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Academic health sciences libraries (“libraries”) offer services that span the entire research lifecycle, positioning them as natural partners in advancing clinical and translational science. Many libraries enjoy active and productive collaborations with Clinical and Translational Science Award (CTSA) Program hubs and other translational initiatives like the IDeA Clinical & Translational Research Network. This article explores areas of potential partnership between libraries and Translational Science Hubs (TSH), highlighting areas where libraries can support the CTSA Program’s five functional areas outlined in the Notice of Funding Opportunity. It serves as a primer for TSH and libraries to explore potential collaborations, demonstrating how libraries can connect researchers to services and resources that support the information needs of TSH.
We identify a set of essential recent advances in climate change research with high policy relevance, across natural and social sciences: (1) looming inevitability and implications of overshooting the 1.5°C warming limit, (2) urgent need for a rapid and managed fossil fuel phase-out, (3) challenges for scaling carbon dioxide removal, (4) uncertainties regarding the future contribution of natural carbon sinks, (5) intertwinedness of the crises of biodiversity loss and climate change, (6) compound events, (7) mountain glacier loss, (8) human immobility in the face of climate risks, (9) adaptation justice, and (10) just transitions in food systems.
Technical summary
The Intergovernmental Panel on Climate Change Assessment Reports provides the scientific foundation for international climate negotiations and constitutes an unmatched resource for researchers. However, the assessment cycles take multiple years. As a contribution to cross- and interdisciplinary understanding of climate change across diverse research communities, we have streamlined an annual process to identify and synthesize significant research advances. We collected input from experts on various fields using an online questionnaire and prioritized a set of 10 key research insights with high policy relevance. This year, we focus on: (1) the looming overshoot of the 1.5°C warming limit, (2) the urgency of fossil fuel phase-out, (3) challenges to scale-up carbon dioxide removal, (4) uncertainties regarding future natural carbon sinks, (5) the need for joint governance of biodiversity loss and climate change, (6) advances in understanding compound events, (7) accelerated mountain glacier loss, (8) human immobility amidst climate risks, (9) adaptation justice, and (10) just transitions in food systems. We present a succinct account of these insights, reflect on their policy implications, and offer an integrated set of policy-relevant messages. This science synthesis and science communication effort is also the basis for a policy report contributing to elevate climate science every year in time for the United Nations Climate Change Conference.
Social media summary
We highlight recent and policy-relevant advances in climate change research – with input from more than 200 experts.
Skin and soft-tissue infections (SSTIs) account for 3% of all emergency department (ED) encounters and are frequently associated with inappropriate antibiotic prescribing. We characterized barriers and facilitators to optimal antibiotic use for SSTIs in the ED using a systems engineering framework and matched them with targeted stewardship interventions.
Design and participants:
We conducted semistructured interviews with a purposefully selected sample of emergency physicians.
Methods:
An interview guide was developed using the Systems Engineering Initiative for Patient Safety (SEIPS) framework. Interviews were recorded, transcribed, and analyzed iteratively until conceptual saturation was achieved. Themes were identified using deductive directed content analysis guided by the SEIPS model.
Results:
We conducted 20 interviews with physicians of varying experience and from different practice settings. Identified barriers to optimal antibiotic prescribing for SSTIs included poor access to follow-up (organization), need for definitive diagnostic tools (tools and technology) and fear over adverse outcomes related to missed infections (person). Identified potential interventions included programs to enhance follow-up care; diagnostic aides (eg, rapid MRSA assays for purulent infections and surface thermal imaging for cellulitis); and shared decision-making tools.
Conclusions:
Using a systems engineering informed qualitative approach, we successfully characterized barriers and developed targeted antibiotic stewardship interventions for SSTIs managed in the ED work system. The interventions span multiple components of the ED work system and should inform future efforts to improve antibiotic stewardship for SSTIs in this challenging care setting.
Depression, the most frequent and harmful mental disorder, has been associated with specific somatic diseases as the leading cause of death. The purposes of this prospective study were to predict incident chronic diseases based on baseline depressive symptoms and to test sex-dependent effects.
Methods
In a representative German community sample of over 12 000 participants, baseline depressive symptoms (assessed using the Patient Health Questionnaire-9) were tested as a predictor of new onset of cardiovascular disease (CVD), chronic obstructive lung disease, diabetes, cancer, and migraine at 5-year follow-up. To study disease incidence, we created subsamples for each chronic disease by excluding participants who already had the respective disease at baseline. Potential confounders were included in logistic regression models and sex-specific analyses were performed.
Results
Controlling for demographic characteristics and loneliness, in men and women, baseline depressive symptoms were predictive of CVD, chronic obstructive lung disease, diabetes, and migraine, but not of cancer. When we additionally adjusted for metabolic and lifestyle risk factors, there was an 8% increase of chronic obstructive lung disease and migraine per point of depressive symptoms. There was a trend for CVD (4%; p = 0.053). Sex-sensitive analyses revealed trends for the relevance of depressive symptoms for CVD in men (p = 0.065), and for diabetes in women (p = 0.077).
Conclusions
These findings underscore the need to implement screening for depression in the treatment of major somatic illnesses. At the same time, depressed patients should be screened for metabolic and lifestyle risk factors and for somatic diseases and offered lifestyle interventions.
This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.
The analysis of the geographical distribution of hospital cases is obviously important for the purpose of planning hospital services, but it is of even greater significance in the planning of psychiatric services. This concern motivated our seven-year-long study, which examined hospitalization risks among various categories of psychiatric disorders in the major German city of Hamburg. Our database encompassed 77% (n = 64,000) of all psychiatric admissions in a total of 41 hospitals, most of which are general hospitals. In order to carry out the geographical analysis we employed a new statistical method based on a mixture distribution model. According to our findings, the strongest indications of an increased frequency were among male cases of schizophrenia, drug abuse and organic psychoses, and female cases of neurotic disorders, personality disorders, drug abuse and schizophrenia. We found that some areas are exposed to a risk of hospitalization for these diagnostic categories which is more than 50% above the reference. Contrary to other authors we did not identify an increased frequency of admission concentrated in the inner-city area for any of the diagnostic groups. The risk of hospitalization for schizophrenics was almost entirely associated with the close proximity of psychiatric units, while the risks for neuroses and personality disorders, as well as alcohol and drug abuse, appeared to be concentrated in areas of low social status. However, a statistically relevant correlation between an increased risk of hospitalization and low social status could be determined only for drug abuse and alcoholism. In the end, we did identify two areas in which there was an increased risk of hospitalization for several diagnostic groups, and this information will undoubtedly facilitate the planning of hospital and psychiatric services. The fact that our findings deviate to some extent from other authors – especially with respect to neuroses and personality disorders, but also to addiction – can be attributed to the inclusion of psychiatric cases from general hospitals in our geographic analysis.
The commercially available collar device MooMonitor+ was evaluated with regards to accuracy and application potential for measuring grazing behavior. These automated measurements are crucial as cows feed intake behavior at pasture is an important parameter of animal performance, health and welfare as well as being an indicator of feed availability. Compared to laborious and time-consuming visual observation, the continuous and automated measurement of grazing behavior may support and improve the grazing management of dairy cows on pasture. Therefore, there were two experiments as well as a literature analysis conducted to evaluate the MooMonitor+ under grazing conditions. The first experiment compared the automated measurement of the sensor against visual observation. In a second experiment, the MooMonitor+ was compared to a noseband sensor (RumiWatch), which also allows continuous measurement of grazing behavior. The first experiment on n = 12 cows revealed that the automated sensor MooMonitor+ and visual observation were highly correlated as indicated by the Spearman’s rank correlation coefficient (rs) = 0.94 and concordance correlation coefficient (CCC) = 0.97 for grazing time. An rs-value of 0.97 and CCC = 0.98 was observed for rumination time. In a second experiment with n = 12 cows over 24-h periods, a high correlation between the MooMonitor+ and the RumiWatch was observed for grazing time as indicated by an rs-value of 0.91 and a CCC-value of 0.97. Similarly, a high correlation was observed for rumination time with an rs-value of 0.96 and a CCC-value of 0.99. While a higher level of agreement between the MooMonitor+ and both visual observation and RumiWatch was observed for rumination time compared to grazing time, the overall results showed a high level of accuracy of the collar device in measuring grazing and rumination times. Therefore, the collar device can be applied to monitor cow behavior at pasture on farms. With regards to the application potential of the collar device, it may not only be used on commercial farms but can also be applied to research questions when a data resolution of 15 min is sufficient. Thus, at farm level, the farmer can get an accurate and continuous measurement of grazing behavior of each individual cow and may then use those data for decision-making to optimize the animal management.
Precision technologies and data have had relatively modest impacts in grass-based livestock ruminant production systems compared with other agricultural sectors such as arable. Precision technologies promise increased efficiency, reduced environmental impact, improved animal health, welfare and product quality. The benefits of precision technologies have, however, been relatively slow to be realised on pasture based farms. Though there is significant overlap with indoor systems, implementing technology in grass-based dairying brings unique opportunities and challenges. The large areas animals roam and graze in pasture based systems and the associated connectivity challenges may, in part at least, explain the comparatively lower adoption of such technologies in pasture based systems. With the exception of sensor and Bluetooth-enabled plate metres, there are thus few technologies designed specifically to increase pasture utilisation. Terrestrial and satellite-based spectral analysis of pasture biomass and quality is still in the development phase. One of the key drivers of efficiency in pasture based systems has thus only been marginally impacted by precision technologies. In contrast, technological development in the area of fertility and heat detection has been significant and offers significant potential value to dairy farmers, including those in pasture based systems. A past review of sensors in health management for dairy farms concluded that although the collection of accurate data was generally achieved, the processing, integration and presentation of the resulting information and decision-support applications were inadequate. These technologies’ value to farming systems is thus unclear. As a result, it is not certain that farm management is being sufficiently improved to justify widespread adoption of precision technologies currently. We argue for a user need-driven development of technologies and for a focus on how outputs arising from precision technologies and associated decision support applications are delivered to users to maximise their value. Further cost/benefit analysis is required to determine the efficacy of investing in specific precision technologies, potentially taking account of several yet to ascertained farm specific variables.
This Research Communication describes an investigation of the nutritional depletion of total mixed rations (TMR) by pest birds. We hypothesized that species-specific bird depredation of TMR can alter the nutritional composition of the ration and that these changes can negatively impact the performance of dairy cows. Blackbirds selected the high energy fraction of the TMR (i.e., flaked corn) and reduced starch, crude fat and total digestible nutrients during controlled feeding experiments. For Holsteins producing 37·1 kg of milk/d, dairy production modeling illustrated that total required net energy intake (NEI) was 35·8 Mcal/d. For the reference TMR unexposed to blackbirds and the blackbird-consumed TMR, NEI supplied was 41·2 and 37·8 Mcal/d, and the resulting energy balance was 5·4 and 2·0 Mcal/d, respectively. Thus, Holsteins fed the reference and blackbird-consumed TMR were estimated to gain one body condition score in 96 and 254 d, and experience daily weight change due to reserves of 1·1 and 0·4 kg/d, respectively. We discuss these results in context of an integrated pest management program for mitigating the depredation caused by pest birds at commercial dairies.
Fast computers enable the solution of quantum many-body problems by Monte Carlo methods. As computing power increased dramatically over the years, similarly impressive advances occurred at the level of the algorithms, so that we are now in a position to perform accurate simulations of large systems of interacting quantum spins, Bosons, and (to a lesser extent) Fermions. The purpose of this book is to present and explain the quantum Monte Carlo algorithms being used today to simulate the ground states and thermodynamic equilibrium states of quantum models defined on a lattice. Our intent is not to review all relevant algorithms – there are too many variants to do so comprehensively – but rather to focus on a core set of important algorithms, explaining what they are and how and why they work.
Our focus on lattice models, such as Heisenberg and Hubbard models, has at least two implications. The first is obviously that we are not considering models in the continuum where extensive use of quantum Monte Carlo methods traditionally has focused on producing highly accurate ab initio calculations of the ground states of nuclei, atoms, molecules, and solids. Quantum Monte Carlo algorithms for simulating the ground states of continuum and lattice models, however, are very similar. In fact, the lattice algorithms are in many cases derived from the continuum methods. With fewer degrees of freedom, lattice models are compact and insightful representations of the physics in the continuum.
The second implication is a focus on both zero and finite temperature algorithms. On a lattice, it is natural to study phase transitions. In particular, the recent dramatic advances in quantum Monte Carlo lattice methods for the simulation of quantum spin models were prompted by a need for more efficient and effective ways to study finite-temperature transitions. While quantum Monte Carlo is profitably used to study zero temperature phase transitions (quantum critical phenomena), some ground state algorithms have no finite temperature analogs and vice versa. In many respects, the lattice is where the current algorithmic action is.
The book is divided into four parts. The first part is a self-contained, more advanced than average, discussion of the Monte Carlo method, its use, and its foundations.
Childhood maltreatment (CM) has consistently been linked with adverse outcomes including substance use disorders and adult sexual revictimization. Adult sexual victimization itself has been linked with psychopathology but has predominately been studied in women. The current investigation examines the impact of CM and co-occurring psychopathology on adult sexual victimization in men and women, replicating findings in three distinct samples.
Method
We investigated the association between continuous CM factor scores and adult sexual victimization in the Childhood Trauma Study (CTS) sample (N = 2564). We also examined the unique relationship between childhood sexual abuse (CSA) and adult sexual victimization while adjusting for co-occurring substance dependence and psychopathology. We replicated these analyses in two additional samples: the Comorbidity and Trauma Study (CATS; N = 1981) and the Australian Twin-Family Study of Alcohol Use Disorders (OZ-ALC; N = 1537).
Results
Analyses revealed a significant association with CM factor scores and adult sexual victimization for both men and women across all three samples. The CSA factor score was strongly associated with adult sexual victimization after adjusting for substance dependence and psychopathology; higher odds ratios were observed in men (than women) consistently across the three samples.
Conclusions
A continuous measure of CSA is independently associated with adult sexual trauma risk across samples in models that included commonly associated substance dependence and psychopathology as covariates. The strength of the association between this CSA measure and adult sexual victimization is higher in magnitude for men than women, pointing to the need for further investigation of sexual victimization in male community samples.
Using a validated air sampling method we found Acinetobacter baumannii in the air surrounding only 1 of 12 patients known to be colonized or infected with A. baumannii. Patients’ closed-circuit ventilator status, frequent air exchanges in patient rooms, and short sampling time may have contributed to this low burden.
There is evidence that headache response rates may be higher if triptans are used early when a migraine attack is still mild, as compared to when it is treated after pain has reached moderate or severe intensity.
Methods:
In this randomized, double blind, placebo controlled, parallel group clinical trial, 361 patients took either placebo, sumatriptan 50 mg, or sumatriptan 100 mg in a single attack study. The primary outcome measure was pain-free status at two hours.
Results:
In the intention to treat group, two hour pain free rates were 16%, 40%, and 50% in the placebo group, sumatriptan 50 mg group, and the sumatriptan 100 mg group respectively (p<0.001, active treatment groups vs. placebo).
Conclusions:
Both sumatriptan 50 mg and 100 mg were significantly superior to placebo for the pain-free end point at two hours. The pain-free response rates in this trial where sumatriptan was taken while the headache was still mild were generally higher than in older clinical trials where headache was treated after reaching a moderate or severe intensity.
Chronic daily headache (CDH: headache on fifteen days a month or more) is one of the most common forms of chronic pain. The relative efficacy of different treatment methods for these patients needs to be determined.
Objective:
To compare treatment outcomes for patients with CDH treated in a traditional office-based pharmacological treatment program with a second group treated in a multidisciplinary management program.
Methods:
Patient outcomes were measured using changes in the Headache Disability Inventory (HDI) and the Short-Form-36 (SF-36) over the treatment period. Outcomes from seventy patients treated in an office setting were compared to thirty-seven patients treated in a multidisciplinary headache treatment program. Both groups received similar pharmacological treatment. All patients treated in the office setting and the majority of patients in the multidisciplinary program had transformed migraine.
Results:
Even though a reduction in headache days per month occurred, mean headache related disability (measured by HDI) and mean Health Related Quality of Life (HRQoL measured by SF-36) did not improve for the patient group treated in the office setting but did improve significantly for the patient group treated in the multidisciplinary headache program.
Conclusion:
For patients with CDH, headache-related disability and HRQoL is more likely to improve with management in a multidisciplinary headache treatment program as compared to the traditional specialist consultation - family physician office-based setting.
To examine demographic characteristics and clinical features of headache patients referred to neurologists specializing in headache in Canada.
Methods:
Demographic and clinical data were collected at the time of consultation for 865 new headache patients referred to five headache-specialty clinics in Canada. The Headache Impact Test (HIT-6) and Migraine Disability Questionnaire (MIDAS) were used to measure headache impact and disability. Data were analyzed as part of the Canadian Headache Outpatient Registry and Database (CHORD) Project.
Results:
The average age of the patients was 40 years and the majority were female (78%). Most were employed either full time (49%) or part time (13%). The majority of patients were diagnosed with either migraine or tension-type headache (78%). Over a third of patients experienced headache every day, and half had experienced a headache in the previous month which was of severe intensity. Most (80%) scored in the “very severe” category of the HIT-6 and over half (55%) were severely disabled as measured by the MIDAS.
Conclusion:
Patients referred to headache specialists in Canada are severely disabled by their headache disorders. These patients are in the most productive phase of their lives in terms of age and employment. It is important to provide the best available treatment to headache patients in order to minimize the disability and impact of their headache disorders.
Four matrix-phase crystallographic directions of IN718 are investigated by in situ tensile tests using neutron diffraction. The elastic diffraction constants for all directions measured are compared to theoretical values calculated by the Kröner model. The differences between the microscopic and the macroscopic material response are given. The accumulation of microstrains in the different crystallographic directions is discussed. A comparison between the results of a single phase material (ingot IN718) and two differently thermal treated multiphase materials is presented.
Forsmark in Mideastern Sweden is chosen as site for the planned Swedish deep-rock repository for spent nuclear fuel. The construction, operation and decommissioning of the repository require assessments of various types of risks for health and environment on a wide range of temporal scales. This study is focused on the assessment of environmental impacts during the relatively short construction and operation phases, during which the repository will be kept drained by means of groundwater diversion. This diversion may influence hydrogeological and hydrological conditions and thereby cause ecological and other types of consequences in the surroundings of the repository. We here describe methodology and some main findings from the ecohydrological assessment of consequences for aquatic and terrestrial ecosystems in Forsmark. The assessment combines the results of a number of steps, including ecological field inventories and predictive water-flow modelling. The results of the study show that subsurface disposal of radioactive waste is an important application of ecohydrological concepts in assessments of sites with nature values.