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The Scientific Advisory Committee on Nutrition (SACN) provides independent advice on nutrition and related health matters to UK government organisations. In keeping with its commitment to openness and transparency, SACN follows a set ‘Framework’ to ensure a prescribed and consistent approach is taken in all its evidence evaluations. Following an update of the SACN Framework in 2020, which addressed some straightforward issues, the SACN Framework subgroup was established in 2021 to consider more complex matters that were not addressed in the 2020 update. The SACN Framework subgroup considered 4 main topics for update: 1) the different types of evidence evaluations produced by SACN, 2) interpretation of statistical data, 3) tools for assessment of study quality, 4) tools to assess the certainty of a body of evidence for exposure-outcome relationships. The Framework subgroup agreed clear definitions and processes for the different types of evidence evaluations produced by SACN and agreed that interpretation of p values should be informed by consideration of study size, power and methodological quality. The subgroup recommended use of the AMSTAR 2 tool for quality assessment of evidence from systematic reviews and use of the GRADE approach to assess the certainty of evidence. The updated Framework was published in January 2023. This was followed by publication of a further update in October 2024. As a ‘living’ document, the Framework will be subject to regular review by the Framework subgroup and continue to evolve in line with best practice.
We provide an assessment of the Infinity Two fusion pilot plant (FPP) baseline plasma physics design. Infinity Two is a four-field period, aspect ratio $A = 10$, quasi-isodynamic stellarator with improved confinement appealing to a max-$J$ approach, elevated plasma density and high magnetic fields ($ \langle B\rangle = 9$ T). Here $J$ denotes the second adiabatic invariant. At the envisioned operating point ($800$ MW deuterium-tritium (DT) fusion), the configuration has robust magnetic surfaces based on magnetohydrodynamic (MHD) equilibrium calculations and is stable to both local and global MHD instabilities. The configuration has excellent confinement properties with small neoclassical transport and low bootstrap current ($|I_{bootstrap}| \sim 2$ kA). Calculations of collisional alpha-particle confinement in a DT FPP scenario show small energy losses to the first wall (${\lt}1.5 \,\%$) and stable energetic particle/Alfvén eigenmodes at high ion density. Low turbulent transport is produced using a combination of density profile control consistent with pellet fueling and reduced stiffness to turbulent transport via three-dimensional shaping. Transport simulations with the T3D-GX-SFINCS code suite with self-consistent turbulent and neoclassical transport predict that the DT fusion power$P_{{fus}}=800$ MW operating point is attainable with high fusion gain ($Q=40$) at volume-averaged electron densities $n_e\approx 2 \times 10^{20}$ m$^{-3}$, below the Sudo density limit. Additional transport calculations show that an ignited ($Q=\infty$) solution is available at slightly higher density ($2.2 \times 10^{20}$ m$^{-3}$) with $P_{{fus}}=1.5$ GW. The magnetic configuration is defined by a magnetic coil set with sufficient room for an island divertor, shielding and blanket solutions with tritium breeding ratios (TBR) above unity. An optimistic estimate for the gas-cooled solid breeder designed helium-cooled pebble bed is TBR $\sim 1.3$. Infinity Two satisfies the physics requirements of a stellarator fusion pilot plant.
Transport characteristics and predicted confinement are shown for the Infinity Two fusion pilot plant baseline plasma physics design, a high field stellarator concept developed using modern optimization techniques. Transport predictions are made using high-fidelity nonlinear gyrokinetic turbulence simulations along with drift kinetic neoclassical simulations. A pellet-fuelled scenario is proposed that enables supporting an edge density gradient to substantially reduce ion temperature gradient turbulence. Trapped electron mode turbulence is minimized through the quasi-isodynamic configuration that has been optimized with maximum-J. A baseline operating point with deuterium–tritium fusion power of $P_{{fus,DT}}=800$ MW with high fusion gain $Q_{{fus}}=40$ is demonstrated, respecting the Sudo density limit and magnetohydrodynamic stability limits. Additional higher power operating points are also predicted, including a fully ignited ($Q_{{fus}}=\infty$) case with $P_{{fus,DT}}=1.5$ GW. Pellet ablation calculations indicate it is plausible to fuel and sustain the desired density profile. Impurity transport calculations indicate that turbulent fluxes dominate neoclassical fluxes deep into the core, and it is predicted that impurity peaking will be smaller than assumed in the transport simulations. A path to access the large radiation fraction needed to satisfy exhaust requirements while sustaining core performance is also discussed.
The selection, design and optimization of a suitable blanket configuration for an advanced high-field stellarator concept is seen as a key feasibility issue and has been incorporated as a vital and necessary part of the Infinity Two fusion pilot plant physics basis. The focus of this work was to identify a baseline blanket which can be rapidly deployed for Infinity Two while also maintaining flexibility and opportunities for higher performing concepts later in development. Results from this analysis indicate that gas-cooled solid breeder designs such as the helium-cooled pebble bed (HCPB) are the most promising concepts, primarily motivated by the neutronics performance at applicable blanket build depths, and the relatively mature technology basis. The lithium lead (PbLi) family of concepts, particularly the dual-cooled lithium lead, offer a compelling alternative to solid blanket concepts as they have synergistic developmental pathways while simultaneously mitigating much of the technical risk of those designs. Homogenized three-dimensional neutronics analysis of the Infinity Two configuration indicates that the HCPB achieves an adequate tritium breeding ratio (TBR) (1.30 which enables sufficient margin at low engineering fidelity), and near appropriate shielding of the magnets (average fast fluence of 1.3 ${\times}$ 10$^{18}$ n cm$^{-2}$ per full-power year). The thermal analysis indicates that reasonably high thermal efficiencies (greater than 30 %) are readily achievable with the HCPB paired with a simple Rankine cycle using reheat. Finally, the tritium fuel cycle analysis for Infinity Two shows viability, with anticipated operational inventories of less than one kilogram (approximately 675 g) and a required TBR (TBR$_{\textrm {req}}$) of less than 1.05 to maintain fuel self-sufficiency (approximately 1.023 for a driver blanket with no inventory doubling). Although further optimization and engineering design are still required, at the physics basis stage all initial targets have been met for the Infinity Two configuration.
This study aimed to explore the genetic variability present in tamarind fruits. A survey and collection of twenty-nine tamarind accessions from the Bastar region of Chhattisgarh was conducted, focusing on morphological traits, biochemical properties, and mineral content. The analysis revealed significant variation in fruit characteristics, including pod weight (91.1–528.3 g), pod length (4.11–15.39 cm), pulp weight (32.88–275.68 g), number of seeds (26–237), seed weight (23.14–214.08 g), pulp percentage (26.43–52.18%), vitamin C content (54.5–92 mg/100 g), phenolic content (51.53–296.4 mg GAE/g fw), flavonoid content (75.91–280.88 mg QE/ 100 g fw), acidity (5.3–12.60%), reducing sugars (24.67–68.29%), total sugars (24.89–78.87%), calcium (0.15–1.28%), and iron content (26.6–125.7 ppm) across different accessions. Based on the overall evaluation, five accessions B21, B26, B15, B25, and B7 with the best combination of desirable fruit traits, were identified as the most promising. Additionally, five sweet accessions with acidity levels below 6% were identified (B26, B21, B15, B12, B11). Principal component analysis (PCA) was applied, identifying five principal components that accounted for 86.73% of the total variability. Correlation analysis showed a significant positive relationship between pod weight and pulp weight (r = 0.93), shell weight (r = 0.70), number of seeds (r = 0.89), and seed weight (r = 0.89). The biplot of PC1 and PC2 illustrated the distribution of accessions across all four quadrants, with B27, B8, B26, B29, B14, B18, and B13 displaying distinct differences from one another.
Direct numerical simulations of the turbulence of a Herschel–Bulkley (HB) fluid in a rough channel are performed at a shear Reynolds number $Re_{\tau } \approx 300$ and a Bingham number ${Bn} \approx 0.9$. For the type of rough surface used in this study, the results indicate that Townsend's wall similarity hypothesis also holds for HB fluids. However, there are notable differences compared with the effect of roughness on Newtonian fluids. More specifically, the effect of roughness appears to be slightly stronger for HB fluids, in the sense that the bulk Reynolds number, based on the viscosity at the wall, is reduced further due to the increase in viscosity in the troughs of the roughness surface induced by the low shear. At the same time, for the simulated rough surface, the contribution of form drag to the total pressure drop is reduced from 1/4 to about 1/5 due to the persistence of viscous shear in the boundary layer, reducing its shielding effect. As for the friction factor, due to the nonlinearity of the HB constitutive relation, its use with the wall shear rate from the mean wall shear stress underpredicts the minimum viscosity at the wall by up to 18 %. This inevitably leads to uncertainties in the prediction of the friction factor. Finally, it is observed that the rough surface is unable to break the peculiar near-wall flow structure of HB fluids, which consists of long persistent low-speed streaks occupying the entire domain. This means that the small-scale energy is significantly reduced for HB fluids, even in rough channels, with the energy more concentrated in the lower wavenumber range, implying an increase in the slope of the power spectrum to $-7/2$ in the inertial range, as shown by Mitishita et al. (J. Non-Newtonian Fluid Mech., vol. 293, 2021, 104570).
Mental health apps (MHAs) are increasingly popular in India due to rising mental health awareness and app accessibility. Despite their benefits, like mood tracking, sleep tools and virtual therapy, MHAs lack regulatory oversight. India's framework, including the Central Drugs Standard Control Organization (CDSCO) and Medical Device Rules 2017, does not cover standalone health apps, raising concerns about data privacy and accuracy. Establishing a centralised regulatory body with guidelines for MHAs is essential for user safety and efficacy. This paper examines the current regulatory landscape, compares international approaches and proposes a tiered regulatory framework to foster responsible innovation while safeguarding user interests in digital mental health services.
Twelve lacustrine sediment samples from a relict lake in the Kalla Glacier valley were co-dated using AMS radiocarbon (14C) and infrared stimulated luminescence (IRSL) dating methods. In general, the radiocarbon ages of bulk organic matter were older by a minimum of 1500 years compared to (age depth) modeled luminescence ages after fading corrections. This is observed for the first time in the lake sediments of High Himalayan Crystalline zone. A combination of lipid n-alkane data, Raman spectra and geochemical proxies suggested that this was due to ancient organic carbon (OCancient) that is a mixture of pre-aged (OCpre-aged) and petrogenic (OCpetro) organic carbon within older glacial moraine debris that served as sediment source to the lake. Raman spectra suggest the presence of moderate to highly graphitized OCpetro in all the profile samples. The OCpetro contributed 0.064 ± 0.032% to the sediment and the lake stored 2.5 ± 0.7 Gg OCpetro at variable rates during the last 16 kyr, with the mean burial flux 160 kg OCpetro yr−1. This study implies (1) employing another independent dating method in addition to radiocarbon method using bulk sediment organic matter, if the carbon content is low, to observe any discrepancy, and (2) a need to investigate on the fate of OCpetro as many such small lakes become relict in this region.
Background: Duchenne muscular dystrophy (DMD) is caused by DMD gene mutations. Delandistrogene moxeparvovec is an investigational gene transfer therapy, developed to address the underlying cause of DMD. We report findings from Part 1 (52 weeks) of the two-part EMBARK trial (NCT05096221). Methods: Key inclusion criteria: Ambulatory patients aged ≥4-<8 years with a confirmed DMD mutation within exons 18–79 (inclusive); North Star Ambulatory Assessment (NSAA) score >16 and <29 at screening. Eligible patients were randomized 1:1 to intravenous delandistrogene moxeparvovec (1.33×1014 vg/kg) or placebo. The primary endpoint was change from baseline in NSAA total score to Week 52. Results: At Week 52 (n=125), the primary endpoint did not reach statistical significance, although there was a nominal difference in change from baseline in NSAA total score in the delandistrogene moxeparvovec (2.6, n=63) versus placebo groups (1.9, n=61). Key secondary endpoints (time to rise, micro-dystrophin expression, 10-meter walk/run) demonstrated treatment benefit in both age groups (4-5 and 6-7 years; p<0.05).There were no new safety signals, reinforcing the favorable and manageable safety profile observed to date. Conclusions: Based on the totality of functional assessments including the timed function tests, treatment with delandistrogene moxeparvovec indicates beneficial modification of disease trajectory.
To estimate the effect of income change on difficulty accessing food since the COVID-19 pandemic for South African youth and evaluate whether this effect was modified by receiving social grants.
Design:
A cross-sectional, online survey was conducted between December 2021 and May 2022. Primary outcome was increased difficulty accessing food since the COVID-19 pandemic. Income change was categorised as ‘Decreased a lot’, ‘Decreased slightly’ and ‘Unchanged or increased’. Multivariable logistic regressions were used, with an interaction term between social grant receipt and income change.
Setting:
eThekwini district, South Africa.
Participants:
Youth aged 16–24 years.
Results:
Among 1,620 participants, median age was 22 years (IQR 19–24); 861 (53 %) were women; 476 (29 %) reported increased difficulty accessing food; 297 (18 %) reported that income decreased a lot, of whom 149 (50 %) did not receive social grants. Experiencing a large income decrease was highly associated with increased difficulty accessing food during the COVID-19 pandemic (adjusted OR [aOR] 3·63, 95 % CI 2·70, 4·88). The aOR for the effect of a large income decrease on difficulty accessing food, compared to no income change, were 1·49 (95 % CI 0·98, 2·28) among participants receiving social grants, and 6·63 (95 % CI 4·39, 9·99) among participants not receiving social grants.
Conclusions:
While social grant support made a great difference in lowering the effect of income decrease on difficulty accessing food, it was insufficient to fully protect youth from those difficulties. In post-pandemic recovery efforts, there is a critical need to support youth through economic empowerment programming and food schemes.
This contribution focuses on the abatement with hydrogen of CO2 and non-CO2 emissions. It is agenda-setting in two respects. Firstly, it challenges the globally accepted hydrocarbon sustainable aviation fuel (SAF) pathway to sustainability and recommends that our industry accelerates along the hydrogen pathway to ‘green’ aviation. Secondly, it reports a philosophical and analytical investigation of appropriate accuracy on abatement strategies for nitrogen oxides and contrails of large hydrogen airliners. For the second contribution, a comparison is made of nitrogen oxide emissions and contrail avoidance options of two hydrogen airliners and a conventional airliner of similar passenger capacity. The hydrogen aircraft are representative of the first and second innovation waves where the main difference is the weight of the hydrogen tanks. Flights of 1000, 2000, 4000 and 8000 nautical miles are explored. Cranfield’s state of the art simulators for propulsion system integration and gas turbine performance (Orion and Turbomatch) were used for this. There are two primary contributions to knowledge. The first is a new set of questions to be asked of SAF and hydrogen decarbonising features. The second is the quantification of the benefits from hydrogen on non-CO2 emissions. For the second generation of long-range hydrogen-fuelled aircraft having gas turbine propulsion, lighter tanks (needing less thrust and lower gas temperatures) are anticipated to reduce NOx emissions by over 20%; in the case of contrails, the preliminary findings indicate that regardless of the fuel, contrails could largely be avoided with fuel-burn penalties of a few per cent. Mitigating action is only needed for a small fraction of flights. For conventional aircraft this penalty results in more CO2, while for hydrogen aircraft the additional emission is water vapour. The conclusion is that our research community should continue to consider hydrogen as the key ‘greening’ option for aviation, notwithstanding the very significant costs of transition.
Epigenetic modifications, such as DNA methylation, are enzymatically regulated processes that directly impact gene expression patterns. In early life, they are central to developmental programming and have also been implicated in regulating inflammatory responses. Research into the role of epigenetics in neonatal health is limited, but there is a growing body of literature related to the role of DNA methylation patterns and diseases of prematurity, such as the intestinal disease necrotizing enterocolitis (NEC). NEC is a severe intestinal inflammatory disease, but the key factors that precede disease development remain to be determined. This knowledge gap has led to a failure to design effective targeted therapies and identify specific biomarkers of disease. Recent literature has identified altered DNA methylation patterns in the stool and intestinal tissue of neonates with NEC. These findings provide the foundation for a new avenue in NEC research. In this review, we will provide a general overview of DNA methylation and then specifically discuss the recent literature related to methylation patterns in neonates with NEC. We will also discuss how DNA methylation is used as a biomarker for other disease states and how, with further research, methylation patterns may serve as potential biomarkers for NEC.
A total of 108 diverse sorghum (Sorghum bicolor) accessions were characterized for quantitative and qualitative fodder-related traits and zonate leaf spot (ZLS) (Gloeocercospora sorghi) disease during two successive wet seasons of 2019 and 2020 in augmented randomized block design. The Shannon's diversity index and analysis of variance showed the existence of significant variability among qualitative and quantitative traits. K-mean clustering showed strong relationship between green fodder yield (GFY) and other yield-contributing traits. The dendrogram constructed based on morphological traits classified accessions into four diverse groups and most of genotype fall under cluster II. The principal component analysis bi-plot analysis showed a total variation of 68.96%, where GFY, stem weight per plant, panicle length and dry matter yield (DMY) contributed significantly. From the experimental results, three sorghum genotypes viz., IG-03-424, IG-01-436 and IG-03-438 were identified as promising for higher GFY (808.66 g/plant) and DMY (238.0 g/plant), respectively. Further, based on disease reactions under natural condition, five genotypes viz., EC-512397, EC512393, EC512394, EC512399 and IG-02-437 were identified as potential donor for resistance to ZLS disease. These selected lines could be used as promising sources for high biomass and disease resistance in forage sorghum breeding programme.
Tight focusing with very small f-numbers is necessary to achieve the highest at-focus irradiances. However, tight focusing imposes strong demands on precise target positioning in-focus to achieve the highest on-target irradiance. We describe several near-infrared, visible, ultraviolet and soft and hard X-ray diagnostics employed in a ∼1022 W/cm2 laser–plasma experiment. We used nearly 10 J total energy femtosecond laser pulses focused into an approximately 1.3-μm focal spot on 5–20 μm thick stainless-steel targets. We discuss the applicability of these diagnostics to determine the best in-focus target position with approximately 5 μm accuracy (i.e., around half of the short Rayleigh length) and show that several diagnostics (in particular, 3$\omega$ reflection and on-axis hard X-rays) can ensure this accuracy. We demonstrated target positioning within several micrometers from the focus, ensuring over 80% of the ideal peak laser intensity on-target. Our approach is relatively fast (it requires 10–20 laser shots) and does not rely on the coincidence of low-power and high-power focal planes.
Silcretes developed within the in situ regolith in the Barr Smith Range, Western Australia, were investigated using optical and electron-beam techniques. One of the cementing agents in these silcretes showed gel-like optical properties and had a variable aluminosilicate chemical composition at the scale of electron microprobe analysis so that it might be considered as allophane-like material. High resolution transmission electron microscopy demonstrated that the material consists of a fine-grained and poorly ordered kaolinite embedded in a matrix of amorphous silica.
Diagnostic stewardship seeks to improve ordering, collection, performance, and reporting of tests. Test results play an important role in reportable HAIs. The inclusion of HAIs in public reporting and pay for performance programs has highlighted the value of diagnostic stewardship as part of infection prevention initiatives. Inappropriate testing should be discouraged, and approaches that seek to alter testing solely to impact a reportable metric should be avoided. HAI definitions should be further adapted to new testing technologies, with focus on actionable and clinically relevant test results that will improve patient care.
We have employed the VULCAN laser facility to generate a laser plasma X-ray source for use in photoionization experiments. A nanosecond laser pulse with an intensity of order 1015 Wcm−2 was used to irradiate thin Ag or Sn foil targets coated onto a parylene substrate, and the L-shell emission in the 3.3–4.4 keV range was recorded for both the laser-irradiated and nonirradiated sides. Both the experimental and simulation results show higher laser to X-ray conversion yields for Ag compared with Sn, with our simulations indicating yields approximately a factor of two higher than those found in the experiments. Although detailed angular data were not available experimentally, the simulations indicate that the emission is quite isotropic on the laser-irradiated side but shows close to a cosine variation on the nonirradiated side of the target as seen experimentally in the previous work.
Electrothermal bipolar vessel sealing devices are electrosurgical devices that seal tissues and blood vessels up to 7 mm in diameter. This paper discusses our experience using electrothermal bipolar vessel sealing devices in transoral head and neck surgery.
Methods
Electrothermal bipolar vessel sealing devices were used in five patients with lesions of varying size and type within the pharyngo-larynx. These were treated transorally by the otolaryngology department at the Royal Adelaide Hospital. Either the Medtronic LigaSure or BiZact devices were used for transoral resection, debulking or division of these lesions.
Results
Electrothermal bipolar vessel sealing devices were considered helpful in four out of the five cases. Success was dependent on suitable transoral access. A single unsuccessful case reflected the LigaSure jaw's inability to engage a large tumour effectively.
Conclusion
Electrothermal bipolar vessel sealing devices can be safely deployed transorally to treat lesions of the upper aero-digestive tract in selected patients. Further studies investigating additional indications would broaden applications of this approach.
Adequate nutrition is necessary during childhood and early adolescence for adequate growth and development. Hence, the objective of the study was to assess the association between dietary intake and blood levels of minerals (calcium, iron, zinc, and selenium) and vitamins (folate, vitamin B12, vitamin A, and vitamin D) in urban school going children aged 6–16 years in India, in a multicentric cross-sectional study. Participants were enrolled from randomly selected schools in ten cities. Three-day food intake data was collected using a 24-h dietary recall method. The intake was dichotomised into adequate and inadequate. Blood samples were collected to assess levels of micronutrients. From April 2019 to February 2020, 2428 participants (50⋅2 % females) were recruited from 60 schools. Inadequate intake for calcium was in 93⋅4 % (246⋅5 ± 149⋅4 mg), iron 86⋅5 % (7⋅6 ± 3⋅0 mg), zinc 84⋅0 % (3⋅9 ± 2⋅4 mg), selenium 30⋅2 % (11⋅3 ± 9⋅7 mcg), folate 73⋅8 % (93⋅6 ± 55⋅4 mcg), vitamin B12 94⋅4 % (0⋅2 ± 0⋅4 mcg), vitamin A 96⋅0 % (101⋅7 ± 94⋅1 mcg), and vitamin D 100⋅0 % (0⋅4 ± 0⋅6 mcg). Controlling for sex and socioeconomic status, the odds of biochemical deficiency with inadequate intake for iron [AOR = 1⋅37 (95 % CI 1⋅07–1⋅76)], zinc [AOR = 5⋅14 (95 % CI 2⋅24–11⋅78)], selenium [AOR = 3⋅63 (95 % CI 2⋅70–4⋅89)], folate [AOR = 1⋅59 (95 % CI 1⋅25–2⋅03)], and vitamin B12 [AOR = 1⋅62 (95 %CI 1⋅07–2⋅45)]. Since there is a significant association between the inadequate intake and biochemical deficiencies of iron, zinc, selenium, folate, and vitamin B12, regular surveillance for adequacy of micronutrient intake must be undertaken to identify children at risk of deficiency, for timely intervention.