West Cornwall Hospital

Abstract Granitic melts derived from anatexis of metasedimentary rocks, particularly biotite-dehydration reactions, are important lithium (Li) sources. Petrogenetic models depend on mineral-melt lithium partitioning, yet published partition coefficients ( $${D}_{{{{\rm{Li}}}}}^{{{{\rm{mineral/melt}}}}}$$ D Li mineral/melt ) vary by over an order of magnitude, and are commonly used as static values. Here we use thermodynamic modelling coupled with relevant published $${D}_{{{{\rm{Li}}}}}^{{{{\rm{mineral/melt}}}}}$$ D Li mineral/melt ranges, including a dynamic composition- and temperature-dependent $${D}_{{{{\rm{Li}}}}}^{{{{\rm{biotite/melt}}}}}$$ D Li biotite/melt , to quantify viable enrichment during partial melting and fractional crystallisation. Using the lithium-rich Cornubian granite batholith, we demonstrate the sensitivity of results to $${D}_{{{{\rm{Li}}}}}^{{{{\rm{mineral/melt}}}}}$$ D Li mineral/melt choices for modally-dominant lithium-poor phases (e.g. quartz), as well as phases traditionally thought to dominate lithium budgets (e.g. biotite). While economic lithium enrichment can result from extreme fractionation with selective $${D}_{{{{\rm{Li}}}}}^{{{{\rm{mineral/melt}}}}}$$ D Li mineral/melt , we suggest that dehydration melting of fluorinated biotite is the most viable petrogenetic model. The latter reconciles the common observations of fluorite in lithium-granites and their late-orogenic occurrence, and provides a mechanism for extensive fractionation.

Older age is a major risk factor for many neurocognitive disorders like Alzheimer's disease. While there are limited treatment options for improving memory in this population, research has shown that special psychotherapeutic modalities like Cognitive Remediation Therapy (CRT), especially when coupled with psychosocial and vocational rehabilitation(PSR and VCR respectively), benefit older adults. This study examines the availability of these services in US mental health (MH) facilities serving older adults and compares the characteristics of the facilities providing these services. Our study includes 1216 MH facilities using the 2022 National Substance Use and Mental Health Services Survey (N-SUMHSS) data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to determine availabilities, while multivariable logistic regression was used to compare facilities that offer the services compared to those that do not. Of the total facilities included, 78 (6%), 634 (52%), and 381 (31%) offered CRT, PSR, and VCR respectively. Facilities that provided only MH services compared to those providing substance use and MH services, those that offer special services for veterans, and special Alzheimer's programs compared to those that do notwere more likely to have CRT services. MH facilities that provide supplemental employment services, housing services and recovery housing were more likely to offer PSR and VCR compared to those that do not. Compared to facilities in Midwest states, facilities in East South-Central were less likely to offer PSR and VCR. This study highlights the relative unavailability of CRT, indicating a need for more interest in evidence-based nonpharmacological treatment options for cognitive decline in the aging population.

Abstract Coastal bottlenose dolphin populations are highly vulnerable due to their small population sizes and proximity to human activities. Long‐term studies in the UK have monitored populations protected within Special Areas of Conservation (SACs) since the 1990s, but a small community of bottlenose dolphins inhabiting the coastal waters of southern England has received much less attention. The English Channel is one of the most heavily impacted marine ecosystems worldwide and increasing anthropogenic pressures pose a severe threat to the long‐term viability of this population. Conservation measures to protect these animals have been hindered by a lack of knowledge of population size, distribution and ranging behaviour. This study aimed to fill these knowledge gaps. A citizen science sighting network yielded 7458 sighting reports of bottlenose dolphins between 2000 and 2020. Resightings of identified individuals were used to estimate abundance, distribution, and ranging behaviour. Social structure analysis revealed a discrete interconnected group of animals in shallow coastal waters, which did not appear to mix with conspecifics identified further offshore. A Bayesian multi‐site mark–recapture analysis estimated that this population comprises around 48 animals (CV = 0.18, 95% HPDI = 38–66). These dolphins ranged between North Cornwall and Sussex, with an average individual range of 530 km (68–760 km). Areas of high‐modelled habitat suitability were found to overlap with high levels of anthropogenic pressure, with pollution and boat traffic identified as the most pervasive threats. Although adult survival rates indicated that the population was relatively stable from 2008 to 2019 (0.945 (0.017 ± SE)), the small population size implies a significant risk to their long‐term viability and resilience to environmental change. By highlighting the most deleterious anthropogenic activities and regions of conservation significance, our results will be useful for developing management policies for threat mitigation and population conservation, to protect this vulnerable group of dolphins.

Mangrove forests provide many ecosystem services but are among the world’s most threatened ecosystems. Mangroves vary substantially according to their geomorphic and sedimentary setting; while several conceptual frameworks describe these settings, their spatial distribution has not been quantified. Here, we present a new global mangrove biophysical typology and show that, based on their 2016 extent, 40.5% (54,972 km2) of mangrove systems were deltaic, 27.5% (37,411 km2) were estuarine and 21.0% (28,493 km2) were open coast, with lagoonal mangroves the least abundant (11.0%, 14,993 km2). Mangroves were also classified based on their sedimentary setting, with carbonate mangroves being less abundant than terrigenous, representing just 9.6% of global coverage. Our typology provides a basis for future research to incorporate geomorphic and sedimentary setting in analyses. We present two examples of such applications. Firstly, based on change in extent between 1996 and 2016, we show while all types exhibited considerable declines in area, losses of lagoonal mangroves (− 6.9%) were nearly twice that of other types. Secondly, we quantify differences in aboveground biomass between mangroves of different types, with it being significantly lower in lagoonal mangroves. Overall, our biophysical typology provides a baseline for assessing restoration potential and for quantifying mangrove ecosystem service provision.

During 2015, two drift endocarps of Pangium edule were found stranded in southern British waters, the first from Dungeness, Kent (25/09/2015) and the second from Loe Bay Beach, Cornwall (13/11/2015). The specimens represent the first records of P. edule drift endocarps from British waters. Four specimens have previously been recorded from Dutch (3) and Danish (1) waters. A first record of P. edule from Bermuda (NW Atlantic) in mid-December 2015 is also reported.

Introduction:In recognition of the value of long-term real-world data, a postauthorizationsafety study of the inhaled corticosteroid (ICS) fluticasone propionate andlong-acting β2-agonist (LABA) formoterol fumarate(fluticasone/formoterol; Flutiform®) was conducted.Methods:This was a 12-month observational study of outpatients with asthma aged ⩾ 12years in eight European countries. Patients were prescribedfluticasone/formoterol according to the licensed indication, andindependently of their subsequent enrolment in the study. They were thentreated according to local standard practice. The study objectives were toevaluate the safety and effectiveness of fluticasone/formoterol underreal-world conditions.Results:The safety population for this study comprised 2539 patients (mean age 47.7years; 94.3% aged ⩾ 18 years; 63.4% female). Most patients (1538/2539,60.6%) had switched to fluticasone/formoterol from another ICS/LABA,primarily due to lack of efficacy (1150/2539, 45.3%). Three quarters (77.4%)of patients were treated for 12 months, and 80.6% continuedfluticasone/formoterol treatment after the study. Adverse events (AEs)occurred in 60.0% patients, and 10.2% had AEs considered possibly related tofluticasone/formoterol [most commonly asthma exacerbation (2.0% patients),dysphonia (1.8%) and cough (1.1%)]. Thirty-six severe AEs, but no seriousAEs, were considered possibly related to fluticasone/formoterol. Theproportion of patients with controlled asthma (based on Asthma Control Testscore ⩾ 20) increased from 29.4% at baseline to 67.4% at study end (lastobservation carried forward). The proportion of patients experiencing atleast one severe exacerbation decreased from 35.8% in the year prior toenrolment to 9.8% during the study. Improvements from baseline to study endwere also observed in Asthma Quality of Life scores and physician/patientreports of satisfaction with treatment.Conclusion:In this real-world postauthorization safety study, fluticasone/formoteroldemonstrated a safety profile consistent with that seen in controlledclinical trials, with effectiveness in improving asthma control.

On 30 December 2015, a single specimen of Juglans was found stranded on Tramore Beach (54° 48′ 25″N, 08° 30′ 01″W), Rosbeg, Co Donegal, NW Ireland. A second specimen was found on Black Rock Beach, Widemouth Bay, south of Bude, north Cornwall, UK (SS19760178) c.14 March 2016. Based on morphological features, both specimens were identified as J. jamaicensis C. DC., and represent the first records of this species from Irish, UK and NW European waters. It is hypothesised that these walnuts most likely originated in the Greater Antilles where J. jamaicensis is endemic to Cuba, Hispaniola (Dominican Republic & Haiti) and Puerto Rico. At least four other species of walnut have been recorded from NW European waters: J. regia, J. nigra, J. ailanthifolia, and J. californica.

The tree that produces the Box Fruit is known as the Fish Poison or Sea Poison Tree, Barringtonia asiatica (L.) Kurz, which is native to mangrove habitats on tropical coasts and islands in the Indi...

A patient with apparently well-controlled epilepsy with a painful musculoskeletal condition was treated successfully with two sessions of acupuncture. However, 4 h after the first treatment and during the second, an adverse event involving impairment of consciousness occurred. The patient subsequently experienced an increased frequency of complex partial seizures resulting in the loss of his driving licence. A detailed retrospective review of the past medical history indicated that the patient probably had comorbidities in the form of rapid eye movement sleep behaviour disorder and dysfunctional somatosensory/vestibular processing. Acupuncture may have triggered the adverse event via shared neurosubstrates. This adverse event raises possible implications regarding safe clinical acupuncture practice.