carriage of antimicrobial resistance genes (ARGs) and healthcare/environmental factors were identified, and the presence of ARGs was a predictor of neonatal sepsis and adverse birth outcomes. Analysis of gut microbiota of mothers and its neonates—as part of the BARNARDS study—reveals associations between β-lactamase gene carriage and neonatal sepsis risk in low-income settings.

STEP is a spherical tokamak prototype power plant that is being designed to demonstrate net electric power. The design phase involves the exploitation of plasma models to optimise fusion performance subject to satisfying various physics and engineering constraints. A modelling workflow, including integrated core plasma modelling, MHD stability analysis, SOL and pedestal modelling, coil set and free boundary equilibrium solvers, and whole plant design, has been developed to specify the design parameters and to develop viable scenarios. The integrated core plasma model JETTO is used to develop individual flat-top operating points that satisfy imposed criteria for fusion power performance within operational constraints. Key plasma parameters such as normalised beta, Greenwald density fraction, auxiliary power and radiated power have been scanned to scope the operational space and to derive a collection of candidate non-inductive flat-top points. The assumed auxiliary heating and current drive is either from electron cyclotron systems only or a combination of electron cyclotron and electron Bernstein waves. At present stages of transport modelling, there is a large uncertainty in overall confinement for relevant parameter regimes. For each of the two auxiliary heating and current drive systems scenarios, two candidate flat-top points have been developed based on different confinement assumptions, totalling to four operating points. A lower confinement assumption generally suggests operating points in high-density, high auxiliary power regimes, whereas higher confinement would allow access to a broader parameter regime in density and power while maintaining target fusion power performance.

In Hybrid plasma operation in JET with its ITER-like wall (JET-ILW) it is found that n>1 tearing activity can significantly enhance the rate of on-axis peaking of tungsten impurities, which in turn significantly degrades discharge performance. Core n=1 instabilities can be beneficial in removing tungsten impurities from the plasma core (e.g. sawteeth or fishbones), but can conversely also degrade core confinement (particularly in combination with simultaneous n=3 activity). The nature of MHD instabilities in JET Hybrid discharges, with both its previous Carbon wall and subsequent JET-ILW, is surveyed statistically and the character of the instabilities is examined. Possible qualitative models for how the n>1 islands can enhance on-axis tungsten transport accumulation processes are presented.

Calculations of tearing mode stability in tokamaks split conveniently into an external region, where marginally stable ideal MHD is applicable, and a resonant layer around the rational surface where sophisticated kinetic physics is needed. These two regions are coupled by the stability parameter. Pressure and current perturbations localized around the rational surface alter the stability of tearing modes. Equations governing the changes in the external solution and - are derived for arbitrary perturbations in axisymmetric toroidal geometry. The relationship of - with and without pressure flattening is obtained analytically for four pressure flattening functions. Resistive MHD codes do not contain the appropriate layer physics and therefore cannot predict stability directly. They can, however, be used to calculate -. Existing methods (Ham et al. 2012 Plasma Phys. Control. Fusion 54 025009) for extracting - from resistive codes are unsatisfactory when there is a finite pressure gradient at the rational surface and favourable average curvature because of the Glasser stabilizing effect. To overcome this difficulty we introduce a specific pressure flattening function that allows the earlier approach to be used. The technique is first tested numerically in cylindrical geometry with an artificial favourable curvature. Its application to toroidal geometry is then demonstrated using the toroidal tokamak tearing mode stability code T7 (Fitzpatrick et al. 1993 Nucl. Fusion 33 1533) which uses an approximate analytic equilibrium. The prospects for applying this approach to resistive MHD codes such as MARS-F (Liu et al. 2000 Phys. Plasmas 7 3681) which utilize a fully toroidal equilibrium are discussed.

New results from MAST are presented that focus on validating models in order to extrapolate to future devices. Measurements during start-up experiments have shown how the bulk ion temperature rise scales with the square of the reconnecting field. During the current ramp up models are not able to correctly predict the current diffusion. Experiments have been performed looking at edge and core turbulence. At the edge detailed studies have revealed how filament characteristic are responsible for determining the near and far SOL density profiles. In the core the intrinsic rotation and electron scale turbulence have been measured. The role that the fast ion gradient has on redistributing fast ions through fishbone modes has led to a redesign of the neutral beam injector on MAST Upgrade. In H-mode the turbulence at the pedestal top has been shown to be consistent with being due to electron temperature gradient modes. A reconnection process appears to occur during ELMs and the number of filaments released determines the power profile at the divertor. Resonant magnetic perturbations can mitigate ELMs provided the edge peeling response is maximised and the core kink response minimised. The mitigation of intrinsic error fields with toroidal mode number n>1 has been shown to be important for plasma performance.

The purpose of this article is to educate and provide practice implications to advanced practice providers caring for patients with Wilson disease. The pathogenesis, risk factors/genetics, screening, diagnosis, clinical presentations, and predictors of mortality are discussed, along with treatment options, including supportive care, nutritional needs, pharmacotherapy, and liver transplantation. Special considerations in the setting of acute liver failure, pregnancy, and malignancy risks are also addressed. Research and future directions for treatment and management are considered. Finally, practice implications for advanced practice providers to better address this population’s unique needs using a multidisciplinary approach are discussed. •Wilson disease causes excessive amounts of copper to accumulate in the body.•Copper accumulation causes cytotoxicity within the liver and the central nervous system.•Anticopper therapies have improved outcomes significantly in this population.•Liver transplantation is curative in patients with decompensated cirrhosis or who are in acute liver failure.

This study explored tourists’ blogs to identify sustainability challenges and opportunities that help to inform best-practice management of the whale shark tourism industry worldwide. Few researchers have investigated blogs in the context of swim-with whale shark experiences as recounted from the tourist perspective. This research was based on a content analysis of a sample of 58 tourist blogs, amounting to 31,509 words of content. The findings explored common sustainability themes within the whale shark tourist experience including proximity of the encounter, nature of the interaction, and whale shark tourist behaviour. By comparing three whale shark tourism destinations, Mexico, the Philippines and Australia, several sustainability challenges and opportunities were identified. The findings contribute to previous knowledge by advancing our understanding of whale shark tourists’ perception of critical aspects during their swim-with whale shark experience, which guided recommendations for improved and sustainable management.

This study explored tourists' blogs to identify sustainability challenges and opportunities to inform best-practice management of the whale shark tourism industry worldwide. Few researchers have investigated blogs in the context of swim-with whale shark experiences as recounted from the tourist perspective. This research was based on a content analysis of a sample of 58 tourist blogs, amounting to 31,509 words of content. The findings explored common sustainability themes within the whale shark tourist experience including proximity of the encounter, nature of the interaction, and whale shark tourist behavior. By comparing three whale shark tourism destinations-Mexico, the Philippines, and Australia-several sustainability challenges and opportunities were identified. The findings contribute to previous knowledge by advancing our understanding of whale shark tourists' perception of critical aspects during their swim-with whale shark experience, which guided recommendations for improved and sustainable management.

A feeding trial was conducted to test the effects of partial replacement of fishmeal (FM) protein and fish oil (FO) with partially defatted black soldier fly, Hermetia illucens insect protein, and oil, respectively, on growth performance, immune response, gut and skin barrier status, and flesh quality in juvenile barramundi. Four isonitrogenous and isocaloric diets used in the study were a control diet based on FM, 30% FM replaced with H. illucens protein (HiP), 30% FO replaced with H. illucens oil (HiO), and both 30% FM and 30% FO replaced with H. illucens protein and oil (HiPO). Diets were fed twice a day to satiety in triplicated groups of barramundi with an initial body weight of 1.74 ± 0.15 g per fish. At the end of the trial, growth and feed utilization indices were found insignificant (p > 0.05) between the test diets and control. A significant increase in bactericidal activity was observed in fish fed the HiP diet while serum lysozyme activity was unchanged. Stress-related heat shock proteins (HSP70 and HSP90) did not differ significantly among the test diets while immune-relevant genes (IL-1β and IL-10) were significantly upregulated in HiP and HiOP groups. The number of mucin cells were increased in the gut and skin of HiP and HiOP fed fish when compared to the control diet. The total fatty acid compositions (∑SFA, ∑MUFA, ∑PUFA, ∑n-3, and ∑n-6) in the muscles of barramundi were not significantly influenced with H. illucens protein and oil diets when compared to the control.

Associated with the exploitation of metallic minerals in Europe during the 20th century, several mining areas were abandoned without adequate environmental intervention. Furthermore, these areas lack studies to characterize the impact of pollution on the hydrogeological system. The area surrounding the tungsten mine of Regoufe, in northern Portugal, is one such area exploited during the Second World War. The accumulation of sulfide-rich tailings may have caused an acid mine drainage (AMD), where the leaching processes caused by seepage water led to soil contamination, evidenced by its acid character and anomalous concentrations of some Potentially Toxic Elements (PTE) reported in previous studies. The present research proposes an innovative approach that seeks the integration of different geophysical techniques to characterize the impact of mining activity on the subsurface. Electrical resistivity (ER) and electromagnetic (EM) were used to measure subsurface electrical properties. In addition, seismic refraction and Multichannel Analysis of Surface Waves (MASW) were performed to characterize the geometry, depth, and geomechanical behavior of the soil and rock bodies. The integration of these techniques allowed the interpretation of hydrogeological sections and a 3D resistivity volume to gain insight into the distribution of potentially contaminating fluids and tailings material present in the mining valley.