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Element-Based Predictive Modeling Of Hydrothermal Liquefaction Bioproducts Derived From Corn Stover, Isamu Umeda, Meicen Liu, Yi Zheng, Jiefu Wang, Zhiwu Wang, Sandeep Kumar

Civil & Environmental Engineering Faculty Publications

The hydrothermal liquefaction (HTL) process offers an energetic advantage over pyrolysis because it does not require prior drying of the biomass feedstock. However, there are significant challenges in simultaneously estimating both the yields and characteristics of products from the HTL of biomass with theoretical support. This study developed a unique element-based kinetic model to predict the yields, higher heating values, and fuel characteristics of solid residue and heavy bio-oil, based on the temperature, residence time, solid loading, and elemental composition (C, H, N, and O) of corn stover. Furthermore, the model predicted the weights of dissolved carbon and nitrogen in …

Harnessing Activated Sludge For The Treatment Of Hydrothermal Liquefaction Wastewater: A Proof-Of-Concept Study, Cyrus Li, Jiefu Wang, Meicen Liu, Yi Zheng, Sandeep Kumar, Isamu Umeda, Chandan Mahata, John Norton

Civil & Environmental Engineering Faculty Publications

Although hydrothermal liquefaction (HTL) is the leading technology in converting wet biomass into bioenergy, the treatment of its toxic-laden aqueous phase wastewater presents a major challenge on its path toward commercial viability. This study presents the first-ever assessment of sewage sludge-fed HTL wastewater (SS-HTLWW) treatment and toxic compound removal using municipal activated sludge (AS) by optimizing its cultivation condition. It was found that AS with optimized pretreatment can remove up to 91.2% of the soluble chemical oxygen demand (sCOD) in SS-HTLWW, of which up to 82% can be attributed to biological mineralization and adsorption of sCOD by AS. Conventional bioprocess …

Educational Case: Meningioma, Ashley M. Carter, Harrison Dai, Harrison Klause, Alberto Musto, Richard M. Conran

Department of Medicine Faculty Publications

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology.

Nature-Based Solutions For Urban Resilience And Environmental Justice In Underserved Coastal Communities: A Case Study On Oakleaf Forest In Norfolk, Va, Farzaneh Soflaei, Mujde Erten-Unal, Carol L. Considine, Faeghe Borhani

Civil & Environmental Engineering Faculty Publications

Climate change and sea-level change (SLC) are intensifying flooding in U.S. coastal communities, with disproportionate impacts on Black and minority neighborhoods that face displacement, economic hardship, and heightened health risks. In Norfolk, Virginia, sea levels are projected to rise by at least 0.91 m (3 ft) by 2100, placing underserved neighborhoods such as Oakleaf Forest at particular risk. This study investigates the compounded impacts of flooding at both the building and urban scales, situating the work within the framework of the UN Sustainable Development Goals (UN SDGs). A mixed-method, community-based approach was employed, integrating literature review, field observations, and community …

Nonstationary Spatial Correlation Of Earthquake Ground Motions In California, Pengfei Wang, Busra Bocekli, Junhui Yang, Scott J. Brandenberg, Jonathan P. Stewart

Civil & Environmental Engineering Faculty Publications

Assessing seismic risk to spatially distributed infrastructure systems requires realistic representations of spatially correlated ground motions. Existing models for the spatial correlations of ground motions rely on strong second-order stationarity assumptions, under which the correlation structure is assumed to be invariant across space, potentially masking regional variations. Because repeatable site and path effects can vary spatially, the resulting correlation structure is likely to be nonstationary. We propose a nonstationary spatial correlation method that captures geographically varying correlation decay behavior. We compute site-to-site Pearson correlations of within-event residuals using earthquakes recorded at both sites in each site pair and model the …

Assessing Positive Digital Experiences: A Spanish Validation Of The Digital Flourishing Scale For Adolescents, Alfredo Zarco-Alpuente, Victor Ciudad Fernández, Jasmina Rosič, Sophie Janicke-Bowles, Tamara Escrivà-Martínez, Paula Samper-García

Communication Faculty Articles and Research

Background: Adolescents are immersed in digital communication, which can benefit or harm their well-being. Digital flourishing captures positive perceptions of this communication-connectedness, authentic self-presentation, positive social comparison, civil participation, and self-control-and how it contributes to well-being. In Spain there is still no validated instrument for adolescents. Method: We adapted and validated the Digital Flourishing Scale for Adolescents (DFSA) for Spanish adolescents. Study 1 involved a pilot survey (n = 13) and cognitive interviews (n = 10) to improve clarity and cultural relevance. Study 2 used a cross-sectional survey (n = 1,786) to examine the DFSA’s latent structure, measurement invariance by …

Efficacy And Safety Of Pyrimidine Nucleos(T)Ide Therapy In Thymidine Kinase 2 Deficiency, Michio Hirano, Caterina Garone, Richard Haas, Carmen Paradas, Fernando Scaglia, Irene Rebollo Mesa, Carl Chiang, Anny-Odile Colson, Susan Vanmeter, Cristina Domínguez-González

Faculty, Staff and Students Publications

Thymidine kinase 2 deficiency (TK2d) (MIM 609560) is an ultra-rare, autosomal recessive mitochondrial myopathy caused by TK2 variants, leading to mitochondrial DNA depletion and/or multiple deletions. People with thymidine kinase 2 deficiency experience progressive myopathy, bulbar weakness and respiratory insufficiency, often losing the ability to walk, eat and breathe independently. Doxecitine and doxribtimine represents the first approved treatment for patients with thymidine kinase 2 deficiency with age of symptom onset ≤12 years by the US Food and Drug Administration and the European Medicines Agency; previously, disease management was limited to supportive care. We investigated the efficacy and safety of pyrimidine …

Rare But Relevant? Assessing Variants In Dystonia-Linked Genes In Parkinson's Disease, Lara M Lange, Zih-Hua Fang, Laurel Screven, Ai Huey Tan, Roy N Alcalay, Rim Amouri, Roberta Bovenzi, Matilda Fenn, Joshua L I Frost, Joseph Jankovic, Simona Jasaityte, Zane Jaunmuktane, Beomseok Jeon, Ignacio Juan Keller Sarmiento, Rejko Krüger, Gregor Kuhlenbäumer, Chin-Hsien Lin, Lukas Pavelka, Maria Teresa Periñan, Samia Ben Sassi, Tommaso Schirinzi, Jung Hwan Shin, Joshua M Shulman, Yi Wen Tay, Ryan Uitti, Tom Warner, Zbigniew K Wszolek, Lesley Wu, Ruey-Meei Wu, Kirsten E Zeuner, Cornelis Blauwendraat, Andrew Singleton, Niccolò E Mencacci, Huw R Morris, Shen-Yang Lim, Katja Lohmann, Christine Klein

Faculty, Staff and Students Publications

Background: Dystonia and Parkinson's disease (PD) exhibit clinical and genetic overlap, but the relevance of dystonia gene variants in PD remains unclear.

Objective: The aim was to assess the frequency of dystonia-linked pathogenic variants in PD.

Methods: We screened sequencing data from 15,684 individuals (8272 PD, 3200 atypical parkinsonism, and 4212 unaffected) from the Global Parkinson's Genetics Program (GP2) and Accelerating Medicines Partnership-Parkinson's Disease (AMP-PD) for variants in genes linked to isolated dystonia, dystonia-parkinsonism, and myoclonus-dystonia.

Results: Pathogenic variants were identified only in PD patients. Forty-five PD individuals (0.54%) carried 26 distinct (likely) pathogenic variants in nine dystonia-linked genes, most …

A Nonlinear Relationship Of Evoked Responses Following Charge-Balanced Single-Pulse Electrical Stimulation With Varying Pulse Widths, Isabel A Danstrom, Joshua A Adkinson, Zoe Liu, Meghan E Robinson, Denise Oswalt, Garrett P Banks, Atul Maheshwari, Lu Lin, Ben Shofty, Mohammed Hasen, Alica Goldman, Eleonora Bartoli, Sarah R Heilbronner, Kelly R Bijanki

Faculty, Staff and Students Publications

Background: Single-pulse electrical stimulation (SPES) can help guide neuromodulation therapy in an iterative process to reveal ideal circuits and degrees of engagement. Understanding the relationship between parameter input and neural output will be necessary both to build informative models of the brain's functional connectivity and to improve responses to stimulation-based neuromodulation therapies. Modulating pulse width alters the total charge delivered to neural tissue and is thought to selectively activate fibers with different diameters, potentially shifting therapeutic thresholds. The anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC) are of great clinical relevance to the pathophysiology and treatment of neuropsychiatric disorders.

Objective: …

A Note On The Novel Passive Sampling In Environmental Dna (Edna) Collection Technique To Detect Yellow Mud Turtle (Kinosternon Flavescens): Field And Laboratory Approaches In Turtle Edna, Sakib Tahmid Rishan, Richard J. Kline, Md. Saydur Rahman

School of Integrative Biological & Chemical Sciences Faculty Publications

Environmental DNA (eDNA) is a powerful and sensitive method for monitoring aquatic and terrestrial organisms, offering insights into their distribution. Usually, eDNA is collected using a filter membrane through water filtration. However, the passive eDNA method can simplify sampling and broaden its scope, offering new insights for ecological surveillance. This study examined the efficacy of six different membrane filters in detecting the yellow mud turtle (Kinosternon flavescens) through a novel passive eDNA method. After being immersed in water for 12 h, only the mixed cellulose ester (MCE) membrane filter consistently demonstrated specific polymerase chain reaction (PCR) amplification using …

Transient Disruption Of Bladder Control Linked To Periaqueductal Gray Fibers Following Deep Brain Stimulation For Psychiatric Disorders, Thomas Hamre, Hideo Suzuki, Sarah Soubra, Reem El Jammal, Melissa A Ryan, Sanjay J Mathew, Jeffrey A Herron, Nidal Moukaddam, Eric A Storch, Nora Vanegas Arroyave, Kara L Marshall, Garrett P Banks, Nader Pouratian, Wayne K Goodman, Nicole R Provenza, Sameer A Sheth, Sarah R Heilbronner

Faculty, Staff and Students Publications

No abstract provided.

Noradrenergic Innervation Across Brain Regions Is Altered By Aging And By Disease Progression In A Mouse Model Of Alzheimer’S Disease Neuropathology, Nicole M Hernandez, Manuel Silva-Pérez, Jeannie Chin

Faculty, Staff and Students Publications

Norepinephrine plays critical roles in modulating arousal and attention, is highly dynamic in awake, behaving individuals, and has anti-inflammatory and neuroprotective actions. Notably, the locus coeruleus (LC), the primary source of norepinephrine in the central nervous system, is among the first brain regions to show pathological alterations in early stages of Alzheimer's disease (AD). LC neuronal loss and associated reductions in norepinephrine in the brain have therefore been postulated to play a key role in AD pathophysiology. LC neurons and their axons have been studied in several mouse models of AD-related neuropathology to investigate their contribution to brain dysfunction in …

Frontline Aspiration Versus Stent Retriever Thrombectomy For M2 Occlusions: Insights From The Star Registry, Michael Gaub, Rahim Abo Kasem, Ilko Maier, Ansaar Rai, Pascal Jabbour, Joon-Tae Kim, Brian Howard, Ali Alawieh, Stacey Quintero Wolfe, Robert M Starke, Marios-Nikos Psychogios, Amir Shaban, Nitin Goyal, Justin Dye, Ali Alaraj, Mohamad Ezzeldin, Shinichi Yoshimura, David Fiorella, Omar Tanweer, Daniele G Romano, Pedro Navia, Hugo Cuellar, Isabel Fragata, Adam Polifka, Joshua Osbun, Fazeel Siddiqui, Mark Moss, Kaustubh Limaye, Maxim Mokin, Charles Matouk, Min S Park, Waleed Brinjikji, Ergun Daglioglu, Richard Williamson, David J Altschul, Christopher S Ogilvy, Roberto Crosa, Michael R Levitt, Benjamin Gory, Alexandra Paul, Peter Kan, Walter Casagrande, Shakeel Chowdhry, Michael F Stiefel, Ramesh Grandhi, Alejandro Spiotta, Justin Mascitelli

Faculty, Staff and Students Publications

Background: Recent trials have furthered uncertainty regarding the endovascular benefit for medium vessel occlusions (MeVO). Stent retrievers (SR) were employed in the first attempt in most interventional arm participants. We sought to compare outcomes in acute MCA M2 occlusions between frontline aspiration and SR, and to delineate procedural and anatomical covariates associated with differential treatment effect.

Methods: Retrospective analysis of a multicenter stroke thrombectomy cohort identified cases of MT for M2 occlusions. Unmatched and propensity score-matched (PSM) cohorts were generated comparing frontline aspiration to standalone and combined SR. The primary outcome was functional independence (mRS 0-2) at 90 days. Recanalization, …

Mapping The Structural Connections Between The Anterior Cingulate Cortex And The Insula/Ventrolateral Prefrontal Cortex.Mapping The Structural Connections Between The Anterior Cingulate Cortex And The Insula/Ventrolateral Prefrontal Cortex, Wei Tang, Javier Guaje, Shreyas Fadnavis, Sarah R Heilbronner, Eleftherios Garyfallidis

Faculty, Staff and Students Publications

The anterior cingulate cortex (ACC) is functionally closely related with the insula and the ventral lateral prefrontal cortex (vlPFC). The ACC and insula are the main hubs of the salience network, a set of functionally related brain regions involved in detecting salient stimuli and coordinating inter-network communication, while communication between ACC and vlPFC is closely linked to inhibitory control. However, despite strong indirect evidence from nonhuman primate (NHP) tract tracing, the structural connections between the ACC and the insula/vlPFC remain poorly understood in the human brain, in part because standard approaches fail to capture this projection. In this study, we …

Old Lesions And New Targets: Seeg-Identified Onsets In Traditionally Inoperable Epilepsy Lesions And Associated Surgical Outcomes, Yosef M Dastagirzada, Spencer Frome, Daniel J Curry, Howard L Weiner

Faculty, Staff and Students Publications

Background: Patients with epilepsy who do not respond to pharmacotherapy are often offered a noninvasive diagnostic workup to localize an epileptogenic focus that might be treated with resection, neuromodulation, or ablation. Yet in many cases, this evaluation fails to identify surgical candidates.

Summary: Patients with tuberous sclerosis, periventricular nodular heterotopia, or polymicrogyria may have clearly visible lesions on MRI, but the resulting epileptogenic onset zones/networks are often too complex for scalp electroencephalography to decode. Similarly, seizures arising from the cingulate gyrus originate in deep structures that are inaccessible to noninvasive techniques. In post-traumatic epilepsy without a dominant lesion such as …

Surgical Outcomes And Learning Curve Of Robotic Single-Port Vaginal Natural Orifice Transluminal Endoscopic Surgery (Vnotes) Hysterectomy Using The Da Vinci Single-Port System, Qiannan Yang, Daniel Y Lovell, Xiaoming Guan

Faculty, Staff and Students Publications

Objective: This study aims to assess the surgical outcomes and learning curve of robotic single-port vaginal natural orifice transluminal endoscopic surgery (RSP-vNOTES) for hysterectomy in benign gynecologic conditions.

Materials and methods: A retrospective observational analysis was conducted of 97 consecutively enrolled patients who underwent RSP-vNOTES hysterectomy using the da Vinci (single-port) SP system between December 2023 and July 2025 at a single tertiary care center.

Results: Median procedural durations included a total operative time of 151 minutes, a port placement time of five minutes, a docking time of two minutes, a robotic console time of 78 minutes, and a hysterectomy …

Optimizing Tbi Care: Brain Oxygen Monitoring In Nursing - An Evidence-Based Practice, Alyssa Grisham

Loma Linda University Electronic Theses, Dissertations & Projects

Purposes/Aims

This DNP project aims to enhance the care of patients with traumatic brain injury (TBI) by improving nurses’ knowledge, clinical decision-making, and early intervention strategies through the integration of brain oxygenation data into routine neurocritical care assessments. This project seeks to promote personalized patient care, reduce secondary brain injury, and improve neurological outcomes for critically ill adults with TBI by implementing an educational protocol designed to deepen understanding of brain oxygen monitoring.

Background of Problem & Description of Current Practice

TBI remains a leading cause of death and disability worldwide and continues to pose a significant public health burden. …

Patient And Practitioner Workshops For An Intellectual Disabilities And Epilepsy Neuropsychiatric Genetic Research Database Register: Ethical Dilemmas For Study Design, Rohit Shankar, Jon Allard, Dannielle Bilkey, Brendan Mclean, Pamela Bowman, Chloe Staples, Lance Watkins, Anna Simpson, Elizabeth Boardman, Sarah Mitchell, Sarah Lennard

Peninsula Medical School

BackgroundThere is a need for more research studies focussed on People with ID (PwID) and Epilepsy and for the design of these studies to be shaped by this complex and vulnerable population and those who care for and support them.AimsTo develop understanding as to how a future NHS genetic research database register for PwID and Epilepsy should be conducted in a way which is inclusive, suitable and appropriate for them, their carers and the NHS settings where the research would be undertaken.MethodsThree workshops were completed with 17 formal participants: (1) PwID and Epilepsy (n2); (2) carers of PwID and Epilepsy …

Involving Parents In Prevention: A Case Example Of Research And Intervention Development To Improve Financial Well-Being Support, Nick Axford, Gisella Hanley, Rebecca Summers, Kristin Liabo, Amy Bond, Eleanor Bryant, Georgia Smith, Rachel Silcock, Vashti Berry

Peninsula Medical School

The adverse effects on parent and child outcomes of poverty and stressors associated with low income are well established. With notable exceptions, however, the potential role of frontline services in improving family financial well-being is underexplored. This article outlines how patient and public involvement (PPI) was initiated early on in research on financial well-being support (FWbS). It illustrates how research can build on and integrate what parents say about services and how to research them. The involvement work was undertaken in one city in part to inform the adaptation of an income maximisation service to be delivered in local children’s …

Designing A Mobile App For Post Traumatic Stress Disorder: Insights From Lived Experience And Clinical Practice, Rohit Shankar, Richard Laugharne, Michael Loizou, Marius Varga, Sivia Lin, Bojana Daw Srdanovic, Roger Farrell

Peninsula Medical School

Post-traumatic stress disorder (PTSD) is a disabling anxiety disorder precipitated by severe trauma. Many people with this condition have little access to clinical interventions, especially in low-middle-income countries. For the development of any digital health intervention, it is vital to know the opinions of PLE and clinicians to guide the developers. We conducted two focus groups, one with clinicians (n = 5) and one with people with lived experience (PLE) (n = 11), to gain knowledge of their views on the development of a PTSD App. Transcripts of both focus groups were coded and thematically analysed. The key themes that …

Royal College Of Psychiatrists College Report 244: Optimising Psychotropic Medication Prescribing For People With Intellectual Disability, Rohit Shankar

Peninsula Medical School

No abstract provided.

Best Practice Guidelines For Professional Carers In Emergency Seizure Medication, Rohit Shankar

Peninsula Medical School

No abstract provided.

“The True Me”: Unravelling The Dual Narrative Of Borderline Personality Disorder And Autistic Spectrum Disorder, Robin Iliffe-Lewis, Alison Bacon

School of Psychology

Objectives: There is growing recognition that some individuals who receive a diagnosis of Borderline Personality Disorder (BPD) are later diagnosed with autism. However, existing literature on this topic remains limited. This study aimed to explore the experiences of individuals diagnosed with BPD prior to autism, how they made sense of these diagnoses, navigated clinical systems, and learnt to manage the complex challenges associated with this diagnostic sequence.Methods: Thirteen (6 male, 6 female, 1 non-binary) adult participants took part in semi-structured interviews exploring their diagnostic journeys. Reflexive thematic analysis was used to develop a nuanced understanding of their experiences.Results: Three themes …

Psychophysiological Recovery From Viewing Nature And Urban Settings: A Multisite Replication, A. E. Van Den Berg, K. Dijkstra, D. Meuwese, F. Beute, P. M. Darcy, S. Dewitte, B. Gatersleben, C. J. Gidlow, C. M. Hägerhäll, J. A. Hipp, Y. Joye, Y. A.W. De Kort, S. C.M. Lechner, C. Neale, Sang Ode Sang, J. Roe, D. T. Scheepers, K. Smolders, H. Staats, R. S. Steensma, K. J. Wyles, S. L. Koole

School of Psychology

The idea that merely viewing nature can promote stress recovery has profound societal implications, driving the use of nature imagery in the design of environments where access to real nature is limited. Scientific support for this concept originates from a pioneering study by Ulrich et al. (1991), which demonstrated superior psycho-physiological stress recovery during exposure to nature videos compared to urban videos. Despite its influence, this foundational study has never been systematically replicated. To address this gap, ten research teams across the Netherlands, Belgium, the UK, Sweden, and the USA collaborated on a multisite replication. A final sample of 959 …

Integrating Neuroscience And Social Psychology In Researching Interprofessional Education: The Inspire Framework, Kimberley Schenke, Pamela Rae, Jaysan Charlesford, Phil Gee

School of Psychology

There is an increasing focus on the importance of interprofessional education as an integral part of health and social care training. However, the fundamental psychological processes underlying successful interprofessional education are not well understood. Here we propose a single framework, Integrating Neuroscience and Social Psychology In Researching Interprofessional Education (INSPIRE), grounded in evidence from social psychology and neuroscience that could be used to generate testable hypotheses to inform the design, development and evaluation of interprofessional education. The application of this framework offers a novel, scientifically grounded approach to improving the learning outcomes of interprofessional education and provides a foundation for …

The Career Choices Of Final Year Nursing Students In The United Kingdom: A Qualitative Study., Kevin Hambridge, Frazer Underwood, Gosia Bettache, Matt Carey, Halil Kaya, Lisa Burrows, Rachel Tims, Christian Brailsford

School of Nursing and Midwifery

Aim: The aim of this study is to explore the career choices of final year under-graduate nursing students in the United Kingdom. Background: Worldwide there is a decreasing number of nurses and in the United Kingdom there is a decreasing amount of nursing students. There is sparce evidence relating to the career's choices of nursing students and reasons for those choices. Obtaining a deeper comprehension of these choices may aid healthcare employers, in partnership with universities, to design the future nursing workforce. Design: A qualitative design was used. Methods: Twenty-one final year under-graduate nursing students from across a range of …

Staphylococcus Aureus Strain Heterogeneity Modulates Virulence Traits Associated To Dual-Species Biofilms With Candida Albicans, Laure Nicolas Annick Ries, Beata Adrienn Brezniczky, Binduja Srelatha Pradeep, Esther Olabamiji, Lee Hutt, Glenn M. Harper, Alexander Strachan, Gyorgy Fejer

School of Biomedical Sciences

Staphylococcus aureus is a commensal Gram-positive bacterium and opportunistic pathogen that exhibits substantial variation in antimicrobial resistance and virulence traits. S. aureus is frequently co-isolated with the fungus Candida albicans, and together they represent the most common microorganisms recovered from biofilm-associated infections originating from both biotic and abiotic surfaces. Despite this clinical relevance, the impact of bacterial intra-species variation on interkingdom interactions remains poorly understood. This study therefore investigated how S. aureus strain heterogeneity influences C. albicans within dual-species biofilms. The majority of the 60 S. aureus strains tested suppressed fungal growth in a contact-dependent manner across different nutrient conditions …

Assessing The Application Of Optical-Photothermal Infrared Spectroscopy For Single-Grain Chemical Palynology, Laura Scoble, Hao Meng, Simon J. Ussher, Mark F. Fitzsimons, Lauren Ansell, Mustafa Kansiz, Billy Simmonds, Nick Stone, Ralph M. Fyfe

School of Geography, Earth and Environmental Sciences

Single-grain pollen analysis is essential for advancing chemical palynology, which classifies morphologically similar taxa based on taxon-specific pollen and sporopollenin chemistry. Fourier-Transform Infrared (FT-IR) spectroscopy and microspectroscopy (μFT-IR) are widely used to differentiate morphologically similar grains but face limitations from Mie scattering and coarse spatial resolution. Here, we present the first application of Optical-PhotoThermal Infrared (O-PTIR) spectroscopy to chemically treated single pollen grains, using Molinia caerulea as a model taxon to fully test and evaluate the technical capabilities and limitations of this technique. O-PTIR achieves sub-micron “super-resolution” infrared spectroscopy through non-contact, non-destructive measurements by exploiting the photothermal effect. O-PTIR spectra …

Nutrient Legacy And Cycling In The Somerset Levels And Moors, Oscar Kemble, Paul Lunt

School of Geography, Earth and Environmental Sciences

1. Executive summaryThe Somerset Levels and Moors (SLMs) are one of the UK’s most extensive and ecologically significant lowland wetland systems, supporting internationally important bird populations and nationally important assemblages of wetland plants and invertebrates. However, the ecological condition of the SLMs Ramsar and underpinning SSSIs has deteriorated in recent decades, driven primarily by phosphorus (P) enrichment. In 2021, Natural England downgraded the SLMs to “unfavourable declining”, citing persistent eutrophication, floating plant dominance, and loss of submerged macrophytes as key symptoms.This review synthesises current evidence and provides critical overviews for the following themes: (1) The Somerset Levels and Moors (SLMs) …

What Is The Evidence For Effective Teaching Of Clinical Reasoning In Pre-Registration Dentistry?, Sally Hanks

Peninsula Dental School

A Commentary on: The impact of different teaching methods on clinical reasoning and clinical decision-making of dentistry students: a systematic review. Journal of Dental Education, 2026, 90(1), pp.33–42 Design: This systematic review examined evidence on educational interventions aimed at developing clinical reasoning and decision-making skills in undergraduate dental students. Searches of PubMed, MEDLINE (Ovid), Cochrane Library, and Scopus were conducted to 15 September 2023. Eighteen studies met the inclusion criteria for qualitative synthesis. Study designs included cross-sectional and case–control approaches. PRISMA guidance was followed, and a flow diagram was provided. Case selection: Eligible studies were English-language reports evaluating clinical reasoning …