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The use of explosive weapons in populated areas (EWIPA) has a disproportionate impact on civilians. Many humanitarian organizations utilize varying sheltering guidelines to recommend safe positions for civilians affected by explosive threats. It is not known whether these recommendations are standardized or derived from evidence. This study aimed to identify existing recommendations and potential gaps in literature relevant to sheltering guidelines for civilians during explosive events.
Methods
A scoping review was conducted of the literature including indexed databases and grey literature to identify reports that described sheltering guidelines for civilians during explosive events. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology was followed.
Results
The search identified 3582 peer-reviewed records. After title/abstract and full text screening, only 2 peer-reviewed reports remained eligible. These were combined with 13 gray literature reports obtained from humanitarian organizations and internet searches. The peer-reviewed reports included mine and unexploded ordnance guidelines, not guidelines for EWIPA or aerial bombardments. There is a substantial knowledge gap and heterogeneity in existing sheltering guidelines from explosive events, particularly those appropriate for protection from EWIPA.
Conclusions
Findings from this scoping review demonstrate a need for the creation and standardization of evidence-based civilian sheltering guidelines to mitigate the threat of explosive weapons to civilians in conflict.
Internal and external rotation of the shoulder is often challenging to quantify in the clinic. Existing technologies, such as motion capture, can be expensive or require significant time to setup, collect data, and process and analyze the data. Other methods may rely on surveys or analog tools, which are subject to interpretation. The current study evaluates a novel, engineered, wearable sensor system for improved internal and external shoulder rotation monitoring, and applies it in healthy individuals. Using the design principles of the Japanese art of kirigami (folding and cutting of paper to design 3D shapes), the sensor platform conforms to the shape of the shoulder with four on-board strain gauges to measure movement. Our objective was to examine how well this kirigami-inspired shoulder patch could identify differences in shoulder kinematics between internal and external rotation as individuals moved their humerus through movement patterns defined by Codman’s paradox. Seventeen participants donned the sensor while the strain gauges measured skin deformation patterns during the participants’ movement. One-dimensional statistical parametric mapping explored differences in strain voltage between the rotations. The sensor detected distinct differences between the internal and external shoulder rotation movements. Three of the four strain gauges detected significant temporal differences between internal and external rotation (all p < .047), particularly for the strain gauges placed distal or posterior to the acromion. These results are clinically significant, as they suggest a new class of wearable sensors conforming to the shoulder can measure differences in skin surface deformation corresponding to the underlying humerus rotation.
Magnetic reconnection is an important process in astrophysical environments, as it reconfigures magnetic field topology and converts magnetic energy into thermal and kinetic energy. In extreme astrophysical systems, such as black hole coronae and pulsar magnetospheres, radiative cooling modifies the energy partition by radiating away internal energy, which can lead to the radiative collapse of the reconnection layer. In this paper, we perform two- and three-dimensional simulations to model the MARZ (Magnetic Reconnection on Z) experiments, which are designed to access cooling rates in the laboratory necessary to investigate reconnection in a previously unexplored radiatively cooled regime. These simulations are performed in GORGON, an Eulerian two-temperature resistive magnetohydrodynamic code, which models the experimental geometry comprising two exploding wire arrays driven by 20 MA of current on the Z machine (Sandia National Laboratories). Radiative losses are implemented using non-local thermodynamic equilibrium tables computed using the atomic code Spk, and we probe the effects of radiation transport by implementing both a local radiation loss model and $P_{1/3}$ multi-group radiation transport. The load produces highly collisional, super-Alfvénic (Alfvén Mach number $M_A \approx 1.5$), supersonic (Sonic Mach number $M_S \approx 4-5$) strongly driven plasma flows which generate an elongated reconnection layer (Aspect Ratio $L/\delta \approx 100$, Lundquist number $S_L \approx 400$). The reconnection layer undergoes radiative collapse when the radiative losses exceed the rates of ohmic and compressional heating (cooling rate/hydrodynamic transit rate = $\tau _{\text {cool}}^{-1}/\tau _{H}^{-1}\approx 100$); this generates a cold strongly compressed current sheet, leading to an accelerated reconnection rate, consistent with theoretical predictions. Finally, the current sheet is also unstable to the plasmoid instability, but the magnetic islands are extinguished by strong radiative cooling before ejection from the layer.
Consumption of traditional foods is decreasing amid a lifestyle transition in Greenland as incidence of type 2 diabetes (T2D) increases. In homozygous carriers of a TBC1D4 variant, conferring postprandial insulin resistance, the risk of T2D is markedly higher. We investigated the effects of traditional marine diets on glucose homoeostasis and cardio-metabolic health in Greenlandic Inuit carriers and non-carriers of the variant in a randomised crossover study consisting of two 4-week dietary interventions: Traditional (marine-based, low-carbohydrate) and Western (high in imported meats and carbohydrates). Oral glucose tolerance test (OGTT, 2-h), 14-d continuous glucose and cardio-metabolic markers were assessed to investigate the effect of diet and genotype. Compared with the Western diet, the Traditional diet reduced mean and maximum daily blood glucose by 0·17 mmol/l (95 % CI 0·05, 0·29; P = 0·006) and 0·26 mmol/l (95 % CI 0·06, 0·46; P = 0·010), respectively, with dose-dependency. Furthermore, it gave rise to a weight loss of 0·5 kg (95 % CI; 0·09, 0·90; P = 0·016) relative to the Western diet and 4 % (95 % CI 1, 9; P = 0·018) lower LDL:HDL-cholesterol, which after adjustment for weight loss appeared to be driven by HDL elevation (0·09 mmol/l (0·03, 0·15), P = 0·006). A diet–gene interaction was indicated on insulin sensitivity in the OGTT (p = 0·093), which reflected a non-significant increase of 1·4 (–0·6, 3·5) mmol/l in carrier 2-h glucose. A Traditional diet marginally improved daily glycaemic control and plasma lipid profile compared with a Westernised diet in Greenlandic Inuit. Possible adverse effects on glucose tolerance in carriers of the TBC1D4 variant warrant further studies.
The aim of this study was to investigate whether there were differences in fearfulness between laying hens (Gallus gallus domesticus) housed in aviaries and in cages. The tonic immobility (TI) test was used to assess the fearfulness. Norwegian light hybrid White Leghorn hens were housed in battery cages and in three types of aviaries: the Marielund, the Laco-Volétage and the Tiered Wire Floor. Each system housed about 1,500 birds. Tests were performed on 50 birds per housing system at 70 weeks of age in one laying flock and at 30 and 70 weeks of age in the next.
At 30 weeks of age in the second laying flock, the duration of the tonic immobility response was unaffected by type of system. At 70 weeks, however, hens in cages showed tonic immobility of longer duration than hens in aviaries, in the first as well as in the second laying flock No differences in TI between hens from the three types of aviaries were found. The duration of TI did not correlate with plumage condition or body-weight, except for a longer duration of TI with poorer plumage condition in aviaries at 30 weeks. These results indicate that the fearfulness of hens in cages, as measured by the TI test, increased considerably with time. The lower fearfulness shown by hens in aviaries suggests that this important aspect of welfare is more secured in aviaries than in cages.
Since the release of the revised Appendix A from the Council of Europe for housing of laboratory animals there have been claims that laboratory animals should be housed under more complex conditions; known popularly as enrichment. A number of studies have expressed concerns that this may increase uncontrollable variation in the animals, thereby creating the need for greater numbers of animals. Within neurobiology there would appear to be a scientific basis for such concern. However, even though this may be used as an argument for denying the animal environmental enrichment, it is unclear whether there is any basis for concern within other research areas. The aim of this study, therefore, was to explore whether clinical pathology and cardiovascular parameters were influenced by housing rats under environmentally enriched conditions. Male, Sprague-Dawley rats were housed under three different regimes: non-enriched, standard-enriched (according to the guidelines of the Council of Europe) and extra-enriched with a shelf and higher cages. All housing forms were based upon commercially available, standardised equipment. A total of 41 different parameters were monitored via clinical pathology, telemetry and coagulation tests and virtually no differences were observed in relation to the manner in which the rats were housed. The uncontrollable variation observed in our study was compared to within-strain variation data supplied from the breeder and was relatively low in all three types of housing. We conclude, based upon our studies in male, Sprague-Dawley rats, that so far there is no basis for concern that enriched housing will lead to increased group sizes when using animals for research within this field and, as such, there is no reason not to enrich the environment of such rats.
Recent estimates suggest that 40% of dementia cases could be avoided by treating recognised cardiovascular risk factors such as hypertension, diabetes, smoking and physical inactivity. Whether diet is associated with dementia remains largely unknown. We tested if low adherence to established dietary guidelines is associated with elevated lipids and lipoproteins and with increased risk of Alzheimer's disease and non-Alzheimer's dementia – a dementia subtype with a high frequency of cardiovascular risk factors.
Methods
We used the prospective Copenhagen General Population Study including 94 184 individuals with dietary information and free of dementia at baseline. Mean age at study entry was 58 years, and 55% (N = 51 720) were women and 45% (N = 42 464) were men. Adherence to dietary guidelines was grouped into low, intermediate and high adherence based on food frequency questionnaires. Main outcomes were non-Alzheimer's dementia and Alzheimer's disease.
Results
Low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol and plasma triglyceride levels were higher in individuals with intermediate and low adherence to dietary guidelines compared with individuals with high adherence (all p for trends <0.001). Age and sex-adjusted hazard ratios (HRs) for non-Alzheimer's dementia v. individuals with high adherence were 1.19 (95% confidence interval 0.97–1.46) for intermediate adherence, and 1.54 (1.18–2.00) for low adherence. Corresponding HRs in multivariable-adjusted models including APOE genotype were 1.14 (0.92–1.40) and 1.35 (1.03–1.79). These relationships were not observed in individuals on lipid-lowering therapy.
Conclusions
Low adherence to national dietary guidelines is associated with an atherogenic lipid profile and with increased risk of non-Alzheimer's dementia – the subtype of dementia with a high frequency of vascular risk factors. This study suggests that implementation of dietary guidelines associated with an anti-atherogenic lipid profile could be important for prevention of non-Alzheimer's dementia.
Glacier motion responds dynamically to changing meltwater inputs, but the multi-decadal response of basal sliding to climate remains poorly constrained due to its sensitivity across multiple timescales. Observational records of glacier motion provide critical benchmarks to decode processes influencing glacier dynamics, but multi-decadal records that precede satellite observation and modern warming are rare. Here we present a record of motion in the ablation zone of Saskatchewan Glacier that spans seven decades. We combine in situ and remote-sensing observations to inform a first-order glacier flow model used to estimate the relative contributions of sliding and internal deformation on dynamics. We find a significant increase in basal sliding rates between melt-seasons in the 1950s and those in the 1990s and 2010s and explore three process-based explanations for this anomalous behavior: (i) the glacier surface steepened over seven decades, maintaining flow-driving stresses despite sustained thinning; (ii) the formation of a proglacial lake after 1955 may support elevated basal water pressures; and (iii) subglacial topography may cause dynamic responses specific to Saskatchewan Glacier. Although further constraints are necessary to ascertain which processes are of greatest importance for Saskatchewan Glacier's dynamic evolution, this record provides a benchmark for studies of multi-decadal glacier dynamics.
Maintenance is an essential aspect to keeping production facilities running and safe. However, without an overview of the maintenance impact on production, gaining clarification of the impact of maintenance is difficult. This paper introduces modularization of maintenance based on the dimensions of maintenance: physical, action, and process. The approach is applied in a case study where maintenance decisions are improved and faster than prior to the introduction of the modularized maintenance.
This longitudinal study examined the influence of child-specific and environmental factors on the development of English receptive vocabulary and grammar by two groups of Danish children: Early Starters (ES) and Late Starters (LS). Age of onset, gender, language aptitude and SES significantly predicted both outcome measures. English competence beliefs (ECB) were positively related to L2 proficiency but only for children with low foreign language classroom anxiety (FLCA), suggesting a dynamic relationship between ECB and FLCA. Extramural audiovisual viewing and reading played a differential role for ES vs. LS whereas extramural English speaking significantly interacted with gender. Finally, child-specific factors explained more of the variance in English proficiency than environmental factors. This finding, which contradicts results obtained in instructed settings (e.g., Sun, Steinkrauss, Tendeiro & de Bot, 2016) but parallels those in naturalistic settings (e.g., Paradis, 2011), supports the special status of English in countries with a high degree of informal contact with English.
The impact of nutrition information on public health is partly determined by the population's level of nutrition literacy (NL), which involves functional NL (such as knowledge of dietary guidelines) and critical NL (such as the ability to distinguish between evidence-based nutrition information and alternative facts). The aim of this cross-sectional study was to describe aspects of functional and critical NL and predictors of NL scores among university students and employees. We recruited at different university campuses, 414 students and 112 employees, of which 80 % were females and 69 % were in the ages of 18–30 years. In total, 82 % reported knowledge about where to find information on nutrition issues, and 70 % were familiar with Norwegian dietary guidelines. Being female, having higher age, being highly physically active and studying or working within health sciences were significant predictors of higher levels of functional nutrition knowledge. Significantly more women than men found it difficult to judge if media information on nutritional issues could be trusted (69 v. 54 %) and found it hard to distinguish between scientific and non-scientific information about diet (60 v. 42 %). Our findings indicate that for a sample of university students and employees, affiliation with health sciences, being female, having a higher age and being physically active were associated with higher functional NL. Women did, however, seem to have lower levels of some aspects of critical NL, e.g. how to critically judge nutrition information. A more thorough assessment of NL in university students and employees should therefore be conducted.
In this study, we examined the relationship between polygenic liability for depression and number of stressful life events (SLEs) as risk factors for early-onset depression treated in inpatient, outpatient or emergency room settings at psychiatric hospitals in Denmark.
Methods
Data were drawn from the iPSYCH2012 case-cohort sample, a population-based sample of individuals born in Denmark between 1981 and 2005. The sample included 18 532 individuals who were diagnosed with depression by a psychiatrist by age 31 years, and a comparison group of 20 184 individuals. Information on SLEs was obtained from nationwide registers and operationalized as a time-varying count variable. Hazard ratios and cumulative incidence rates were estimated using Cox regressions.
Results
Risk for depression increased by 35% with each standard deviation increase in polygenic liability (p < 0.0001), and 36% (p < 0.0001) with each additional SLE. There was a small interaction between polygenic liability and SLEs (β = −0.04, p = 0.0009). The probability of being diagnosed with depression in a hospital-based setting between ages 15 and 31 years ranged from 1.5% among males in the lowest quartile of polygenic liability with 0 events by age 15, to 18.8% among females in the highest quartile of polygenic liability with 4+ events by age 15.
Conclusions
These findings suggest that although there is minimal interaction between polygenic liability and SLEs as risk factors for hospital-treated depression, combining information on these two important risk factors could potentially be useful for identifying high-risk individuals.
Intake of vegetables is recommended for the prevention of myocardial infarction (MI). However, vegetables make up a heterogeneous group, and subgroups of vegetables may be differentially associated with MI. The aim of this study was to examine replacement of potatoes with other vegetables or subgroups of other vegetables and the risk of MI. Substitutions between subgroups of other vegetables and risk of MI were also investigated. We followed 29 142 women and 26 029 men aged 50–64 years in the Danish Diet, Cancer and Health cohort. Diet was assessed at baseline by using a detailed validated FFQ. Hazard ratios (HR) with 95 % CI for the incidence of MI were calculated using Cox proportional hazards regression. During 13·6 years of follow-up, 656 female and 1694 male cases were identified. Among women, the adjusted HR for MI was 1·02 (95 % CI 0·93, 1·13) per 500 g/week replacement of potatoes with other vegetables. For vegetable subgroups, the HR was 0·93 (95 % CI 0·77, 1·13) for replacement of potatoes with fruiting vegetables and 0·91 (95 % CI 0·77, 1·07) for replacement of potatoes with other root vegetables. A higher intake of cabbage replacing other vegetable subgroups was associated with a statistically non-significant higher risk of MI. A similar pattern of associations was found when intake was expressed in kcal/week. Among men, the pattern of associations was overall found to be similar to that for women. This study supports food-based dietary guidelines recommending to consume a variety of vegetables from all subgroups.
To investigate how individuals with a history of affective disorder use and perceive their use of social media and online dating.
Methods:
A questionnaire focusing on affective disorders and the use of social media and online dating was handed out to outpatients from unipolar depression and bipolar disorder clinics and general practice patients with or without a history of affective disorders (latter as controls). The association between affective disorders and use of social media and online dating was analysed using linear/logistic regression.
Results:
A total of 194 individuals with a history of unipolar depression, 124 individuals with a history of bipolar disorder and 196 controls were included in the analysis. Having a history of unipolar depression or bipolar disorder was not associated with the time spent on social media compared with controls. Using the controls as reference, having a history bipolar disorder was associated with use of online dating (adjusted odds ratio: 2.2 (95% CI: 1.3; 3.7)). The use of social media and online dating had a mood-congruent pattern with decreased and more passive use during depressive episodes, and increased and more active use during hypomanic/manic episodes. Among the respondents with a history of affective disorder, 51% reported that social media use had an aggravating effect on symptoms during mood episodes, while 10% reported a beneficial effect. For online dating, the equivalent proportions were 49% (aggravation) and 20% (benefit), respectively.
Conclusion:
The use of social media and online dating seems related to symptom deterioration among individuals with affective disorder.
Replacing intake of SFA with PUFA reduces serum cholesterol levels and CVD risk. The effect on glycaemic regulation is, however, less clear. The main objective of the present study was to investigate the short-term effect of replacing dietary SFA with PUFA on glycaemic regulation. Seventeen healthy, normal-weight participants completed a 25-d double-blind, randomised and controlled two-period crossover study. Participants were allocated to either interventions with PUFA products or SFA products (control) in a random order for three consecutive days, separated by a 1·5-week washout period between the intervention periods. Glucose, insulin and TAG were measured before and after an oral glucose tolerance test. In addition, fasting total cholesterol, NEFA and plasma total fatty acid profile were measured before and after the 3-d interventions. Fasting and postprandial glucose, insulin, and TAG levels and fasting levels of NEFA and plasma fatty acid profile did not differ between the groups. However, replacing dietary SFA with PUFA significantly reduced total cholesterol levels by 8 % after 3 d (P = 0·002). Replacing dietary SFA with PUFA for only 3 d has beneficial cardio-metabolic effects by reducing cholesterol levels in healthy individuals.
The challenge of user requirements for maintenance scheduling design in large asset-intensive industries suffers from lack of academic and empirical studies. Therefore, using a representative case study, this paper aims to: (1) identify the current practices and complex scheduling requirements; (2) propose a design support tool to optimize the maintenance scheduling process; and (3) report the gained benefits. The results reveal that the proposed tool can decrease the resource requirements, increase the capacity utilization, and reduce the cost while addressing the complex user requirements.
It is important to be able to compare and evaluate different solutions early in development. This paper proposes a method for structuring historical data into a data model that can support the evaluation of new design concepts. The data is contextualized by linking it to a hierarchical decomposition of existing products. Two case studies were conducted to evaluate the value of using historical data when evaluating new concepts. The cases confirm that the proposed method is useful for evaluation of new concepts.
Introduction: Epidemiologic and modeling studies suggest that between 45 and 70% of individuals with chronic hepatitis C virus (HCV) infection in Canada remain undiagnosed. The Canadian Association for the Study of the Liver (CASL) recommends one-time screening of baby boomers (1945-1975). Screening programs in the US have shown a very high prevalence of previously undiagnosed HCV among patients seen in the emergency department (ED). We sought to assess the feasibility of implementing a targeted birth-cohort HCV screening program in a Canadian ED setting. Methods: Patients born from 1945 to 1975 presenting to the ED of a downtown Toronto hospital were offered HCV testing. Patients with life-threatening conditions, unable to provide verbal consent in English or intoxication were excluded. Blood samples were collected by finger prick on Dried Blood Spot (DBS) collection cards and tested for anti-HCV antibody with reflex to HCV RNA. Patients with positive HCV RNA were referred to a liver specialist. Results: During a 27-month period (July 2017 - Sept 2019), 8363 patients in the birth cohort presented to the ED during daytime hours. 80% (6714) met eligibility criteria, and 48.4% (3247) were offered testing. Screening was performed by non-medical staff (mean 8/day, median spots on DBS 4). 345 (10.6%) had been previously tested, and 639 (19.7%) declined. 2136 (65.8%) patients underwent testing: median age 58.4 years (40-82), 1117 male (52.3%). Of these, 45 patients (2.1%; 95% CI 1.5%-2.7%) were anti-HCV positive: 32 (76.2%) were HCV RNA positive, 10 (23.8%) negative and 3 not done due to inadequate DBS sample. 26 patients (81.3%) were linked to care and 3 (9.4%) lost to follow-up. HCV prevalence in the ED was significantly higher than the general Canadian population (2.1% vs 0.7%; p < 0.0001) but much lower than reported rates in American EDs (2.1% vs 10.3%; p < 0.0001). Conclusion: Acceptance of HCV screening in the ED birth cohort was high and easily performed using DBS to ensure the majority of positive samples were tested for HCV RNA. Challenges included implementation that limited number of people tested, and linkage to care for HCV positive patients. HCV prevalence among this ED birth cohort was higher than the general population but lower than seen in the ED in the US. This may in part be due to exclusion of individuals with more severe medical issues, refusal by higher risk subgroups, or population and healthcare system differences between countries.
On 30 September 2017, an Air France Airbus A380-800 suffered a failure of its fourth engine while over Greenland. This failure resulted in the loss of the engine fan hub, fan blades and surrounding structure. An initial search recovered 30 pieces of light debris, but the primary part of interest, a ~220 kg titanium fan hub, was not recovered because it had a different fall trajectory than the light debris, impacted into the ice-sheet's snow surface, and was quickly covered by drifting snow. Here we describe the methods used for the detection of the fan hub and details of the field campaigns. The search area included two crevasse fields of at least 50 snow-covered crevasses 1 to ~30 m wide with similar snow bridge thicknesses. After 21 months and six campaigns, using airborne synthetic aperture radar, ground-penetrating radar, transient electromagnetics and an autonomous vehicle to survey the crevasse fields, the fan hub was found within ~1 m of a crevasse at a depth of ~3.3 to 4 m and was excavated with shovels, chain saws, an electric winch, sleds and a gasoline heater, by workers using fall-arrest systems.
In the mink industry, feed costs are the largest variable expense and breeding for feed efficient animals is warranted. Implementation of selection for feed efficiency must consider the relationships between feed efficiency and the current selection traits BW and litter size. Often, feed intake (FI) is recorded on a cage with a male and a female and there is sexual dimorphism that needs to be accounted for. Study aims were to (1) model group recorded FI accounting for sexual dimorphism, (2) derive genetic residual feed intake (RFI) as a measure of feed efficiency, (3) examine the relationship between feed efficiency and BW in males (BWM) and females (BWF) and litter size at day 21 after whelping (LS21) in Danish brown mink and (4) investigate direct and correlated response to selection on each trait of interest. Feed intake records from 9574 cages, BW records on 16 782 males and 16 875 females and LS21 records on 6446 yearling females were used for analysis. Genetic parameters for FI, BWM, BWF and LS21 were obtained using a multivariate animal model, yielding sex-specific additive genetic variances for FI and BW to account for sexual dimorphism. The analysis was performed in a Bayesian setting using Gibbs sampling, and genetic RFI was obtained from the conditional distribution of FI given BW using genetic regression coefficients. Responses to single trait selection were defined as the posterior distribution of genetic superiority of the top 10% of animals after conditioning on the genetic trends. The heritabilities ranged from 0.13 for RFI in females and LS21 to 0.59 for BWF. Genetic correlations between BW in both sexes and LS21 and FI in both sexes were unfavorable, and single trait selection on BW in either sex showed increased FI in both sexes and reduced litter size. Due to the definition of RFI and high genetic correlation between BWM and BWF, selection on RFI did not significantly alter BW. In addition, selection on RFI in either sex did not affect LS21. Genetic correlation between sexes for FI and BW was high but significantly lower than unity. The high correlations across sex allowed for selection on standardized averages of animals’ breeding values (BVs) for RFI, FI and BW, which yielded selection responses approximately equal to the responses obtained using the sex-specific BVs. The results illustrate the possibility of selecting against RFI in mink with no negative effects on BW and litter size.