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Food environments around secondary schools are a strong influence on adolescents’ food purchasing habits1. We conducted a repeat cross-sectional study using Google Street View to examine school food environments in regional and metropolitan NSW, Australia over 17-years. Findings showed that unhealthful food outlets such as fast-food franchises, consistently dominated school food environments over 2007-2023. Increasing levels of poor nutrition among youth has been raised as a concern2 by the Health Advisory Panel for Youth at the University of Sydney [HAPYUS] - an established group of 16 adolescents aged 13-18 years residing in NSW3. To gain further insight into the study findings and how it may impact adolescents’ health, it is critical to include voices of adolescents in this research. The aim of this sub-study was to engage with members of our youth advisory group and conduct a consultation exercise on these study findings, drawing upon their lived experiences of school food environments. In Aug-2023, we engaged four youth advisors from HAPYUS. Study authors provided an overview of the study and its findings to the youth advisors via a Zoom call. Youth advisors formulated a 500-word statement on their perspectives and lived experiences of food environments surrounding their high schools over the subsequent 4 weeks. Adolescents agreed that physical proximity to unhealthy food outlets around schools was a key contributor to unhealthy eating habits however also recognised social and economic factors which play a significant role in shaping poor diets. The following quotes from their combined statement reflect social and economic concerns: i) “[We] observed on a daily basis young people were opting to travel to the closest food court for fast food, or in some extreme cases, even order fast food via a meal delivery app, to be delivered to the school - as opposed to choosing the closest outlet” ii) “Overpriced foods in schools with some drinks costing 2x more than a heavily discounted KFC meal, no meaningful difference between foods sold at canteens and those sold at fast food outlets - heavily processed, packaged snacks, pre-made reheated foods” iii) “Most unhealthy food outlets choose a location that is not only close to schools but also close to major shopping centres and food courts… ideal for an after-school social catchup as it appears to accommodate the needs of a large group of people.” Consultation findings revealed the importance of social and economic factors that must be analysed in addition to adolescents’ physical proximity to food outlets around their schools. Youth advisors call for governments to take immediate action to implement policies that ensure schools have cheap and healthy foods at canteens to mitigate against the purchase of foods from nearby unhealthy food outlets.
Mental health and psychosocial support (MHPSS) staff in humanitarian settings have limited access to clinical supervision and are at high risk of experiencing burnout. We previously piloted an online, peer-supervision program for MHPSS professionals working with displaced Rohingya (Bangladesh) and Syrian (Turkey and Northwest Syria) communities. Pilot evaluations demonstrated that online, peer-supervision is feasible, low-cost, and acceptable to MHPSS practitioners in humanitarian settings.
Objectives
This project will determine the impact of online supervision on i) the wellbeing and burnout levels of local MHPSS practitioners, and ii) practitioner technical skills to improve beneficiary perceived service satisfaction, acceptability, and appropriateness.
Methods
MHPSS practitioners in two contexts (Bangladesh and Turkey/Northwest Syria) will participate in 90-minute group-based online supervision, fortnightly for six months. Sessions will be run on zoom and will be co-facilitated by MHPSS practitioners and in-country research assistants. A quasi-experimental multiple-baseline design will enable a quantitative comparison of practitioner and beneficiary outcomes between control periods (12-months) and the intervention. Outcomes to be assessed include the Kessler-6, Harvard Trauma Questionnaire and Copenhagen Burnout Inventory and Client Satisfaction Questionnaire-8.
Results
A total of 80 MHPSS practitioners will complete 24 monthly online assessments from May 2022. Concurrently, 1920 people receiving MHPSS services will be randomly selected for post-session interviews (24 per practitioner).
Conclusions
This study will determine the impact of an online, peer-supervision program for MHPSS practitioners in humanitarian settings. Results from the baseline assessments, pilot evaluation, and theory of change model will be presented.
In this retrospective cohort study of patients presenting to a national direct-to-consumer medical practice, we found that provider geographic location is a stronger driver of antibiotic prescribing than patient location. Physicians in the Northeast and South are significantly more likely than physicians in the West to prescribe antibiotics for upper respiratory infection and bronchitis.
In this paper, the generation of relativistic electron mirrors (REM) and the reflection of an ultra-short laser off the mirrors are discussed, applying two-dimension particle-in-cell simulations. REMs with ultra-high acceleration and expanding velocity can be produced from a solid nanofoil illuminated normally by an ultra-intense femtosecond laser pulse with a sharp rising edge. Chirped attosecond pulse can be produced through the reflection of a counter-propagating probe laser off the accelerating REM. In the electron moving frame, the plasma frequency of the REM keeps decreasing due to its rapid expansion. The laser frequency, on the contrary, keeps increasing due to the acceleration of REM and the relativistic Doppler shift from the lab frame to the electron moving frame. Within an ultra-short time interval, the two frequencies will be equal in the electron moving frame, which leads to the resonance between laser and REM. The reflected radiation near this interval and corresponding spectra will be amplified due to the resonance. Through adjusting the arriving time of the probe laser, a certain part of the reflected field could be selectively amplified or depressed, leading to the selective adjustment of the corresponding spectra.
Co-receptor tropism has been identified to correlate with HIV-1 transmission and the disease progression in patients. A molecular epidemiology investigation of co-receptor tropism is important for clinical practice and effective control of HIV-1. In this study, we investigated the co-receptor tropism on HIV-1 variants of 85 antiretroviral-naive patients with Geno2pheno algorithm at a false-positive rate of 10%. Our data showed that a majority of the subjects harboured the CCR5-tropic virus (81.2%, 69/85). No significant differences in gender, age, baseline CD4+ T-cell counts and transmission routes were observed between subjects infected with CXCR4-tropic or CCR5-tropic virus. The co-receptor tropism appeared to be associated with the virus genotype; a significantly more CXCR4-use was predicted in CRF01_AE infections whereas all CRF07_BC and CRF08_BC were predicted to use CCR5 co-receptor. Sequences analysis of V3 revealed a higher median net charge in the CXCR4 viruses over CCR5 viruses (4.0 vs. 3.0, P < 0.05). The predicted N-linked glycosylation site between amino acids 6 and 8 in the V3 region was conserved in CCR5 viruses, but not in CXCR4 viruses. Besides, variable crown motifs were observed in both CCR5 and CXCR4 viruses, of which the most prevalent motif GPGQ existed in both viral tropism and almost all genotypes identified in this study except subtype B. These findings may offer important implications for clinical practice and enhance our understanding of HIV-1 biology.
To investigate a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak event involving multiple healthcare facilities in Riyadh, Saudi Arabia; to characterize transmission; and to explore infection control implications.
Design
Outbreak investigation.
Setting
Cases presented in 4 healthcare facilities in Riyadh, Saudi Arabia: a tertiary-care hospital, a specialty pulmonary hospital, an outpatient clinic, and an outpatient dialysis unit.
Methods
Contact tracing and testing were performed following reports of cases at 2 hospitals. Laboratory results were confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) and/or genome sequencing. We assessed exposures and determined seropositivity among available healthcare personnel (HCP) cases and HCP contacts of cases.
Results
In total, 48 cases were identified, involving patients, HCP, and family members across 2 hospitals, an outpatient clinic, and a dialysis clinic. At each hospital, transmission was linked to a unique index case. Moreover, 4 cases were associated with superspreading events (any interaction where a case patient transmitted to ≥5 subsequent case patients). All 4 of these patients were severely ill, were initially not recognized as MERS-CoV cases, and subsequently died. Genomic sequences clustered separately, suggesting 2 distinct outbreaks. Overall, 4 (24%) of 17 HCP cases and 3 (3%) of 114 HCP contacts of cases were seropositive.
Conclusions
We describe 2 distinct healthcare-associated outbreaks, each initiated by a unique index case and characterized by multiple superspreading events. Delays in recognition and in subsequent implementation of control measures contributed to secondary transmission. Prompt contact tracing, repeated testing, HCP furloughing, and implementation of recommended transmission-based precautions for suspected cases ultimately halted transmission.
White clayey geomaterials were collected from northeast of the Nefza region (northern Tunisia). These deposits belong to the Mio-Pliocene molassic basins (basin of Tamra-Sidi Dris, Boukhchiba) and Oligocene Numidien in the area of El Aouinet. Analysis by X-ray diffraction showed associations of halloysite and kaolinite (Tamra), kaolinite and illite (Aouinet zone) and mixed layers, kaolinite and feldspars (Boukhchiba zone). Semi-industrial processed bricks showed promising characteristics and were visibly free of defects. Ceramic tiles had a bending strength that met the required standards but water absorption was somewhat high. So, to achieve higher quality, optimisation needs to be carried out in the formulation of batches or in the processing conditions. Finally, the incorporation in whitish sanitary-ware glaze formulations generated smooth coating layers that showed the required strong brightness and were free of defects.
To study the clinical effect of lens cleaning paper patching on traumatic eardrum perforations.
Methods:
A total of 122 patients were divided into 2 groups, of which 56 patients were treated with lens cleaning paper patching and 66 acted as controls. The closure rate and healing time were compared between the two groups.
Results:
The healing rate of small perforations was 96.4 per cent (27 out of 28) in the patching group and 90 per cent (27 out of 30) in the control group. The difference was not statistically significant (p > 0.05). The healing rate of large perforations was 89.3 per cent (25 out of 28) and 80.6 per cent (29 out of 36) in the two groups, respectively. The difference was statistically significant (p < 0.05). The healing time of large perforations was shorter in the patching group than in the control group (p < 0.01).
Conclusion:
Patching with lens cleaning paper under an endoscope can accelerate the closure of large traumatic eardrum perforations.
The negative effect of invasive species on native species, communities, and ecosystems is widely recognized, and the economic effects in the United States are estimated to be billions of dollars annually. Studies often examine traits of nonnative species or examine what makes a particular habitat invasible. To better understand the factors governing invasions, we used the flora of Nebraska to characterize and compare native and nonnative plant occurrences throughout the state. In addition, we assessed four critical landscape predictors of nonnative plant richness: human population size and three land cover attributes that included percentage of grassland, percentage of agriculture, and percentage of public lands. Results indicated that individual plant species richness has increased by about 35% through invasions (primarily of annuals from the family Poaceae). In addition, human population density, percentage of agriculture, and percentage of public lands all show a positive association with nonnative plant richness. Successful plant invasions may change the composition of species communities, basic ecological functions, and the delivery of ecosystem services. Thus, identifying the factors that influence such variation in distribution patterns can be fundamental to recognizing the present and potential future extent of nonnative plant infestations and, in turn, developing appropriate management programs.
Much can be learned from terrestrial planets that appear to have had the potential to be habitable, but failed to realize that potential. Mars shows evidence of a once hospitable surface environment. The reasons for its current state, and in particular its thin atmosphere and dry surface, are of great interest for what they can tell us about habitable zone planet outcomes. A main goal of the MAVEN mission is to observe Mars’ atmosphere responses to solar and space weather influences, and in particular atmosphere escape related to space weather ‘storms’ caused by interplanetary coronal mass ejections (ICMEs). Numerical experiments with a data-validated MHD model suggest how the effects of an observed moderately strong ICME compare to what happens during a more extreme event. The results suggest the kinds of solar and space weather conditions that can have evolutionary importance at a planet like Mars.
The objective of this study was to determine if a moderate or high reduction of dietary CP, supplemented with indispensable amino acids (IAA), would affect growth, intestinal morphology and immunological parameters of pigs. A total of 40 barrows (initial BW=13.50±0.50 kg, 45±2 day of age) were used in a completely randomized block design, and allocated to four dietary treatments containing CP levels at 20.00%, 17.16%, 15.30% and 13.90%, respectively. Industrial AA were added to meet the IAA requirements of pigs. After 4-week feeding, blood and tissue samples were obtained from pigs. The results showed that reducing dietary CP level decreased average daily gain, plasma urea nitrogen concentration and relative organ weights of liver and pancreas (P<0.01), and increased feed conversion ratio (P<0.01). Pigs fed the 13.90% CP diet had significantly lower growth performance than that of pigs fed higher CP at 20.00%, 17.16% or 15.30%. Moreover, reducing dietary CP level decreased villous height in duodenum (P<0.01) and crypt depth in duodenum, jejunum and ileum (P<0.01). The reduction in the dietary CP level increased plasma concentrations of methionine, alanine (P<0.01) and lysine (P<0.05), and decreased arginine (P<0.05). Intriguingly, reducing dietary CP level from 20.00% to 13.90% resulted in a significant decrease in plasma concentration of IgG (P<0.05), percentage of CD3+T cells of the peripheral blood (P<0.01), also down-regulated the mRNA abundance of innate immunity-related genes on toll-like receptor 4, myeloid differentiation factor 88 (P<0.01) and nuclear factor kappa B (P<0.05) in the ileum. These results indicate that reducing dietary CP level from 20.00% to 15.30%, supplemented with IAA, had no significant effect on growth performance and had a limited effect on immunological parameters. However, a further reduction of dietary CP level up to 13.90% would lead to poor growth performance and organ development, associated with the modifications of intestinal morphology and immune function.
Enterotoxigenic Escherichia coli (ETEC) is a type of pathogenic bacteria that cause diarrhea in piglets through colonizing pig small intestine epithelial cells by their surface fimbriae. Different fimbriae type of ETEC including F4, F18, K99 and F41 have been isolated from diarrheal pigs. In this study, we performed a genome-wide association study to map the loci associated with the susceptibility of pigs to ETEC F41 using 39454 single nucleotide polymorphisms (SNPs) in 667 F2 pigs from a White Duroc×Erhualian F2 cross. The most significant SNP (ALGA0022658, P=5.59×10−13) located at 6.95 Mb on chromosome 4. ALGA0022658 was in high linkage disequilibrium (r2>0.5) with surrounding SNPs that span a 1.21 Mb interval. Within this 1.21 Mb region, we investigated ZFAT as a positional candidate gene. We re-sequenced cDNA of ZFAT in four pigs with different susceptibility phenotypes, and identified seven coding variants. We genotyped these seven variants in 287 unrelated pigs from 15 diverse breeds that were measured with ETEC F41 susceptibility phenotype. Five variants showed nominal significant association (P<0.05) with ETEC F41 susceptibility phenotype in International commercial pigs. This study provided refined region associated with susceptibility of pigs to ETEC F41 than that reported previously. Further works are needed to uncover the underlying causal mutation(s).
Understanding the physiological mechanisms of biomass accumulation and partitioning in the grain, and the nitrogen (N) uptake associated with different plant densities and N management strategies, is essential for achieving both high yield and N use efficiency (NUE) in maize plants. A field experiment was conducted in 2013 and 2014, using five rates of N application and three plant densities (6·0, 7·5 and 9·0 plants/m2) in Quzhou County on the North China Plain (NCP). The objective was to evaluate whether higher plant density can produce more biomass allocated to the grain to achieve higher grain yield and to determine the optimal N management strategies for different plant densities. The highest grain yield and NUE were achieved in the 7·5 plants/m2 treatment; both the sub-optimal (6·0 plants/m2) and supra-optimal (9·0 plants/m2) plant densities resulted in diminished yield and NUE. Compared to 6·0 plants/m2, the 7·5 plants/m2 treatment displayed higher biomass accumulation during the grain-filling period and also exhibited more biomass allocated to kernels with similar total biomass accumulation compared with the 9·0 plants/m2 treatment, which contributed to its higher grain yield. The N uptake in the 7·5 plants/m2 treatment was similar to that in the 9·0 plants/m2 treatment up to pre-silking. However, the post-silking N uptake of the 7·5 plants/m2 treatment was 66·4 kg/ha, which was 29·1% higher than that of the 9·0 plants/m2 treatment. Furthermore, the highest maize grain yield was achieved in the 0·7 × optimal N rate (ONR × 0·7), ONR and ONR × 1·3 treatments for 6·0, 7·5 and 9·0 plants/m2, respectively, which suggests that different N management strategies are needed for different plant densities. In conclusion, selecting a planting density of 7·5 plants/m2 with an in-season root zone N management is a potentially effective strategy for achieving high grain yield and high NUE for maize production on the NCP.
Chemoradiotherapy followed by monthly temozolomide (TMZ) is the standard of care for patients with glioblastoma multiforme (GBM). Case reports have identified GBM patients who experienced transient radiological deterioration after concurrent chemoradiotherapy which stabilized or resolved after additional cycles of adjuvant TMZ, a phenomenon known as radiographic pseudoprogression. Little is known about the natural history of radiographic pseudoprogression.
Methods:
We retrospectively evaluated the incidence of radiographic pseudoprogression in a population-based cohort of GBM patients and determined its relationship with outcome and MGMT promoter methylation status.
Results:
Out of 43 evaluable patients, 25 (58%) exhibited radiographic progression on the first MRI after concurrent treatment. Twenty of these went on to receive adjuvant TMZ, and subsequent investigation demonstrated radiographic pseudoprogression in 10 cases (50%). Median survival (MS) was better in patients with pseudoprogression (MS 14.5 months) compared to those with true radiologic progression (MS 9.1 months, p=0.025). The MS of patients with pseudoprogression was similar to those who stabilized/responded during concurrent treatment (p=0.31). Neither the extent of the initial resection nor dexamethasone dosing was associated with pseudoprogression.
Conclusions:
These data suggest that physicians should continue adjuvant TMZ in GBM patients when early MRI scans show evidence of progression following concurrent chemoradiotherapy, as up to 50% of these patients will experience radiologic stability or improvement in subsequent treatment cycles.
With the rapid developments in the exoplanet field, more and more terrestrial exoplanets are being detected. Characterizing their atmospheres using transit observations will become a key datum in the quest for detecting an Earth-like exoplanet. The atmospheric transmission spectrum of our Earth will be an ideal template for comparison with future exo-Earth candidates. By observing a lunar eclipse, which offers a similar configuration to that of an exoplanet transit, we have obtained a high-resolution and high signal-to-noise ratio (SNR) transmission spectrum of the Earth's atmosphere. This observation was performed with the High Resolution Spectrograph at Xinglong Station, China during the total lunar eclipse in December 2011. We compare the observed transmission spectrum with our atmospheric model, and determine the characteristics of the various atmospheric species in detail. In the transmission spectrum, O2, O3, O2 · O2, NO2 and H2O are detected, and their column densities are measured and compared with the satellites data. The visible Chappuis band of ozone produces the most prominent absorption feature, which suggests that ozone is a promising molecule for the future exo-Earth characterization. Due to the high resolution and high SNR of our spectrum, several novel details of the Earth atmosphere's transmission spectrum are presented. The individual O2 lines are resolved and O2 isotopes are clearly detected. Our new observations do not confirm the absorption features of Ca II or Na I which have been reported in previous lunar eclipse observations. However, features in these and some other strong Fraunhofer line positions do occur in the observed spectrum. We propose that these are due to a Raman-scattered component in the forward-scattered sunlight appearing in the lunar umbral spectrum. Water vapour absorption is found to be rather weak in our spectrum because the atmosphere we probed is relatively dry, which prompts us to discuss the detectability of water vapour in Earth-like exoplanet atmospheres.
Assessing carbon footprint (CF) of crop production in a whole crop life-cycle could provide insights into the contribution of crop production to climate change and help to identify possible greenhouse gas (GHG) mitigation options. In the current study, data for the major crops of China were collected from the national statistical archive on cultivation area, yield, application rates of fertilizer, pesticide, diesel, plastic film, irrigated water, etc. The CF of direct and indirect carbon emissions associated with or caused by these agricultural inputs was quantified with published emission factors. In general, paddy rice, wheat, maize and soybean of China had mean CFs of 2472, 794, 781 and 222 kg carbon equivalent (CE)/ha, and 0·37, 0·14, 0·12 and 0·10 kg CE/kg product, respectively. For dry crops (i.e. those grown without flooding the fields: wheat, maize and soybean), 0·78 of the total CFs was contributed by nitrogen (N) fertilizer use, including both direct soil nitrous oxide (N2O) emission and indirect emissions from N fertilizer manufacture. Meanwhile, direct methane (CH4) emissions contributed 0·69 on average to the total CFs of flooded paddy rice. Moreover, the difference in N fertilizer application rates explained 0·86–0·93 of the provincial variations of dry crop CFs while that in CH4 emissions could explain 0·85 of the provincial variation of paddy rice CFs. When a 30% reduction in N fertilization was considered, a potential reduction in GHGs of 60 megatonne (Mt) carbon dioxide equivalent from production of these crops was projected. The current work highlights opportunities to gain GHG emission reduction in production of crops associated with good management practices in China.
In many base-station applications, the load/usage fluctuates over time periods of hours to days, thereby varying the required transmit power by as much as 10 dB. It is desirable to maintain high efficiency and linearity in the power amplifier under these back-off conditions in order to achieve high long-term efficiency. This paper demonstrates a scalable digital predistortion (DPD) approach that can be applied under different power back-off levels in envelope-tracking (ET) amplifiers and quantifies the associated efficiency. Efficiency comparisons are made with other amplifier configurations such as Class B and Doherty. Efficiency of 60% at full power (35 W average power) and >30% efficiency at 10 dB average power back-off are measured in an ET amplifier with a 7.54 dB peak-to-average ratio (PAPR) single-carrier WCDMA signal while meeting linearity specifications. Long-term base-station usage probability functions are presented. The long-term efficiency of the ET amplifiers is simulated to be greater than that of Class B and Doherty amplifiers.
A ‘pulsar timing array’ (PTA), in which observations of a large sample of pulsars spread across the celestial sphere are combined, allows investigation of ‘global’ phenomena such as a background of gravitational waves or instabilities in atomic timescales that produce correlated timing residuals in the pulsars of the array. The Parkes Pulsar Timing Array (PPTA) is an implementation of the PTA concept based on observations with the Parkes 64-m radio telescope. A sample of 20 ms pulsars is being observed at three radio-frequency bands, 50 cm (~700 MHz), 20 cm (~1400 MHz), and 10 cm (~3100 MHz), with observations at intervals of two to three weeks. Regular observations commenced in early 2005. This paper describes the systems used for the PPTA observations and data processing, including calibration and timing analysis. The strategy behind the choice of pulsars, observing parameters, and analysis methods is discussed. Results are presented for PPTA data in the three bands taken between 2005 March and 2011 March. For 10 of the 20 pulsars, rms timing residuals are less than 1 μs for the best band after fitting for pulse frequency and its first time derivative. Significant ‘red’ timing noise is detected in about half of the sample. We discuss the implications of these results on future projects including the International Pulsar Timing Array and a PTA based on the Square Kilometre Array. We also present an ‘extended PPTA’ data set that combines PPTA data with earlier Parkes timing data for these pulsars.
Background: This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates.
Methods: Information on hospitalized patients with schizophrenia, aged 55 years or older, was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001–2009). Data on 1,452 patients in eight Asian countries and territories including China, Hong Kong, Japan, Korea, Singapore, Taiwan, India, and Malaysia were analyzed. Sociodemographic and clinical characteristics and antipsychotic prescriptions were recorded using a standardized protocol and data collection procedure.
Results: The prescription frequency for low doses of antipsychotic medications was 40.9% in the pooled sample. Multiple logistic regression analysis of the whole sample showed that patients on low doses of antipsychotic medications were more likely to be female, have an older age, a shorter length of illness, and less positive symptoms. Of patients in the six countries and territories that participated in all the surveys between 2001 and 2009, those in Japan were less likely to receive low doses of antipsychotics.
Conclusion: Low doses of antipsychotic medications were only applied in less than half of older Asian patients with schizophrenia.