We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To evaluate the impact of a mobile-app-based central line-associated bloodstream infection (CLABSI) prevention program in oncology clinic patients with peripherally inserted central catheters (PICCs).
Design:
Pre-post prospective cohort study with baseline (July 2015–December 2016), phase-in (January 2017–April 2017), and intervention (May 2017–November 2018). Generalized linear mixed models compared intervention with baseline frequency of localized inflammation/infection and dressing peeling. Cox proportional hazards models compared days-to-removal of lines with localized inflammation/infection. Chi-square test compared bacteremia rates before and after intervention.
Setting:
Oncology clinic at a large medical center.
Patients:
Oncology clinic adult patients with PICCs.
Intervention:
CLABSI prevention program consisting of an actionable scoring system for identifying insertion site infection/inflammation coupled with a mobile-app enabling photo-assessments and automated physician alerting for remote response.
Results:
We completed 5,343 assessments of 569 PICCs in 401 patients (baseline: 2,924 assessments, 300 PICCs, 216 patients; intervention: 2,419 assessments, 269 PICCs, 185 patients). The intervention was associated with a 92% lower likelihood of having a dressing with peeling (OR 0.08, 95%CI 0.04-0.17, P < 0.001), 53% lower local inflammation/infection (OR 0.47, 95%CI 0.27-0.84, P < 0.011), and 24% (non-significant) lower CLABSI rates (P = .63). Physician mobile-app alerting and response enabled 80% lower risk of lines remaining in place after inflammation/infection was identified (HR 0.20, 95%CI:0.14-0.30, P < 0.001) and 85% faster removal of infected lines from mean (SD) 11.1 (9.7) to 1.7 (2.4) days.
Conclusions:
A mobile-app-based CLABSI prevention program decreased frequency of inflamed/infected central line insertion sites and increased speed of removal when inflammation/infection was found.
Entamoeba moshkovskii, according to recent studies, appears to exert a more significant impact on diarrhoeal infections than previously believed. The efficient identification and genetic characterization of E. moshkovskii isolates from endemic areas worldwide are crucial for understanding the impact of parasite genomes on amoebic infections. In this study, we employed a multilocus sequence typing system to characterize E. moshkovskii isolates, with the aim of assessing the role of genetic variation in the pathogenic potential of E. moshkovskii. We incorporated 3 potential genetic markers: KERP1, a protein rich in lysine and glutamic acid; amoebapore C (apc) and chitinase. Sequencing was attempted for all target loci in 68 positive E. moshkovskii samples, and successfully sequenced a total of 33 samples for all 3 loci. The analysis revealed 17 distinct genotypes, labelled M1–M17, across the tested samples when combining all loci. Notably, genotype M1 demonstrated a statistically significant association with diarrhoeal incidence within E. moshkovskii infection (P = 0.0394). This suggests that M1 may represent a pathogenic strain with the highest potential for causing diarrhoeal symptoms. Additionally, we have identified a few single-nucleotide polymorphisms in the studied loci that can be utilized as genetic markers for recognizing the most potentially pathogenic E. moshkovskii isolates. In our genetic diversity study, the apc locus demonstrated the highest Hd value and π value, indicating its pivotal role in reflecting the evolutionary history and adaptation of the E. moshkovskii population. Furthermore, analyses of linkage disequilibrium and recombination within the E. moshkovskii population suggested that the apc locus could play a crucial role in determining the virulence of E. moshkovskii.
Background: SMA affects individuals with a broad age range and spectrum of disease severity. Risdiplam (EVRYSDI®) is a centrally and peripherally distributed, oral SMN2 pre-mRNA splicing modifier. Methods: SUNFISH is a multicenter, two-part, randomized, placebo-controlled, double-blind study in patients with Types 2/3 SMA. Part 1 assessed the safety, tolerability and pharmacokinetics/pharmacodynamics of different risdiplam dose levels in patients with Types 2/3 SMA. Part 2 assessed the efficacy and safety of the selected dose of risdiplam versus placebo in Type 2 and non-ambulant Type 3 SMA. In Part 2, participants were treated with risdiplam or placebo for 12 months, then received risdiplam in a blinded manner until month 24. At month 24, patients were offered the opportunity to enter the open-label extension phase. Results: Change from baseline in MFM32 total score (Part 2- primary endpoint) in patients treated with risdiplam versus placebo was met at month 12. These increases in motor function were sustained in the second and third year after risdiplam treatment. Here we present 4-year efficacy and safety data from SUNFISH. Conclusions: SUNFISH is ongoing and will provide further long-term efficacy and safety data of risdiplam in a broad population of individuals with SMA.
The discovery of new clear windows in the Galactic plane using the VVV near-IR extinction maps allows the study of the structure of the Milky Way (MW) disk. The ultimate goal of this work is to map the spiral arms in the far side of the MW, which is a relatively unexplored region of our Galaxy, using red clump (RC) giants as distance indicators. We search for near-IR clear windows located at low Galactic latitudes ($|b|< 1$ deg) in the MW disk using the VVV near-IR extinction maps. We have identified two new windows named VVV WIN 1607–5258 and VVV WIN 1475–5877, respectively, that complement the previously known window VVV WIN 1713–3939. We analyse the distribution of RC stars in these three clear near-IR windows and measure their number density along the line of sight. This allows us to find overdensities in the distribution and measure their distances along the line of sight. We then use the VVV proper motions in order to measure the kinematics of the RC stars at different distances. We find enhancements in the distance distribution of RC giants in all the studied windows, interpreting them as the presence of spiral arms in the MW disk. These structures are absent in the current models of synthetic population for the same MW lines of sight. We were able to trace the end of the Galactic bar, the Norma arm, as well as the Scutum–Centaurus arm in the far disk. Using the VVV proper motions, we measure the kinematics for these Galactic features, confirming that they share the bulk rotation of the Galactic disk.
Endoscopic hydro-mastoidectomy, in which mastoidectomy is performed underwater, can be employed during transcanal endoscopic ear surgery for cholesteatoma removal. It was hypothesised that endoscopic hydro-mastoidectomy might take less time than endoscopic non-underwater mastoidectomy because the endoscope does not need to be removed for cleaning.
Methods
This study compared the mastoidectomy and total operative durations between the endoscopic hydro-mastoidectomy (n = 25) and endoscopic non-underwater drilling (control, n = 8) groups. Moreover, it compared the size of resected areas of the external auditory canal between the two groups.
Results
The mastoidectomy time of the endoscopic hydro-mastoidectomy group was significantly shorter than that of the control group (p < 0.01). The total operative time did not differ significantly between the endoscopic hydro-mastoidectomy and control groups (p = 0.17). The resected area was significantly larger in the endoscopic hydro-mastoidectomy group than in the control group (p < 0.05).
Conclusion
Endoscopic hydro-mastoidectomy enables more extensive bone resection within a shorter period.
This study evaluated the post-operative indications for sinonasal topical steroid treatment using a corticosteroid (steroid)-eluting, sinus-bioabsorbable device and its effects in patients with eosinophilic chronic rhinosinusitis.
Method
Post-operative courses were investigated in two groups: group A with patients who underwent sinonasal topical steroid treatment, and group B with control patients who did not.
Results
Group A was significantly younger than group B (p < 0.01), and the pre-operative computed tomography score was significantly higher in group A than in group B (p < 0.05). In the post-operative stage, the nasal symptoms questionnaire component of olfactory loss and the post-operative endoscopic appearance score were significantly worse in group A than in group B (p < 0.01).
Conclusion
These data suggest that younger age, more severe rhinosinusitis and post-operative olfactory loss led to the need for sinonasal topical steroid treatment to prevent relapsing inflammation after functional endoscopic sinus surgery in patients with eosinophilic chronic rhinosinusitis.
We present the first results obtained from an extensive study of eclipsing binary (EB) system candidates recently detected in the VISTA Variables in the Vía Láctea (VVV) near-infrared (NIR) Survey. We analyse the VVV tile d040 in the southern part of the Galactic disc wherein the interstellar reddening is comparatively low, which makes it possible to detect hundreds of new EB candidates. We present here the light curves and the determination of the geometric and physical parameters of the best candidates found in this ‘NIR window’, including 37 contact, 50 detached, and 13 semi-detached EB systems. We infer that the studied systems have an average of the $K_s$ amplitudes of $0.8$ mag and a median period of 1.22 days where, in general, contact binaries have shorter periods. Using the ‘Physics Of Eclipsing Binaries’ (PHOEBE) interactive interface, which is based on the Wilson and Devinney code, we find that the studied systems have low eccentricities. The studied EBs present mean values of about 5 700 and 4 900 K for the $T_1$ and $T_2$ components, respectively. The mean mass ratio (q) for the contact EB stars is $\sim$0.44. This new galactic disk sample is a first look at the massive study of NIR EB systems.
We analysed associations between exposure to nightlife businesses and severe acute respiratory syndrome coronavirus 2 PCR test results at a tertiary hospital in Tokyo between March and April 2020. A nightlife group was defined as those who had worked at or visited the businesses. We included 1517 individuals; 196 (12.9%) were categorised as the nightlife group. After propensity score matching, the proportion of positive PCR tests in the nightlife group was significantly higher than that in the non-nightlife group (nightlife, 63.8%; non-nightlife, 23.0%; P < 0.001). An inclusive approach to mitigate risks related to the businesses needs to be identified.
Until the past half-century, all agriculture and land management was framed by local institutions strong in social capital. But neoliberal forms of development came to undermine existing structures, thus reducing sustainability and equity. The past 20 years, though, have seen the deliberate establishment of more than 8 million new social groups across the world. This restructuring and growth of rural social capital within specific territories is leading to increased productivity of agricultural and land management systems, with particular benefits for those previously excluded. Further growth would occur with more national and regional policy support.
Treatment of medical catatonia sometimes requires management of presenting psychiatric syndrome as well as treatment of causative medical illnesses. Treatment response to these approaches may, however, differ even in the same patient suffering a relapse of a similar clinical picture, and this presents a therapeutic challenge for physicians. We therefore report a case of medical catatonia due to Graves’ disease which responded to antithyroid therapy in the first episode but required electroconvulsive therapy (ECT) when relapsed, then discuss the possible mechanism which caused different treatment response.
Methods
We describe the clinical course with the laboratory findings of recurrent catatonic episodes of a patient with Graves’ disease.
Results
A 25-year-old woman manifested stupor, catalepsy and echolalia accompanying goiter, proptosis and tachycardia. Laboratory findings on thyroid function were consistent with Graves’ disease. Treated with thyamazole (TMZ), her psychiatric and physical symptoms gradually subsided. She had remained euthyroid and symptom free for 10 years on TMZ 5 mg every other day. However, at age 35, she exhibited stupor with mannerism and stereotypy. Laboratory findings revealed mild exercerbation of thyroid function. Though antithyroid therapy regained euthyroid, her psychiatric symptoms persisted. Further treatment with neuroleptics did not ameliorate her symptoms. She was thus administered bitemporal ECT and recovered after 7th trial.
Conclusions
Aggravation of thyroid function associated with catatonic symptoms when relapsed was milder compared to the first episode. This suggested that dysregulation of thyroid homeostasis in the central nervous system might have persisted despite the peripheral euthyroid and could affect the treatment response.
The corpus callosum (CC) is the largest interhemispheric white matter commissure connecting the cerebral hemispheres and plays a crucial role in interhemispheric communication and cognitive processes. The subdivisions of the CC were attempted to define corresponding areas of the cortex from which the fibers originate. Previous neuroanatomic studies of the CC provide impetus for investigating its role in obsessive-compulsive disorder (OCD).
Methods:
In this study diffusion tensor imaging (DTI) was employed to microstructural abnormalities of white matter of the CC in OCD patients. Nine patients with OCD and matched control subjects underwent DTI. Fractional anisotropy (FA), an index of the integrity of white matter tracts, was determined in the seven subdivisions of the CC.
Results:
Significant reduction in FA was found in the rostrum of the CC of patients with OCD compared with one of controls. FA of the other subdivisions except the rostrum in OCD patients did not differ compared with control subjects. Higher FA in the rostrum correlated with lower Y-BOCS scores (r = -0.852, p = 0.004).
Conclusions:
The rostrum contains fibers from inferior premotor as well as medial and caudate/orbital prefrontal regions. These results supported the theory of dysfunction of prefrontal cortex and striatal circuits in OCD and suggested the implication of the orbitofrontal circuit for symptom severity in the OCD patients.
Idiopathic basal ganglia calcification (IBGC) is a neuropathological finding known to manifest motor disturbance, cognitive impairment and psychiatric symptoms. Pathophysiology of psychiatric symptoms, however, remains controversial. Previous biochemical study suggests that dopaminergic impairment is involved in IBGC. We therefore performed positron emission tomography (PET) to elucidate the pre- and postsynaptic dopaminergic function and glucose metabolism in two IBGC patients.
Methods:
Case 1 is a 44 years old woman presented with disorganized thought, echolalia, verbigeration and parkinsonism. She was administered bitemporal electro-convulsive therapy (ECT). Case 2 is a 35 years old woman with persecutory delusion. Computed tomography showed bilateral symmetric calcification of striatum, globus pallidus and dentate nucei. Other causes of intracranial calcification were excluded. PET scans were obtained using [11C]-labeled 2β-carbomethoxy-3β-(4-flurophenyl)-tropane, [11C]-labeled raclopride and [18F] fluorodeoxyglucose.
Results:
The decreased binding potential was severe in bilateral head of caudate nuclei and anterior putamen. In case 1, the decline was also found in posterior putamen. There were widespread decreases of glucose uptake in frontal, temporal and parietal cortices bilaterally in case 1. Significant hypometabolism was observed in the right frontal, temporal and parietal cortices. After the ECT session, the previous areas of significant hypometabolism in the right hemisphere had improved. In case 2, there was no significant change of glucose metabolism in cerebral cortex.
Conclusions:
The difference in affected region within basal ganglia might be associated with the diverse clinical pictures in IBGC. Particularly, in the psychiatric manifestation, dopaminergic dysfunction in caudate nucleus and anterior putamen could be participated.
The caudate nucleus is involved in cognitive function. Schizophrenic patients showed cognitive dysfunction. It has been reported that volume reduction of the caudate nucleus was associated with cognitive impairment in schizophrenic patients. Because treatment with olanzapine improves cognitive dysfunction in schizophrenia, olanzapine may affect the caudate nucleus volume in patients with schizophrenia. We measured volumes of grey and white matter in the caudate nucleus of schizophrenic patients.
Methods:
Ten schizophrenic patients and ten healthy subjects were examined magnetic resonance imaging. Ten patients were scanned at the time of pre-treatment and post-treatment with olanzapine. MR data analysis was performed using BRAINS software in order to measure grey and white matter volume of the caudate nucleus.
Results:
Schizophrenic patients had reduced volume of grey and white matter of the caudate nucleus compared with healthy subjects. The average duration of treatment with olanzapine was 186 days in schizophrenic patients. The volume of grey and white matter in the caudate nucleus at the time of post-treatment was significant larger than that at the time of pre-treatment with olanzapine in patients with schizophrenia. There was no significant difference between the volume of grey matter of the caudate nucleus at the post-treatment with olanzapine and that of healthy subjects.
Conclusion:
Schizophrenic patients had reduced volume of the caudate nucleus. Treatment with olanzapine may improve volume reduction of grey matter of the caudate nucleus in schizophrenic patients.
The subdivisions of the corpus callosum (CC) were attempted to define corresponding areas of the cortex from which the fibers originate. Previous neuroanatomic studies of the CC provide impetus for investigating its role in obsessive-compulsive disorder (OCD).
Methods:
In this study diffusion tensor imaging (DTI) was employed to microstructural abnormalities of white matter of the CC in OCD patients. Nine patients with OCD and matched control subjects underwent DTI. Fractional anisotropy (FA), an index of the integrity of white matter tracts, was determined in the seven subdivisions of the CC. We placed each reagions of interest (ROI) over the sagittal plane and all subdivisions were measured.
Results:
Significant reduction in FA was found in the rostrum of the CC of patients with OCD compared with one of controls. FA of the other subdivisions except the rostrum in OCD patients did not differ significantly compared with control subjects. Higher FA in the rostrum correlated significantly with lower Y-BOCS scores (r = -0.803, p = 0.009).
Conclusions:
The rostrum contains fibers from inferior premotor as well as medial and caudate/orbital prefrontal regions. These results supported the theory of dysfunction of prefrontal cortex and striatal circuits in OCD and suggested the implication of the orbitofrontal circuit for symptom severity in the OCD patients.
The giant Hii region W 31 hosts the populous star cluster W 31-CL and others projected on or in the surroundings. The most intriguing object is the stellar cluster SGR 1806-20, which appears to be related to a Luminous Blue Variable (LBV)—a luminous supergiant star. We used the deep VVV J-, H-, and $K_S$-band photometry combined with 2MASS data in order to address the distance and other physical and structural properties of the clusters W 31-CL, BDS 113, and SGR 1806-20. Field-decontaminated photometry was used to analyse colour–magnitude diagrams (CMDs) and stellar radial density profiles, using procedures that our group has developed and employed in previous studies. We conclude that the clusters W 31-CL and BDS 113 are located at 4.5 and 4.8 kpc and have ages of 0.5 and 1 Myr, respectively. This result, together with the pre-main sequence distribution in the CMD, characterises them as members of the W 31 complex. The present photometry detects the stellar content, addressed in previous spectroscopic classifications, in the direction of the cluster SGR 1806-20, including the LBV, Wolf–Rayet, and foreground stars. We derive an age of $10\pm4\,\text{Myr}$ and a distance of $d_{\odot}=8.0\pm1.95\,\text{kpc}$. The cluster is extremely absorbed, with $A_V=25\,\text{mag}$. The present results indicate that SGR 1806-20 is more distant by a factor 1.8 with respect to the W 31 complex, and thus not physically related to it.
This study examines the relationship between paternal height or body mass index (BMI) and birth weight of their offspring in a Japanese general population. The sample included 33,448 pregnant Japanese women and used fixed data, including maternal, paternal and infant characteristics, from the Japan Environment and Children’s Study (JECS), an ongoing nationwide birth cohort study. Relationships between paternal height or BMI and infant birth weight [i.e., small for gestational age (SGA) and large for gestational age (LGA)] were examined using a multinomial logistic regression model. Since fetal programming may be a sex-specific process, male and female infants were analyzed separately. Multivariate analysis showed that the higher the paternal height, the higher the odds of LGA and the lower the odds of SGA in both male and female infants. The effects of paternal BMI on the odds of both SGA and LGA in male infants were similar to those of paternal height; however, paternal height had a stronger impact than BMI on the odds of male LGA. In addition, paternal BMI showed no association with the odds of SGA and only a weak association with the odds of LGA in female infants. This cohort study showed that paternal height was associated with birth weight of their offspring and had stronger effects than paternal BMI, suggesting that the impact of paternal height on infant birth weight could be explained by genetic factors. The sex-dependent effect of paternal BMI on infant birth weight may be due to epigenetic effects.
Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.
Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.
Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?
Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
Thermal transformations of kaolinite were studied by 29Si- and 27Al-MAS/NMR and ESR techniques. In metakaolin, Si is still dominantly in the Q3 state (three Si atoms bonded to an Si-O4 tetrahedron) and Al detectable by NMR is in both 4-coordination and 6-coordination. Coordination polyhedra around Al or Fe replacing Al are much distorted. Metakaolin crystallizes into γ-alumina and mullite exothermically at ∼980°C, this crystallization being preceded by a faint endothermic reaction. The latter is due to segregation of SiO2 and Al2O3, which results in an increase of Si in the Q4 state and an increase of 6-coordinated Al2O3.
Children with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.
Materials and methods
We sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry. The primary outcome was the occurrence of any tracheal-intubation-associated event. Secondary outcomes included the occurrence of severe tracheal-intubation-associated events, multiple intubation attempts, and oxygen desaturation.
Results
A total of 8851 intubations were reported between July, 2012 and March, 2016. Cardiac patients were younger, more likely to have haemodynamic instability, and less likely to have respiratory failure as an indication. The overall frequency of tracheal-intubation-associated events was not different (cardiac: 17% versus non-cardiac: 16%, p=0.13), nor was the rate of severe tracheal-intubation-associated events (cardiac: 7% versus non-cardiac: 6%, p=0.11). Tracheal-intubation-associated cardiac arrest occurred more often in cardiac patients (2.80 versus 1.28%; p<0.001), even after adjusting for patient and provider differences (adjusted odds ratio 1.79; p=0.03). Multiple intubation attempts occurred less often in cardiac patients (p=0.04), and oxygen desaturations occurred more often, even after excluding patients with cyanotic heart disease.
Conclusions
The overall incidence of adverse tracheal-intubation-associated events in cardiac patients was not different from that in non-cardiac patients. However, the presence of a cardiac diagnosis was associated with a higher occurrence of both tracheal-intubation-associated cardiac arrest and oxygen desaturation.
Competition from weeds is one of the major biophysical constraints to rice (Oryza spp.) production in sub-Saharan Africa. Smallholder rice farmers require efficient, affordable and labour-saving weed management technologies. Mechanical weeders have shown to fit this profile. Several mechanical weeder types exist but little is known about locally specific differences in performance and farmer preference between these types. Three to six different weeder types were evaluated at 10 different sites across seven countries – i.e., Benin, Burkina Faso, Côte d'Ivoire, Ghana, Nigeria, Rwanda and Togo. A total of 310 farmers (173 male, 137 female) tested the weeders, scored them for their preference, and compared them with their own weed management practices. In a follow-up study, 186 farmers from Benin and Nigeria received the ring hoe, which was the most preferred in these two countries, to use it during the entire crop growing season. Farmers were surveyed on their experiences. The probability of the ring hoe having the highest score among the tested weeders was 71%. The probability of farmers’ preference of the ring hoe over their usual practices – i.e., herbicide, traditional hoe and hand weeding – was 52, 95 and 91%, respectively. The preference of this weeder was not related to gender, years of experience with rice cultivation, rice field size, weed infestation level, water status or soil texture. In the follow-up study, 80% of farmers who used the ring hoe indicated that weeding time was reduced by at least 31%. Of the farmers testing the ring hoe in the follow-up study, 35% used it also for other crops such as vegetables, maize, sorghum, cassava and millet. These results suggest that the ring hoe offers a gender-neutral solution for reducing labour for weeding in rice as well as other crops and that it is compatible with a wide range of environments. The implications of our findings and challenges for out-scaling of mechanical weeders are discussed.